Attachment theory

Attachment theory is a psychological and evolutionary framework, concerning the relationships between humans, particularly the importance of early bonds between infants and their primary caregivers. Developed by psychiatrist and psychoanalyst John Bowlby (1907–90), the theory posits that infants need to form a close relationship with at least one primary caregiver to ensure their survival, and to develop healthy social and emotional functioning.^[1][2]

For infants and toddlers, the "set-goal" of the behavioural system is to maintain or achieve proximity to attachment figures, usually the parents.

Pivotal aspects of attachment theory include the observation that infants in Western nuclear families may seek proximity to attachment figures, especially during stressful situations.^[2][3] The theory proposes that secure attachments are formed when caregivers are sensitive and responsive in social interactions, and consistently available, particularly between the ages of six months and two years. As children grow, they are thought to use these attachment figures as a secure base from which to explore the world and to return to for comfort. Interactions with caregivers have been hypothesized to form a specific kind of 'attachment behavioral system' – or, more recently, 'internal working model' – the relative in/security of which influences characteristic patterns of behavior when forming future relationships.^[4] Separation anxiety or grief following the loss of an attachment figure is considered to be a normal and adaptive response for an attached infant.^[5]

Research by developmental psychologist Mary Ainsworth in the 1960s and '70s expanded on Bowlby's work, introducing the concept of the "secure base", impact of maternal responsiveness and sensitivity to infant distress, and identified attachment patterns in infants: secure, avoidant, anxious, and disorganized attachment.^[6][7] In the 1980s, attachment theory was extended to adult relationships and attachment in adults, making it applicable beyond early childhood.^[8] Bowlby's theory integrated concepts from evolutionary biology, object relations theory, control systems theory, ethology, and cognitive psychology, and was fully articulated in his trilogy, Attachment and Loss (1969–82).^[9]

While criticized from its inception in the 1950s by academic psychologists and psychoanalysts,^[10] attachment theory has become a dominant approach to understanding early social development and has generated extensive research.^[11] Most damagingly, a series of researchers–starting with Michael Lamb and his colleagues in the mid-1980s–have shown that diagnoses of attachment in/security constructed using procedures like the Strange Situation primarily reflect what is going on in the social environment external to the child and his or her caregiver(s).^[12][13] Other findings challenge the theory's observational claims, the role of temperament in shaping attachment behaviour, the unobservability of internal working models, and the limitations of discrete attachment patterns. Such criticisms are rarely addressed by attachment advocates and so the theory's core concepts continue to influence therapeutic practices and social and childcare policies. Recent findings show that attachment theory is mistaken to assume a one-to-one program underpins infant social behaviour. In short, attachment theory overemphasizes maternal influence on shaping children's social lives while overlooking genetic, cross-cultural, and broader social factors.^{[14][15][16][17]}

Attachment

Although it is usual for the mother to be the primary attachment figure, infants will form attachments to any carer who is sensitive and responsive in social interactions with them.

Within attachment theory, attachment means an affectional bond or tie between an individual and an attachment figure (usually a caregiver/guardian). Such bonds may be reciprocal between two adults, but between a child and a caregiver, these bonds are not attributed to the actions of caregivers so much as to the child's own actions in pursuit of safety, security, and protection—which is most important in infancy and childhood.^[18] Attachment theory is not an exhaustive explanation of human relationships. For example, attachment is not synonymous with love and affection, although these may be used to indicate that attachment bonds exist. In child-to-adult relationships, the child's tie is called the "attachment" and the caregiver's reciprocal equivalent is referred to as the "caregiving bond".^[19] Just as the child's tie is generated through the operation of a hypothesized "attachment behavioral system" in the child, so the caregiving bond is held to be produced by the caregiver's "caregiving behavioral system."^[20]

The theory proposes that children attach to carers instinctively,^[21] for the purpose of survival (and ultimately, therefore, if we accept W.D. Hamilton's gene-centred view of evolution, genetic replication).^[19] In short, the theory holds that the biological aim of attachment is survival and its psychological aim is security.^[11]

The relationship that a child has with their attachment figure is deemed to be especially important in threatening situations, particularly if there are no other caregivers around as is often the case in nuclear families with a traditional division of labour. The presence of at least one supportive attachment figure is especially important in a child's developmental years.^[22] In addition to support, attunement (accurate understanding and emotional connection) is crucial in a caregiver-child relationship. If the primary caregiver and the child are poorly attuned, the child may grow to feel misunderstood and anxious.^[23]

Attachment theory holds that infants may form attachments to any consistent and available caregiver who is sensitive and responsive in social interactions with them. The quality of social engagement is more influential than the amount of time spent. In a nuclear family with traditional female-male roles, the biological mother is the usual principal attachment figure, but the role can be assumed by anyone who consistently behaves in a "mothering" way over a period of time. Within attachment theory, mothering equates to a set of behaviours that involves engaging in lively social interaction with the infant and responding readily to signals and approaches.^[24] Nothing in the theory suggests that fathers are not equally likely to become principal attachment figures if they provide most of the child care and related social interaction.^[25][26] A secure attachment to a father who is a "secondary attachment figure" may counter the possible negative effects of an unsatisfactory attachment to a mother who is the primary attachment figure.^[27]

Babies can discriminate between caregivers as early as three months of age, if not earlier. But even six-month-olds typically direct smiles cries and other attachment (proximity seeking) behaviours indiscriminately towards caregivers, if more than one is available. Eventually, during the period from seven months to 2+ years of age, a single figure will become the focus of these behaviours, according to the theory. Where there is more than one caregiver, attachments to different caregivers should be arranged hierarchically, with the principal attachment figure at the top.^[28] The set-goal of the attachment behavioural system is to maintain a bond with an accessible and available attachment figure.^[29]

"Alarm" is the term used for activation of the attachment behavioural system caused by fear of danger. "Anxiety" is the anticipation or fear of being cut off from the attachment figure. And, if an attchment-figure is unavailable or unresponsive, separation distress may occur.^[30] In infants, extended physical separation can lead to anxiety and anger, followed by sadness and despair. The theory holds that, after the attachment behavioural system has fully-formed (by age three or four), extended physical separation is no longer such a threat to the child's bond with the attachment figure. Threats to security in older children and adults arise from prolonged absence, breakdowns in communication, emotional unavailability or signs of rejection or abandonment.^[29]

Behaviours

Insecure attachment patterns can compromise exploration and the achievement of self-confidence. A securely attached baby is free to concentrate on their environment.

Bowlby held that all human babies are born biologically programmed to develop a thermostat-like attachment behavioural system over the first three years of life: a system which has proximity-to-mother or mother-figure as its "set-goal." The raw materials for this system, first emitted in the two or three months after birth (which he called Phase One of attachment formation), Bowlby called "attachment behaviours": for example, smiling, crying, sucking, rooting and looking. During the first six months of life, these behaviours do not constitute intentional 'goal-corrected' signals, but they can function as if they are signals when they serve to trigger the caregiving behaviour of anyone in their vicinity.

During the second phase of attachment-formation (three to six months), the infant is said to discriminate between familiar and unfamiliar adults, becoming more responsive toward the caregiver, while following and clinging are added to the range of behaviours. The infant's behaviour toward the caregiver becomes organized on a goal-directed basis to achieve the conditions that make it feel secure.^[31]

Phase Three of attachment formation is said to last from around six or seven months of age to two or more years. By the end of the first year, the infant will be able to display a range of attachment behaviours designed to maintain proximity. These manifest as protesting the caregiver's departure, greeting the caregiver's return, clinging when frightened, and following when able.^[32]

With the development of locomotion, the infant begins to use the caregiver or caregivers as a "safe base" from which to explore.^[31][33] Infant exploration is greater when the caregiver is present because the infant's attachment system is relaxed and it is free to explore. If the caregiver is inaccessible or unresponsive, attachment behaviour is more strongly exhibited.^[34] Anxiety, fear, illness, and fatigue will cause a child to increase attachment behaviours.^[35]

After the second year, as the child begins to see the caregiver as an independent person, Phase Four begins and a more complex and goal-corrected partnership develops.^[36] Children begin to notice others' goals and feelings and plan their actions accordingly.

For coverage of this topic in Wolves, see Attachment behaviour in wolves.

Tenets

Modern attachment theory is based on three principles:^[37]

1. One-to-one bonding is an intrinsic human need.
2. The regulation of emotion and fear can enhance vitality.
3. The promotion of adaptiveness and growth.

Bowlby did not make a distinction between primates who breed cooperatively, happily passing newborns from adult to adult—like marmosets and tamarins and human hunter-gatherers—and primates who do not: jealously rearing their young one-to-one, like gorillas and chimpanzees.^[38] So he proposed that one-to-one attachment behaviours and their associated emotions were likely to be adaptive in the young of all primates who socialised in the possessive one-to-one manner of gorillas and chimps, a group which he (mistakenly) believed to include pre-human and human hunter-gatherers.

It is a truism that the long-term evolution of any social species must have involved selection for social behaviours, in both infants and adults, that make individual or group survival more likely in that species. Yet, distinctively, Bowlby's theory does not focus on how much the survival of primate infants depends on the caring behaviour of their older companions. His theory's primary focus attributes infant survival to something innate in newborns themselves. This means his theory initially sidelines the advantages for infant safety of adult vigilance and caregiving, focusing instead on toddlers' own efforts to stay near familiar people when they feel stressed. This emphasis made him suggest that the crucial factor for infant safety and survival, both today and in the environment of pre-human adaptation, must have been the acquisition and development of an innate 'attachment system' which now underpins the panhuman social psychology of infancy.

While citing no ethnographic evidence, Bowlby pictured the evolutionary environment of early pre-human adaptation as one in which the infant was always in close proximity to their mother, being 'carried by his mother on her back,' a picture which he (incorrectly) assumed also to represent current hunter-gatherer societies.^[39] Imagined like this, and sidelining the efficacy of protective caregiving initiatives by the infant's older companions, he proposed there would be a survival necessity for infants to evolve the capacity to sense possibly dangerous conditions such as isolation from companions or rapid approach by strangers. Hence, according to Bowlby, evolution must have ensured that young children's proximity-seeking to a 'mother-figure' in the face of threat has become the "set-goal" of what he called the attachment instinct or attachment behavioural system.^[40]

Taking up Konrad Lorenz's findings about imprinting in ducklings and goslings, Bowlby's also initially hypothesised that there was a sensitivite period during which this attachment system best operated, lasting from six weeks to twelve months of age. But, over time, research proved there were more differences than similarities between attachment behaviours in human babies and imprinting in waterbirds, so the analogy was dropped.^[10][41]

With further research, authors discussing attachment theory have come to appreciate social development is affected by a family's social background, social support for caregivers and by later as well as earlier relationships. Attachments form most obviously if the infant lives in social conditions which mean he or she has only one caregiver, with, perhaps, some occasional care from a small number of other people. Around the world, from the start of life onwards, most children have many more than one important figure in their lives with whom they may smile, cry, cling and play, or to whom (in Bowlby's language) they may 'direct attachment behaviour'. According to Bowlby, these figures are not treated alike; and, in traditional nuclear families, young children often 'direct attachment behaviour' mainly toward one particular person. Reflecting his observations of English families, Bowlby believed the one-to-oneness of the child's first strong relationship was a human universal, using the term "monotropy" to describe it.^[42] Once again, however, researchers and theorists have abandoned the concept of monotropy insofar as it may be taken to mean the relationship with the special figure differs qualitatively from that of other figures. Instead, current attachment theorists postulate very young children develop hierarchies of relationship.^[10][43]

Early experiences with caregivers gradually give rise to a system of thoughts, memories, beliefs, expectations, emotions, and behaviours about the self and others. This system, called by attachment advocates the "internal working model of social relationships", is hypothesized to continue to develop with time and experience.^[44]

While these internal working models still lack an agreed definition, attachment theory holds that they regulate, interpret, and predict attachment-related behaviour in the self and in the attachment figure. Supposing they develop in line with environmental and developmental changes, they would then incorporate the capacity to reflect and communicate about past and future attachment relationships.^[4] As such, they would enable the growing child to handle new types of social interactions; knowing, for example, an infant should be treated differently from an older child, or that interactions with teachers and parents share characteristics. Internal working models are hypothesized to continue to develop through adulthood, helping cope with friendships, marriage, and parenthood, all of which involve different behaviours and feelings.^[45][44] For example, one article has found that athletes' who have strong relationships with their coaches thrive more than those who do not, especially if their needs are met. Some see this finding as a confirmation of attachment theory and the importance of internal working models.^[46]

The development of attachment is held to be a transactional process. But not from the beginning. Bowlby proposed that young infants' attachment behaviours consist of one-function stereotyped fixed action patterns which are not goal-corrected and have well-defined predictable triggers. We now know, however, that the behaviours he named, like smiling, rooting, looking and sucking, are all flexible in form, often goal-corrected, and all have several causes including functions unrelated to attachment.^[47] And, like all social behaviours, Bowlby's "attachment behaviours" are held to change with age in ways affected by experiences and situational factors, including relationships.^[48] Thus, what a young child does when reunited with a caregiver varies considerably and may be influenced by how the caregiver has treated the child before, and the history of effects the child has had on the caregiver, as well as the infant-caregiver couple's current well-being (physical comfort, fatigue, health, hunger) and social circumstances.^[49][50]

Cultural differences

In Western cultures of child-rearing, there is a focus on single attachment to primarily the mother. This dyadic model is not the only strategy of attachment producing a secure and emotionally adept child. Having a single, dependably responsive and sensitive caregiver (namely the mother) does not guarantee the ultimate success of the child. Results from Israeli, Dutch and east African studies show children with multiple caregivers grow up not only feeling secure, but developed "more enhanced capacities to view the world from multiple perspectives."^[51] This evidence can be more readily found in hunter-gatherer communities, like those that exist in rural Tanzania.^[52]

In hunter-gatherer communities of the past and present, mothers may be the primary caregivers, but not in the same way as a stay-at-home mother in Western cultures. Some Australian Aboriginal languages do not distinguish mothers, calling them 'aunt.' This reflects the fact that a baby's adult kin share parental responsibilities for ensuring a child's survival with a variety of different allomothers. So while a mother is important, she does not offer the only opportunity for care and security. Several group members (with or without blood relation) contribute to the task of bringing up a child, sharing the parenting role and therefore can be sources of multiple relationships and attachments. There is evidence of this communal parenting throughout history that "would have significant implications for the evolution of multiple attachment."^[53]

In rural India where a family typically consists of 3 generations (and sometimes 4: great-grandparents, grandparents, parents, and child or children), the child or children would have four to six caregivers from whom to select their favourite "attachment figure". A child's "uncles and aunts" (parents' siblings and their spouses) contribute significantly to the child's and the mother's psycho-social enrichment.^[54]

Although it has been debated for years, and there are differences across cultures, some research findings suggest that three basic aspects of attachment theory are widespread across cultures.^[55] On the other hand, studies in Israel and Japan produced distributions of attachment measures which diverge widely from those found in Western Europe and the United States.

Empirical research and theoretical developments

John Bowlby initially conceptualized infant attachments as observable entities. Mary Ainsworth and her colleagues then devised an observational procedure for measuring infants' attachments based on Bowlby's discussion of "separation anxiety" and "fear of strangers". They predicted that, once infants have begun to form attachments to their mothers around the end of their first year, they should predictably use her as a secure base to explore an unfamiliar room, and even more so, when confronted by a "stranger". They called this procedure the Strange Situation.

Ainsworth's Strange Situation protocol specifies that four participants (mother, baby, stranger and observer) enact an eight-stage introduction of a baby to a "stranger" in order to categorize the baby's observable responses. There are eight stages, lasting about 30 minutes in all:

1. The mother, accompanied by the observer, carries the baby into the room and the observer leaves.
2. The mother puts the baby down in a specified location, then sits quietly in her chair until the baby solicits her attention.
3. The stranger enters, sits quietly for one minute, then converses with the mother for one minute, and then gradually approaches the baby. The mother then leaves the room.
4. If the baby is playing with its toys, the stranger merely observes. If the baby is not playing with its toys, the stranger tries to interest the baby in the toys. If the baby is distressed, the stranger tries to comfort the baby.
5. The mother enters, and pauses in the doorway so that the baby can respond to her presence. The stranger then leaves. After the baby begins to play with its toys again, the mother leaves again and says, "bye-bye".
6. the baby is left alone for three minutes, unless the baby is so distressed it has to be comforted.
7. The stranger enters and repeats the same behavior from the fourth episode.
8. The mother returns, the stranger leaves, and the mother reunites with her baby.

These eight episodes were observed through an adjoining room, and the baby's responses were categorized into different types of attachment behaviours.^[56]

Bretherton (1992) then followed this theoretical development, highlighting Bowlby's interdisciplinary framework. He relied on the concepts of ethology, psychoanalysis, and cognitive science. Ainsworth introduced the systematic classification of attachment styles contingent upon infant caregivers' interactive experiences.^[57]

Building on this foundation, Main and Solomon (1990) extended the original attachment classification to identify a disorganized/disoriented attachment style. They observed infants displaying contradictory or confused behaviors when reunited with a caregiver.^[58] This further complicated the understanding of attachment patterning and has informed clinical practice and developmental research.

Empirical studies have further classified how early attachment is formed and passed on across generations. Beebe et al. (2010) studied four-month-old mother interactions using microanalytic methods. They determined that coordinated gazes and vocal affect predicted attachment security at twelve months using the Strange Situation Procedure.^[59] Similarly, Steele et al. (1996) found intergenerational continuity regarding parents' attachment classifications and those of infants.^[60]

Another one of the most influential studies supporting the principle of attachment theory was conducted by Harry Harlow. Harlow's research with rhesus monkeys demonstrated the critical importance of caregiving and emotional comfort in creating attachment. In these experiments, infant monkeys were separated from their biological mothers and given the choice between two inanimate surrogate mothers: one made of wire and wood and one made of foam and cloth. In addition, the monkeys were assigned one of two conditions: one condition where the wire mother provided milk while the cloth mother had no food to offer, and the other condition where the cloth mother provided food while the wire mother did not. In both conditions, the infant monkeys overwhelmingly preferred the cloth mother, clinging to it for comfort and security even though it did not provide nourishment.^[61] The infant monkeys' preference highlighted the importance of comfort, warmth, and emotional security over mere sustenance. Harlow's work provided strong support for Bowlby's claim that the need for affection and emotional security is a fundamental aspect of earlier development, also influencing later social and emotional outcomes. Clearly, children need more than just food and shelter; they require emotional attunement and a reliable source of comfort to develop a sense of security. This introduces the importance of having a "secure base." A secure base allows children to confidently explore their environment, knowing that they have a supportive caregiver to return to when distressed. This level of responsiveness, as well as warmth and responsiveness, is critical for successful relationships and attachment.^[62]

The attachment theory has also been extended into the adult relationship domain. Adult romantic attachment has been reviewed by Fraley and Shaver (2000), who advocated that attachment behaviors are observed in infancy. Seeking proximity and secure base responses were also present in adult romantic relationships.^[63] This review illustrates how the attachment framework can be applied across the lifespan and highlights ongoing debates about continuity, measurements, and individual differences.

Together, both the theoretical advances and empirical studies underscore the importance of early relational experiences. It also supports the broader application of attachment theory in various contexts across developmental stages and relationships.

Attachment patterns

Attachment theory styles

The strength of a child's attachment behaviour in a given circumstance does not indicate the "strength" of the attachment bond. Some insecure children will routinely display very pronounced attachment behaviours, while many secure children find that there is no great need to engage in either intense or frequent shows of attachment behaviour.^[64]

Individuals with different attachment styles have different beliefs about romantic love period, availability, trust capability of love partners and love readiness.^[65]

Secure attachment

Main article: Secure attachment

A toddler who is securely attached to their parent (or other familiar caregiver) will explore freely while the caregiver is present, typically engages with strangers, is often visibly upset when the caregiver departs, and is generally happy to see the caregiver return. The extent of exploration and of distress are affected, however, by the child's temperamental make-up and by situational factors as well as by attachment status. A child's attachment is largely influenced by their primary caregiver's sensitivity to their needs. Parents who consistently (or almost always) respond to their child's needs will create securely attached children. Such children are certain that their parents will be responsive to their needs and communications.^[66]

In the traditional Ainsworth et al. (1978) coding of the Strange Situation, secure infants are denoted as "Group B" infants and they are further subclassified as B1, B2, B3, and B4.^[67] Although these subgroupings refer to different stylistic responses to the comings and goings of the caregiver, they were not given specific labels by Ainsworth and colleagues, although their descriptive behaviours led others (including students of Ainsworth) to devise a relatively "loose" terminology for these subgroups. B1s have been referred to as "secure-reserved", B2s as "secure-inhibited", B3s as "secure-balanced", and B4s as "secure-reactive". However, in academic publications the classification of infants (if subgroups are denoted) is typically simply "B1" or "B2", although more theoretical and review-oriented papers surrounding attachment theory may use the above terminology. Secure attachment is the most common type of attachment relationship seen throughout societies.^[68]

Securely attached children are best able to explore when they have the knowledge of a secure base (their caregiver) to return to in times of need. When assistance is given, this bolsters the sense of security and also, assuming the parent's assistance is helpful, educates the child on how to cope with the same problem in the future. Therefore, secure attachment can be seen as the most adaptive attachment style. According to some psychological researchers, a child becomes securely attached when the parent is available and able to meet the needs of the child in a responsive and appropriate manner. At infancy and early childhood, if parents are caring and attentive towards their children, those children will be more prone to secure attachment.^[69]

Anxious - ambivalent attachment

Anxious - ambivalent attachment is a form of insecure attachment and is also misnamed as "resistant attachment".^[68][70] In general, a child with an anxious - ambivalent pattern of attachment will typically explore little (in the Strange Situation) and is often wary of strangers, even when the parent is present. When the caregiver departs, the child is often highly distressed showing behaviours such as crying or screaming. The child is generally ambivalent when the caregiver returns.^[67] The anxious - ambivalent strategy is a response to unpredictably responsive caregiving, and the displays of anger (ambivalent resistant, C1) or helplessness (ambivalent passive, C2) towards the caregiver on reunion can be regarded as a conditional strategy for maintaining the availability of the caregiver by preemptively taking control of the interaction.^[71][72]

The C1 (ambivalent resistant) subtype is coded when "resistant behavior is particularly conspicuous. The mixture of seeking and yet resisting contact and interaction has an unmistakably angry quality and indeed an angry tone may characterize behavior in the preseparation episodes".^[67]

Regarding the C2 (ambivalent passive) subtype, Ainsworth et al. wrote:

Perhaps the most conspicuous characteristic of C2 infants is their passivity. Their exploratory behavior is limited throughout the SS and their interactive behaviors are relatively lacking in active initiation. Nevertheless, in the reunion episodes they obviously want proximity to and contact with their mothers, even though they tend to use signalling rather than active approach, and protest against being put down rather than actively resisting release ... In general the C2 baby is not as conspicuously angry as the C1 baby.^[67]

Research done by McCarthy and Taylor (1999) found that children with abusive childhood experiences were more likely to develop ambivalent attachments. The study also found that children with ambivalent attachments were more likely to experience difficulties in maintaining intimate relationships as adults.^[73]

Dismissive - avoidant attachment

An infant with a dismissive - avoidant pattern of attachment will avoid or ignore the caregiver—showing little emotion when the caregiver departs or returns. The infant will not explore very much regardless of who is there. Infants classified as dismissive - avoidant (A) represented a puzzle in the early 1970s. They did not exhibit distress on separation, and either ignored the caregiver on their return (A1 subtype) or showed some tendency to approach together with some tendency to ignore or turn away from the caregiver (A2 subtype). Ainsworth and Bell theorized that the apparently unruffled behaviour of the avoidant infants was in fact a mask for distress, a hypothesis later evidenced through studies of the heart-rate of avoidant infants.^[74][75]

Infants are depicted as dismissive - avoidant when there is:

... conspicuous avoidance of the mother in the reunion episodes which is likely to consist of ignoring her altogether, although there may be some pointed looking away, turning away, or moving away ... If there is a greeting when the mother enters, it tends to be a mere look or a smile ... Either the baby does not approach his mother upon reunion, or they approach in "abortive" fashions with the baby going past the mother, or it tends to only occur after much coaxing ... If picked up, the baby shows little or no contact-maintaining behavior; he tends not to cuddle in; he looks away and he may squirm to get down.^[67]

Ainsworth's narrative records showed that infants avoided the caregiver in the stressful Strange Situation Procedure when they had a history of experiencing rebuff of attachment behaviour. The infant's needs were frequently not met and the infant had come to believe that communication of emotional needs had no influence on the caregiver.

Ainsworth's student Mary Main theorized that avoidant behaviour in the Strange Situation Procedure should be regarded as "a conditional strategy, which paradoxically permits whatever proximity is possible under conditions of maternal rejection" by de-emphasising attachment needs.^[76]

Main proposed that avoidance has two functions for an infant whose caregiver is consistently unresponsive to their needs. Firstly, avoidant behaviour allows the infant to maintain a conditional proximity with the caregiver: close enough to maintain protection, but distant enough to avoid rebuff. Secondly, the cognitive processes organizing avoidant behaviour could help direct attention away from the unfulfilled desire for closeness with the caregiver who is avoiding a situation in which the child is overwhelmed with emotion ("disorganized distress"), and therefore unable to maintain control of themselves and achieve even conditional proximity.^[77]

Disorganized - disoriented attachment

Beginning in 1983, Crittenden offered A/C and other new organized classifications (see below). Drawing on records of behaviours discrepant with the A, B and C classifications, a fourth classification was added by Ainsworth's colleague Mary Main.^[58] In the Strange Situation, the attachment system is expected to be activated by the departure and return of the caregiver. If the behaviour of the infant does not appear to the observer to be coordinated in a smooth way across episodes to achieve either proximity or some relative proximity with the caregiver, then it is considered 'disorganized' as it indicates a disruption or flooding of the attachment system (e.g. by fear). Infant behaviours in the Strange Situation Protocol coded as disorganized/disoriented include overt displays of fear; contradictory behaviours or affects occurring simultaneously or sequentially; stereotypic, asymmetric, misdirected or jerky movements; or freezing and apparent dissociation. Lyons-Ruth has urged, however, that it should be more widely "recognized that 52% of disorganized infants continue to approach the caregiver, seek comfort, and cease their distress without clear ambivalent or avoidant behavior".^[78]

The benefit of this category was hinted at earlier in Ainsworth's own experience finding difficulties in fitting all infant behaviour into the three classifications used in her Baltimore study. Ainsworth and colleagues sometimes observed

tense movements such as hunching the shoulders, putting the hands behind the neck and tensely cocking the head, and so on. It was our clear impression that such tension movements signified stress, both because they tended to occur chiefly in the separation episodes and because they tended to be prodromal to crying. Indeed, our hypothesis is that they occur when a child is attempting to control crying, for they tend to vanish if and when crying breaks through.^[79]

Such observations also appeared in the doctoral theses of Ainsworth's students. Crittenden, for example, noted that one abused infant in her doctoral sample was classed as secure (B) by her undergraduate coders because her strange situation behaviour was "without either avoidance or ambivalence, she did show stress-related stereotypic headcocking throughout the strange situation. This pervasive behavior, however, was the only clue to the extent of her stress".^[80]

There is rapidly growing interest in disorganized attachment from clinicians and policy-makers as well as researchers.^[81] However, the disorganized/disoriented attachment (D) classification has been criticized by some for being too encompassing, including Ainsworth herself.^[82] In 1990, Ainsworth put in print her blessing for the new 'D' classification, though she urged that the addition be regarded as "open-ended, in the sense that subcategories may be distinguished", as she worried that too many different forms of behaviour might be treated as if they were the same thing.^[83] Indeed, the D classification puts together infants who use a somewhat disrupted secure (B) strategy with those who seem hopeless and show little attachment behaviour; it also puts together infants who run to hide when they see their caregiver in the same classification as those who show an avoidant (A) strategy on the first reunion and then an ambivalent-resistant (C) strategy on the second reunion. Perhaps responding to such concerns, George and Solomon have divided among indices of disorganized/disoriented attachment (D) in the Strange Situation, treating some of the behaviours as a 'strategy of desperation' and others as evidence that the attachment system has been flooded (e.g. by fear, or anger).^[84]

Crittenden also argues that some behaviour classified as Disorganized/disoriented can be regarded as more 'emergency' versions of the avoidant and/or ambivalent/resistant strategies, and function to maintain the protective availability of the caregiver to some degree. Sroufe et al. have agreed that "even disorganized attachment behaviour (simultaneous approach-avoidance; freezing, etc.) enables a degree of proximity in the face of a frightening or unfathomable parent".^[85] However, "the presumption that many indices of 'disorganization' are aspects of organized patterns does not preclude acceptance of the notion of disorganization, especially in cases where the complexity and dangerousness of the threat are beyond children's capacity for response."^[86] For example, "Children placed in care, especially more than once, often have intrusions. In videos of the Strange Situation Procedure, they tend to occur when a rejected/neglected child approaches the stranger in an intrusion of desire for comfort, then loses muscular control and falls to the floor, overwhelmed by the intruding fear of the unknown, potentially dangerous, strange person."^[87]

Main and Hesse^[88] found most of the mothers of these children had suffered major losses or other trauma shortly before or after the birth of the infant and had reacted by becoming severely depressed.^[89] In fact, fifty-six per cent of mothers who had lost a parent by death before they completed high school had children with disorganized attachments.^[88] Subsequent studies, while emphasising the potential importance of unresolved loss, have qualified these findings.^[90] For example, Solomon and George found unresolved loss in the mother tended to be associated with disorganized attachment in their infant primarily when they had also experienced an unresolved trauma in their life prior to the loss.^[91]

Categorization differences across cultures

Across different cultures deviations from the Strange Situation Protocol have been observed. A Japanese study in 1986 (Takahashi) studied 60 Japanese mother-infant pairs and compared them with Ainsworth's distributional pattern. Although the ranges for securely attached and insecurely attached had no significant differences in proportions, the Japanese insecure group consisted of only resistant children, with no children categorized as avoidant. This may be because the Japanese child rearing philosophy stressed close mother infant bonds more so than in Western cultures. In Northern Germany, Grossmann et al. (Grossmann, Huber, & Wartner, 1981; Grossmann, Spangler, Suess, & Unzner, 1985) replicated the Ainsworth Strange Situation with 46 mother infant pairs and found a different distribution of attachment classifications with a high number of avoidant infants: 52% avoidant, 34% secure, and 13% resistant (Grossmann et al., 1985). Another study in Israel found there was a high frequency of an ambivalent pattern, which according to Grossman et al. (1985) could be attributed to a greater parental push toward children's independence.

Later patterns and the dynamic-maturational model

Techniques have been developed to guide a child to verbalize their state of mind with respect to attachment. One such is the "stem story", in which a child receives the beginning of a story that raises attachment issues and is asked to complete it. This is modified for older children, adolescents and adults, where semi-structured interviews are used instead, and the way content is delivered may be as significant as the content itself.^[11] However, there are no substantially validated measures of attachment for middle childhood or early adolescence (from 7 to 13 years of age).^[92]

Some studies of older children have identified further attachment classifications. Main and Cassidy observed that disorganized behaviour in infancy can develop into a child using caregiver-controlling or punitive behaviour to manage a helpless or dangerously unpredictable caregiver. In these cases, the child's behaviour is organized, but the behaviour is treated by researchers as a form of disorganization, since the hierarchy in the family no longer follows parenting authority in that scenario.^[93]

American psychologist Patricia McKinsey Crittenden has elaborated classifications of further forms of avoidant and ambivalent attachment behaviour, as seen in her dynamic-maturational model of attachment and adaptation (DMM). These include the caregiving and punitive behaviours also identified by Main and Cassidy (termed A3 and C3, respectively), but also other patterns such as compulsive compliance with the wishes of a threatening parent (A4).^[94]

Crittenden's ideas developed from Bowlby's proposal: "Given certain adverse circumstances during childhood, the selective exclusion of information of certain sorts may be adaptive. Yet, when during adolescence and adulthood the situation changes, the persistent exclusion of the same forms of information may become maladaptive".^[95]

Crittenden theorizes the human experience of danger comprise two basic components:^[96]

1. Emotions provoked by the potential for danger, which Crittenden refers to as "affective information." In childhood, the unexplained absence of an attachment figure would cause these emotions. A strategy an infant faced with insensitive or rejecting parenting may use to maintain availability of the attachment figure is to repress emotional information that could result in rejection by said attachment figure.^[97]
2. Causal or other sequentially ordered knowledge about the potential for safety or danger, which would include awareness of behaviours that indicate whether an attachment figure is available as a secure haven. If the infant represses knowledge that the caregiver is not a reliable source of protection and safety, they may use clingy and/or aggressive behaviour to demand attention and potentially increase the availability of an attachment figure who otherwise displays inconsistent or misleading responses to the infant's attachment behaviours.^[98]

Crittenden proposes both kinds of information can be split off from consciousness or behavioural expression as a 'strategy' to maintain the availability of an attachment figure (see disorganized/disoriented attachment for type distinctions). Type A strategies split off emotional information about feeling threatened, and Type C strategies split off temporally-sequenced knowledge about how and why the attachment figure is available.^[99] In contrast, Type B strategies use both kinds of information without much distortion.^[100] For example, a toddler may have come to depend upon a Type C strategy of tantrums to maintain an unreliable attachment figure's availability, which may cause the attachment figure to respond appropriately to the child's attachment behaviours. As a result of learning the attachment figure is becoming more reliable, the toddler's reliance on coercive behaviours is reduced, and a more secure attachment may develop.^[101]

Significance of patterns

Research based on data from longitudinal studies, such as the National Institute of Child Health and Human Development Study of Early Child Care and the Minnesota Study of Risk and Adaption from Birth to Adulthood, and from cross-sectional studies, consistently shows associations between early attachment classifications and peer relationships as to both quantity and quality. Lyons-Ruth, for example, found that "for each additional withdrawing behavior displayed by mothers in relation to their infant's attachment cues in the Strange Situation Procedure, the likelihood of clinical referral by service providers was increased by 50%."^[102]

There is an extensive body of research demonstrating a significant association between attachment organizations and children's functioning across multiple domains.^[103] Early insecure attachment does not necessarily predict difficulties, but it is a liability for the child, particularly if similar parental behaviours continue throughout childhood.^[104] Compared to that of securely attached children, the adjustment of insecure children in many spheres of life is not as soundly based, putting their future relationships in jeopardy. Although the link is not fully established by research and there are other influences besides attachment, secure infants are more likely to become socially competent than their insecure peers. Relationships formed with peers influence the acquisition of social skills, intellectual development and the formation of social identity. Classification of children's peer status (popular, neglected or rejected) has been found to predict subsequent adjustment.^[11] Insecure children, particularly avoidant children, are especially vulnerable to family risk. Their social and behavioural problems increase or decline with deterioration or improvement in parenting. However, an early secure attachment appears to have a lasting protective function.^[105] As with attachment to parental figures, subsequent experiences may alter the course of development.^[11]

Studies have suggested that infants with a high-risk for autism spectrum disorder (ASD) may express attachment security differently from infants with a low-risk for ASD.^[106] Behavioural problems and social competence in insecure children increase or decline with deterioration or improvement in quality of parenting and the degree of risk in the family environment.^[105]

Some authors have questioned the idea that a taxonomy of categories representing a qualitative difference in attachment relationships can be developed. Examination of data from 1,139 15-month-olds showed that variation in attachment patterns was continuous rather than grouped.^[107] This criticism introduces important questions for attachment typologies and the mechanisms behind apparent types. However, it has relatively little relevance for attachment theory itself, which "neither requires nor predicts discrete patterns of attachment."^[108]

There is some evidence that gender differences in attachment patterns of adaptive significance begin to emerge in middle childhood. There has been a common tendency observed by researchers that males demonstrate a greater tendency to engage in criminal behaviour which is suspected to be related to males being more likely to experience inadequate early attachments to primary caregivers.^[109] Insecure attachment and early psychosocial stress indicate the presence of environmental risk (for example poverty, mental illness, instability, minority status, violence). Environmental risk can cause insecure attachment, while also favouring the development of strategies for earlier reproduction. Different reproductive strategies have different adaptive values for males and females: Insecure males tend to adopt avoidant strategies, whereas insecure females tend to adopt anxious/ambivalent strategies, unless they are in a very high risk environment. Adrenarche is proposed as the endocrine mechanism underlying the reorganization of insecure attachment in middle childhood.^[110]

Changes in attachment during childhood and adolescence

Childhood and adolescence allows the development of an internal working model useful for forming attachments. This internal working model is related to the individual's state of mind which develops with respect to attachment generally and explores how attachment functions in relationship dynamics based on childhood and adolescent experience. The organization of an internal working model is generally seen as leading to more stable attachments in those who develop such a model, rather than those who rely more on the individual's state of mind alone in forming new attachments.^[111]

Age, cognitive growth, and continued social experience advance the development and complexity of the internal working model. Attachment-related behaviours lose some characteristics typical of the infant-toddler period and take on age-related tendencies. The preschool period involves the use of negotiation and bargaining.^[112] For example, four-year-olds are not distressed by separation if they and their caregiver have already negotiated a shared plan for the separation and reunion.^[113]

Ideally, these social skills become incorporated into the internal working model to be used with other children and later with adult peers. As children move into the school years at about six years old, most develop a goal-corrected partnership with parents, in which each partner is willing to compromise in order to maintain a gratifying relationship.^[112] By middle childhood, the goal of the attachment behavioural system has changed from proximity to the attachment figure to availability. Generally, a child is content with longer separations, provided contact—or the possibility of physically reuniting, if needed—is available. Attachment behaviours such as clinging and following decline and self-reliance increases. By middle childhood (ages 7–11), there may be a shift toward mutual coregulation of secure-base contact in which caregiver and child negotiate methods of maintaining communication and supervision as the child moves toward a greater degree of independence.^[112]

The attachment system used by adolescents is seen as a "safety regulating system" whose main function is to promote physical and psychological safety. There are two different events that can trigger the attachment system. Those triggers include, the presence of a potential danger or stress, internal and external, and a threat of accessibility and/or availability of an attachment figure. The ultimate goal of the attachment system is security, so during a time of danger or inaccessibility the behavioural system accepts felt security in the context of the availability of protection. By adolescence we are able to find security through a variety of things, such as food, exercise, and social media.^[114] Felt security can be achieved through a number of ways, and often without the physical presence of the attachment figure. Higher levels of maturity allows adolescent teens to more capably interact with their environment on their own because the environment is perceived as less threatening. Adolescents teens will also see an increase in cognitive, emotional and behavioural maturity that dictates whether or not teens are less likely to experience conditions that activate their need for an attachment figure. For example, when teenagers get sick and stay home from school, surely they want their parents to be home so they can take care of them, but they are also able to stay home by themselves without experiencing serious amounts of distress.^[115] Additionally, the social environment that a school fosters impacts adolescents attachment behaviour, even if these same adolescents have not had issues with attachment behaviour previously. High schools that have a permissive environment compared to an authoritative environment promote positive attachment behaviour. For example, when students feel connected to their teachers and peers because of their permissive schooling environment, they are less likely to skip school. Positive-attachment behaviour in high schools have important implications on how a school's environment should be structured.^[116]

Here are the attachment style differences during adolescence:^[117]

• Secure adolescents are expected to hold their mothers at a higher rate than all other support figures, including father, significant others, and best friends.
• Insecure adolescents identify more strongly with their peers than their parents as their primary attachment figures. Their friends are seen as a significantly strong source of attachment support.
• Dismissing adolescents rate their parents as a less significant source of attachment support and would consider themselves as their primary attachment figure.
• Preoccupied adolescents would rate their parents as their primary source of attachment support and would consider themselves as a much less significant source of attachment support.^[117]

Attachment styles in adults

Main article: Attachment in adults

See also: Attachment measures

Attachment theory was extended to adult romantic relationships in the late 1980s by Cindy Hazan and Phillip Shaver.^[118] Four styles of attachment have been identified in adults: secure, anxious-preoccupied, dismissive-avoidant and fearful-avoidant. These roughly correspond to infant classifications: secure, insecure-ambivalent, insecure-avoidant and disorganized/disoriented.^[119]

Securely attached

Securely attached adults have been "linked to a high need for achievement and a low fear of failure (Elliot & Reis, 2003)". They will positively approach a task with the goal of mastering it and have an appetite for exploration in achievement settings (Elliot & Reis, 2003). Research shows that securely attached adults have a "low level of personal distress and high levels of concern for others".^[120] Due to their high rates of self-efficacy, securely attached adults typically do not hesitate to remove a person having a negative impact from problematic situations they are facing.^[120] This calm response is representative of the securely attached adult's emotionally regulated response to threats that many studies have supported in the face of diverse situations. Adult secure attachment comes from an individual's early connection with their caregiver(s), genes and their romantic experiences.^[121]

Within romantic relationships, a securely attached adult will appear in the following ways: excellent conflict resolution, mentally flexible, effective communicators, avoidance of manipulation, comfortable with closeness without fearfulness of being enmeshed, quickly forgiving, viewing sex and emotional intimacy as one, believing they can positively impact their relationship, and caring for their partner in the way they want to be cared for. In summation, they are great partners who treat their partners very well, as they are not afraid to give positively and ask for their needs to be met. Securely attached adults believe that there are "many potential partners that would be responsive to their needs", and if they come across an individual who is not meeting their needs, they will typically lose interest quickly.^[121]

Anxious-preoccupied

Anxious preoccupied adults seek high levels of intimacy, approval and responsiveness from partners, becoming overly dependent. They tend to be less trusting, have less positive views about themselves than their partners, and may exhibit high levels of emotional expressiveness, worry and impulsiveness in their relationships. The anxiety that adults feel prevents the establishment of satisfactory defence exclusion. Thus, it is possible that individuals that have been anxiously attached to their attachment figure or figures have not been able to develop sufficient defences against separation anxiety. Because of their lack of preparation these individuals will then overreact to the anticipation of separation or the actual separation from their attachment figure. The anxiety comes from an individual's intense and/or unstable relationship that leaves the anxious or preoccupied individual relatively defenceless.^[122]

In terms of adult relationships, if an adult experiences this inconsistent behaviour from their romantic partner or acquaintance, they might develop some of the aspects of this attachment type. Besides, insecurity and distress about relationships can be driven by individuals who exhibit inconsistent connection or emotionally abusive behaviours.^[123] However, a secure relationship can also reduce anxious behaviour and be a resource for safety and support.^[124]

Dismissive-avoidant

Dismissive-avoidant adults desire a high level of independence, often appearing to avoid attachment altogether.^[125] They view themselves as self-sufficient, invulnerable to attachment feelings and not needing close relationships.^[126] They tend to suppress their feelings, dealing with conflict by distancing themselves from partners of whom they often have a poor opinion.^[127] Adults lack the interest of forming close relationships and maintaining emotional closeness with the people around them. They have a great amount of distrust in others, but at the same time possess a positive model of self; they would prefer to invest in their own ego skills. They try to create high levels of self-esteem by investing disproportionately in their abilities or accomplishments. These adults maintain their positive views of self, based on their personal achievements and competence rather than searching for and feeling acceptance from others. These adults will explicitly reject or minimize the importance of emotional attachment and passively avoid relationships when they feel as though they are becoming too close. They strive for self-reliance and independence. When it comes to the opinions of others about themselves, they are very indifferent and are relatively hesitant to internalize positive feedback from their peers. Dismissive avoidance is considered to be the result of defensive deactivation and disconnection to avoid potential rejection, and is in some cases amplified by a genuine disinterest in social connection.^[128]

Adults with dismissive-avoidant patterns are less likely to seek social support than other attachment styles.^[129] They are likely to fear intimacy and lack confidence in others.^[130][131] Because of their distrust they cannot be convinced that other people have the ability to deliver emotional support.^[128] Under a high cognitive load, however, dismissive-avoidant adults appear to have a lowered ability to suppress difficult attachment-related emotions, as well difficulty maintaining positive self-representations.^[132] This suggests that hidden vulnerabilities may underlie an active denial process.^[132][133]

Fearful-avoidant

Fearful-avoidant adults have mixed feelings about close relationships, both desiring and feeling uncomfortable with emotional closeness. The dangerous part about the contrast between wanting to form social relationships while simultaneously fearing the relationship is that it creates mental instability. This mental instability then translates into mistrusting the relationships they do form and also viewing themselves as unworthy. Furthermore, fearful-avoidant adults also have a less pleasant outlook on life compared to anxious-preoccupied and dismissive avoidant groups.^[134] Like dismissive-avoidant adults, fearful-avoidant adults tend to seek less intimacy, suppressing their feelings.^{[8][135][136][137]}

According to research studies, an individual with a fearful avoidant attachment might have had childhood trauma or persistently negative perceptions and actions from their family members. Apart from these, genetic factors and personality may also have an impact on how an individual behaves with parents as well as how they understand their relationships in their adulthood.^[138]

Assessing and measuring attachment

Two main aspects of adult attachment have been studied. The organization and stability of the mental working models that underlie the attachment styles is explored by social psychologists interested in romantic attachment.^[139][140] Developmental psychologists interested in the individual's state of mind with respect to attachment generally explore how attachment functions in relationship dynamics and impacts relationship outcomes. The organization of mental working models is more stable while the individual's state of mind with respect to attachment fluctuates more. Some authors have suggested that adults do not hold a single set of working models. Instead, on one level they have a set of rules and assumptions about attachment relationships in general. On another level they hold information about specific relationships or relationship events. Information at different levels need not be consistent. Individuals can therefore hold different internal working models for different relationships.^[140][141]

There are a number of different measures of adult attachment, the most common being self-report questionnaires and coded interviews based on the Adult Attachment Interview. The various measures were developed primarily as research tools, for different purposes and addressing different domains, for example romantic relationships, platonic relationships, parental relationships or peer relationships. Some classify an adult's state of mind with respect to attachment and attachment patterns by reference to childhood experiences, while others assess relationship behaviours and security regarding parents and peers.^[142]

Associations of adult attachment with other traits

Adult attachment styles are related to individual differences in the ways in which adults experience and manage their emotions. Recent meta-analyses link insecure attachment styles to lower emotional intelligence^[143] and lower trait mindfulness.^[144]

History

Main article: History of attachment theory

Formulation of the theory

Following the publication of Maternal Care and Mental Health,^[145] Bowlby sought new understanding from the fields of evolutionary biology, ethology, developmental psychology, cognitive science and the theory of control systems. He formulated the innovative proposition that mechanisms underlying an infant's emotional tie to the caregiver(s) were not learnt, but emerged as a result of evolutionary pressure. He set out to develop a theory of motivation and behaviour-control built on observational science rather than Freudian interpretation. Bowlby argued that with attachment theory he had made good the "deficiencies of the data and the lack of theory to link alleged cause and effect" of Maternal Care and Mental Health.

Psychoanalysis

Bowlby was trained as a psychoanalyst under the supervision of Melanie Klein in the school of object relations theory. Unlike Freudian theory, which holds that infants are born into a state of primary narcissism that makes social relations with other people impossible, object relations theory proposes that babies have emotional relations with their mother from the start of life, albeit dominated by phantasy. Thus Bowlby was educated to believe that the infant-mother relationship is of supreme importance to human beings from the dawn of life, a belief that attachment theory celebrates.

Ethology

One of the main lessons Bowlby drew from ethology was the importance of the direct observation of animals in their 'home' environments to scientific theory-building. Thus he constantly stressed the advantages of basing his theory of infancy on verifiable observations of babies' action patterns, rather than psychoanalytic reconstruction of their fantasy lives. After Bowlby's attention was drawn to ethology in the early 1950s by reading Konrad Lorenz's work,^[146] he imported several ethological concepts into attachment theory including imprinting, critical periods, fixed action patterns, instincts and later, behavioural systems. He also took from ethology the importance of recognizing the evolutionary origins of human social behaviour, particularly in infants.

Internal working model

Bowlby discovered the internal working model construct in the writings of an eminent scientist interested in the neural basis of animal memory, John Zachary Young, while rethinking what he considered to be scientifically outdated explanations of the psychoanalytic “internal world.”^[147] Young himself was influenced by the work of the philosopher Kenneth Craik.

Cybernetics

The theory of control systems (cybernetics), developing during the 1930s and 1940s, influenced Bowlby's thinking.^[148] The young child's need for proximity to the attachment figure was seen as balancing homeostatically with the need for exploration. (Bowlby compared this process to physiological homeostasis whereby, for example, blood pressure is kept within limits). The actual distance maintained by the child would vary as the balance of needs changed. For example, the approach of a stranger, or an injury, would cause the child exploring at a distance to seek proximity. The child's goal is not an object (the caregiver) but a state; maintenance of the desired distance from the caregiver depending on circumstances.^[1]

Cognitive development

Bowlby's reliance on Piaget's theory of cognitive development gave rise to questions about object permanence (the ability to remember an object that is temporarily absent) in early attachment behaviours. An infant's ability to discriminate strangers and react to the mother's absence seemed to occur months earlier than Piaget suggested would be cognitively possible.^[149] More recently, it has been noted that the understanding of mental representation has advanced so much since Bowlby's day that present views can be more specific than those of Bowlby's time.^[150]

Neurobiology of attachment

In addition to longitudinal studies, there has been psychophysiological research on the neurobiology of attachment.^[151] Research has begun to include neural development,^[152] behaviour genetics and temperament concepts.^[153] Generally, temperament and attachment constitute separate developmental domains, but aspects of both contribute to a range of interpersonal and intrapersonal developmental outcomes.^[153] Some types of temperament may make some individuals susceptible to the stress of unpredictable or hostile relationships with caregivers in the early years.^[154] In the absence of available and responsive caregivers it appears that some children are particularly vulnerable to developing attachment disorders.^[155]

The quality of caregiving received at infancy and childhood directly affects an individual's neurological systems which controls stress regulation.^[151] In psychophysiological research on attachment, the two main areas studied have been autonomic responses, such as heart rate or respiration, and the activity of the hypothalamic–pituitary–adrenal axis, a system that is responsible for the body's reaction to stress.^[156] Infants' physiological responses have been measured during the Strange Situation procedure looking at individual differences in infant temperament and the extent to which attachment acts as a moderator. Recent studies convey that early attachment relationships become molecularly instilled into the being, thus affecting later immune system functioning.^[157] Empirical evidence communicates that early negative experiences produce pro inflammatory phenotype cells in the immune system, which is directly related to cardiovascular disease, autoimmune diseases, and certain types of cancer.^[158]

Recent^[when?] improvements involving methods of research have enabled researchers to further investigate the neural correlates of attachment in humans. These advances include identifying key brain structures, neural circuits, neurotransmitter systems, and neuropeptides, and how they are involved in attachment system functioning and can indicate more about a certain individual, even predict their behaviour.^[159] There is initial evidence that caregiving and attachment involve both unique and overlapping brain regions.^[160] Another issue is the role of inherited genetic factors in shaping attachments: for example one type of polymorphism of the gene coding for the D₂ dopamine receptor has been linked to anxious attachment and another in the gene for the 5-HT_2A serotonin receptor with avoidant attachment.^[161]

Studies show that attachment in adulthood is simultaneously related to biomarkers of immunity. For example, individuals with an avoidance attachment style produce higher levels of the pro inflammatory cytokine interleukin-6 (IL-6) when reacting to an interpersonal stressor,^[162] while individuals representing an anxious attachment style tend to have elevated cortisol production and lower numbers of T cells.^[163] Although children vary genetically and each individual requires different attachment relationships, there is consistent evidence that maternal warmth during infancy and childhood creates a safe haven for individuals resulting in superior immune system functioning.^[164] One theoretical basis for this is that it makes biological sense for children to vary in their susceptibility to rearing influence.^[165]

Crime

Attachment theory has often been applied in the discipline of criminology.^[166] It has been used in an attempt to identify causal mechanisms in criminal behaviour – with uses ranging from offender profiling, better understanding types of offence and the pursuit of preventative policy. It has been found that disturbances early on in child-caregiver relationships are a risk factor in criminality. Attachment theory in this context has been described as "perhaps the most influential of contemporary psychoanalytically oriented theories of crime".^[167]

Age distribution of crime

Two theories about why the crime peaks around the late teenage years and early twenties are called the developmental theory and life-course theory, and both involve attachment theory. Developmental perspectives argue that individuals who have disrupted childhood attachments will have criminal careers that continue long into adulthood.^[168] Life course perspectives argue that relationships at every stage of the life course can influence an individual's likelihood of committing crimes.^[169]

Types of offences

Disrupted attachment patterns from childhood have been identified as a risk factor for domestic violence.^[170] These disruptions in childhood can prevent the formation of a secure attachment relationship, and in turn adversely affecting a healthy way to deal with stress.^[171] In adulthood, lack of coping mechanisms can result in violent behaviour.^[172] Bowlby's theory of functional anger states that children signal to their caregiver that their attachment needs are not being met by use of angry behaviour. This perception of low support from partner has been identified as a strong predictor of male violence. Other predictors have been named as perceived deficiency in maternal love in childhood, low self-esteem.^[171] It has also been found that individuals with a dismissive attachment style, often seen in an antisocial/narcissistic-narcissistic subtype of offender, tend to be emotionally abusive as well as violent. Individuals in the borderline/emotionally dependent subtype have traits which originate from insecure attachment in childhood, and tend to have high levels of anger.^[170]

It has been found that sexual offenders have significantly less secure maternal and paternal attachments compared with non-offenders which suggests that insecure attachments in infancy persist into adulthood.^[173] In a recent study, 57% of sexual offenders were found to be of a preoccupied attachment style.^[174] There is also evidence that suggests subtypes of sexual crime can have different attachment styles. Dismissive individuals tend to be hostile towards others, and are more likely to offend violently against adult women. By contrast, child abusers are more likely to have preoccupied attachment styles as the tendency to seek approval from others becomes distorted and attachment relationships become sexualized.^[175]

Uses within probation practice

Attachment theory has been of special interest within probation settings. When put into practice, probation officers aim to learn their probationer's attachment history because it can give them insight into how the probationer will respond to different scenarios and when they are the most vulnerable to reoffend. One of the primary strategies of implementation is to set up the probation officer as a secure base. This secure base relationship is formed by the probation officer being reliable, safe, and in tune with the probationer, and is intended to help give them a partly representational secure relationship that they have not been able to form.^[176]

Practical applications

As a theory of socioemotional development, attachment theory has implications and practical applications in social policy, decisions about the care and welfare of children and mental health. Attachment theory research also highlights that insecure attachment styles are linked to difficulties in emotional regulation and the development of maladaptive coping strategies, which can have long-term implications for mental health treatment planning.^[177]

Child care policies

Social policies concerning the care of children were the driving force in Bowlby's development of attachment theory. The difficulty lies in applying attachment concepts to policy and practice.^[178] In 2008 C.H. Zeanah and colleagues stated, "Supporting early child-parent relationships is an increasingly prominent goal of mental health practitioners, community-based service providers and policy makers ... Attachment theory and research have generated important findings concerning early child development and spurred the creation of programs to support early child-parent relationships."^[179] Additionally, practitioners can use the concepts of attachment theory that suggests deep relationships which builds attachment security towards mental health interventions. Attachment security has been found to strengthen one's ability to cope with stress, anxiety, and maintain that, in turn, can contribute to the person's well-being and mental health^[180] For example, previous studies have demonstrated that individuals who demonstrate avoidance attachment styles experiences less stress and distress when presented with ostracism.^[181] However, finding quality childcare while at work or school is an issue for many families. NIHD recent study convey that top notch day care contributes to secure attachment relationships in children.^[182]

People have commented on this matter stating that "legislative initiatives reflecting higher standards for credentialing and licensing childcare workers, requiring education in child development and attachment theory, and at least a two-year associate degree course as well as salary increases and increased stature for childcare positions".^[183] Corporations should implement more flexible work arrangements that recognize child care as essential for all its employees. This includes re-examination of parental leave policies. Too many parents are forced to return to work too soon post childbirth because of company policy or financial necessity. No matter the reason, this inhibits early parent child bonding.^[157] In addition to this, there should be increased attention to the training and screening of childcare workers. In his article reviewing attachment theory, Sweeney suggested, among several policy implications, "legislative initiatives reflecting higher standards for credentialing and licensing childcare workers, requiring education in child development and attachment theory, and at least a two-year associate degree course as well as salary increases and increased stature for childcare positions".^[183]

Historically, attachment theory had significant policy implications for hospitalized or institutionalized children, and those in poor quality daycare.^[184] Controversy remains over whether non-maternal care, particularly in group settings, has deleterious effects on social development. It is plain from research that poor quality care carries risks but that those who experience good quality alternative care cope well although it is difficult to provide good quality, individualized care in group settings.^[178]

Attachment theory has implications in residence and contact disputes,^[184] and applications by foster parents to adopt foster children. In the past, particularly in North America, the main theoretical framework was psychoanalysis. Increasingly attachment theory has replaced it, thus focusing on the quality and continuity of caregiver relationships rather than economic well-being or automatic precedence of any one party, such as the biological mother. Rutter noted that in the UK, since 1980, family courts have shifted considerably to recognize the complications of attachment relationships.^[185] Children tend to have attachment relationships with both parents and often grandparents or other relatives. Judgements need to take this into account along with the impact of step-families. Attachment theory has been crucial in highlighting the importance of social relationships in dynamic rather than fixed terms.^[178]

Attachment theory can also inform decisions made in social work, especially in humanistic social work (Petru Stefaroi),^[186][187] and court processes about foster care or other placements. Considering the child's attachment needs can help determine the level of risk posed by placement options.^[188][189] Within adoption, the shift from "closed" to "open" adoptions and the importance of the search for biological parents would be expected on the basis of attachment theory. Many researchers in the field were strongly influenced by it.^[178]

Clinical practice in children

Although attachment theory has become a major scientific theory of socioemotional development with one of the widest research lines in modern psychology, it has, until recently, been less used in clinical practice.^[190] The attachment theory focused on the attention of the child when the mother is there and the responses that the child shows when the mother leaves, which indicated the attachment and bonding of the mother and the child. The attention therapy is done while the child is being restrained by the therapists and the responses displayed were noted. The tests were done to show the responses of the child.^{[citation needed]}

This may be partly due to lack of attention paid to clinical application by Bowlby himself and partly due to broader meanings of the word 'attachment' used among practitioners. It may also be partly due to the mistaken association of attachment theory with the pseudoscientific interventions misleadingly known as attachment therapy or holding therapy.^[191]

Prevention and treatment

Main article: Attachment-based therapy

In 1988, Bowlby published a series of lectures indicating how attachment theory and research could be used in understanding and treating child and family disorders. His focus for bringing about change was the parents' internal working models, parenting behaviours and the parents' relationship with the therapeutic intervenor.^[192] Ongoing research has led to a number of individual treatments and prevention and intervention programs.^[192] In regards to personal development, children from all the age groups were tested to show the effectiveness of the theory that is being theorized by Bowlby. They range from individual therapy to public health programs to interventions designed for foster caregivers. For infants and younger children, the focus is on increasing the responsiveness and sensitivity of the caregiver, or if that is not possible, placing the child with a different caregiver.^[193][194] An assessment of the attachment status or caregiving responses of the caregiver is invariably included, as attachment is a two-way process involving attachment behaviour and caregiver response. Some programs are aimed at foster cares because the attachment behaviours of infants or children with attachment difficulties often do not elicit appropriate caregiver responses. Modern prevention and intervention programs have proven successful.^[195]

Reactive attachment disorder and attachment disorder

Main articles: Reactive attachment disorder and Attachment disorder

One atypical attachment pattern is considered to be an actual disorder, known as reactive attachment disorder or RAD, which is a recognized psychiatric diagnosis (ICD-10 F94.1/2 and DSM-IV-TR 313.89). Against common misconception, this is not the same as 'disorganized attachment'. The essential feature of reactive attachment disorder is markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before age five years, associated with gross pathological care. There are two subtypes, one reflecting a disinhibited attachment pattern, the other an inhibited pattern. RAD is not a description of insecure attachment styles, however problematic those styles may be; instead, it denotes a lack of age-appropriate attachment behaviours that may appear to resemble a clinical disorder.^[196] Although the term "reactive attachment disorder" is now popularly applied to perceived behavioural difficulties that fall outside the DSM or ICD criteria, particularly on the Web and in connection with the pseudo-scientific attachment therapy, "true" RAD is thought to be rare.^[197]

"Attachment disorder" is an ambiguous term, which may refer to reactive attachment disorder or to the more problematic insecure attachment styles (although none of these are clinical disorders). It may also be used to refer to proposed new classification systems put forward by theorists in the field,^[198] and is used within attachment therapy as a form of unvalidated diagnosis.^[197] One of the proposed new classifications, "secure base distortion" has been found to be associated with caregiver traumatization.^[199]

Clinical practice in adults and families

As attachment theory offers a broad, far-reaching view of human functioning, it can enrich a therapist's understanding of patients and the therapeutic relationship rather than dictate a particular form of treatment.^[200] Some forms of psychoanalysis-based therapy for adults—within relational psychoanalysis and other approaches—also incorporate attachment theory and patterns.^[200][201]

Criticism

In his 1984 book The Nature of the Child, Jerome Kagan challenged central assumptions of attachment theory, particularly the notion that the quality of early attachments to caregivers is a primary determinant of a child's future well-being. Through a series of essays, Kagan argued that the emphasis on early attachment experiences is often overstated and insufficiently supported by empirical evidence. He proposed that a child's temperament and later development are more strongly influenced by biological factors and cognitive maturation than by early relational experiences alone.^[202]

A 2010 study in the Journal of Personality looked at twins in Italy using the ACE Model and found that their shared environment (including shared aspects of their upbringing) was "completely irrelevant" in explaining their adult attachment styles.^[14] Instead, levels of attachment-related anxiety and avoidance in the adult twins were completely explained by their genes and their unshared environment (aspects of the environment that were different for the twins).^[14]

A 2013 study from Utah State suggests an individual can have different attachment styles in relation to different people and that "parents' time away from their child was not a significant predictor of attachment."^[15] Attachment theory models are heavily focused on attachment to the mother, not other family members and peers, also noted by Rosjke Hasseldine.^[203] Salvador Minuchin suggested that attachment theory's focus on the mother-child relation ignores the value in other familial influences: "The entire family—not just the mother or primary caretaker—including father, siblings, grandparents, often cousins, aunts and uncles, are extremely significant in the experience of the child...And yet, when I hear attachment theorists talk, I don't hear anything about these other important figures in a child's life."^[204]

A 2016 article from the Psychological Bulletin suggests that one's attachment could largely be due to heredity; hence, the authors point to the need to focus research on nonshared environmental effects, requiring "behavioral genetic designs that afford differentiating heritability from shared and nonshared environmental influences".^[16]

A 2018 paper critiques attachment theory's claim to universality, highlighting its basis in Western middle class values and its neglect of diverse cultural caregiving practices. It argues that applying Western parenting norms in non-Western contexts without understanding local cultures is scientifically flawed and ethically questionable.^[17]

See also

• Psychology portal
• Zoology portal

• Atlas personality – Personality trait found in those who took on adult responsibilities early
• Attachment parenting – Parenting philosophy
• Attachment theory and psychology of religion
• Fathers as attachment figures
• Human bonding – Process of development of a close, interpersonal relationship
• Nurture kinship – Acts of nurture between individuals
• Parental love – Feeling of attachment towards progeny
• Passionate and companionate love – Two fundamental ways to experience romantic feelings for another person
• Relationship science – Field dedicated to the scientific study of interpersonal relationship processes