Turning Points in the Assessment and Clinical Applications of Individual Differences in Attachment
Authors: Crittenden Patricia , Spieker Susan J. , Farnfield Steve 
Published: February 2021

Attachment may have reached a turning point in which two sometimes incompatible approaches to individual differences in attachment are being compared. The outcome could influence future work in attachment. This article focuses on individual differences because applications of attachment are predicated on the consequences of individual differences for adaptation and well-being. The issue is which model is better suited to future research and clinical applications. Both models augment the original Ainsworth ABC model that everyone agrees is not sufficiently differentiated to cover the range of human behavior. The two models are “ABC+D” (the model that has disorganization (D) as its fourth category) and “DMM” (the model that expands the A and C categories from two subcategories each to a total of eight each, plus A/C combinations). The current disagreement has two sources: (a) the increasing acceptance outside the United States of the DMM, particularly in clinical and forensic settings, while the US remains largely unaware of the DMM; and (b) the recent announcement by prominent ABC+D researchers from Europe and the US that D is not a suitable category for clinical or forensic use. ABC+D researchers have not proposed an alternative, and some US funding sources and courts eschew attachment altogether, believing the theory itself lacks validity and utility, thus weakening attachment’s potential to inform clinical research and decision-making. This article proposes DMM as a viable alternative to both ABC+D and psychiatric diagnoses and examines the development and contributions of each model for the purpose of creating a model of individual differences in attachment that is scientifically robust, open to change as new evidence becomes available, and applicable to troubled individuals and families. Notably, attachment theory has engendered controversy from its beginnings. When John Bowlby offered attachment as a universal human characteristic that promoted species and individual survival, he was criticized by others in his field. When Mary Ainsworth identified the ABC categories of individual differences in attachment, her ideas were attacked from outside attachment theory. While the “first generation” issue around the existence of attachment has largely died away, a second generation of attachment theorists is disputing the nature of individual differences, their focus on individuals (ABC+D) or interpersonal systems (DMM Family Functional Formulations), and their relevance to clinical work. The ABC+D and DMM models that expand Ainsworth’s work were developed by two of her students, Mary Main (ABC+D) and Patricia Crittenden (DMM). They and their colleagues have worked separately for half a century producing two large and sometimes discrepant bodies of work, which have now become the topic of open debate. This bibliography focuses on the conceptual and empirical bases for that exchange. Part I outlines the roots of the ABC+D and DMM models, together with comparative validating information. Part II presents the central research findings on individual differences in attachment from four decades of research with each model. The authors wish to thank Robbie Duschinsky, Udita Iyengar, and Andrea Landini for their helpful comments on this bibliography.