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Tijdschrift voor Psychiatrie 43 (2001) 5, 333 - 342

Review article

Attachment and psychopathology: an overview

N. Nicolaï

background In John Bowlby's work a relation was proposed between early attachment experiences and psychopathology in adulthood. Attachment experiences in childhood become internalised as mental representations or internal working models. These can be evaluated with the Adult Attachment Interview. In recent developmental research a relation has been found between attachment, described as an internal working model of the mind and psychopathology. Attachment status is a state of mind with respect to attachment. It is evolved from attachment behaviour in childhood and is classified according discourse on attachment, not on (retrospective) life history.
aims This review describes the results of a recent research on attachment style and psychopathology.
methods Recent handbooks and overviews on internet on attachment related sites were selected. PsycLit has been consulted to search for references and also special sites on attachment in research centres (Berkeley, London).
results Individuals with psychiatric problems as anxiety disorders, conduct disorders, eating disorders and some personality disorders have nearly all insecure attachment, measured with the Adult Attachment Interview (aai). However, a clear-cut relation between attachment style and psychopathology does not exist. More than insecurity, disorganisation of attachment by loss or trauma seems to be a decisive factor in the enhancement of vulnerability.
conclusions Disorganisation of attachment by loss or trauma is correlated with coercive behaviour in childhood and the development of dissociative disorders. In this article an overview of recent research in the area of psychopathology and attachment is given.

keywords attachment, dissociation, psychopathology, trauma