A systematic review of measures of adult disorganized attachment

Background: Disorganized attachment has been identified as an important factor in the development and maintenance of mental health problems. Further research is required to understand the mechanism by which this attachment pattern predisposes individuals to develop, and maintain, personal and social difficulties and mental health problems utilizing valid and reliable measurement tools. The assessment of adult disorganized attachment is therefore important for both applied psychologists and researchers.

Method: We conducted a systematic review using the COSMIN guidelines to identify and critically appraise instruments which measure adult disorganized attachment. A systematic database search was performed using MEDLINE, EMBASE, Web of Science, PsychInfo and CINHAL in accordance with PRISMA guidelines.

Results: Database searching provided 5757 results, with 18 measures identified across 27 eligible papers which were critically evaluated. Measurement properties were promising for the Childhood Disorganization and Role Reversal Scale, Psychological Treatment Inventory-Attachment Styles Scale, Attachment Style Questionnaire - Short Form and the Adult Attachment Interview. However, overall, due to inconsistent quality of methodology and reporting of results, it is challenging to reach sufficient conclusions and suggestions regarding the best instrument to use to measure adult disorganized attachment.

Conclusion: The Childhood Disorganization and Role Reversal Scale, Psychological Treatment Inventory-Attachment Styles Scale. Attachment Style Questionnaire-Short-Form and Adult Attachment Interview are the best available measures of disorganized attachment in adulthood. This review highlights the need for further psychometric testing of existing measures, or development of new instruments, grounded in sound methodology.