Assessing patterns of adult attachment in medical patients

Objective: Patterns of adult attachment affect physical health and yet are unfamiliar to many clinicians. The purpose of this review was to derive descriptions of prototypic patterns of adult attachment that are relevant to health care. Methods: Observations from attachment research using diverse methods to measure adult attachment were reviewed. A synthetic approach was used to integrate these observations into coherent descriptions of prototypic patterns of attachment. Results: Four patterns of adult attachment (secure, preoccupied, dismissing and fearful) are distinguished by prototypic patterns in intimate relationships, affect regulation, use of social support, trait descriptors, mentalization and narrative coherence. These patterns are linked to health care relationships and health outcomes. Conclusion: Prototypic descriptions of patterns of adult attachment may guide clinicians in appreciating individual differences in interpersonal style that affect the health of patients. (C) 2009 Elsevier Inc. All rights reserved.