Maternal and paternal sensitivity: Key determinants of child attachment security examined through meta-analysis.

Sensitive caregiving behavior, which involves the ability to notice, interpret, and quickly respond to a child's signals of need and/or interest, is a central determinant of secure child-caregiver attachment. Yet, significant heterogeneity in effect sizes exists across the literature, and sources of heterogeneity have yet to be explained. For all child-caregiver dyads, there was a significant and positive pooled association between caregiver sensitivity and parent-child attachment (r = .25, 95% CI [.22, .28], k = 174, 230 effect sizes, N = 22,914). We also found a positive association between maternal sensitivity and child attachment security (r = .26, 95% CI [.22, .29], k = 159, 202 effect sizes, N = 21,483), which was equivalent in magnitude to paternal sensitivity and child attachment security (r = .21, 95% CI [.14, 27], k = 22, 23 effect sizes, N = 1,626). Maternal sensitivity was also negatively associated with all three classifications of insecure attachment (avoidant: k = 43, r = -.24 [-.34, -.13]; resistant: k = 43, r = -.12 [-.19, -.06]; disorganized: k = 24, r = -.19 [-.27, -.11]). For maternal sensitivity, associations were larger in studies that used the Attachment Q-Sort (vs. the Strange Situation), used the Maternal Behavior Q-Sort (vs. Ainsworth or Emotional Availability Scales), had strong (vs. poor) interrater measurement reliability, had a longer observation of sensitivity, and had less time elapse between assessments. For paternal sensitivity, associations were larger in older (vs. younger) fathers and children. These findings confirm the importance of both maternal and paternal sensitivity for the development of child attachment security and add understanding of the methodological and substantive factors that allow this effect to be observed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Neural processing of cry sounds in the transition to fatherhood: Effects of a prenatal intervention program and associations with paternal caregiving.

This study examined whether neural processing of infant cry sounds changes across the transition to fatherhood (i.e., from the prenatal to postnatal period), and examined whether an interaction-based prenatal intervention modulated these changes. Furthermore, we explored whether postnatal activation in brain regions showing transition or intervention effects was associated with sensitive care and involvement. In a randomized controlled trial, 73 first-time expectant fathers were enrolled, of whom 59 had at least 1 available fMRI scan. Intervention and transition effects on cry processing were analyzed in the amygdala and superior frontal gyrus (SFG) using linear mixed effect models with all available data and with intent-to-treat analyses. Further, exploratory whole-brain analyses were performed. ROI analyses suggest that the transition to fatherhood is characterized by decreasing activation in response to cry vs control sounds in the amygdala but not SFG. Exploratory whole-brain analyses also show a decrease in activation over the transition to fatherhood in the sensorimotor cortex, superior lateral occipital cortex, hippocampus, and regions of the default mode network. In the putamen and insula, larger decreases were found in fathers with more adverse childhood caregiving experiences. In regions showing transitional changes, higher postnatal activation was associated with more concurrent parenting sensitivity. No effects of the intervention were found. The decrease in activation from the pre- to postnatal period may reflect fathers' habituation to cry sounds over repeated exposures. The positive association between postnatal neural activation and paternal sensitive care suggest that continued sensitivity to cry sounds may be conducive to parenting quality.

Childhood Adversity and Incident Psychotic Experiences in Early Adulthood: Cognitive and Psychopathological Mediators.

BACKGROUND AND HYPOTHESIS: Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood. STUDY DESIGN: We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula. STUDY RESULTS: In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results. CONCLUSIONS: Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.

Attachment relationship quality with mothers and fathers and child temperament: An individual participant data meta-analysis.

A growing body of research suggests that, compared with single parent-child attachment relationships, child developmental outcomes may be better understood by examining the configurations of child-mother and child-father attachment relationships (i.e., attachment networks). Moreover, some studies have demonstrated an above-chance level chance of concordance between the quality of child-mother and child-father attachment relationships, and child temperament has been offered as a plausible explanation for such concordance. To assess whether temperament plays a role in the development of different attachment network configurations, in this preregistered individual participant data meta-analysis we tested the degree to which the temperament dimension of negative emotionality predicts the number of secure, insecure-avoidant, insecure-resistant, and disorganized attachment relationships a child has with mother and father. Data included in the linear mixed effects analyses were collected from seven studies sampling 872 children (49% female; 83% White). Negative emotionality significantly predicted the number of secure (d = -0.12) and insecure-resistant (d = 0.11), but not insecure-avoidant (d = 0.04) or disorganized (d = 0.08) attachment relationships. Nonpreregistered exploratory analyses indicated higher negative emotionality in children with insecure-resistant attachment relationships with both parents compared to those with one or none (d = 0.19), suggesting that temperament plays a small yet significant role in child-mother/child-father insecure-resistant attachment relationships concordance. Taken together, results from this study prompt a more in-depth examination of the mechanism underlying the small yet significantly higher chance that children with increased negative emotionality have for developing multiple insecure-resistant attachment relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Oxytocin and state attachment responses to secure base support after stress in middle childhood.

We tried to replicate the finding that receiving care increases children's oxytocin and secure state attachment levels, and tested whether secure trait attachment moderates the oxytocin and state attachment response to care. 109 children (9-11 years old; M = 9.59; SD = 0.63; 34.9% boys) participated in a within-subject experiment. After stress induction (Trier Social Stress Test), children first remained alone and then received maternal secure base support. Salivary oxytocin was measured eight times. Secure trait and state attachment were measured with questionnaires, and Secure Base Script knowledge was assessed. Oxytocin levels increased after receiving secure base support from mother after having been alone. Secure state attachment changed less. Trait attachment and Secure Base Script knowledge did not moderate oxytocin or state attachment responses to support. This might mean that, regardless of the attachment history, in-the-moment positive attachment experiences might have a beneficial effect on trait attachment development in middle childhood.

Maternal cognitive functioning and psychopathology predict quality of parent-child relationship in the context of substance use disorder: A 15-month longitudinal study.

This longitudinal study aimed to investigate the role of maternal cognitive functioning and psychopathology in parent-child relationship quality during residential treatment for mothers with Substance Use Disorder (SUD), in order to identify factors that may enhance or limit intervention effects.We assessed cognitive functioning (Esame Neuropsicologico Breve-2 [ENB-2]) and psychopathology (Symptom Checklist-90 Revised [SCL-90-R]) in 60 mothers diagnosed with SUD (Mage = 30.13 yrs; SD = 6.79) at treatment admission. Parent-child relationship quality was measured during free-play interactions using the Emotional Availability Scales every three months from admission (Child Mage = 17.17m; SD = 23.60) to the 15th month of the residential treatment.A main effect of maternal psychopathology and an interaction effect of time and cognitive functioning were found. More maternal psychopathology predicted lower mother-child relationship quality. Mothers with higher cognitive functioning presented a better treatment trajectory, with an increase in mother-child relationship quality, whereas mothers with lower cognitive functioning showed a decrease in relationship quality after initial improvement.These findings suggest that maternal psychopathology and cognitive functioning may influence the treatment of parent-child relationships in the context of SUD, although causality is not yet established. Implications for assessment and intervention are discussed.

[Formula: see text] Interventions to improve executive functions in children and adolescents with acquired brain injury: a systematic review and multilevel meta-analysis.

To investigate the effectiveness of interventions aiming to improve hot and cold executive functions (EFs) in children and adolescents with acquired brain injury (ABI) and to examine whether characteristics of the intervention, participants, etiology of ABI (Traumatic-brain-injury [TBI] or non-TBI), time of assessment, or study quality moderate intervention effects. Whereas cold EFs refer to purely cognitive EFs, hot EFs refer to the affective aspects of these cognitive skills. A total of 970 participants from 23 randomized-controlled-trial studies (112 effect sizes [ES]) were included. A three-level random effects approach (studies, ES, individual participants) was used. Moderation analyses were conducted through meta-regressions. The three-level random effects model showed a better fit than the two-level model. Almost all individual studies showed non-significant ES across outcomes but in combination interventions were effective (Cohen's d = 0.38, CI 0.16 ~ 0.61). Lower methodological quality, inclusion of participants with non-TBI, and parental participation predicted larger ES. Participants' age, time of assessment, number of sessions, and focus on hot or cold EFs were not related to ES. We found no evidence of publication bias. Interventions are effective with small to medium ES according to conventional criteria. Intervention effects do not seem to fade away with time. Parent participation in the intervention is important to improve EFs. The efficacy of interventions seems larger when non-TBI is part of the etiology of ABI. Variation between studies is relevant for tracing the effective intervention characteristics. Most studies are conducted in adolescence, and studies in early childhood are needed.

DNA methylation at birth and lateral ventricular volume in childhood: a neuroimaging epigenetics study.

BACKGROUND: Lateral ventricular volume (LVV) enlargement has been repeatedly linked to schizophrenia; yet, what biological factors shape LVV during early development remain unclear. DNA methylation (DNAm), an essential process for neurodevelopment that is altered in schizophrenia, is a key molecular system of interest. METHODS: In this study, we conducted the first epigenome-wide association study of neonatal DNAm in cord blood with LVV in childhood (measured using T1-weighted brain scans at 10 years), based on data from a large population-based birth cohort, the Generation R Study (N = 840). Employing both probe-level and methylation profile score (MPS) approaches, we further examined whether epigenetic modifications identified at birth in cord blood are: (a) also observed cross-sectionally in childhood using peripheral blood DNAm at age of 10 years (Generation R, N = 370) and (b) prospectively associated with LVV measured in young adulthood in an all-male sample from the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 114). RESULTS: At birth, DNAm levels at four CpGs (annotated to potassium channel tetramerization domain containing 3, KCTD3; SHH signaling and ciliogenesis regulator, SDCCAG8; glutaredoxin, GLRX) prospectively associated with childhood LVV after genome-wide correction; these genes have been implicated in brain development and psychiatric traits including schizophrenia. An MPS capturing a broader epigenetic profile of LVV - but not individual top hits - showed significant cross-sectional associations with LVV in childhood in Generation R and prospectively associated with LVV in early adulthood within ALSPAC. CONCLUSIONS: This study finds suggestive evidence that DNAm at birth prospectively associates with LVV at different life stages, albeit with small effect sizes. The prediction of MPS on LVV in a childhood sample and an independent male adult sample further underscores the stability and reproducibility of DNAm as a potential marker for LVV. Future studies with larger samples and comparable time points across development are needed to further elucidate how DNAm associates with this clinically relevant brain structure and risk for neuropsychiatric disorders, and what factors explain the identified DNAm profile of LVV at birth.

Is the association between mothers' autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?

BACKGROUND: Previous studies showed that there is a positive association between mothers' and children's autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI). METHOD: The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years). RESULT: Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; ßadjusted = 0.20, p < 0.01), in early childhood (Generation R; ßadjusted = 0.19, p < 0.01), and in early adolescence (Generation R; ßadjusted = 0.16, p < 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (ßadjusted = 0.03, p < 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight. CONCLUSION: We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.

Transitioning from childhood into adolescence: A comprehensive longitudinal behavioral and neuroimaging study on prosocial behavior and social inclusion.

Acting prosocially and feeling socially included are important factors for developing social relations. However, little is known about the development of neural trajectories of prosocial behavior and social inclusion in the transition from middle childhood to early adolescence. In this pre-registered study, we investigated the development of prosocial behavior, social inclusion, and their neural mechanisms in a three-wave longitudinal design (ages 7-13 years; NT1 = 512; NT2 = 456; NT3 = 336). We used the Prosocial Cyberball Game, a ball tossing game in which one player is excluded, to measure prosocial compensating behavior. Prosocial compensating behavior showed a linear developmental increase, similar to parent-reported prosocial behavior, whereas parent-reported empathy showed a quadratic trajectory with highest levels in late childhood. On a neural level we found a peak in ventral striatum activity during prosocial compensating behavior. Neural activity during social inclusion showed quadratic age effects in anterior cingulate cortex, insula, striatum, and precuneus, and a linear increase in temporo-parietal junction. Finally, changes in prosocial compensating behavior were negatively associated with changes in ventral striatum and mPFC activity during social inclusion, indicating an important co-occurrence between development in brain and social behavior. Together these findings shed a light on the mechanisms underlying social development from childhood into adolescence.

The polygenic and reactive nature of observed parenting.

In Wertz et al. (2019), parents' polygenic scores of educational attainment (PGS-EA) predicted parental sensitive responses to the child's needs for support, as observed in a dyadic task (i.e., observed sensitivity). We aimed to replicate and expand these findings by combining longitudinal data, child genotype data and several polygenic scores in the Generation R Study. Mother-child dyads participated in two developmental periods, toddlerhood (14 months old; n = 648) and early childhood (3-4 years old, n = 613). Higher maternal PGS-EA scores predicted higher observed sensitivity in toddlerhood (b = 0.12, 95% CI 0.03, 0.20) and early childhood (b = 0.16, 95% CI 0.08, 0.24). Child PGS-EA was significantly associated with maternal sensitivity in early childhood (b = 0.11, 95% CI 0.02, 0.21), and the effect of maternal PGS-EA was no longer significant when correcting for child PGS-EA. A latent factor of PGSs based on educational attainment, intelligence (IQ) and income showed similar results. These polygenic scores might be associated with maternal cognitive and behavioral skills that help shape parenting. Maternal PGSs predicted observed sensitivity over and above the maternal phenotypes, showing an additional role for PGSs in parenting research. In conclusion, we replicated the central finding of Wertz et al. (2019) that parental PGS-EA partially explains parental sensitivity. Our findings may be consistent with evocative gene-environment correlation (rGE), emphasizing the dynamic nature of parenting behavior across time, although further research using family trios is needed to adequately test this hypothesis.

The trajectory of maternal perinatal depressive symptoms predicts executive function in early childhood.

BACKGROUND: Perinatal maternal depression may affect fetal neurodevelopment directly or indirectly via exposures such as smoking, alcohol, or antidepressant use. The relative contribution of these risk factors on child executive function (EF) has not been explored systematically. METHODS: A prospective pregnancy cohort of 197 women and their children was studied to determine whether maternal depression diagnosis and the trajectory of maternal depressive symptoms (MDSs) from early pregnancy to 12 months postpartum predicts child EF at age 4 (measured using the preschool age psychiatric assessment, NEPSY-II, and Shape School task) using latent growth curve modeling. Indirect effects of smoking, alcohol, and antidepressant use were also formally tested. RESULTS: Increasing maternal perinatal depressive symptoms over time predicted more inattentive symptoms, poorer switching, and motor inhibition, but not cognitive inhibition. When adjusted for multiple comparison, and after accounting for maternal cognition and education, the association with child inattentive symptoms remained significant. However, diagnosed depression did not predict child EF outcomes. Prenatal exposure to smoking, alcohol, and antidepressants also did not mediate pathways from depressive symptoms to EF outcomes. Our findings were limited by sample size and statistical power to detect outcome effects of smaller effect size. CONCLUSIONS: This study suggests that increasing MDSs over the perinatal period is associated with poorer EF outcomes in children at age 4 - independent of prenatal smoking, drinking, or antidepressant use. Depressive chronicity, severity, and postpartum influences may play crucial roles in determining childhood outcomes of EF.

Response bias is genetically biased: Another argument for Kagan's philippic against questionnaires in developmental psychology.

One of the concerns of Jerome Kagan (2007) in his article "A Trio of Concerns" was the frequent use of questionnaires in developmental psychology and related disciplines. His main reasons were the minimal overlap between (self-)reported and observed phenotypes, the ambiguity of items, and systematic socioeconomic status (SES) disparities in responding. We wondered whether genetic differences would also influence response bias in cases of ambiguous or even absurd items triggering an acquiescence bias to agree with even impossible question content. We examined the genetic predisposition for the acquiescence response bias in 257 families with twins. Both parents and twins completed a modified Wildman Symptoms Questionnaire and provided salivary DNA samples. From published genome-wide association studies (GWAS), we derived polygenic score (PGS) algorithms for indicators of SES (educational attainment [EA] and income) and for general intelligence (IQ), which were applied to the GWAS results of our participants' DNA. The twins (N = 514 children, 55% monozygotic pairs) were on average 7.92 years old (SD = 0.66), and 51.6% were female. The primary parents were on average 40.48 years old (SD = 4.66), and 91% were female. In 90% of the families, both parents were born in the Netherlands and 91% were from a middle or higher socioeconomic background. Higher PGSs for EA and income but not for IQ predicted less acquiescence response bias in parents and children. In addition to Kagan's reasons for his concerns about questionnaires, we found a genetic predisposition to response bias triggered by the ambiguous form of questions and answers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Developmental patterns and individual differences in responding to social feedback: A longitudinal fMRI study from childhood to adolescence.

Learning to control behavior when receiving feedback underlies social adaptation in childhood and adolescence, and is potentially strengthened by environmental support factors, such as parents. This study examined the neural development of responding to social feedback from childhood to adolescence, and effects of parental sensitivity on this development. We studied these questions in a 3-wave longitudinal fMRI sample (ages 7-13 years, n = 512). We measured responses to feedback using the fMRI Social Network Aggression Task through noise blasts following peer feedback and associated neural activity, and parental sensitivity using observations of parent-child interactions during Etch-a-Sketch. Results revealed largest reductions in noise blasts following positive feedback between middle and late childhood and following negative feedback between late childhood and early adolescence. Additionally, brain-behavior associations between dorsolateral prefrontal cortex activation and noise blast durations became more differentiated across development. Parental sensitivity was only associated with noise blast duration following positive feedback in childhood, but not in adolescence. There was no relation between parental sensitivity and neural activity. Our findings contribute to our understanding of neural development and individual differences in responding to social feedback, and the role of parenting in supporting children's adaption to social feedback.

Facing ostracism: micro-coding facial expressions in the Cyberball social exclusion paradigm.

BACKGROUND: Social exclusion is often measured with the Cyberball paradigm, a computerized ball-tossing game. Most Cyberball studies, however, used self-report questionnaires, leaving the data vulnerable to reporter bias, and associations with individual characteristics have been inconsistent. METHODS: In this large-scale observational study, we video-recorded 4,813 10-year-old children during Cyberball and developed a real-time micro-coding method measuring facial expressions of anger, sadness and contempt, in a multi-ethnic population-based sample. We estimated associations between facial expressions and self-reported negative feelings, explored associations of child characteristics such as sex and parental national origin with observed and self-reported feelings during social exclusion, and tested associations of observed and self-reported feelings during social exclusion with behavior problems at age 14. RESULTS: Facial expressions of sadness and anger were associated with self-reported negative feelings during the game, but not with such feelings after the game. Further, girls reported to have had less negative feelings during the game than boys, but no such sex-differences were found in total observed emotions. Likewise, children with parents of Moroccan origin reported less negative feelings during the game than Dutch children, but their facial expressions did not indicate that they were differently affected. Last, observed emotions related negatively to later internalizing problems, whereas self-report on negative feelings during the game related positively to later internalizing and externalizing problems. CONCLUSIONS: We show that facial expressions are associated with self-reported negative feelings during social exclusion, discuss that reporter-bias might be minimized using facial expressions, and find divergent associations of observed facial expressions and self-reported negative feelings with later internalizing problems.

Parents' secure base script knowledge predicts observed sensitive caregiving and discipline toward twin children.

The present study investigated associations between parents' secure base script knowledge and parental sensitivity and sensitive discipline in 461 families with 922 same-sex twin children (Mage = 7.00, SD = 2.18). In addition, we explored whether the strength of the associations between parents' secure base script knowledge and parental sensitivity and sensitive discipline were similar for mono- and dizygotic twin siblings. Parental sensitivity was observed during a computerized version of a structured cooperative drawing task (Etch-A-Sketch). Sensitive discipline was observed during a "Don't touch task" or during a "Do-Don't task". Parental sensitivity and discipline strategies were observed twice, once with each twin sibling. Parents' knowledge of the secure base script was measured with the Attachment Script Assessment. Linear mixed model analyses showed that parents with more secure base script knowledge interacted with their twin children in a more sensitive manner and showed more sensitive discipline. These findings show for the first time that parents' secure base script knowledge predicts not only parental sensitivity but also sensitive discipline. Associations between parents' secure base script knowledge and parental sensitivity and sensitive discipline were not impacted by children's similarity in genetic makeup. Future longitudinal studies utilizing multiple measures of sensitivity and discipline across the infancy, childhood, and early adolescence periods could provide more insight into the continuity of relations between secure base script knowledge and parental sensitivity and sensitive discipline. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sensitive responsiveness in expectant and new fathers.

Fathers have an increasingly important role in the family and contribute through their sensitive responsiveness to positive child development. Research on parenting more often included fathers as caregivers in the past two decades. We present a neurobiological model of sensitive responsive parenting with a role for fathers' hormonal levels and neural connectivity and processing of infant signals. We tested this model in a research program ("Father Trials") with correlational and randomized experimental studies, and we review the results of these studies. So far, interaction-focused behavioral interventions seem most promising in supporting fathers' sensitive responsiveness, even though the mechanisms are still uncharted.

Development of the virtual-VIPP and a systematic review of online support for families during the COVID-19 pandemic.

During the COVID-19 pandemic lockdowns made it impossible for parenting coaches to reach the families without digital means of communication. Several studies were initiated to transform existing parenting interventions into hybrid or fully online versions and to examine their feasibility, acceptability and efficacy. We present one such transformation in detail, the Virtual-VIPP which is based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). Furthermore, we report a systematic review of 17 published trials with online versions of parenting programs. Overall, online parenting interventions seem feasible to implement, are well-received by most families, and to show equivalent effects to face-to-face approaches. Careful preparation of technicalities and monitoring of fidelity are prerequisites. Advantages of online parenting interventions are their potentially broader reach, more detailed process documentation, and better cost-utility balance. We expect that online parenting interventions are here to stay, but their efficacy needs to be rigorously tested.

Maternal attachment state of mind and perinatal emotional wellbeing: Findings from a pregnancy cohort study.

OBJECTIVES: Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. METHODS: This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). LIMITATIONS: Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. CONCLUSIONS: This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing.