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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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“Cronbach α has been reported to range from 0.768 to 0.855 across subscales (25), and validity demonstrated by positive association with related measures (26).”
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“The R-AAS has strong validity and reliability and correlates well with related concepts, such as psychological distress, self-esteem, and satisfaction in romantic relationships (Ravitz et al., 2010).”
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“The ECR-R has demonstrated good psychometric properties (Sibley and Liu, 2004; Sibley et al., 2005) and is among the most commonly used attachment scales in psychosomatic research (Ravitz et al., 2010).”
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“array of instruments to capture the varying dimensions of attachment [12], attachment orientations have been associated with numerous cognitive components [13,14,15], behavioural outcomes [16,17,18] and affective variables [5,19].”
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“Within interpersonal theories, various measures tapping into different facets of relatedness and self-definition have been developed and validated (Locke 2011), while attachment research has focused on interview-based measures, such as the Adult Attachment Interview and the Child Attachment Interview, and experimental…”
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“An advantage of the RAAS over other attachment measures is that it evaluates attachment on a continuous scale, rather than using a categorical approach (Collins & Read, 1990; Ravitz et al., 2010).”
BackgroundThe Role of Attachment in Gambling Behaviors and Gambling Disorder: A Systematic Review
Ghinassi, S., & Casale, S. (2022) · Journal of Gambling Studies · doi:10.1007/s10899-022-10163-1 · Cited by 22
“Over time, attachment theory has been extended from infant-mother relationships to adult relationships, and numerous categorical and dimensional conceptualizations have been proposed (Ravitz et al., 2010).”
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“A recent review described that insecure attachment in patients was more prevalent than in the general population [17].”
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The Multimodal Assessment of Adult Attachment Security: Developing the Biometric Attachment Test
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Development and Validity Test of Social Attachment Multidimensional Scale
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“…measures are a product of subjective and conscious thoughts and mostly differentiate between secure and insecure avoidant or anxious attachment (Ravitz et al., 2010), while narrative methods allow analyzing representations of attachment including defensive processes (e. g., deactivation,…”
BackgroundMethodAttachment as a Moderator in the Relation Between Child Maltreatment and Symptoms of Depression
Nowalis, S., Godleski, S. A., & Schenkel, L. S. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520933050 · Cited by 24
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“A further critique of the RQ concerns its reliability (Ravitz et al., 2010), which suggests that the stability of the underlying concepts we are measuring may be even higher than we were able to observe.”
BackgroundMethodThe Association Between Parent–Child Attachment and Academic Adjustment: A Multilevel Meta-Analysis
Yang, Y. M., Li, S., Fang, X., & Chen, X. (2024) · Educational Psychology Review · doi:10.1007/s10648-024-09920-y · Cited by 17
“Moreover, these approaches may overlook attachment phenomena requiring activation to manifest (Ravitz et al., 2010).”
Wu, X., Liew, K., & Dorahy, M. J. (2025) · JMIR AI · doi:10.2196/68960 · Cited by 29
“…by devaluation of the importance of close relationships, avoidance of intimacy and dependence, and decreased engagement in attachment behavior, while anxious attachment involves preoccupation with the availability and responsiveness of attached figures, fear of separation, and abandonment [24,30].”
Intellectual disability and attachment theory among adults: An early systematic review
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Adult attachment: Investigating the factor structure of the Relationship Scales Questionnaire
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“As highlighted in previous studies focused on self‐report instruments of adult attachment (e.g., Fraley et al., 2015; Mikulincer & Shaver, 2016; Ravitz et al., 2010), categorical questionnaires are criticized theoretically for considering the differences among individuals within a single category…”
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“Considering the possible underlying social factors, subjects who experienced low care during childhood tend to experience interpersonal stress and fail to get adequate social support in adulthood ([40]); arguably, considering the close relationship between inadequate parenting and insecure attachment, [28,29] the latt…”
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“This factor structure is in line with previous two-factor conceptualizations of attachment (Cameron et al., 2012; Ravitz et al., 2010) and is equal to findings from the ECR-RS with nine items for each specific relationship domain (Fraley et al., 2011).”
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“The decision to include solely studies using validated self-reported measures of attachment was taken to avoid inconsistencies between attachment measurements (Ravitz et al., 2010; Roisman et al., 2007).”
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Linking attachment theory to abusive supervision
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“Since then, various categorizations and dimensional models of adult attachment have been developed (see Ravitz et al., 2010).”
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“In addition, since there have been reported relationships between attachment representation and personality traits in past studies (Ravitz et al., 2010; Shaver & Mikulincer, 2005), the relationships between the ECR-RS and subdimensions of Table 1.”
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“The internal consistency reported is near or above α = 0.90 for both the anxiety and avoidance scales; the test-retest reliability is reported to be between 0.50 and 0.75 (Ravitz et al., 2010).”
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“Although these measures are well validated and present a high internal consistency, they are showing some limitations in that they are too abstract and decontextualized from real situations and they are not able to activate specific phenomena that need to be activated in order to be manifested, such as attachment situ…”
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“The relative merits and drawbacks of different attachment measures have been comprehensively reviewed elsewhere (Ravitz, Maunder, Hunter, Sthankiya, & Lancee, 2010).”
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Achterhof, R., Schneider, M., Kirtley, O. J., Wampers, M., Decoster, J., Derom, C. A., Binder, M. D., Gülöksüz, S., Jacobs, N., Menne‐Lothmann, C., et al. (2022) · Developmental Psychology · doi:10.1037/dev0001315 · Cited by 15
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“A recent literature review (46) reported that AAS-R had a good reliability and validity, is widely used, and has potential utility for psychosomatic research.”
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Exploration of Resilience in Relation to Mindfulness, Self-Compassion, and Attachment Styles
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Food allergy and attitudes to close interpersonal relationships: An exploratory study on attachment
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“The ECR is one of the most widely-used tools to assess adult attachment styles (Ravitz et al., 2010) and has been used in a large study with transition-age foster youth (Courtney et al., 2004).”
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“T hi s ar tic le is in te nd ed so le ly fo r th e pe rs on al us e of th e in di vi du al us er an d is no t to be di ss em in at ed br oa dl y. style (Ravitz et al., 2010) and IFTs (Epitropaki et al., 2013) are available, and may be included in future studies on attachment and IFTs.”
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Attachment and Autonomy Problems in Adults With ADHD
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My social comfort zone: Attachment anxiety shapes peripersonal and interpersonal space
von Mohr, M., Silva, P. C., Vagnoni, E., Bracher, A., Bertoni, T., Serino, A., Banissy, M. J., Jenkinson, P. M., & Fotopoulou, A. (2023) · iScience · doi:10.1016/j.isci.2023.105955 · Cited by 16
“27 Of interest, another line of work proposed that PPS expands by trait-anxiety 23 in line with the idea that the functioning of the human defensive systems relates to personality traits such as fear and anxiety.”
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“To begin with, we must consider that attachment is not an easy construct to measure and different methods may lead to different estimations.(83) Furthermore, changes of attachment style could occur through the lifetime(84) which presents numerous challenges for testing the model.”
Rice, K. G., Gnilka, P. B., Davis, D. E., & Ashby, J. S. (2017) · Assessment · doi:10.1177/1073191117702241 · Cited by 13
Insecure and Unresolved/Disorganized Attachment in Patients With Psychogenic Nonepileptic Seizures
Gerhardt, C., Hamouda, K., Irorutola, F., Rose, M., Hinkelmann, K., Buchheim, A., & Senf, P. (2020) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.psym.2020.05.014 · Cited by 17
Two is a perfect number: Patient–doctor relationship and patient attachment style in palliative care
Zaporowska-Stachowiak, I., Stachowiak-Szymczak, K., & Stachnik, K. (2017) · Journal of Health Psychology · doi:10.1177/1359105317721307 · Cited by 13
“Thus, our method focused on the patients’ “conscious attitudes towards, or awareness of behaviors in, experiences of separation, loss, intimacy dependence and trust” (Ravitz et al., 2010), rather than on interviews.”
MethodGugová, G. R., Heretik, A., & Hajdúk, M. (2014) · Studia Psychologica · doi:10.21909/sp.2014.01.649 · Cited by 13
“In accordance with the general development of methodology in psychology, original categorical agreement/disagreement measures of different attachment styles were factor-analyzed and turned into continuous scales (see Fraley et al., 2000; Ravitz et al., 2010).”
BackgroundReconceptualizing adult attachment relationships: A network perspective
McWilliams, L. A., & Fried, E. I. (2019) · Personal Relationships · doi:10.1111/pere.12263 · Cited by 15
Holt, R., Kornhaber, R. A., Kwiet, J., Rogers, V., Shaw, J., Law, J. S., Proctor, M.-T., Vandervord, J. G., Streimer, J. H., Visentin, D. C., et al. (2019) · Burns · doi:10.1016/j.burns.2019.03.011 · Cited by 13
“and discriminant validityas a questionnaire [30].”
BackgroundValentini, E., Koch, K., Nicolardi, V., & Aglioti, S. M. (2015) · NeuroImage · doi:10.1016/j.neuroimage.2015.07.025 · Cited by 12
“This may be due to a lower sensitivity of the ASQ with respect to other attachment measures (Ravitz et al., 2010) or to a low number of observations compared to previous results (Meredith et al.”
Roth, M. C., Humphreys, K., King, L. S., Mondal, S., Gotlib, I., & Robakis, T. K. (2020) · Child Psychiatry and Human Development · doi:10.1007/s10578-020-01073-7 · Cited by 12
Michael, T., & Snow, M. S. (2019) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-019-09375-9 · Cited by 12
Personal Agency in Borderline Personality Disorder: The Impact of Adult Attachment Style
Hashworth, T., Reis, S. L., & Grenyer, B. F. S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.669512 · Cited by 12
Ferrajão, P. C., & Elklit, A. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105271 · Cited by 12
West, T. N., Don, B. P., & Fredrickson, B. L. (2022) · Emotion · doi:10.1037/emo0001049 · Cited by 15
Bracht, T., Denier, N., Wallimann, M., Walther, S., Mertse, N., Breit, S., Federspiel, A., Wiest, R., & Soravia, L. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100435 · Cited by 12
A Confirmatory Factor Analysis and Validation of the Vulnerable Attachment Style Questionnaire
Kupeli, N., Norton, S., Chilcot, J., Schmidt, U. H., Campbell, I. C., & Troop, N. A. (2014) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-014-9432-3 · Cited by 12
“develop measures to assess patterns of attachment behavior in adulthood (see reviews: Crowell and Treboux 1995; Lyddon et al. 1993; Ravitz et al. 2010).”
BackgroundChaperon, É., & Dandeneau, S. (2017) · European Review of Applied Psychology · doi:10.1016/j.erap.2017.04.002 · Cited by 12
Attachment security, values, and prosocial attitudes
Sánchez, A. M., García‐Martínez, J. M. A., Santa‐Bárbara, E. S., & Calvo‐Salguero, A. (2018) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12442 · Cited by 15
Listening to Sutra-Chanting Reduces Bereavement Stress in Japan
Taniyama, Y., Becker, C., Takahashi, H., Tokumaru, S., Suzuki, I., Okui, K., Gohori, J., Imai, Y., & Morita, T. (2019) · Journal of Health Care Chaplaincy · doi:10.1080/08854726.2019.1653637 · Cited by 13
Spies, R., & Duschinsky, R. (2021) · SAGE Open · doi:10.1177/21582440211047577 · Cited by 12
“Yet a strong tradition of self-report research on adult attachment emerged from within social psychology in the 1980s, led by researchers such as Phillip Shaver (Ravitz et al., 2010).”
BackgroundData quality and factor analysis of the Danish version of the Relationship Scale Questionnaire
Andersen, C. M., Pedersen, A. F., Carlsen, A. H., Olesen, F., & Vedsted, P. (2017) · PLoS ONE · doi:10.1371/journal.pone.0176810 · Cited by 12
“Numerous other self-report measures assessing attachment among adults have also been developed [20].”
BackgroundBattered Woman Syndrome Questionnaire (BWSQ) Subscales: Development, Reliability, and Validity
Millen, D. H., Kennedy, T. D., Black, R. A., Detullio, D., & Walker, L. E. (2019) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2019.1627684 · Cited by 12
Prinsen, J., Deschepper, A., Maes, E., & Alaerts, K. (2019) · Biological Psychology · doi:10.1016/j.biopsycho.2019.107773 · Cited by 11
The role of early attachment experiences in modulating defensive peripersonal space
Fossataro, C., Adenzato, M., Bruno, M., Fontana, E., Garbarini, F., & Ardito, R. B. (2023) · Scientific Reports · doi:10.1038/s41598-023-30985-2 · Cited by 11
Foster parents’ history of adverse childhood experiences, adult attachment, and parenting stress
Reisz, S., Aviles, A. I., & Adkins, T. (2023) · Children and Youth Services Review · doi:10.1016/j.childyouth.2023.107005 · Cited by 15
Dinzinger, A., Ismair, S., Brisch, K. H., Sperl, W., Deneault, A., Nolte, T., Hitzl, W., & Priewasser, B. (2023) · Attachment & Human Development · doi:10.1080/14616734.2023.2258354 · Cited by 14
“Psychometric properties were described as excellent in several studies (Ravitz et al., 2010).”
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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