Though researchers have attended to disorganized attachment in infants and children, they have infrequently focused on the character of disorganized attachment in adults. In this study, we aimed to identify clusters of participants based on attachment levels and styles, seeking to better delineate severity and stylistic differences in disorganized attachment than has been previously articulated. We used a new assessment approach focused on a hierarchy of attachment organization, including secure, insecure (dismissive and preoccupied), rigid-controlling (hostile control and compulsive caregiving) and disorganized (contradictory, impoverished and unresolved) levels of attachment. Clinical evaluators used information from diagnostic and attachment-based interviews to rate participants on each of these aspects of attachment. Latent class analysis revealed a 4-class solution, including a secure (n = 33), insecure (n = 110) and two disorganized classes. One disorganized class (disorganized-oscillating) was characterized by elevations on contradictory and preoccupied styles (n = 77) and another (disorganized-impoverished) showed elevations on impoverished and dismissive styles (n = 53). The disorganized-oscillating class exhibited elevated PD severity and general symptom severity, BPD, histrionic and antisocial dimensional scores, and the most severe identity disturbance compared to the other classes. The impoverished-dismissive class exhibited the highest avoidant and schizoid PD dimensional scores of the classes, and higher PD severity compared to the insecure and secure classes. These results highlight the possibility of identifying distinct classes of attachment organization, differentiated both by aspects of severity and interpersonal style. They also shed light on the manifestation of attachment disorganization in adults.

The present study investigated links between the observer-rated process of psychotherapy and two key psychotherapy relationship variables (i.e., working alliance and attachment to the therapist) in the context of a brief, attachment-based, home-visiting, mother-infant intervention that aimed to promote later secure infant attachment. Additionally, links between observer ratings of intervener and mother contributions to process were examined. Participants included 85 economically stressed mothers of first-born, 5.5-month-old, temperamentally irritable infants. Therapists included two doctoral-level and four master’s-level home visitors. Observer-rated therapist psychotherapy process variables (i.e., warmth, exploration, and negative attitude) were not linked to maternal ratings of working alliance. Therapist warmth, however, was positively associated with maternal ratings of security of attachment to the therapist, and therapist negative attitude was positively related to maternal ratings of preoccupied-merger attachment to the therapist. As expected, both therapist warmth and exploration were positively associated with both maternal participation and exploration. Therapist negative attitude was inversely related to maternal exploration, but not to maternal participation. Results support the idea that attention to the psychotherapy process and relationship may be important in the context of a brief, home-visiting parenting intervention with a non-clinical sample.

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