@article {mclaughlin_attachment_2012,
	title = {Attachment security as a mechanism linking foster care placement to improved mental health outcomes in previously institutionalized children},
	journal = {Journal of Child Psychology and Psychiatry},
	volume = {53},
	number = {1},
	year = {2012},
	month = {jan},
	pages = {46{\textendash}55},
	abstract = {
	BACKGROUND: Children reared in institutions experience elevated rates of psychiatric disorders. Inability to form a secure attachment relationship to a primary caregiver is posited to be a central mechanism in this association. We determined whether the ameliorative effect of a foster care (FC) intervention on internalizing disorders in previously institutionalized children was explained by the development of secure attachment among children placed in FC. Second we evaluated the role of lack of attachment in an institutionalized sample on the etiology of internalizing disorders within the context of a randomized trial.



	METHODS: A sample of 136 children (aged 6-30 months) residing in institutions was recruited in Bucharest, Romania. Children were randomized to FC (n = 68) or to care as usual (CAU; n = 68). Foster parents were recruited, trained, and overseen by the investigative team. Attachment security at 42 months was assessed using the Strange Situation Procedure, and internalizing disorders at 54 months were assessed using the Preschool Age Psychiatric Assessment.



	RESULTS: Girls in FC had fewer internalizing disorders than girls in CAU (OR = 0.17

},
	keywords = {anxiety disorders, Child, Depressive Disorder, Female, Foster Home Care, Humans, Infant, institutionalization, Institutionalized, Internal-External Control, Male, Mental Disorders, Object Attachment, Psychiatric Status Rating Scales, Romania, Sex Distribution},
	issn = {1469-7610},
	doi = {10.1111/j.1469-7610.2011.02437.x},
	author = {McLaughlin, Katie A. and Zeanah, Charles H. and Fox, Nathan A. and Nelson, Charles A.}
}
