Journal of Consulting and Clinical Psychology Copyright 1996 by the American Psychological Association, Inc.

1996. Vol. 64. No. 2, 244-25 3 0022-006X/96/J3.00

Adolescent Attachment and Psychopathology

Diana S. Rosenstein and Harvey A. Horowitz

Institute of Pennsylvania Hospital

The relationships among attachment classification, psychopathology, and personality traits were ex-
amined in a group of 60 psychiatrically hospitalized adolescents. The concordance of attachment
classification was examined in 27 adolescent-mother pairs. Both adolescent and maternal attach-
ment status were overwhelmingly insecure and were highly concordant. Adolescents showing a dis-
missing attachment organization were more likely to have a conduct or substance abuse disorder,
narcissistic or antisocial personality disorder, and self-reported narcissistic, antisocial, and paranoid
personality traits. Adolescents showing a preoccupied attachment organization were more likely to
have an affective disorder, obsessive-compulsive, histrionic, borderline or schizotypal personality
disorder, and self-reported avoidant, anxious, and dysthymic personality traits. The results support
a model of development of psychopathology based partially on relational experiences with parents.

Although there is now consensus that attachment is a promi-
nent developmental issue throughout the life span, relatively lit-
tle attention has been paid to the relation of attachment pro-
cesses to the development of psychopathology beyond child-
hood, particularly in the adolescent years (Sroufe & Rutter,
1984). Several prominent exceptions include studies of adoles-
cent aifect regulation and symptom reporting (Cole-Detke &
Kobak, 1996; Kobak & Sceery, 1988), and family interaction
patterns (Allen, Hauser, & Borman-Spurrell, 1996). The pur-
pose of this study is to identify the quality of attachment in
psychiatrically ill adolescents and their mothers and to explore
the role of attachment in the development of adolescent
psychopathology.
Attachment theory views development as a process of di-
rected change, of competencies, adaptive patterns and person-
ality emerging from the reorganization of previous patterns,
structures and competencies (Sroufe, 1979; Werner, 1957).
This viewpoint stresses the connections between the normal on-
togenetic process and pathologic development (Overton & Ho-
rowitz, 1991) and conceptualizes psychopathology as a devia-
tion from a normal developmental pathway in an effort toward
adaptation. From a developmental pathways perspective, the
Diana S. Rosenstein and Harvey A. Horowitz, Institute of Pennsylva-
nia Hospital.
This research was supported by grants from the Sigmund R. Miller
Memorial Fund, Biomedical Grant in Aid of Research 1-2065-40, and
the 76 Fund and the Academic Development Fund of the Institute of
Pennsylvania Hospital. This article is based on a dissertation written by
Diana S. Rosenstein in partial fulfillment of the requirements for the
degree of doctor of philosophy, University of Pennsylvania.
We thank Peter Badgio, David Fink, Richard Summers, Thea Abul-
El Haj, Carol Fultz, and Elizabeth Gorsch for AAI interviewing and
Robert Pianta for AAI reliability coding. Thanks also to Bill Overton
and David Williams for careful critiques of earlier drafts of this article.
Correspondence concerning this article should be addressed to Diana
S. Rosenstein, Department of Psychology, Institute of Pennsylvania
Hospital, 111 North 49th Street, Philadelphia, Pennsylvania 19139.
quality of attachment plays a large part in determining an indi-
vidual's degree of vulnerability to developmental deviations
(Bowlby, 1980,1988). On the basis of the affective experiences
involved in seeking and receiving caregiving from primary at-
tachment figures, attachment becomes structuralized as an in-
ternal working model representing the relationship among the
self, the attachment figure, and the external world. Later expe-
rience is interpreted on the basis of this internal working model
so that continuity is one's sense of self is experienced. Thus, the
quality of the caregiver's emotional availability early in life is
fundamental to the nature of the child's relation to its attach-
ment figure and the internal working model that subsequently
develops.
Ainsworth was the first to classify individual differences in
infant behavior in a structured series of separation and reunion
experiences, the Strange Situation (Ainsworth, Blehar, Waters,
& Wall, 1978). On reunion, secure infants seek pleasurable
comforting and contact with the caregiver. There are several
variations of insecure reunion patterns. Avoidant infants are
indifferent to or ignore the caregiver. Ambivalent infants request
contact with the caregiver, although resist it when offered and
fail to be comforted. A newer insecure pattern, disorganized,
describes a group of infants who do not possess a coherent strat-
egy for responding to separation or reunion (Main & Solomon,
1986). Sensitive, attuned, and accepting caregivers enhance
their children's expectations that the attachment figure will be
available (Ainsworth et al., 1978). On the basis of this secure
internal working model, which expectably develops out of such
interactions, a strategy is formed that involves relative freedom
of attention to and coherent integration of information about
the attachment figure, as well as adaptive affect regulation.
Unresponsive, interfering, rejecting, and otherwise insensi-
tive parenting is expected to foster the development of insecure
working models in the offspring. Main (1990) has proposed
that when caregivers are insensitive, offspring may develop con-
ditional or secondary attachment strategies to permit continued
maintenance of proximity and self-organization. Children
whose caregivers are consistently inaccessible or rejecting tend

244
 SPECIAL SECTION: ADOLESCENT ATTACHMENT
to develop a strategy of minimizing the output of attachment
behaviors (Main, 1990). These avoidant children appear to
have little need for the attachment figure and show little overt
distress, although they are are angered and made anxious by
rejection. Children of inconsistently available caretakers de-
velop a strategy of maximizing attachment behaviors, because
they are fearful of the caregiver's potential inaccessibility
(Main, 1990). Efforts by the caregiver to soothe these ambiva-
lent children are not always welcomed. Children with a disorga-
nized attachment have no coherent strategy to respond to sepa-
ration or reunion. Each of the insecure models, based on incon-
sistencies among the child's experience, behavior, and the
responses of the caregiver, is highly vulnerable to fragmentation
or incoherence, producing multiple, inconsistent models. Some
of the models remain unconscious as a result of a defensive
effort that allows the child to cope with painful affects elicited
by the caregiver's incompetence (Bowlby, 1973). Limitations
in the cognitive capacities of young children may make them
especially vulnerable to multiple models, whose unconscious
nature makes them less easily revised than models based in se-
curity (Main, 1991). Defensively biased multiple models form
the initial stages of defensive structures that can ultimately lead
to distortions in personality and psychopathology.
In support of this view, insecure attachment has been suggested
as a risk factor in the development of childhood psychopathology
(Lewis, Feiring, McGuffog, & Jaskir, 1984; Sroufe & Egelund,
1989). The connection between avoidant attachment and antiso-
cial or disruptive behavior has most frequently been reported
(Renken, Egeland, Marvinney, Mangelsdorf, & Sroufe, 1989;
Speltz, Greenberg, & DeKlyen, 1991). Ambivalent attachment
has been associated with social withdrawal in infants and toddlers
(Rubin & Lollis, 1988) and with loneliness (Berlin, Cassidy, &
Belsky, 1991). However, in many studies, the number of ambiva-
lent infants has been so small as to preclude analysis of the associ-
ated psychopathology.
Pathologic outcomes from an insecure attachment organization
assumes developmental continuity in the mental organization of
attachment. There is increasing evidence that the quality of attach-
ment is stable to age 6 (Main & Cassidy, 1988; Main, Kaplan, &
Cassidy, 1985; Wartner, Grossman, Fremmer-Bombik, & Suess,
1994), to age 10 (Grossman & Grossman, 1991) and through
midadolescence (Urban, Carlson, Egeland, & Sroufe, 1991). A
related idea is that continuity in the organization of attachment
exists across generations. Maternal and child attachment organi-
zation has shown a high degree of correspondence in studies using
retrospective, cross-sectional and prospective designs (Benoit &
Parker, 1994; Fonagy, Steele, & Steele, 1991; Radojevic, 1992;
Ward & Carlson, 1995). The argument for intergenerational trans-
mission closely follows the argument for stability of attachment
organization within an individual. The unconscious nature of in-
ternal working models of attachment and their resistance to
change guides expectations and evaluations of relationships, allow-
ing one to construct new relationships consonant with internal
working models. The behavior of the mother with the child is
therefore guided by her internal working models, determining the
quality of her relationship to her child.
Since the development of the Adult Attachment Interview
(AAI; George, Kaplan, & Main, 1985), the biased mental models
245
of attachment in insecure adolescents and their parents can be
studied and linked with the adolescents' difficulties in interper-
sonal and intrapsychic functioning. This study constitutes the first
reported use of the AAI with an inpatient psychopathological ad-
olescent population, and the first concurrent assessment of mater-
nal and adolescent attachment organization. The AAI classifies the
overall coherence observed in an individual's description, integra-
tion, and evaluation of attachment-related experiences. The four
AAI classifications—autonomous, dismissing, preoccupied, and
unresolved—were designed to parallel the infant attachment clas-
sifications, secure, avoidant, ambivalent, and disorganized, respec-
tively, in the similarity of internal working models and in the de-
fensive strategies employed (Main etal., 1985).
Autonomous adolescents and adults value attachment relation-
ships and regard attachment-related experiences as influential.
Their view of parents is objective, coherent, and consistent, al-
though flexible enough to incorporate new ideas gained through
reflection on attachment experiences. Individuals with a dismiss-
ing attachment, using a minimizing strategy, either dismiss the im-
portance of attachment or the depth of influence attachment has
on themselves. The impact of negative experiences with attach-
ment figures (particularly experiences of rejection) is negated
through normalization, idealization of parents, or poor memory
for childhood. Adolescents and adults with a preoccupied attach-
ment, using a maximizing strategy, appear confused and entangled
by attachment relationships, and lack the objectivity to move be-
yond their preoccupation. An unresolved attachment results from
unintegrated responses to trauma or loss surrounding attachment
figures in childhood. Unresolved individuals experience disorga-
nization and disorientation when describing these events, as man-
ifest in irrational thought processes about the trauma or loss, un-
founded fear, unfounded guilt, and continuing disbelief that the
events occurred. Because the disorganization occurs only in dis-
cussing loss or traumatic events, another underlying attachment
organization should be discernable in the remainder of the attach-
ment discourse.
From the standpoint of psychopathology, associations be-
tween the AAI as a measure of attachment insecurity and in-
creased symptomatology have consistently been shown for ado-
lescents. Kobak and Sceery (1988) confirmed theoretically de-
rived predictions about the association between adolescent
attachment classification and strategies of affect regulation
based on representations of self and others. Dismissing attach-
ment was associated with denial of distress or symptoms, poor
support from parents, and perception by others as hostile. Pre-
occupied attachment was associated with self-report of distress,
although high levels of parental support and poor dating skills.
Adolescents classified as insecure are more likely to engage in
drug abuse (Allen et al., 1996). The associations in female par-
ticipants between depression and preoccupied attachment sta-
tus and eating disorders and dismissing attachment status
(Cole-Detke & Kobak, 1996) underscore the importance of
gender in both attachment organization and diagnosis for
adolescents.
It is the hypothesis of this study that continuity within the
mental organization of attachment throughout the life span and
between generations is of central importance in the psychopa-
thology of adolescence. Therefore, a high correspondence
246 ROSENSTEIN AND HOROWITZ
should occur between adolescent and maternal attachment clas-
sifications. In addition, specific forms of adolescent psychopa-
thology should be associated with distinct kinds of mental orga-
nizations regarding attachment. Psychiatric disorders in which
distress is denied, affect is contained, and in which symptomatic
expression is directed against others, as in conduct disorder or
narcissistic personality disorder, are hypothesized to co-occur
with a dismissing attachment organization. Disorders in which
distress is acknowledged, affect is unmodulated, and symptom-
atic expression is directed toward the self, as in depressive and
anxiety disorders or histrionic personality disorder, are thought
to be found in individuals with a preoccupied attachment orga-
nization. In addition, the links between attachment and person-
ality and psychopathology should be differentially influenced by
gender.
Method
Participants
Participants included 60 adolescents (32 male, 28 female) admitted
to a private psychiatric hospital and 27 of their mothers. Ages of the
adolescents ranged between 13.08 and 19.75 years (M = 16.36 years).
Participants were predominately White (95%). Forty-five percent were
from intact families, 37% were living with single parents, and 18% were
from blended families. All adolescents admitted to the hospital were
invited to participate. Six adolescents' participation was contraindi-
cated on clinical grounds (e.g., acute psychosis) or by mental retarda-
tion (Wechsler Intelligence Scale for Children—Revised [ WISC-R] or
Wechsler Adult Intelligence Scale—Revised [WAIS-R] Full Scale IQ <
65). The sample was deliberately unselected to obtain attachment data
on adolescents with a broad range of psychopathology. Of the 122 pa-
tients approached, 63 agreed to participate with parental consent.
Three participants' data were lost by tape recorder malfunction. Fifty-
nine adolescents (38 male, 21 female) refused to participate. Mothers
of the first 47 adolescent participants were asked to participate, and 31
agreed. Four mothers' data were lost by tape recorder malfunction dur-
ing either their or their adolescent's interview.
Procedures
Adolescent participants participated in diagnostic and personality as-
sessments. Both adolescents and mothers were given the attachment
interview.
Measures
Diagnostic assessment: Structured Clinical Interview for Diagno-
sis—Patient version (SCID-P; Spitzer, Williams, & Gibbon, 1987).
This semistructured diagnostic interview was developed to reliably pro-
duce zDiagnosticand Statistical Manual for Mental Disorders(3rded.,
revised; DSM-III-R; American Psychiatric Association, 1987) Axis I
(major psychiatric disorder) diagnosis for adults. Although the in-
terview has not been validated on adolescents, DSM-III-R criteria for
making the specific diagnoses covered by the interview are the same for
adolescents and adults. Where appropriate, DSM-III-R diagnoses not
directly assessed by the SCID-P were made and marked as tentative
pending corroboration from another research diagnostic source.
Psychological test battery. This test battery was administered without
the examiner's knowledge of the patient's participation in this study. The
battery consisted of objective and projective personality tests, screening for
organic impairment and an IQ test, either the WISC-R (Wechsler, 1974,
for those under age 16) or WAIS-R (Wechsto; 1981; for those age 16 or
older). IQ scores (^ferbal, Performance, and Fun Scale).and DSM-III-R
diagnoses (both Axis land Axis 11) made as a result of this assessment were
used as study data. IQ data were available for 59 adolescents. Verbal IQ
ranged from 77-141 (M = 102.75,50 = 14.36), Performance IQ ranged
from 68-134 (M= 104.51, SD= 15.50), and Full Scale IQ ranged from
74-134 (M= 103.73, SD= 14.33).
The final research diagnosis, made by the administrative psychiatrists
associated with the adolescent treatment units, was based on informa-
tion from the two independent sources, supplemented by their knowl-
edge of the patients, ensuring accuracy and completeness of the diagno-
sis. The broad range of major psychiatric diagnoses was then sorted
into several categories to allow sufficient numbers for analysis. These
categories were (a) conduct disorder (CD), including oppositional de-
fiant disorder; (b) affective disorder (AFF), including major depres-
sion, dysthymic disorder, and schizoaffective disorder; and (c) sub-
stance abuse (SA). All combinations of these categories were used so
that the complexity of psychopathology in participants with comorbid
diagnoses would be reflected in the data. The match between the SCID-
P and psychological testing diagnoses was 71% for CD, 79% for AFF,
and 58% for CD plus AFF. Overall kappa was .754.
Fifty-five percent of participants had an AFF; 13%, a CD; and 20%,
AFF plus CD. Twelve percent of participants did not fit into these cate-
gories, 2 with an anxiety disorder, 1 with substance abuse (SA) alone, I
with attention deficit disorder alone, 2 with atypical psychoses, and 1
participant with a multiple personality disorder. Half the participants
had a comorbid SA diagnosis. Diagnosis from chart review, psychologi-
cal testing, or both was available for 51 of the 59 adolescents refusing
participation. Twelve percent had CD, 45% had AFF, and 16% had AFF
plus CD. The distribution of diagnoses is close to the study sample with
two exceptions; an overrepresentation among the adolescents refusing
participation of psychotic disorders (16%) and personality disorders
without an Axis I diagnosis (10%).
Psychiatric symptoms and personality dimensions. The Millon Clini-
cal Multiaxial Inventory (MCMI; Millon, 1983) is a 175-item self-report
personality and diagnostic inventory with specific usefulness in diagnosing
personality disorders and dimensions. Scoring yields ratings on 20 dimen-
sions corresponding to DSM-III-R personality disorders and symptom-
atic scales. The 20 subscales show high test-retest reliability. Mean corre-
lations across personality scales is .73 (Overholser, 1990).
Symptom Checklist—90—Revised (SCL-90-R). The SCL-90
(Derogatis, 1977) is a 90-item self-report survey of symptoms typically
reported by medical and psychiatric patients. The participant rates the
presence or absence and intensity of each symptom. Scoring yields three
ratings of global emotional functioning and nine symptom clusters. In-
ternal consistency coefficients (Cronbach's a) and split-half reliabilities
(Spearman-Brown) for the scale have been reported as .98 (Hoffman &
Overall, 1978).
AAI. The AAI (George et al., 1985) is a semistructured interview
designed to elicit memories of childhood interactions with parents. The
interview yields an attachment classification based on the individual's
current state of mental organization expressed in the coherency of
thought and feeling regarding attachment. The interview transcript is
scored on eleven 9-point scales. Three scales represent the content of
the adult's probable childhood experiences and childhood relationship
to each parent (e.g., loving, rejecting, involving). Eight scales assess
current state of mind, including formal aspects of the transcript's co-
herency, facility of memory, and ability to mitigate strong negative affect
(e.g., coherency, lack of memory, angry preoccupation, uninvolved
derogation). A major attachment classification is made independent of
subscale scores, but subscale scores are expected to load differentially
on each attachment classification. Bakermans-Kranenburg and van U-
zendoom (1993) report the test-retest reliability of the AAI at a 78%
 SPECIAL SECTION: ADOLESCENT ATTACHMENT
match (K = .63), whereas Benoit and Parker (1994) found a 90% match
(K = .79). All transcripts were scored by the first author, blind to the
identities of the participants and diagnostic variables, using the Adult
Attachment Classification System Manual, Version 5.0 (Main & Gold-
wyn, 1985-1991). Robert Pianta coded 25% of the transcripts for reli-
ability. Both coders were trained at the 1988 Charlottesville, Virginia,
AA1 workshop conducted by Mary Main and Erik Hesse, and achieved
acceptable reliability on a set of training transcripts. Agreement on clas-
sifications for this study reached a kappa of .540. Consensual data,
achieved by rater discussion, were used for analysis.
Results
Adolescent A ttachment
Because participants with unresolved attachment display
their lack of resolution only in discussing loss or traumatic
events, their underlying secondary attachment classifications
should be apparent in the remaining AAI discourse. Therefore,
data on attachment classifications were analyzed twice, once us-
ing a four-category system including the unresolved category,
and once using the traditional three categories. Using the four-
category system, 38% were dismissing, 2% autonomous, 42%
preoccupied, and 18% unresolved. Using the three-category
system, 3% of participants were autonomous, 47% dismissing,
and 50% preoccupied. These very high rates of insecure attach-
ment were expected on the basis of similar rates found in other
psychopathological populations (100% of adults with serious
psychopathology, Dozier, 1990; 84% of clinic-referred pre-
school children with behavior disorders, Speltz, Greenberg, &
DeKlyen, 1991). However, pervasive attachment insecurity has
not been shown for psychiatrically ill adolescents before.
Attachment and Intelligence
The role of intelligence in determining attachment classifi-
cation was examined (Table 1). Using a series of one-way anal-
yses of variance (ANO\As), Verbal, Performance and Full
Scale IQ scores were unrelated to attachment classification in
both the three- and four-category systems. In addition, IQ
scores did not relate to Axis I diagnosis or gender. When the
autonomous group was removed from the analysis because of
its small size (« = 2), the relationship of IQ to attachment, gen-
der, and diagnosis remained statistically insignificant.
Attachment and Major Psychiatric Diagnosis
The autonomous group was removed from all subsequent
analyses comparing attachment groups because of its small size.
To test the hypothesis that CDs and AFFs would be associated
with dismissing and preoccupied attachment, respectively, a se-
ries of likelihood ratio chi-square analyses were performed. As
expected, significant associations between attachment and Axis
I diagnosis were found using both the four- and three-category
attachment classifications (Table 2). CD alone was associated
with a dismissing attachment. AFF alone was associated with a
preoccupied attachment. Participants with concurrent CDs
and AFFs were likely to have a dismissing classification. Unre-
solved attachment was associated with AFFs, with or without
247
comorbid CD. One autonomous participant was primarily un-
resolved with an AFF, and the other had a CD.
Adolescent substance abuse also showed a significant rela-
tionship to attachment classification for the three-category sys-
tem only, x 2 ( 1, N = 29) = 4.48, p < .034. As predicted, the SA
group was almost twice as likely to have a dismissing organiza-
tion as the non-SA group. The associations among SA in com-
bination with other Axis I diagnoses and attachment classifica-
tion were significant only using the four-category system, x a (6,
N=29)= 14.752, p < .022. However, the pattern of results was
the same using the three-category system. In the SA group,
those with CD were strongly associated with a dismissing clas-
sification. Participants with comorbid CD + AFF + SA tended
toward a dismissing classification. Participants with AFF and
SA were split between preoccupied and dismissing classifica-
tions. Overall SA is not as strong a predictor of dismissing at-
tachment as is CD.
Gender Differences
As anticipated, strong gender differences were found both in
attachment classification and diagnosis using a series of likeli-
hood ratio chi-square analyses. Because neither male nor fe-
male participants were favored within the unresolved category,
the four-category system was dropped from all analyses of gen-
der differences. As displayed in Table 3, male adolescents were
significantly more likely to have a dismissing organization than
preoccupied (66% vs. 34%) and to have a dismissing attach-
ment than female adolescents (75% vs. 25%). Female adoles-
cents were more likely to have a preoccupied organization than
dismissing (68% vs. 25%) and to have a preoccupied attach-
ment than male participants (63% vs. 37%). The two partici-
pants with an autonomous attachment were female. This pat-
tern of gender differences is consistent with all other studies of
adolescents or pathological populations using the AAI (Dozier,
1990; Kobak & Sceery, 1988). Although AFFs were the most
common diagnoses among male and female participants, as ex-
pected, male participants were more likely than female partici-
pants to have a CD (Table 3). Conversely, female adolescents
showed very high rates of AFF alone, with consequent low rates
of CD with or without comorbid AFF. No significant gender
differences in the distribution of diagnoses were found in the
SA group. However, twice as many male adolescents as female
adolescents had SA diagnoses.
To test for the role of gender in determining of both attach-
ment classification and diagnosis, we analyzed the relationship
between attachment and diagnosis for each gender separately
with likelihood ration chi squares (Table 4). A three-way log-
linear analysis could not be used because of small cell sizes.
Attachment classification for male participants only showed a
significant relationship to diagnosis. The relationship was very
strong between CDs and a dismissing attachment for male par-
ticipants. Male adolescents with AFFs alone were equally likely
to have a dismissing or preoccupied attachment. However, all
male adolescents with a preoccupied attachment had AFFs. For
female adolescents, the rate of CD alone was so low (N = 1) that
the relationship between AFFs and preoccupied attachment
may have been obscured.
248 ROSENSTEIN AND HOROWITZ

Table 1
1Q as a Function of Attachment, Diagnosis, and Gender

VIQ PIQ FIQ

Attachment, diagnosis,
and gender n M SD M SD M SD

Attachment
Four-category system
Dismissing 23 104.04 14.28 106.26 16.44 105.26 14.68
Autonomous 1 118.00 0.00 115.00 0.00 118.00 0.00
Preoccupied 23 103.39 16.05 103.04 15.07 103.65 15.24
Unresolved 12 97.75 10.56 103.08 15.78 99.75 12.13
F(3, 55) 0.54 0.41 0.61
P <.66 <.74 <.61
Three-category system
Dismissing 28 102.96 13.66 106.07 15.55 104.50 13.90
Autonomous 2 116.50 2.12 116.00 1.41 117.00 1.41
Preoccupied 29 101.59 15.23 102.21 15.72 102.07 14.94
F(2, 56) 1.01 1.012 1.10
P <.37 <.37 <.34
Diagnosis
CD 7 106.83 6.94 108.67 12.44 108.50 6.57
CD + AFF 12 95.17 11.42 106.92 12.99 100.00 10.69
AFF 33 103.59 13.68 103.38 15.04 103.78 13.87
F (2, 49) 2.90 0.59 0.83
P <.07 <.56 <.44
Gender
Male 27 104.41 13.97 105.52 16.73 105.19 14.67
Female 32 101.34 14.75 103.66 14.60 102.50 14.16
t(57) 0.82 0.45 0.71
P <-42 <.65 <.48

Note. VIQ = Verbal IQ; PIQ = Performance IQ; FIQ = Full Scale IQ; CD = conduct disorder, CD + AFF
= concurrent conduct disorder and affective disorder; AFF = affective disorder.

Attachment, Symptoms, and Personality The second analysis examined the interrelation of personality
dimensions and attachment classification. Participants were
Three analyses were conducted to examine the relation be-
classified for each scale on the basis of scores reaching a clinical
tween varying aspects of symptomatic and personality function-
level (base rate > 74). A series of likelihood ratio chi squares
ing and attachment classification. In the first analysis, all SCL-
examined the relationship between MCMI classification and di-
90 scales were entered as independent variables in a simulta-
agnosis or attachment classification. Results showed that the
neous regression procedure, with attachment classification as
dismissing group differed significantly from the preoccupied
the independent variable, yielding no significant results, F(9,
group by being more antisocial, narcissistic, and paranoid, with
43) = 0.737, p < .673. Self-acknowledged symptomatic distress
a trend for drug abuse (Table 5). By contrast, the preoccupied
is a weak discriminator of attachment groups in this clinical
group was significantly more avoidant, with a trend for anxiety
sample, likely resulting from the attenuated range of scores.
and dysthymia. The term avoidant, as used on the MCMI, de-

Table 2 Table 3
Relation Between Major Psychiatric Disorders Gender Differences in Attachment Classification and Diagnosis
and Attachment Classification
Classification and diagnosis Male Female Total
System and attachment CD CD + AFF AFF Total
AA1 classification8
Four-category" Dismissing 21 7 28
Dismissing 6 6 8 20 Preoccupied 11 19 30
Preoccupied 1 1 19 21 Major psychiatric disorders'1
Unresolved 0 5 6 11 CD 6 2 8
Three-category11 CD + AFF 9 3 12
Dismissing 6 9 10 25 AFF 13 20 33
Preoccupied 1 3 22 26
Note. AAI = Adult Attachment Interview; CD = conduct disorder;
Note. CD = conduct disorder; CD -I- AFF = concurrent conduct dis- CD + AFF = concurrent conduct disorder and affective disorder, AFF
order and affective disorder, AFF = affective disorder. = affective disorder.
1 2
x (4, f f = 52) = 18.584,,p< .001. b X2(2, If = 51) = 11.694,p< .003. ' X2( 1, N = 58) = 8.863, p < .003. " x\2, N •* 53) = 6.559, p < .04.
 SPECIAL SECTION: ADOLESCENT ATTACHMENT 249

Table 4 personality disorders and their associated attachment classifi-

Relation Between Diagnosis and Attachment Classification cation were found. Both participants with obsessive-compulsive
for Male and Female Participants personality disorder were female adolescents and had preoccu-
pied attachments. Both participants with narcissistic personal-
n participants with:
ity disorders were male adolescents and had dismissing organi-
Gender and
classification CD CD + AFF AFF Total zations. Both participants with histrionic personality disorder
were female, with preoccupied attachments. The participant
Female" with a schizotypal personality disorder was male and had a pre-
Dismissing 0 1 5 6 occupied attachment. Only borderline personality disorder oc-
Preoccupied 1 2 14 17
curred in large numbers—14 of the 24 participants with per-
Male"
Dismissing 6 8 5 19 sonality disorders. The majority was female and more likely to
Preoccupied 0 1 8 9 have a preoccupied organization (64%) than a dismissing one
(29%). Interestingly, 10 male adolescents (and 3 female
Note. CD = conduct disorder; CD + AFF = concurrent conduct dis-
adolescents) with a borderline personality disorder refused to
order and affective disorder; AFF = affective disorder.
1 2
* (2, N = 23) = 0.683, p < .711. " X2(2, N = 28) = 11.563,p < .003. participate in the study.

Maternal Attachment Classification

scribes an individual who withdraws from interpersonal in-
teraction for fear of criticism or rebuffbut who is highly inter-
ested in others, partially to alleviate their anxiety. All findings
were consistent with prediction. CD alone was significantly as-
sociated with antisocial and paranoid features, whereas AFF
alone was associated with avoidance, anxiety, and dysthymia.
These results demonstrate that the relationship between MCMI
personality traits and attachment classification was not strictly
a function of diagnosis.
A third analysis examined the relationship of an Axis II
(personality disorder) diagnosis of DSM-I1I-R and attach-
ment classification. Forty percent (24 participants) had an Axis
II diagnosis. All were in addition to an Axis I diagnosis of AFF.
Although the numbers of participants were insufficient for sta-
tistical analysis, the anticipated relationships between specific
Of the 27 mothers who were interviewed with the AAI, 4 were
dismissing; 2, autonomous; 10, preoccupied; and 11, unre-
solved. The entire group of mothers with an unresolved attach-
ment had secondary insecure classifications. The predicted as-
sociation of concurrent maternal and adolescent attachment
classifications was confirmed using a likelihood ratio chi square
analysis (Table 6). With the three-category system, the match
was 81% (K = .615). The match for the four-category system
was not calculated, because the unresolved category was not
necessarily expected to co-occur in mothers and adolescents.
This is because the timing of the trauma or loss producing the
lack of resolution in either partner would not necessarily occur
within the period in which transmission is thought to take
place.

Tables
Clinical Elevations (Base Rate > 74) on Millon Mulliaxial Personality Inventory Scales
for Insecure Attachment Groups and Diagnosis

Attachment classification Diagnosis

Dismissing Preoccupied CD AFF

Rating scale (n = 24) (n = 28) P (n = 32) P

Schizoid 3 9 .08 0 9 .14

Avoidant 5 13 .04* 0 13 .05*
Dependent 6 8 .73 3 10 .37
Histrionic 13 12 .42 5 17 .17
Narcissistic 14 6 .005** 4 12 .18
Antisocial 11 2 .001** 4 6 .014*
Compulsive 0 0 0 0
Passive-aggressive 13 15 .97 2 21 .14
Schizotypal 0 1 .34 0 1 .66
Borderline 4 7 .43 1 10 .47
Paranoid 8 2 .02* 3 2 .004**
Anxiety 9 17 .058 1 22 .017*
Dysthymia 9 17 .058 1 21 .03*
Alcohol abuse 5 4 .80 1 4 .78
Drug abuse 11 6 .059 3 9 .29

Note. All I tests are two-tailed. CD - conduct disorder, AFF = affective disorder.
250 ROSENSTEIN AND HOROWITZ
Table 6
Relation Between Maternal and Adolescent
Attachment Classification
Maternal attachment
Adolescent
attachment Dismissing Autonomous Preoccupied
Dismissing 5 0 4 to the imposition of other risk factors. This study was limited in
Autonomous 0 I 0 that it assessed psychopathology and attachment concurrently,
Preoccupied 0 1 16
2
Note. x (l,W = 27) = 12.655,p<.0001.Boldfacednumbersindicate
predicted associations.
Discussion
In this psychiatric sample, the adolescent's state of mind with
respect to attachment was related to clinical diagnosis and, with
more limited support, to personality dimensions. The attach-
ment group contrasts were not the result of differences in intel-
ligence or general severity of psychopathology. Gender differ-
ences further specify the relationships among quality of attach-
ment, personality, and psychopathology. A striking similarity
between the adolescents' and their mothers' attachment classi-
fications was also found. Relationships between adolescent at-
tachment and psychopathology and between maternal and ado-
lescent attachment organization in a clinically disturbed popu-
lation have not previously been shown.
The findings are consistent with a developmental pathways
perspective in which internal working models of attachment,
guiding patterns of behavior, and affect regulation, give rise to
attachment strategies. These attachment strategies produce
differential vulnerability to psychiatric syndromes and person-
ality traits. Our results showed that the psychiatric syndromes
and personality traits theoretically expected to arise from each
of the attachment strategies were associated with the respective
insecure attachment classifications. Adolescents using a dis-
missing attachment organization rely on an attachment strategy
that minimizes distressing thoughts and affects associated with
rejection by the attachment figure. Thus, psychiatric disorders,
such as CD or SA, in which overt denial or downplaying of dis-
tress, coupled with actions that display those distressing affects,
did occur in the context of a dismissing attachment organiza-
tion. This association is consistent with previous work that
linked behavior disorders to avoidant attachment in childhood
(Speltz et al., 1991). Conversely, adolescents using a preoccu-
pied attachment strategy rely on maximization of the attach-
ment system, in which signals of distress intended to draw in
an inconsistent attachment figure are pronounced. Therefore,
psychiatric disorders, such as AFFs, in which negative affects
are acknowledged or even exaggerated, although in an incoher-
ent form, occurred in the context of a preoccupied attachment
organization.
Diagnostic criteria as assessed through behavior and attach-
ment classification as assessed by internal representations seem
to be tapping the same salient dimensions of experience. This is
not to say, however, that a classification of internal representa-
tions of attachment is the same activity as making a psychiatric
diagnosis. Many other environmental and constitutional fac-
tors, such as family history of psychopathology, trauma, and
unfavorable social or economic conditions, coupled with inse-
curity in attachment relations contribute toward the ultimate
emergence of psychiatric disturbance. What is so salient about
attachment in this process is the very early onset of deviation
from a normal developmental pathway, making for sensitivity
providing no direct evidence for a developmental pathways
model. A longitudinal investigation could better serve this goal.
The association between preoccupied attachment and AFF
in adolescents is in keeping with the finding of Cole-Detke
and Kobak (1996), although this link has not been consis-
tently found in young or school-aged children or in dysthy-
mic adults (Patrick, Hobson, Castle, Howard, & Maughan,
1994). A developmental phenomenon may be responsible.
The rates of depression increase in adolescence, particularly
for girls, who formed the bulk of the participants with depres-
sion and preoccupied attachment this study. It may be only
with the transition to adolescence, and the renewed press for
autonomy that adolescence brings, that relational patterns
characteristic of preoccupied individuals, which discourage
autonomy and encourage overinvolvement with the parent,
take on renewed import. Cole-Detke and Kobak (1996) iden-
tify guilt and an "overfocus" on a depressed parent as salient
in the etiology of the child's depression. Because of the ado-
lescent's focus on the depressed parent, the adolescent fails to
learn a means to regulate negative affect and lacks explor-
atory competence to learn these skills from other sources. In-
terestingly, this parent-adolescent dynamic anticipates our
finding of close correspondence between maternal and ado-
lescent attachment styles. What is suggested is that maternal
depression and preoccupation causes the mother to turn to
her child for provision of her own attachment needs and alle-
viation of her distress, thus perpetuating from one generation
to the next similarity in attachment and defensive styles.
As with major psychiatric disorders, the relationship between
personality functioning and attachment rests on the similarity
in strategies used to regulate against painful negative affects
while simultaneously maintaining involvement with the attach-
ment figure. The two groups of adolescents with insecure states
of mind were distinguishable by the quality of their self-re-
ported personality functioning. Adolescents with self-reported
narcissistic, antisocial, and paranoid personality traits were
likely to have a dismissing attachment. Preoccupied attachment
was linked with self-reported avoidant, anxious, and dysthymic
personality traits. Observed personality functioning as mea-
sured by diagnoses of personality disorders provided more
modest differentiation of the two groups with insecure classifi-
cations. It was surprising to find that the two groups of adoles-
cents with insecure states of mind did not differ on the amount
or kind of self-reported psychiatric symptoms experienced. The
failure to find this previously reported difference (Kobak &
Sceery, 1988) most likely represents a ceiling effect. Both
groups of adolescents with insecure states of mind reported
clinically significant levels of psychic distress and symptoms.
Perhaps the fact of psychiatric hospitalization mitigated against
 SPECIAL SECTION: ADOLESCENT ATTACHMENT
the tendency of adolescents with a dismissing classification to
deny that they are in distress and have psychiatric problems.
The relation of borderline personality disorder and borderline
traits to attachment organization was complex and contradic-
tory in this study. Adolescents showing clinical levels of border-
line personality traits failed distinctively to have a preoccupied
classification. However, adolescents with a borderline personal-
ity disorder tended to have a preoccupied classification, agree-
ing with the report of Patrick et al. (1994). The lack of consis-
tent association between the borderline construct and preoccu-
pied attachment in this study may be explained by differences in
methodology between the two studies. The Patrick et al. (1994)
sample contained only female adolescents and required a more
stringent definition of borderline personality disorder (seven of
eight DSM-IIl-R criteria vs. five of eight in our sample), with
no dysthymic criteria. All in our group of adolescents with bor-
derline personality disorder had an AFF (dysthymia being the
least severe form) and most had a comorbid CD. The greater
heterogeneity of our borderline group may have accounted for
the higher incidence of dismissing attachment in these adoles-
cents. One limitation was the tendency of male adolescents with
borderline personality disorder to refuse participation in our
study, shrinking the group to a size inappropriate for statistical
manipulation and skewing it in favor of female adolescents. Fur-
ther studies should include a larger group of adolescents with
borderline personality disorder, balancing gender, to better char-
acterize the relationship to attachment organization.
Setting aside comparisons with other studies, two other
points may explain discrepancies in the relation between at-
tachment classification and the borderline construct. The first
involves the lack of coordination of definitions of borderline
between the DSM-III-R borderline personality disorder diag-
nosis and the MCMI borderline scale. On the MCMI, border-
line traits are part of a cluster of traits, including narcissistic,
antisocial, and histrionic, bound together through exploitative
interpersonal relations, the ability to discount dissonant infor-
mation and stimulus seeking behavior. The latter qualities are
more descriptive of a dismissing than preoccupied organization
of attachment.
Secondly, inconsistency in attachment organization within
diagnostic groups may point to the lack of complete specificity
of attachment classifications and the multiplicity of underlying
working models of attachment; that is, according to Main and
Goldwyn (1985-1991), elements of the other insecure attach-
ment organization should be present in the AAI records of each
insecure group, particularly at the extremes. The relative pre-
dominance of each insecure classification determines the ulti-
mate organization. Instruments tapping personality traits (such
as the MCMI), which are complexly determined and overlap
across traits, may capture the nonexclusive nature of attach-
ment classification. As Pianta (1992) suggests, the attachment
organizations and their concomitant behaviors appear to be in
an adaptive hierarchy. As one form of the organization breaks
down, a new underlying organization emerges. Close family
members are often the only ones able to see the defensive nature
of the individual's behavioral organization and understand their
underlying vulnerability (Dozier, Stevenson, Lee, & Velligan,
1991). Similar layering of adaptive organizations may occur in
251
individuals who have multiple concurrent diagnoses, which
provide more limited predictive power to attachment classifi-
cation. These ideas underscore the importance of looking be-
yond surface symptomatic presentations to the often unstated
organizing representations of relationships and their associated
motivating affects.
Gender differences emerged in the organization of attach-
ment security and in the attribution of psychiatric diagnoses.
The majority of male adolescents had dismissing classifications,
whereas most female adolescents were classified as preoccupied.
Overall, the relationship between attachment and clinical diag-
nosis was not simply a reflection of gender differences. Discrim-
ination of attachment classification emerged although the ma-
jority of male and female participants had AFFs. A dismissing
classification in male adolescents was not in itself associated
with a specific diagnosis. However, the inclusion of CD as all or
part of a male adolescent's diagnosis almost perfectly predicted
a dismissing classification (14 of 15 participants). As Bowlby
(1944) described from his clinical observations, the presence of
CD in male adolescents is pivotal in anticipating their attach-
ment organization. Parallel associations between attachment
and clinical diagnosis for female adolescents were not found.
Very small numbers of female adolescents with CD alone pro-
vided insufficient statistical power to replicate the association
between preoccupied attachment and depression in female ad-
olescents (Cole-Detke&Kobak, 1996).
Finally, there is the very high concordance between adoles-
cent and maternal attachment classification to consider. Al-
though in this sample the association was high, maternal preoc-
cupied status was the least predictive of adolescent status. Sub-
sequent analysis of the mismatched mother-adolescent pairs
showed that a group of four adolescents with dismissing classi-
fication all had mothers with preoccupied organizations. Three
of the four were male adolescents with a primary unresolved
classification. Their interviews showed a unique feature. All
claimed lack of memory for childhood, yet seemed to the in-
terviewer as if they were holding back from discussing painful
experiences that they wished they had forgotten. They were pas-
sively noncompliant with the interview, answering questions
only minimally. The fourth adolescent, who was female, exhib-
ited the same withholding posture but seemed angry and defi-
ant. These four participants may have a split combination of
dismissing and preoccupied attachment analogous to the avoid-
ant-ambivalent classification Crittenden (1988) has found in a
sample of maltreated infants, and subsumed within Main and
Goldwyn's (1985-1991) classification system under the "can-
not classify" designation.
While not directly studied in this investigation, the conso-
nance between adolescent and maternal attachment classifica-
tion lends support to Bowlby's (1973) claim that styles of adap-
tation and defensive bias arise in the context of mother-child
interaction. Maternal behavior is, in turn, a function of her
mental organization of her own attachment experiences. Ac-
cording to this logic, maternal attachment patterns are internal-
ized by the child through working models and maintained both
by the defensive biases inherent in the models and by continuing
interaction with the attachment figure. If the extremity of the
_ adolescent's psychopathology were influencing current mental
252 ROSENSTEIN AND HOROWITZ
organization, then one would not expect to find correspondence
to maternal attachment. The fact of such a correspondence ar-
gues against the idea of the adolescent's psychopathology en-
tirely determining attachment organization and leads back
again to a model based in developmental psychopathology.
References
Ainsworth, M.D.S., Blehar, M.C. Waters, E., & Wall, S. (1978). Pat-
terns of attachment: A psychological study of the Strange Situation.
Hillsdale, NJ: Erlbaum.
Allen, J.P., Mauser, ST., & Borman-Spurrell, E. (1996). Attachment
theory as a framework for understanding sequelae of severe adoles-
cent psychopathology: An 11-year follow-up study. Journal of Con-
sulting and Clinical Psychology, 64,254-263.
American Psychiatric Association. (1987). Diagnostic and statistical
manual of mental disorders (3rd ed., revised). Washington, DC:
Author.
Bakermans-Kranenberg, M.J., & van Uzendoorn, M.H. (1993). A psy-
chometric study of the Adult Attachment Interview: Reliability and
discriminant validity. Developmental Psychology, 29,870-879.
Benoit, D., & Parker, K.C.H. (1994). Stability and transmission of at-
tachment across three generations. Child Development, 65, 1444-
1456.
Berlin, L.J., Cassidy, J., & Belsky, J. (1991). Loneliness in young chil-
dren and infant-mother attachment. Unpublished manuscript, Penn-
sylvania State University.
Bowlby, J. (1944). Forty-four juvenile thieves: Their characters and
hame-\ife. International Journal of Psychoanalysis, 25. 19-53, 107-
127.
Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation, anxiety and
anger. New York: Basic.
Bowlby, J. (1980). Attachment and loss: Vol 3. Loss. New York: Basic.
Bowlby, J. (1988)./I secure base. New York: Basic.
Cole-Detke, H.E., & Kobak, R. (1996). Attachment processes in eating
disorder and depression. Journal of Consulting and Clinical Psychol-
ogy, 64, 282-290.
Crittenden, P. (1988). Relationships at risk. In J. Belsky & T. Nezworski
(Eds.), Clinical implications of attachment (pp. 136-174). Hillsdale,
NJ: Erlbaum.
Derogatis, L.R. (1977). SCL-90-R administration, scoring and proce-
dures manual—I. Baltimore: Johns Hopkins University.
Dozier, M. (1990). Attachment organization and treatment use for
adults with serious psychopathological disorders. Development and
Psychopathology, 2, 47-60.
Dozier, M., Stevenson, A.L., Lee, S. W, & Velligan, D.I. (1991). Attach-
ment organization and familial overinvolvement for adults with seri-
ous psycho-pathological disorders. Development and Psychopathol-
ogy, 3, 475-489.
Fbnagy, P., Steele, H., & Steele, M. (1991). Maternal representations
of attachment during pregnancy predict the organization of infant-
mother attachment at one year of age. Child Development, 62, 891-
905.
George, C, Kaplan, N., & Main, M. (1985). An adult attachment in-
terview: Interview protocol. Unpublished manuscript, Department of
Psychology, University of California, Berkeley.
Grossman, K.E., & Grossman, K. (1991). Attachment quality as an
organizer of emotional and behavioral responses in a longitudinal
perspective. In CM. Parkes, J. Stevenson-Hinde, & P. Marris (Eds.),
Attachment across the life cycle (pp. 93-114). London: Tavistock.
Hoffman, N.G., & Overall, P.B. (1978). Factor structure of the SCL-
90 in a psychiatric population. Journal of Consulting and Clinical
Psychology, ^6,1187-1191.
Kobak, R.R., & Sceery, A. (1988). Attachment in adolescence: Work-
ing models, affect regulation and representation of self and others.
Child Development, 59, 135-146.
Lewis, M., Feiring, C., McGuffog, C., & Jaskir, J. (1984). Predicting
psychopathology in six-year-olds from early social relations. Child
Development, 55, 123-136.
Main, M. (1990). Cross-cultural studies of attachment organization:
Recent studies, changing methodologies, and the concept of condi-
tional strategies. Human Development, 33, 48-61.
Main, M. (1991). Metacognitive knowledge, metacognitive monitor-
ing, and singular (coherent) vs. multiple (incoherent) models of at-
tachment. Findings and directions for future research. In CM.
Parkes, J. Stevenson-Hinde, & P. Marris (Eds.), Attachment across
the life cycle (pp. 127-159). London: Routledge-Kegan Paul.
Main, M., & Cassidy, J. (1988). Categories of responses to reunion with
the parent at age six: Predictable from infant attachment classifica-
tion and stable over a one-month period. Developmental Psychology,
24,415-426.
Main, M., & Goldwyn, R. (1985—1991). Adult attachment classifica-
tion system. Unpublished manuscript, Department of Psychology,
University of California at Berkeley.
Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, child-
hood, and adulthood: A move to the level of representation. Growing
points of attachment theory and research. Monographs of the Society
for Research in Child Development, 50(1-2, Serial No. 209), 66-104.
Main, M., & Solomon, J. (1986). Discovery of a new, insecure-disorga-
nized-disoriented attachment pattern. In T.B. Brazelton & M. Yog-
man (Eds.), Affective development in infancy (pp. 95-124). Nor-
wood, NJ: Ablex.
Millon, R. (1983). The Millon Clinical Multiaxial Inventory manual
(3rd ed.). Minneapolis, MN: National Computer Systems.
Overholser, J.C. (1990). Retest reliability of the Millon Clinical
Multiaxial Inventory. Journal of Personality Assessment, 55, 202-
208.
Overton, W.F., & Horowitz, H.A. (1991). Developmental psychopa-
thology: Integrations and differentiations. In D. Cicchetti & S.L. Toth
(Eds.), Rochester Symposium on Developmental Psychopathology:
Vol. 3, Models and integrations (pp. 1-42). Rochester, NY: University
of Rochester Press.
Patrick, M., Hobson, R.P., Castle, D., Howard, R., & Maughan, B.
(1994). Personality disorder and the mental representation of early
social experience. Development and Psychopathology, 6, 375-388.
Radojevic, M. (1992). Predicting quality of infant attachment to father
a! 15 months from prenatal paternal representations of attachment:
An Australian contribution. Paper presented at the 25th International
Congress of Psychology, Brussels, Belgium.
Renken, B., Egeland, B., Marvinney, D., Mangelsdorf, S., & Sroufe,
L.A. (1989). Early childhood antecedents of aggression and passive
withdrawal in early elementary school. Journal of Personality, 57,
257-281.
Rubin, K.H., & Lollis, S.P. (1988). Origins and consequences of social
withdrawal. In J. Belsky & T. Nezwoiski (Eds.), Clinical implications
of attachment (pp. 219-252). Hillsdale, NJ: Erlbaum.
Speltz, M.L., Greenbeig, M.T., & DeKJyen, M. (1991, April). Attach-
ment in preschoolers with disruptive behavior: A comparison of clinic-
referred and nonproblem children. Paper presented at the Biennial
Meeting of the Society for Research in Child Development, Seattle.
Spitzer, R.L., Williams, J.B.W., &Gibbon, M. (1987). Structured Clin-
ical Interview for DSM-II1-R. Unpublished manuscript, New York
State Psychiatric Institute, New York.
Sroufe, L.A. (1979). The coherence of individual development. Ameri-
can Psychologist, 34. 834-841.
Sroufe, L.A., & Egeland, B. (1989, April). Early predictors of psycho-
 SPECIAL SECTION: ADOLESCENT ATTACHMENT
pathology and competence in children. Paper presented at the Bien-
nial Meeting of the Society for Research in Child Development, Kan-
sas City.
Sroufe, L.A., & Rutter, M. (1984). The domain of developmental psy-
chopathology. Child Development, 55.1184-1199.
Urban, J., Carlson, E., Egeland, B., & Sroufe, L.A. (1991). Patterns of
individual adaptation across childhood. Development and Psychopa-
thology, 3, 445-460.
Ward, M.J., & Carlson, E.A. (1995). Associations among adult attach-
ment representations, maternal sensitivity, and infant-mother at-
tachment in a sample of adolescent mothers. Child Development, 66.
69-79.
Wanner, U.G., Grossman, K., Fremmer-Bombik, E., & Suess, G.
(1994). Attachment patterns at age six in South Germany: Predict-
253
ability from infancy and implications for preschool behavior. Child
Development, 65,1014-1027.
Wechsler, D. (1974). Manual for the Wechsler Intelligence Scale for
Children—Revised. New \brk: The Psychological Corporation.
Wechsler, D. (1981). Wechsler Adult Intelligence Scale—Revised, man-
ual. New \brk: The Psychological Corporation.
Werner, H. (1957). The concept of development from a comparative
and organismic point of view. In D. B. Harris (Ed.), The concept of
development: An issue in the study of human development (pp. 125-
148). Minneapolis: University of Minnesota Press.
Received October 27, 1993
Revision received June 27, 1994
Accepted May 5, 1995 •