Cited by 133Attachment and Relationship DynamicsPsychometric Methodologies and TestingPsychological Testing and Assessment

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Attachment measures in middle childhood and adolescence: A systematic review of measurement properties

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Jewell, Tom, Gardner, Tessa, Susi, Karima, Watchorn, Kate, Coopey, Emily, Simic, Mima, Fonagy, Peter, Eisler, Ivan·2019·Clinical Psychology Review

DOI 10.1016/j.cpr.2018.12.004

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Abstract

BACKGROUND: Attachment theory proposes that humans develop representations of self and other in early childhood which are relatively stable across the life-course, and play a key role in psychological adaptation. However, to date, the psychometric properties of attachment measures in middle childhood and adolescence have not been evaluated in a systematic review. METHOD: A systematic review (PROSPERO ID: CRD42017057772) was conducted using COSMIN criteria. Two researchers independently searched MEDLINE, PsychINFO and Embase databases for relevant articles. RESULTS: Fifty-four studies were included in the review. The methodological quality of studies was typically fair or poor, with only a small number of studies being rated as of good or excellent quality. The measurement properties of attachment measures in this age group were frequently rated as inadequate according to COSMIN criteria. The Child Attachment Interview (CAI) has the best psychometric properties of the interview and projective measures, and the Inventory of Parent and Peer Attachment (IPPA) the best evidence of the self-report measures. Overall, the evidence for the CAI and IPPA included both positive and negative findings relating to adequacy of measurement properties. CONCLUSIONS: Attachment measures in middle childhood and adolescence currently have limited evidence for the adequacy of their psychometric properties.

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Explicit and implicit attachment representations in cognitively able school-age children with autism spectrum disorder: A window to their inner world
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The role of child‐keyworker attachment in burnout among Saudi residential staff
Sochos, A., & Aljasas, N. A. (2020) · International Journal of Psychology · doi:10.1002/ijop.12692 · Cited by 4
Validation of the Inventory of Parent and Peer Attachment in Cypriot Clinical and non-Clinical Adolescents
Demetriou, C., Charalampous, K., Uzun, B., & Essau, C. A. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02326-w · Cited by 4
“Numerous studies have similarly shown high internal consistency for the IPPA (Essau, 2004; Gallarin & AlonsonArbiol, 2013; Guarnieri et al., 2010; Jewell et al., 2019; Liable et al., 2000; Ridenour et al., 2006; Vignoli & Mallet, 2004).”
Background
Psychometric properties of self-reported instruments for occupational balance: A COSMIN-based systematic review
Park, S., & Lee, C. D. (2023) · Journal of Occupational Science · doi:10.1080/14427591.2023.2243281 · Cited by 4
“Furthermore, they can be applied to systematically review the psychometric properties across more than two instruments which measure one speci ﬁ c construct (Harrison et al., 2022; Jewell et al., 2019; Shoman et al., 2021; Soh et al., 2021).”
A systematic review of social support instruments for measurement-based care in posttraumatic stress disorder
Fortney, J. C., Garcia, N. M., Simpson, T. L., Bird, E. R., Carlo, A. D., Rennebohm, S. B., & Campbell, S. B. (2024) · Current Psychology · doi:10.1007/s12144-024-05799-8 · Cited by 4
Advancement in the child attachment interview and the child and adolescent reflective functioning scale using a PDM-2 framework: case reports
Bizzi, F., Locati, F., Parolin, L. A. L., Shmueli‐Goetz, Y., & Brusadelli, E. (2022) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2022.586 · Cited by 4
“However, the CAI is considered a goal standard instrument to investigate children’s representations of their attachment relationships in scholar-aged (Jewell et al., 2019).”
Background
Mentalization and Emotion Regulation in Adolescent Attachment: A Scoping Review
Salavou, V., Papanikolaou, Κ., Pehlivanidis, A., & Giannakopoulos, G. (2026) · Children · doi:10.3390/children13030420 · Cited by 5
“Meta-analytic evidence supports the use of attachment interviews in adolescence [61,62], which allow for multidimensional assessment of relational emotion regulation and men-talization processes beyond attachment classification.”
Does attachment predict the outcome of cognitive processing therapy for posttraumatic stress disorder in adolescent patients with interpersonal traumatization?
Rimane, E., Steil, R., Renneberg, B., & Rosner, R. (2021) · Psychotherapy Research · doi:10.1080/10503307.2021.1977866 · Cited by 3
Attachment representations in 7‐year‐old children at familial high risk of schizophrenia or bipolar disorder: Associations with mental disorders and daily functioning
Gregersen, M., Ellersgaard, D., Søndergaard, A., Christiani, C. J., Hemager, N., Spang, K. S., Burton, B. K., Uddin, M. J., Ohland, J., Gantriis, D. L., et al. (2023) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12941 · Cited by 3
Helping Institutionalised Children through a Trusting Relationship—Findings from a One-Year Psychosocial Intervention Programme
Misevičė, M., Gervinskaitė-Paulaitienė, L., & Lesinskienė, S. (2024) · Behavioral Sciences · doi:10.3390/bs14070595 · Cited by 5
“The CAI was developed by Shmueli-Goetz et al. from the Anna Freud National Centre for Children and Families as a measure designed to assess attachment in middle childhood and adolescence [37–39].”
Method
Psychometric validation of Attachment Style Classification Questionnaire-Bangla (ASCQ-B) among secondary school students of Bangladesh: A classical test theory approach
Mahmood, S., Lakatos, K., Arató, N., & Kaló, Z. (2025) · Acta Psychologica · doi:10.1016/j.actpsy.2025.105262 · Cited by 3
Factor Structure and Convergent Validity of the Short Version of the Bielefeld Partnership Expectations Questionnaire in Patients With Anxiety Disorder and Healthy Controls
Altmann, U., Brenk-Franz, K., Strauss, B. M., & Petrowski, K. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.638644 · Cited by 4
Assessment of adult attachment: Construction and validation of a hybrid self-report measure
van Geel, R., & Houtmans, M. J. M. (2022) · International Journal of Personality Psychology · doi:10.21827/ijpp.8.38297 · Cited by 3
“Recently, Jewell et al. (2019) meticulously reviewed the psychometric properties of several self-report attachment measures used in childhood and adolescence.”
BackgroundMethod
Through each other's eyes: initial results and protocol for the co-design of an observational measure of adolescent-parent interaction using first-person perspective
Wright, N., Pearson, R. M., Crook, D., Bond, A., & Jewell, T. (2024) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2023.1214890 · Cited by 4
“Jewell et al. (19) conducted a systematic review of attachment measures in middle childhood and adolescence, but only identi ﬁ ed one scheme assessing observed adolescent-parent interaction, the goal-corrected partnership adolescent coding system (GPACS) (20), with all other observer-rated schemes assessing the child…”
Self-citation
Exploring the relationship between peer attachment, and disordered eating behaviours and body dissatisfaction in adolescence: a systematic review
Chan, C., Donnelly, C., Eshetu, A., & Nicholls, D. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01273-3 · Cited by 2
“Additionally, the names of established measures of peer attachment were included, as reported by Jewell et al. [59].”
Attachment representations in pre‐adolescents at familial high risk of schizophrenia or bipolar disorder and population‐based controls—Characteristics of attachment from middle childhood to pre‐adolescence, and its relation to parental functioning and child mental disorder
Krantz, M. F., Gregersen, M., Veddum, L., Hjorthøj, C. R., Prøsch, Å. K., Ohland, J., Brandt, J. M., Rohd, S. B., Knudsen, C. B., Andreassen, A. K., et al. (2024) · JCPP Advances · doi:10.1002/jcv2.12274 · Cited by 2
“In pre ‐ adolescence, attachment studies of offspring to parents with severe mental illness are few, and assessments are challenged by lack of agreement in the literature about the best approach to measure attachment in middle childhood and pre ‐ adolescence (Jewell et al., 2019).”
When all is at sea: Attachment insecurity as a mediator of risk in Tamil asylum-seeking children
Ratnamohan, L., Silove, D. M., Mares, S. P., Krishna, Y., Thambi, B., & Steel, Z. (2024) · Development and Psychopathology · doi:10.1017/s0954579424001445 · Cited by 2
“Instead, representational procedures that access the child ’ s internal scripts for negotiating danger offer a window into how the child regulates attention and affect vis-à-vis attachment figures when the attachment system is activated (Jewell et al., 2019).”
Integration of donor conception into identity and parental attachment: adolescents in heterosexual-couple and lesbian-couple families
Groundstroem, H., Paulin, J., Sydsjö, G., & Lampic, C. (2024) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2024.104758 · Cited by 2
Story Completion Methods in Qualitative Research
Braun, V., Clarke, V., Frith, H., & Moller, N. P. (2025) · Oxford University Press eBooks · doi:10.1093/oso/9780197681039.003.0003 · Cited by 2
The Child Attachment Style Interview (Child-ASI) and depression: Preliminary findings
Bifulco, A. T., Jacobs, C., Oskis, A., Bunn, A., & Spence, R. (2021) · Educational and Child Psychology · doi:10.53841/bpsecp.2021.38.1.63 · Cited by 2
Exposure to Secondhand Smoke at Home and Psychological Distress among College Students in China: The Role of Parental Attachment
Wang, Q. (2021) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2021.1953641 · Cited by 2
“The scale was found to be an excellent self-report attachment measure (Jewell et al. 2019), and its Chinese version exhibited good reliability and validity in the adolescent and young adult population (Song, Thompson, and Ferrer 2009).”
Background
Validation of the Adolescent Attachment Anxiety and Avoidance Inventory among Canadian Secondary School Students
Persram, R. J., & Konishi, C. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02392-0 · Cited by 2
“Jewell et al. (2019) found that some measures (e.g., IPPA) did not meet the criteria for adequate structural validity (e.g., factor structures) and testing for associations with other attachment-related constructs.”
Background
Factor Structure of the Experiences in Close Relationships—Relationship Structures Scale (ECR-RS) in Siblings of Children with Chronic Disorders
Fjermestad, K. W., Orm, S., Fredriksen, T., Haukeland, Y. B., & Vatne, T. M. (2024) · Children · doi:10.3390/children11050560 · Cited by 3
“In a review of attachment measures, Jewell and colleagues [17] rated the ECR-RS (36 and 9 item versions) as having no psychometric evidence beyond internal consistency, including lack of structural validity.”
BackgroundMethod
Development of the Arabic Inventory of Parent and Domestic Worker Attachment (A‐IPDWA): A tool to assess adolescents' attachment to secondary figures
Mohammed, A., & Alonso‐Arbiol, I. (2024) · Journal of Adolescence · doi:10.1002/jad.12304 · Cited by 1
Contributions of Attachment and Cognitive Functioning on ADHD Symptoms in Children
Wylock, J.-F., Borghini, A., Delvenne, V., & Slama, H. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01784-1 · Cited by 1
“Attachment can be investigated with story completion tasks, narrative interviews or questionnaires that do not assess the same dimensions of attachment (e.g., automatic processes and strategic processes) [32, 38].”
La asociación entre apego parental y desarrollo socioemocional en infantes y adolescentes: Una revisión sistemática (2014-2024)
Ramírez, J. N. G., Yupanqui, J. M. V., Trujillo-Delgado, Z., Montes-Meza, V., Ponte-Poma, J., & Córdova-Pérez, G. (2026) · Universitas Psychologica · doi:10.11144/javeriana.upsy25.aapd · Cited by 1
“La convergencia es baja a moderada (r rara vez > .40), complicando la comparación directa entre estudios con métodos distintos (Brumariu et al., 2025; Jewell et al., 2019; Petrowski et al., 2025; Strauss et al., 2022).”
Influential
IU – A Digital Application for the Graphical Examination of Interpersonal Attachment
Unger, S., Theis, C., Niedermann, C., & Ostermann, T. (2021) · Studies in health technology and informatics · doi:10.3233/shti210067 · Cited by 1
“However, such types of measurement seem not always to be appropriate in measuring attachment of children [8] or persons with intellectual disabilities [9].”
Background
Using an Attachment-Informed Framework in the Clinical Care of Children and Adolescents: A Review of Attachment Theory and Its Impact on Developmental Psychopathology
Malik, S., Joychan, S., Zajac, J., Sinisgalli, S., & Namerow, L. B. (2021) · Psychiatric Annals · doi:10.3928/00485713-20210608-01 · Cited by 13
Maltreatment and Parent-Child Attachment as Predictors of Dating Violence and Risky Sexual Behaviour Among High-Risk Teens
McIntyre, C. L., Goulter, N., & Moretti, M. M. (2024) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-024-00626-5 · Cited by 1
“…gender and sexual diversities and how risk and protective factors and teens’ relationship behaviours are conceptualized and measured holds significant promise to strengthen our understanding of these experiences and in turn, mitigate adolescent risk. continuous construct (Jewell et al., 2019).”
Attachment representations and emerging borderline personality features in school-aged children under youth protective care, consulting psychologists or child psychiatrists, and from the general population
Didier, O., & Terradas, M. M. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108391 · Cited by 1
Measuring insecure attachment in middle childhood: Psychometric evaluation of the short form of the Preoccupied and Avoidant Coping Questionnaire
Marci, T., Moscardino, U. M. M., Carli, P. D., & Altoè, G. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.03.038 · Cited by 1
Parents' Coherent Self-Knowledge as Mediators of the Relationship between Parental Attachment Components with Students' Self-Concept
SEDGHI, P., Oskoei, A. S., & mogtabaei, M. (2022) · خانواده پژوهی · doi:10.52547/jfr.17.4.685 · Cited by 1
A Social Neuroscience Approach to Interpersonal Interaction in the Context of Disruption and Disorganization of Attachment (NAMDA)Preprint
White, L. O., Schulz, C. C., Schoett, M. J. S., Kungl, M., Keil, J., Borelli, J. L., & Vrtička, P. (2020) · doi:10.31234/osf.io/95eph · Cited by 1
Psychometric properties and latent classes of the Attachment Style Questionnaire in mothers and their offspringPreprint
Blake, J. A., Thomas, H. J., Hurst, C. P., Pelecanos, A. M., McGee, T. R., Najman, J. M., & Scott, J. G. (2023) · Research Square · doi:10.21203/rs.3.rs-2887580/v1 · Cited by 1
Olfactory Identification, Odor Hedonics, and Atypical Behaviors
Cary, J., LaFrance, J., Costello, S., & Bovier, E. R. (2019) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn24.3.184
The Values of Psychological Science: Student and Faculty Perspectives on Research Ethics
Corts, D. P., & Pham, T. D. (2019) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn24.3.144
The Effect of a Fabricated Stereotype Threat on Sex Differences in Object Location Memory
Boomgarden, S. A., Nardi, D., & Aronson, J. M. (2019) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn24.3.166
Evaluación del vínculo de apego en la infancia y adolescencia
Álvarez-Segura, M., & Lacasa, F. (2022) · Revista de Psiquiatría Infanto-Juvenil · doi:10.31766/revpsij.v39n2a5
“Las historias incompletas o las tareas de completamiento de historias son particularmente útiles para cubrir la brecha de evaluaciones que queda entre las observaciones de la SS en niños muy pequeños y las entrevistas formales con adolescentes, es decir en la infancia media ya que a estas edades no existe ninguna prue…”
BackgroundInfluential
Avoidant Attachment: Sex Differences
Ghinassi, S., & Casale, S. (2022) · Springer eBooks · doi:10.1007/978-3-031-08956-5_326-1
Perspectivas de investigación en psicología. Impacto social en diversidad de contextos
Fernando, A. A. O., Mauricio, A. C. D., Torres, B. C., Alberto, C. R. C., Alicia, D. E., Becerra, A. P. E., Federica, F., Giovanni, I., Alejandro, G. G., Pablo, G. O., et al. (2022) · Universidad Santo Tomás eBooks · doi:10.15332/li.lib.2022.00325

Authors: Jewell, T., Gardner, T., Susi, K., Watchorn, K., Coopey, E., Simic, M., Fonagy, P., & Eisler, I.
Affiliations: King's College London (GB)
Anna Freud Centre (GB)
University of Oxford (GB)
University College London (GB)
Leicestershire Partnership NHS Trust (GB)
South London and Maudsley NHS Foundation Trust (GB)
Corresponding author: Jewell, Tom
ORCID: Jewell, Tom
Susi, Karima
Coopey, Emily
Simic, Mima
Fonagy, Peter
Eisler, Ivan
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2019-03
Volume: 68
Pages: 71-82
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2018.12.004
OpenAlex: W2906720146
Cited by: 133
References: 65
Citations by year: 2026: 11 · 2025: 25 · 2024: 17 · 2023: 14 · 2022: 22 · 2021: 16 · 2020: 19 · 2019: 9
FWCI: 2.60
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Clinical Psychology Review (publishedVersion, cc-by)
PubMed (publishedVersion)
Research Portal (King's College London) (submittedVersion, cc-by)
UCL Discovery (University College London) (submittedVersion)
Funders: National Institute of Health Research (NIHR) Clinical Doctoral Research Fellowship (CDRF-2014-05-024)
Topics: Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
Keywords: attachment, psychometric properties, middle childhood, adolescence, Child Attachment Interview, Inventory of Parent and Peer Attachment, self-report measures, projective techniques
MeSH terms: Adolescent, Child, Humans, Interview, Psychological, Object Attachment, Psychological Tests, Psychometrics, Reproducibility of Results

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Attachment measures in middle childhood and adolescence: A systematic review of measurement properties

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