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Adult attachment measures: A 25-year review
Abstract
Objective Over the past 25 years, attachment research has extended beyond infant-parent bonds to examine dyadic relationships in children, adolescents, and adults. Attachment has been shown to influence a wide array of biopsychosocial phenomena, including social functioning, coping, stress response, psychological well-being, health behavior, and morbidity, and has thus emerged as an important focus of psychosomatic research. This article reviews the measurement of adult attachment, highlighting instruments of relevance to-or with potential use in-psychosomatic research.Methods Following a literature search of articles that were related to the scales and measurement methods of attachment in adult populations, 29 instruments were examined with respect to their utility for psychosomatic researchers.Results Validity, reliability, and feasibility were tabulated on 29 instruments. Eleven of the instruments with strong psychometric properties, wide use, or use in psychosomatic research are described. These include the following: Adult Attachment Interview (George, Kaplan, and Main); Adult Attachment Projective (George and West); Adult Attachment Questionnaire (Simpson, Rholes, and Phillips); Adult Attachment Scale (and Revised Adult Attachment Scale) (Collins and Read); Attachment Style Questionnaire (Feeney); Current Relationship Interview (Crowell and Owens); Experiences in Close Relationships (Brennan, Clark, and Shaver) and Revised Experiences in Close Relationships (Fraley, Waller, and Brennan); Parental Bonding Instrument (Parker, Tupling, and Brown); Reciprocal Attachment Questionnaire (West and Sheldon-Keller); Relationship Questionnaire (Bartholomew and Horowitz); and Relationship Scales Questionnaire (Grifiin and Bartholomew).Conclusion In addition to reliability and validity, investigators need to consider relationship focus, attachment constructs, dimensions or categories of interest, and the time required for training, administration, and scoring. Further considerations regarding attachment measurement in the context of psychosomatic research are discussed.
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“The questionnaire has a high reliability and validity [83].”
From Efficacy of oxytocin administration early after psychotrauma in preventing the development of PTSD: study protocol of a randomized controlled trial (2014) · cites this paper as [83]
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“While the RQ remains one of the most frequently used adult attachment measures (Ravitz et al., 2010), in recent years researchers have found that categorical models cannot account for much variation in adult attachment structures.”
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“There exist more in-depth assessments of attachment whether in self-report or interview forms, with the Adult Attachment Interview being the most favored modality (Ravitz et al., 2010).”
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“…and considering the peculiarity of the IPV phenomenon it could be useful to have data from this perspective—dimensional attachment instruments are considered appropriate when conscious attitudes and behaviors in current relationships are relevant to the research question (Ravitz et al., 2010).”
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“In contrast, Liss et al. (2005) suggested that anxiety may be a risk factor for developing extreme sensory processing patterns, and anxiety may also increase the salience of insecure attachment (Ravitz et al., 2010).”
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“Clinicians should employ both self-report measures and clinical interviews when possible (see Ravitz et al., 2010 for an extensive review of adult attachment measures) to examine the patient ’ s beliefs and behaviors about close relationships.”
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“The ECRS-R is widely used to measure romantic attachment, with excellent reliability (see Ravitz, Maunder, Hunter, Sthankiya, & Lancee, in press , for a recent review on attachment measures).”
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“The ECR survey is a widely used self-report measure of attachment anxiety and attachment avoidance in romantic relationships,(30) 31 which has been validated in various health settings.(12) The ECR-M16 uses 16 ECR items, modified to be appropriate to medical patients.”
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“Current attachment representations of early experience can be assessed in adulthood by semi-structured interviews (Ravitz et al., 2010).”
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“The scale has an acceptable test–retest reliability (Griffin and Bartholomew 1994) and good discriminant and face validity (Ravitz et al. 2010).”
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“Despite their reliability and validity, these instruments solely measure conscious attitudes toward relationships and cannot identify when cognitive distortions alter responses (Ravitz et al., 2010).”
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“In the current literature, there has been substantially more research using self-report measures of attachment in adolescents, which are often criticized for problems with subjectivity and difficulty in integrating empirical findings to developmental attachment constructs [1].”
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“Previous research has supported the reliability and validity of the ECR (Ravitz et al. 2010).”
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A dyadic analysis of partner violence and adult attachment
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“More specifically, self-report measures are likely to capture conscious attachment attitudes, whereas interview measures are more likely to capture unconscious attachment attitudes (Ravitz et al. 2010).”
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“In other words, although an eightitem questionnaire captures some aspects of attachment insecurity, researchers should always be cautious to select an instrument which is best suited to their specific study question [22].”
BackgroundInfluentialAttachment security moderates the link between adverse childhood experiences and cellular aging
Dagan, O., Asok, A., Steele, H., Steele, M., & Bernard, K. (2017) · Development and Psychopathology · doi:10.1017/s0954579417001705 · Cited by 50
The role of self-compassion in the well-being of self-identifying gay men
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Ferraro, I. K., & Taylor, A. M. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110641 · Cited by 47
Scrima, F., Stefano, G. D., Guarnaccia, C., & Lorito, L. (2015) · Personality and Individual Differences · doi:10.1016/j.paid.2015.07.013 · Cited by 47
Is Attachment to God a Unique Predictor of Mental Health? Test in a Jewish Sample
Pirutinsky, S., Rosmarin, D. H., & Kirkpatrick, L. A. (2019) · International Journal for the Psychology of Religion · doi:10.1080/10508619.2019.1565249 · Cited by 46
The Relationship between Adult Attachment and Mental Health Care Utilization: A Systematic Review
Adams, G. C., Wrath, A. J., & Meng, X. (2018) · The Canadian Journal of Psychiatry · doi:10.1177/0706743718779933 · Cited by 45
“For a thorough review of attachment measures, see Ravitz et al.(6) According to attachment theory and research, the patterns of interpersonal relationships specific to different attachments may be important determinants of illness behaviour, care seeking, and treatment response in patients.”
BackgroundHayden, M. C., Müllauer, P. K., Gaugeler, R., Senft, B., & Andreas, S. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22673 · Cited by 56
Varfi, N., Rothen, S., Jasiowka, K., Lepers, T., Bianchi‐Demicheli, F., & Khazaal, Y. (2018) · JMIR Mental Health · doi:10.2196/mental.9978 · Cited by 46
“Several studies showed good test-retest reliability and a good association of the subscale scores with other ratings of daily anxiety and avoidance faced with a close companion [66].”
Taylor, G. J., Bagby, R. M., Kushner, S. C., Benoit, D., & Atkinson, L. R. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.03.015 · Cited by 43
“Whereas the AAI yields the primary attachment classifications of secure–autonomous, insecure–dismissing, insecure– preoccupied, and unresolved [23,28], the self-report attachment questionnaires either assign individuals to categories of attachment style or measure the degree to which dimensions of attachment style are…”
BackgroundRisi, A., Pickard, J. A., & Bird, A. L. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260891 · Cited by 78
“However, different attachment measures emphasize different attachment phenomena [33].”
BackgroundResultInfluentialGleeson, G., & Fitzgerald, A. (2014) · Health · doi:10.4236/health.2014.613196 · Cited by 43
Laczkovics, C., Fonzo, G. A., Bendixsen, B. H., Shpigel, E., Lee, I. A., Skala, K., Prunas, A., Gross, J. J., Steiner, H., & Huemer, J. (2018) · Current Psychology · doi:10.1007/s12144-018-9839-1 · Cited by 43
“Attachment styles are quite stable (Ravitz et al. 2010).”
BackgroundInfluentialKrause, S., Pokorný, D., Schury, K., Doyen-Waldecker, C., Hulbert, A.-L., Karabatsiakis, A., Kolassa, I., Gündel, H., Waller, C., & Buchheim, A. (2016) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2016.00627 · Cited by 47
“Oxytocin levels increased from pre to post in the significant majority of 73% participants (p = 0.004) and cortisol decreased in the significant majority of 73% participants (p = 0.004).”
BackgroundInfluentialTibi, L., van Oppen, P., van Balkom, A. J. L. M., Eikelenboom, M., Rickelt, J., Schruers, K. R. J., & Anholt, G. E. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2017.03.009 · Cited by 42
“The RQ shows adequate reliability and convergent validity [46].”
BackgroundInsecure attachment predicts depression and death anxiety in advanced cancer patients
Scheffold, K., Philipp, R., Koranyi, S., Engelmann, D., Schulz‐Kindermann, F., Härter, M. C., & Mehnert, A. (2017) · Palliative & Supportive Care · doi:10.1017/s1478951517000281 · Cited by 42
“Ravitz et al. (2010) suggested that there is no final consensus about whether attachment is inherently categorical or dimensional, but they made it clear that categories can be affiliated with dimensional scales, as was the case in our analysis.”
ResultThe roles of attachment and resilience in perceived stress in medical students
Thompson, G., Wrath, A. J., Trinder, K. M., & Adams, G. C. (2018) · Canadian Medical Education Journal · doi:10.36834/cmej.43204 · Cited by 42
“, disorganized).(16) The latter is believed to combine both anxious and avoidant features.”
BackgroundMethodInfluentialSexual Functioning in Young Women and Men: Role of Attachment Orientation
Dunkley, C. R., Dang, S. S., Chang, S., & Gorzalka, B. B. (2015) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2015.1061075 · Cited by 42
A Novel Integrating Virtual Reality Approach for the Assessment of the Attachment Behavioral System
Giglioli, I. A. C., Pravettoni, G., Martín, D. L. S., Parra, E., & Alcañíz, M. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00959 · Cited by 42
“In attachment research, the assessment methods widely used and validated are self-report questionnaires, interviews or projective measures (see the review of Ravitz et al., 2010), while attachment behaviors have been addressed less in adults.”
BackgroundMethodAttachment style is associated with perceived spouse responses and pain-related outcomes.
Forsythe, L. P., Romano, J. M., Jensen, M. P., & Thorn, B. E. (2012) · Rehabilitation Psychology · doi:10.1037/a0030083 · Cited by 40
“Both categorical and dimensional approaches to the assessment of attachment continue to be represented in the literature (Ravitz et al., 2010).”
BackgroundMonteleone, A. M., Cardi, V., Volpe, U., Fico, G., Ruzzi, V., Pellegrino, F., Castellini, G., Monteleone, P., & Maj, M. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.12.002 · Cited by 44
“Although there is large agreement in considering appropriate the use of dimensional self-report attachment instruments (Ravitz et al., 2010), an interview such as the Adult Attachment Interview, would be a more appropriate instrument.”
Background
Metadata
- Authors
- Ravitz, P., Maunder, R., Hunter, J., Sthankiya, B., & Lancee, W.
- Affiliations
- Mount Sinai Hospital (CA)
- Corresponding author
- Ravitz, Paula
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 69
- Issue
- 4
- Pages
- 419-432
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2048140405
- Cited by
- 709
- References
- 165
- Citations by year
- 2026: 32 · 2025: 38 · 2024: 46 · 2023: 43 · 2022: 62 · 2021: 70 · 2020: 51 · 2019: 55 · 2018: 56 · 2017: 46 · 2016: 43 · 2015: 47 · 2014: 44 · 2013: 44 · 2012: 22
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- adult attachment, attachment measurement, psychosomatic research, psychometric properties, reliability and validity, Experiences in Close Relationships, Adult Attachment Interview, Adult Attachment Scale, Attachment Style Questionnaire, Parental Bonding Instrument, biopsychosocial functioning
- MeSH terms
- Adolescent, Adult, Humans, Object Attachment, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Reproducibility of Results
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