Parent-child attachment and trauma-related dissociation among youth in out-of-home care: The age-dependent roles of caregiver-child attachment and placement duration.

Résumé

BACKGROUND: Child maltreatment and disruptions in attachment relationships have been linked to higher levels of dissociation.OBJECTIVE: This study explored the influences of birth parent-child attachment, caregiver-child attachment, and placement duration on dissociative symptoms among youth living in out-of-home care.PARTICIPANTS AND SETTING: Youth with histories of maltreatment who were recently placed in out-of-home care (N = 310; M = 10.25; 48.9 % female).METHODS: A moderated mediation analysis was employed to examine the effects of birth parent-child attachment on dissociation, and to examine age-conditional indirect effects through caregiver-child attachment and placement duration.RESULTS: Birth parent-child attachment directly influenced dissociative symptoms (B = -3.88, p = 0.004) and was partially mediated by caregiver-child attachment and placement duration. The indirect effects through caregiver-child attachment were negative and significant at younger ages (at age 9.36, B = -1.34, 95 % CI [-3.41, -0.22]; at age 10.25, B = -0.51, 95 % CI [-1.24, -0.07]), and nonsignificant by age 11.14. The indirect effects through placement duration with their caregivers were negative and significant among the older youth (became significant at 10.25, B = -0.69, 95 % CI [-1.66, -0.08], and was strongest by age 11.14, B = -1.90, 95 % CI [-4.12, -0.45]).CONCLUSION: Relational pathways linking parent-child attachment to dissociation are context-dependent. Findings emphasize the need for interventions and programs that help youth navigate relationships with their birth parents and caregivers, encourage emotional and relational safety along with placement stability, and are developmentally sensitive, adapting to changing needs over time.