ATTACHMENT AND PARENTAL SENSITIVITY, PARENTAL WARMTH, AND REJECTION: POLICY IMPLICATIONS
Early relationships with caregivers have direct impacts on child behavior and also appear to set the stage for other relationships through life. Indicators of attachment have been consistently associated with lower levels of physical aggression, violence, and nonviolent offending, so in general, indicators of attachment security are not differential predictors of violence (though the evidence on parental loss and separation, as well as caregiver sensitivity, is inconclusive and these remain good prospects). Indicators of parental warmth do distinguish between violent and nonviolent offenders, though, as was the case for attachment, the strongest effects on violence were evident in studies at the far end of spectrum, parental rejection. Although it is somewhat speculative to say so, since no direct research has been reported, the findings imply to us that policies targeting families in which parents are at high risk of rejecting their children, or where parent loss of serious caregiving interruptions have occurred, has the potential for high magnitude effects. This might include families where the pregnancy is unwanted, the mother is very young, the mother is a substance abuser, either parent has mental health problems, or where a parent has abandoned the family or died.
One promising route for prevention is early parenting intervention. Numerous evaluations have found that prevention programs that focus on single factors, such as child psychopathology, but ignore the family, do not show powerful effects (Wasserman & Miller, 1998). Bakermans-Kranenburg et al. conducted a meta-analysis of intervention studies designed to enhance parental sensitivity and infant attachment security (Bakermans-Kranenburg, van Ijzendoorn, & Juffer, 2003). They conclude from randomized studies that interventions “appeared rather effective in changing insensitive parenting ... and infant attachment insecurity... ” (p. 195). Some of the most successful programs are based on work by Patterson (1982) who found that parents of antisocial children failed to monitor children adequately, to enforce rules unambiguously and tended to yell and threaten, without adjusting their own responses to the child’s behavior. Programs such as parent management training and functional family therapy have showed promising results for reducing problem behavior in children. Utting (2003) sees parenting education programs based on behavioral principles as the “single most effective approach to treating child conduct disorders” (p. 257). He notes, however, that the research indicates that such programs are not likely to work unless action is taken to address the factors that put parenting under stress, such as economic disadvantage and other pressures.
Parent management training programs have been found to be effective in reducing delinquency in children (Farrington & Welsh, 2007). These programs do not link directly into our constructs of attachment or warmth, but it is possible that because parents are taught positive ways of shaping their children’s behavior, they are making their children feel more accepted and less rejected. They are also likely to enhance sensitivity and responsiveness, an important component for attachment. The programs may also may also reduce abusive treatment (see below).
Parent training programs are also “very effective” in helping children and parents in families where the children present with aggression (Bloomquist & Schnell, 2005). Extensive research has been done on “best practices” for these interventions. Investigators at Rand Corporation found that parent training interventions had significant, but delayed, crime reduction effects, and the “cost per crime prevented” was much lower than the cost when high stakes was used instead (Greenwood, Model, Rydell, & Chiesa, 1996). The “incredible years” parent training program has been shown to be effective in parents with and without a history of maltreatment (Hurlburt, Nguyen, Reid, Webster-Stratton, & Zhang, 2013).
In the extremely successful Nurse-Family Partnership (NFP) programs, high- risk families are usually targeted at obstetrical clinics before the child is born. Upon the birth of the child, the mother receives prenatal care and visits from a nurse on a regular basis (usually weekly) for approximately two years. The mission of the program is to empower first-time mothers, to encourage them to stay healthy, and to provide support that will enhance the health of the baby and help the mother transition to employment (Nurse-Family Partnership, 2010). The programs are said to apply attachment theory, but on the whole, they appear to only peripherally focus on the risk factors we have emphasized in our chapters. Nonetheless, they are one of a small number of types of programs advocated by the Blue Prints for Violence Prevention organization based upon multiple randomized experimental evaluations that demonstrate significant differences between the treatment group and the control group on violent behavior in children and risk factors for violence. Little is known about the mechanisms for how the program “works,” but Moss and colleagues recently reported that women receiving a targeted home visit program, focusing on enhancing parental sensitivity, made gains in sensitive parenting significantly greater than a control group. Additionally, the proportion of their children who expressed secure attachment increased dramatically, far in excess of the small gains made in the control group (Moss, Dubois-Comtois, Cyr, Tarabulsy, St-Laurent, & Bernier, 2011).
Farrington and Welsh (2007) included evaluations of home visiting programs in their meta-analysis and estimate a mean effect size of .24 corresponding to a 12% reduction in offending assessed later in life. Their effects were said to be only slightly lower than highly lauded daycare and preschool programs. Karoly et al. (1998) examined the costs and savings to government of the Elmira PEIP nurse home visits program; the cost was approximately $6,000 per child (in 1996 dollars) but the net savings came to about $18,600 by the time the children had reached age 15 (and because this is just the beginning of a criminal career, these savings are likely to have accrued well beyond that age). The benefits included a reduction in criminal activity for children and also their mothers. Importantly, these benefits were only evident among those who were in high-risk families.
Our review included many studies of parental bonds in adolescence. The findings imply that both violent and nonviolent offenders have weaker bonds to their parents than non-offenders. Although we were not able to determine if adolescent social bonds are a particular risk for violence per se, as a point of intervention we see family bonds as very promising. At minimum, those interested in creating sustainable anti-violence policies should consider relationships between offenders and their loved ones. Incarceration separates offenders from their families, impacting the chances for successful reentry upon release and exacting long-term effects on the offender’s children, whose disrupted attachment bonds may be caused by the parent’s incarceration (leading to effects the next generation). Petersilia (1987) saw the maintenance of family and community networks as an advantage of intermediate-sanction programs over incarceration, and other authors have echoed this recommendation. Haggard (2001) found that family orientation was one of a small number of themes she found among a very small number of violent criminal offenders who had desisted in her sample.
It is worthwhile to mention here that an important node of intervention might be the foster care system. Children and adolescents in foster care are already at a higher risk of offending due to other risk factors such as poverty, low parent education, and parent criminality, and in some cases, they are in foster care due to their own behavioral problems. One of the reasons that state governments are reluctant to take children away from their biological families and place them in foster care is because of concerns about the disruption in family bonds; the decision is generally made only when the child is in danger. Although it is a difficult task, foster systems should remain cognizant of the importance of long-term bonds to family and employ creative ways of maintaining these when children are placed in foster care, as well as emulating parental warmth and sensitivity in foster arrangements.