Attachment as a determinant of health


Bowlby's concept of attachment and anchorage behaviour is currently a widespread theoretical and empirical construct that contributes to the understanding of various aspects of the relationship. Considering its complexity, the theory of attachment represents an important framework for research in various fields of psychology.

Bowlby emphasised that attachment plays an important role in the life of a person “from the cradle to the grave”. The foundations for the creation of the style of attachment are already established during early childhood and tend to persist in the later stages of life in the majority of people.

The empirical research on the types of attachment suggests that a secure attachment is usually associated with a well-developed ability of mentalisation (in general we can talk about comprehensive empathy) and it is obviously a factor in resilience (resistance). Safe attachment provides an important preventive factor and helps maintain mental health.

The insecure types of attachments (avoidant, ambivalent, and disorganised) appear to be a risk factor for the occurrence of psychological and psychosomatic illnesses. The research on insecure types of attachment suggests that they not only reduce the capacity to cope with stressors and the appropriate creation of relationships throughout life, but they can significantly influence the behaviour associated with various illnesses and adversely affect caring for a healthy lifestyle and cooperation in prevention and treatment.

Although a psychotherapeutic influence in the case of psychological and psychosomatic illnesses  in later stages of life is possible, prevention, searching for groups at risk, and early intervention are much more important.

Over time, a number of tools for measuring attachment in adults have been developed. Besides semi-structured interviews (e.g. AAA), many self-evaluation questionnaires (e.g. RQ, AAQ, ECR, or ECR-R) have been created. According to recent research, of the existing tools for measuring attachment the ECR-R questionnaire seems to be the most reliable method, providing high reliability that is independent of sample characteristics and measurement conditions.

The questions in the ECR-R questionnaire are grouped into two basic dimensions: anxiety and avoidance. By combining various high scores for these two dimensions the four types of attachment in adults are defined: 1. Secure type – with a low intensity of anxiety and avoidance; 2. Preoccupied type – with low avoidance and high anxiety – corresponding to anxiety-ambivalent attachment; 3. Fearful type – with a high level of anxiety and avoidance – corresponding to disorganised attachment, and 4. Dismissing type – with a high degree of avoidance and a low level of anxiety – corresponding to avoidant attachment.

Currently, the examination of attachment in adulthood is a dynamically developing field of applied psychological research. Further research is needed in this area, including the creation of reliable measurement tools for attachment in adulthood in our conditions and broader research on the relationships of attachment to other variables – personality characteristics, mental health, and satisfaction, as well as psychopathology, mental disorders, and somatic morbidity. The findings of our research can be important for clinical use in the evaluation of attachment in adults.


Current research:

Validation of the Czech version of the self-evaluation questionnaire “How do I experience close relationships” (ECR-R)

Attachment, health and life satisfaction

Occurrence of traumatic events in childhood, stressful events in later life, and the type of attachment in psychiatric patients