Monday, May 2, 2016.  This is an excellent beginning read on a topic that is extremely important to me:

Infant-parent attachment: Definition, types, antecedents, measurement and outcome

By Diane Benoit, MD FRCPC – FULL TEXT free

Paediatrics and Child Health. 2004 Oct; 9(8): 541–545.

PMCID: PMC2724160


Attachment theory is one of the most popular and empirically grounded theories relating to parenting. The purpose of the present article is to review some pertinent aspects of attachment theory and findings from attachment research. Attachment is one specific aspect of the relationship between a child and a parent with its purpose being to make a child safe, secure and protected. Attachment is distinguished from other aspects of parenting, such as disciplining, entertaining and teaching. Common misconceptions about what attachment is and what it is not are discussed. The distinction between attachment and bonding is provided. The recognized method to assess infant-parent attachment, the Strange Situation procedure, is described. In addition, a description is provided for the four major types of infant-parent attachment, ie, secure, insecure-avoidant, insecure-resistant and insecure-disorganized. The antecedents and consequences of each of the four types of infant-parent attachment are discussed. A special emphasis is placed on the description of disorganized attachment because of its association with significant emotional and behavioural problems, and poor social and emotional outcomes in high-risk groups and in the majority of children who have disorganized attachment with their primary caregiver. Practical applications of attachment theory and research are presented.”

Keywords: Attachment, Attachment relationships, Infant-parent attachment


A quick scan through the list of references at the end of this important article will show you a very simplified yet fairly clear idea of where my biases stem from.  It is very common among researchers and practionners of all sorts to leave out any mention or consideration of what you WILL see among those references – Disorganized-Disoriented Insecure Attachment.

Is this the worst, most hurtful of the insecure attachments?  No.  But except for the use of Reactive Attachment Disorder (RAD) there is, to my knowledge, only one more inconsistently referred to and problematic type sometimes referred to as “Cannot Classify.”

All of these “lower” insecure attachment categories involve Disorganized-Disoriented patterns which are created around early abuse and neglect in infancy that forces a developing nervous system/brain to form dissociation within it.

An ACEs measurement in no possible way identifies ANY early attachment problems which, when they exist, have created a PRIOR condition long before any other ACE-related problem could come into play.  We ALL have to understand that early attachment FIRST forms the nervous system-brain, immune system, stress response system, etc. that is the BODY of the person whose processes DO experience a person’s life.

There is nothing I see in ACEs measurement that would let us know who is living from birth in an insecure attachment (0 through age 3) built body and who is not because at LEAST their mother-infant attachment was “good enough” birth to age ONE!


See also:  The Adult Attachment Interview (AAI): Mary Main in a Strange Situation


Does current ACEs “mania” further antagonize our cultural split between “body” and “brain” — as if such is possible?  As I see it, if the formative processes of early attachment relationships are not considered in our ACEs thinking we might as well pretend that we have no body at all!  Take a look at this very short video!!

Dr. Daniel Siegel Defines Mind


I am increasingly concerned that not only does the ACE Questionnaire not have the ability to identify the MOST damaging aspects of troubled early life, but the risk of eliminating the most important sources of these problems cannot be identified, either.  That source is specifically the insecure attachment patterns built into MOTHERS who are likely to pass those patterns to her offspring.

In any case, I believe ACE findings will not have true power to inform if the most important section of time within which human critical development occurs (conception to age 4) cannot be targeted for assessment.  At the very least it must be made clear that this missing information greatly reduces the usefulness of ACEs.

Ignoring what we cannot easily measure or SEE (including in our memory) is going to continue to leave us in the dark.

(Also see comments to my last post — +IS THERE ROOM FOR AN ACEs DEBATE? (Long post) – April 29, 2016 – for some highlights of my thinking on this matter.)


I have been searching around online to see what exists for an adult attachment scale.  So far I have settled on this article for the most helpful information about what’s available:

A Reliability Generalization Meta-Analysis of SelfReport Measures of Adult Attachment

By James M. Grahama, Marta S. Unterschutea

Department of Psychology, Western Washington University

Published online: 25 Jun 2014 — Journal of Personality Assessment

This article was downloaded by: [Northwestern University] On: 04 July 2014, At: 08:26 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK



It appears that this might be the most valid and reliable adult attachment measurement tool available:

The Experiences in Close Relationship Scale (ECR)-Short Form: Reliability, Validity, and Factor Structure

The article at this link gives the questions on the scale as they went through revisions from a 36- to a 12- question scale.


As my daughter prepares to consider her doctoral dissertation topic I am naturally presenting to her my concerns about the failure of the ACE process to identify the so-important elements of early attachment as they ALONE can determine much of the well-being of a person’s life without EVER considering the other difficulties that are considered with ACEs.

I believe an important step that needs to happen before ACEs information can be made maximally useful is some research using at minimum a qualified adult attachment scale in combination with the ACEs questionnaire.  My daughter has the ability to figure out such a plan and to implement it should she do this NOW or sometime after her doctoral work is completed.


Part of what also concerns me is that “attachment” seems to be very loosely translated to being “social support.”  (When it comes to today’s world and what is happening to “attachment,” take a look at what these search terms will produce:  social media may serve attachment functions because)

Infants and very young children are most definitely NOT looking for or reliant upon “social support” unless we are willing to make such an absurd mis-connection between the two!  I would also not consider mate relationships parental relationships at any point on the age spectrum as being “social support,” either.  They  are attachment relationships, as are many true friendships and relationships with family members of all ages.

When it comes to this issue, or to the concerns I have about how ludicrous it seems to me to think the ACEs “movement” can account for those so-critical stages of early attachment growth and development by IGNORING them – I think our society is quite simply OFF ITS ROCKER!


Note:  It probably remains true that the Adult Attachment Interview  (AAI) is the ONLY accurate assessment tool.  It is impossible to use this as a general public instrument.  It was designed ONLY for research purposes.  There are ways, probably impractical, through which some combination of research using an adult attachment tool in combination with the ACE questionnaire could be “run through” a research filter accomplished by those trained and credentialed in administration and assessment of the AAI.

Given enough motivation, and enough money, SOMEONE could come up with a combination that would be able to test the validity of an adult attachment-ACEs interaction.  The AAI would have to be the way to do this at some point in an excellent research pipeline.


While assessing adult attachment is not a direct indicator of earliest attachment there is no doubt a strong correlation, and this connection cannot be ignored.


Read comments  at this link –

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Here is our first book out in ebook format.  Click here to view or purchase–

Story Without Words:  How Did Child Abuse Break My Mother?

It lists for $2.99 and can be read by Amazon Prime customers without charge.  A daring book – for daring readers – about a really tough subject.

Story Without Words is a forensic biography/autobiography in which the author, Linda Danielson, explores three generations of her family history to help understand the horrific abuse she was subjected to from birth at her mother’s hands. Her mother Mildred had a psychotic break while delivering Linda, her second of six children and the only one of whom she targeted directly for abuse. The delivery culminated in Mildred being convinced that Linda had been sent by the devil to kill her, and until Linda left home at age 18 for boot camp, she was subjected to unrelenting abuse.

Story Without Words is a creative and compassionate exploration of early factors that may have contributed to Mildred’s abusive trajectory. The author seeks to give words to her experiences as a child abuse survivor; Story Without Words is unique in providing the words of the abuser and the abused in one volume. The author seeks to provide insight for others who were themselves abused, professionals who wish to learn more about the inner world of survivors, and concerned individuals who wish to help stop the storm of child abuse in our society.


Tags: adult attachment disordersadult reactive attachment disorderanxiety disorders,borderline motherborderline personality disorderbrain developmentchild abuse,depression,derealizationdisorganized disoriented insecure attachment disorder,dissociation,dissociative identity disorderempathyinfant abusePosttraumatic Stress Disorder (PTSD),protective factorsPTSDresiliencyresiliency factorsrisk factorsshame



  1. Interesting. I found a more recent upload of the Adult Attachment Interview, dated 2011 and Mary B. Main is the only author. I could not find any difference in the texts, but did not really look carefully at it. So who is the correct author? Neither is published.

  2. Oh Wow! thank you for such an important discussion (and links to references) about the importance of understanding attachment. I always felt an emptiness when I saw the questions asked in the ACE test. They seemed to rank everything as equal and do not even begin to plumb the depth of problems facing early childhood trauma victims. That is why I also think there are other things that play into measuring the effects of early childhood abuse/maltreatment that we haven’t thought of. Even if we have a measure of attachment, we don’t have a measure of all the side effects (if you will) of attachment disorders.

    What about the attitude of siblings during childhood? Not only does the primary caregiver give the brain a baseline against which to compare all future relationships, but so does the family. Finding out that families do not have to be so abusive is extremely devastating, since the family expects you to return to them at some point. If the mother is physically attacking one child, the others will be in terror as well, and will suffer early childhood trauma. It is in their interest to act toward the rejected child in the same way as the mother, just to get approval. And if they should play with the rejected child? They risk being attacked, too. (The word schizophrenia comes to mind).

    Your point about measuring the adult mother’s attachment is so right on. So many think that because any kind of attachment problem is genetic, simply because it travels in families, are so completely unaware of the depth of effect that rejection by the mother (or any parent), early on in life, has on the child. Since Bessel van der Kolk has said that it changes the entire trajectory of the child’s life, it stands to reason that the abused/maltreated child will pass onto his/her child the same problems, and we do not have to call on genes at all to explain it.

    I suspect there is a continuum, as I explained in my comments to your last post, in effects on the child, reflecting the involvement of the mother/primary carer, but from what to what? We have only a twinkling of an idea about where to begin and certainly have not considered hard enough where to end.

    • You are so correct in all statements!! We cannot lose sight of how important the search is to learn MORE and MORE as we also work to END infant and childhood neglect and abuse!

      Trying to get facts out of the realm of mystical science – as it can seem to lay readers – into the realm of practicality is something that the ACE information is starting to do. Truth such as Schore and many others present it is so difficult to read and comprehend — but I STRONGLY suggest people work away at it!!


      We cannot consider these concerns without realizing there is so much we still need to learn about being human, and about our development! As we continue to do this it will become increasingly clear that there is very little margin for error during the earliest months and years of human life.

      • Oh that margin of error is slim! Yet parents seem so oblivious to it as they scramble for daycare solutions. But then again, the government and employers are truly ignorant, too because they set the bar, trying to equalize mothers’ and fathers’ worklives. The “sympathy” is somewhat admirable, even if for only political reasons, but just does not value the family in the same way that other countries apparently do.

        • I believe as a nation we are escalating our decline in all ways connected to what you are describing here.

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