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The Use of Operant Conditioning in the Facilitation of Positive Attachment Behavior in
Narcissistic Adolescents
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The Use of Operant Conditioning in the Facilitation of Positive Attachment Behavior in
Narcissistic Adolescents
This paper will discuss the application of operant conditioning in facilitating positive
attachment in adolescents. According to Menon, Moyes & Bradley (2018), adolescent
attachment and the forms of attachment recorded depend on the adolescents' capacity and the
parents' to re-define the relationship they have. The relationship and its quality are often
dependent on the process of individuation, developmental changes in the cognitive, social, and
emotional aspects of their lives. 70% of adolescents who suffer from depression are recorded to
have insecure and negative attachment between them and their parents. 2 to 5% of these
adolescents have recurrent episodes of depression and other mental health concerns. Narcissism
could be adaptive or maladaptive, with the latter being the most common form in adolescence. In
adolescence, the occurrence of narcissistic behavior as a personality disorder is influenced by
numerous factors, one of which is self-esteem. What are the main variables relating to the
influence of self-esteem on the depiction of maladaptive narcissism tendencies in adolescents
with insecure attachment?
The attachment theory was first discovered by John Bowlby, who defined attachment as
the long-term connection between human beings. Bowlby sought to investigate and understand
the anxiety that children depict when they are separated from their parents or primary caregivers.
Subsequent research presented that attachment is a learned behavior and that it results from
feeding the relationship between two people with an association. An attachment could be
between caregivers and children, romantic partners, friends, and siblings, among other people.
Bowlby and other theorists suggested that even providing the children with food did not help to
reduce the anxiety, an indication that attachment is critical. Bowlby posited that the earliest
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attachment bond forms when people are born, between their parents and themselves, which are
bonds that last throughout life. Attachment could influence people's personalities, and in
adolescence, such behavioral disorders as narcissism are affiliated with the type of attachments
people have. Narcissistic behavior is associated with avoidant attachment, where individuals feel
an exaggerated sense of independence and power that sets them apart from other people.
Adolescents who depict narcissistic tendencies have different attachment styles, depending on
their self-esteem.
B.F founded operant conditioning. Skinner in the 1930s, informed by the work of Edward
Thorndike. The concept of operant reasoning informs that behavior modification behavior
(punishment or reward) could also be considered instrumental learning. The use of operant
conditioning was originally developed and used in animal model tests. However, today, operant
conditioning is more advanced and is recognized as one of the founding practices of
investigating psychological behavior influences and patterns. For this paper, the role of operant
reasoning is used to promote the influence of attachment in adolescents in relation to their self-
esteem and narcissistic tendencies. For adolescents, maladaptive narcissism combined with low
self-esteem leads to a preoccupied attachment style and, combined with high self-esteem, leads
to avoidant attachment.
Narcissism is a condition characterized by a sense of self-importance, a deep and
excessive need to be admitted and attended to, and an absence of empathy for other people (Kim,
2019). Low self-esteem involves someone lacking confidence in themselves, their personality,
what they can do, and their values. High self-esteem involves an extremely firm belief in one's
capabilities, achievements, and contribution to the world. Attachment is an emotional bond, one
that is shared between two people.
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Literature Review
Theoretical Literature
The emotional and effective adjustments that come with adolescence are highly
dependent on the attachments a person has made. Attachment challenges are a key contributing
factor to the occurrence of narcissistic tendencies or personalities. Child-parent attachment
influences the lives of people, especially at adolescence stages of life. Umemura et al. (2018), in
a study, seek to determine the impact of the attachment theory and attachment hierarchy on
adolescents' personalities. Their study is premised on the attachment theory and the role of
attachment hierarchy between adolescents and their parents. Their study utilized a study sample
of 212 adolescents, who held their parents high in the hierarchy, or low in the hierarchy.
Utilizing an 'important people' interview approach, the researchers indicate that the hierarchy of
attachment is dependent on the attachment figures a person has decided on. To an adolescent,
different people have a different level of importance to them. The most important attachment
figure could be their parents, a sibling, a friend, or any other individual.
The concept of hierarchy in attachment is critical in attachment theory (Umemura et al.,
2018). The researchers found that in the hierarchies of attachment, adolescents who had their
parents high on the hierarchy showed a high score on self-reports negative effect and had low
scores on self-report positive effect. However, their study concluded no significant association
between the adolescents' deviation from the norm and their attachment hierarchies. The findings
made by Umemura et al. (2018) support the hypothesis that self-esteem can influence
attachment, and attachment can influence a person’s self-esteem or cause manifestations of
maladaptive narcissistic behavior. This linkage to the hypothesis is that a high self-report on the
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negative impact shows that children who have positive attachment with their parents have higher
self-esteem and are less opposed to interacting and forming bonds with people.
In a study similar to that of Umemuri et al. (2018), Borelli et al. (2018) sought to
associate the influence of attachment and reflective functioning and narrative coherence of
adolescents on their quality of life. Their study aimed to determine if attachment security
influences their well-being in adulthood or adolescence (emerging adulthood). Borelli et al.
(2018) indicate that adolescents' psychological well-being is an outcome of attachments and
relationships that people employ in their interactions and through their reflective functioning.
Adaptive reasoning and narrative coherence are two constructs of the attachment theory that
predict adulthood and show their abilities to form and maintain relationships with people around
them. The researchers support the current hypothesis that adolescent psychology and quality of
life, including self-esteem and depiction of disorders such as narcissism, are directly linked to the
constructs of attachment leading up to the adolescent stage of life.
Lee and Hankin (2009) link dysfunctional behavior, low self-esteem, and insecure
attachment, providing these as major predictors of psychological behavior in adolescence. To
drive their study, the scholars apply the dictates of the attachment and cognitive theories to
elaborate how these factors influence behavior patterns and personality outcomes in adolescents.
Their study utilized modification of anxiety and avoidant attachment to determine their influence
on depression and anxiety as the outcomes. Lee & Hankin conclude that anxious attachment
leads to anxiety and depression in adolescence and that anxious attachment is a major predictor
of the occurrence of low self-esteem in adolescents. Their study also provided information to
conclude that individuals' cognitive functions are dependent on their self-esteem and the form of
attachments they have developed. Thus, the findings by Lee & Hankin (2009) support the
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hypothesis that self-esteem, as an independent factor, influences attachment. Similarly, the effect
of self-esteem on attachment could be linked to cognitive conditions, such as the depiction and
perceptions associated with narcissism.
Analytical Literature
People with narcissistic personalities tend to have diagnosed or undiagnosed cases of
anxiety. Menon, Moyes & Bradley (2018) suggest that interaction of self-esteem and narcissistic
tendencies inform occurrence or severity of insecure attachment in early adolescence. If an
adolescent has low self-esteem and depicts narcissistic tendencies, their attachment tends to be
avoidant. They avoid interactions with people as much as they can and will shun interactions to
the best of their abilities at any point. However, adolescents with narcissistic tendencies and low
self-esteem have been hypothesized to have a great desire to be praised and recognized and will
display withdrawal in any relationships they may have (Menon, Moyes & Bradley, 2018).
Allen et al. (2018) associate attachment security in adolescence with the relationships
between peers and parents. Using respondents between the ages of fourteen and twenty-four, the
researchers determine the impacts of attachment in the occurrence of behavioral attributes such
as narcissism in adolescence. Their premise is that attachment and relationships between peers
and parents influence the behavior and choices in adolescence. Allen et al. (2018) conclude that
attachment security promotes positive behavioral outcomes, such as higher self–esteem.
Narcissism is sometimes explained as a result of delayed development. Adolescents displaying
narcissistic behavior could be stuck in their infantile and childhood, and their wants and needs
manifest in the exaggerated need for recognition, love, compliment, and attention (Menon,
Moyes, & Bradley, 2018). These manifestations may occur if the person in question did not
receive or experience a positive attachment between themselves and their parents and childhood
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caregivers. Allen et al. (2018) support the current hypothesis in that they explain the association
between attachment and narcissistic behavior. Narcissistic adolescents have different
relationships with people around them based on their level of self-esteem, and the association has
been supported by Allen et al. (2018).
Venta, Shmueli-Goetz & Sharp (2014), through their study on attachment in adolescence
and its impact, present that it is an essential aspect to improved quality of life for adolescents.
Psychopathology is associated with peer relationships in adolescence and their strength. Using
Child Attachment Interviews, Venta, Shmueli-Goetz & Sharp (2014) suggest that a modification
of relationships could be useful in alleviating psychopathologies such as narcissism. In
adolescence, the impact of psychopathology influences numerous other factors of life that are
dependent on positive attachments. The hypothesis that narcissism contributes majorly to the
type of attachment is supported by the conclusions made by Venta, Shmueli-Goetz & Sharp
(2014). A narcissistic adolescent with high self-esteem will have a positive attachment and may
build relationships with people. On the other hand, a narcissistic adolescent with low self-esteem
will have negative attachments. Despite the form of attachment they depict in adolescence,
individuals with narcissistic behavior will have a life that is centered on their perseveration,
which in the end impairs their self-reliance perceptions and their standing in the social scenes of
their lives (Venta, Shmueli-Goetz & Sharp, 2018). Based on these arguments, these scholars
support the current proposal, supporting that there is a positive link between narcissism and
attachment that can be improved through attempts of operant conditioning.
Individuals who are insecurely attached tend to have challenges asking or receiving
assistance from other people (Loeb et al., 2020). In a study aimed at defining the association
between attachment and adult negativity, these scholars utilize 184 adolescents and adults who
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participate in self-report tests and measures. Their findings indicate that individuals with
insecure attachment may depict low self-esteem, and in turn, may have difficulties marinating
relationships with their partners and friends. Moreover, attachment insecurity is facilitated if an
individual feels self-sufficient and undeserving of help from other people. Their research
findings support the current hypothesis that dependency (an attribute associated with
maladaptive narcissism) will combine with other factors, such as self-esteem to influence the
types of attachments that people have.
Chen et al. (2012) conducted a study to associate perfectionistic self-presentation, social
disconnection, and insecure attachment in adolescents. Their study applies the Social
Disconnection Model (PSDM) to demystify adolescents' social aspects and the association of
perfectionism and self-esteem and their impact on an individual’s social connections. Chen et al.
(2012) conclude that having and displaying deceptive self-perfectionism could inhibit one's
ability to keep and grow thriving interpersonal relationships and social support. Their study
findings add information to the hypothesis that narcissism is a key factor in maintaining
relationships and attachment. Narcissism often manifests itself in a feeling of self-importance,
which would lead narcissistic adolescents to depict themselves as perfect while they are not.
Discussion
Summary
Narcissists tend to be focused on their own feelings and are oblivious to the feelings of
other people. According to Kim (2019), a normal level of being narcissistic is required for people
to have good self-esteem. However, maladaptive narcissism is a pathological form where the
individual’s mental capacity is impaired. When coupled with low self-esteem, maladaptive
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narcissism will result in a negative attachment in adolescents. Preoccupied attachment is
characterized by adolescents' inability to interact sociably with other people or participate in
healthy interactions with their peers, parents, or partners. They often seek to be affirmed, which
indicates that they cannot perceive themselves as important or valuable. Maladptively narcissistic
adolescents with high self-esteem will have an avoidant attachment style that points to attributes
of self-enhancement.
Recommendations
The completed research is significant in introducing the associations between attachment
in adolescence, self-esteem, and maladaptive (pathological) narcissism. Numerous lessons can be
taken away from this research, including the associations between narcissism and self-esteem as
indicators of attachment issues in adolescence.
The development of narcissistic defense mechanisms can be learned from this research.
First, adolescent narcissists tend to have a background of having one or both parents or
caregivers who were chronically aggressive or cold towards them (Kim, 2019; Menon, Moyes, &
Bradley, 2018). Therefore, their ability to form and maintain relationships is compromised at an
early stage, and they develop measures of self-preservation. This self-preservation behavior
translates to their self-esteem (whether low or extremely high). Second, in adolescence, their
self-esteem and narcissistic tendencies combine to inform their attachment styles, resulting in a
cycle of factors influencing one another. Third, the outcome of a cold upbringing as a child is a
differentiation of oneself from others, especially in adolescence and adulthood. Finally,
adolescents who have narcissistic tendencies often seem to be drawing comfort from themselves
rather than others because they have internalized a frightening 'object' that does not accord them
assurance, comfort, or peace. These lessons inform that self-esteem, attachment, and narcissism
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are three concepts that work hand in hand in adolescence to inform their behavior patterns and
their ability to form and maintain relationships.
Future Research
A majority of the studies reviewed for the completed study were the initial ones in
explaining the relationships they have reviewed. Future research is recommended in determining
how self-esteem as an individual factor can influence attachment. Additionally, the research on
how well self-esteem influences positive attachments is critical to further link the variable
reviewed in the completed paper.
Conclusion
Menon, Moyes & Bradley hypothesized and confirmed that adolescent girls are more
likely to live in the quest for self-affirmation, while adolescent boys are more likely to seek self-
enhancement narcissistically. The scholars conclude that narcissism has a major role to play in
the development of various aspects of life in adolescence. Their position is supported by the
positions of Chen et al. (2014), that narcissism is a pathological condition that is not born from
the absence of an attachment in childhood. Instead, narcissism is a behavior, and it can be
acquired or developed pathologically as people grow, based on their self-esteem. Maladaptive
narcissism promotes the occurrence of avoidance, which means that an adolescent will
constantly avoid interacting with people around them, unless when they are seeking recognition,
or attention (Menon, Moyes, Bradley, 2018). Such behavior could affect their ability to form
friendships with peers in their adolescence, whether their self-esteem is high or low. A narcissist
with low self-esteem will have challenges forming relationships since they will have a false
perception of everyone trying to attack them. A narcissistic adolescent with high self-esteem will
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have a challenge forming attachments and relationships with peers or friends since they feel too
important to be associated with other people.
Assessment of the Writing Process
Researching for, writing, and presenting a research paper is a mandatory requirement in
academia. Even though it informs a lot of tension and anxiety, the process of developing this
paper was interesting and enlightening, one that led me to learn new material on attachment, self-
esteem, and narcissism in adolescence. The completion of the paper was very rewarding, as it
contributed to the existing body of knowledge and literature on the topic. To derive the correct
paper, I first reproduced my outline into a blank word document and filled the areas with the
relevant information of what I would cover in each section. I then went on to the online libraries
and journal repositories to find the most relevant research papers on operant conditioning and the
use in psychological behavior research. Once I had settled on a topic, I reviewed the article to
find the most relevant ones that were applied in this research paper. Gaining insight on the topic
from the abstracts in these research papers helped me develop my outline in a PowerPoint
presentation, where I could easily follow up on what to include in the research writing.
Completing this assignment was instrumental to my understanding of the different forms
of narcissism and why it occurs. In addition, I have learned that children and adolescents form
bonds with their parents or caregivers that influence their behavior patterns as they grow and
transition through life. These concepts relate directly to behavior and psychological dictates of
the same, which give very instrumental information relating to my career. In my pursuance of a
career in psychological counseling, I feel that this assignment played a primary role in helping
me research, write and communicate.
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References
Allen, J. P., Grande, L., Tan, J., & Loeb, E. (2018). Parent and peer predictors of change in
attachment security from adolescence to adulthood. Child development, 89(4), 1120-
1132. https://doi.org/10.1111/cdev.12840
Borelli, J. L., Brugnera, A., Zarbo, C., Rabboni, M., Bondi, E., Tasca, G. A., & Compare, A.
(2019). Attachment comes of age: adolescents’ narrative coherence and reflective
functioning predict well-being in emerging adulthood. Attachment & human
development, 21(4), 332-351. https://doi.org/10.1080/14616734.2018.1479870
Chen, C., Hewitt, P. L., Flett, G. L., Cassels, T. G., Birch, S., & Blasberg, J. S. (2012). Insecure
attachment, perfectionistic self-presentation, and social disconnection in
adolescents. Personality and Individual Differences, 52(8), 936-941.
https://doi.org/10.1016/j.paid.2012.02.009
Kim, Y. H. (2019). The effects of anxious attachment on social anxiety in college students:
Mediation effects of self-esteem, shame and narcissistic vulnerability. Korean Journal of
Stress Research, 27(2), 174-182. https://doi.org/10.17547/kjsr.2019.27.2.174
Loeb, E. L., Stern, J. A., Costello, M. A., & Allen, J. P. (2020). With (out) a little help from my
friends: insecure attachment in adolescence, support-seeking, and adult negativity and
hostility. Attachment & Human Development, 1-19.
https://doi.org/10.1080/14616734.2020.1821722
Lee, A., & Hankin, B. L. (2009). Insecure attachment, dysfunctional attitudes, and low self-
esteem predicting prospective symptoms of depression and anxiety during
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adolescence. Journal of clinical child & Adolescent Psychology, 38(2), 219-231.
https://doi.org/10.1080/15374410802698396
Menon, M., Moyes, H. C., & Bradley, C. M. (2018). Interactive influences of narcissism and
self-esteem on insecure attachment in early adolescence. The Journal of Early
Adolescence, 38(7), 966-987. https://doi.org/10.1177/0272431617704955
Umemura, T., Lacinová, L., Kraus, J., Horská, E., & Pivodová, L. (2018). Adolescents’ multiple
versus single primary attachment figures, reorganization of attachment hierarchy, and
adjustments: The important people interview approach. Attachment & human
development, 20(5), 532-552. https://doi.org/10.1080/14616734.2018.1464040
Venta, A., Shmueli-Goetz, Y., & Sharp, C. (2014). Assessing attachment in adolescence: A
psychometric study of the Child Attachment Interview. Psychological
assessment, 26(1), 238. https://doi.org/10.1037/a0034712
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Article Abstracts
Abstract 1: Allen et al. (2018)
Interview, self-report, peer report, and observational data were used to examine parent
and peer relationship qualities as predictors of relative changes in attachment security in a
community sample of adolescents followed from ages 14 to 24. Early maternal supportive
behavior predicted relative increases in attachment security from adolescence to adulthood,
whereas psychological control and interparental hostile conflict predicted relative decreases. Peer
predictors of relative increases in security included collaborative and autonomous behaviors and
lack of hostile interactions, with peer predictions growing stronger for relationships assessed at
later ages. Overall, models accounted for sufficient variance as to suggest that attachment
security across this period is well explained by a combination of stability plus theoretically
predicted change linked to social relationship qualities.
Abstract 2: Borelli et al. (2018)
This study investigated the effects of adolescents’ attachment security and reflective
functioning (RF) (assessed by the adult attachment interview [AAI]) in the prediction of well-
being in adulthood. Adolescents (N = 79; M = 14.6 years old; SD = 3.5 years) completed the
AAI at Time 1 (T1), which was subsequently coded for inferred attachment experiences,
narrative coherence, and RF by three non-overlapping teams of raters. Participants completed the
Psychological General Well-being Index at T1 and 8 years later (Time 2, T2). Analyses showed
that (a) both adolescent narrative coherence and RF were significant predictors of almost all
indices of well-being at T2 in adulthood; (b) both narrative coherence and RF indirectly linked
inferred loving parental care and T2 well-being; (c) when included in the same model, RF was a
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significant indirect effect linking inferred loving parental care and T2 well-being. These findings
contribute to theory in suggesting that both RF and narrative coherence are predictive of
subsequent psychological well-being and operate as links between inferred parental care and
subsequent adjustment. Possible mechanisms underlying these findings are discussed.
Abstract 3: Chen et al. (2012)
The purpose of the present study was to investigate several components of the
Perfectionism Social Disconnection Model (PSDM) by assessing the relationships among
perfectionism, insecure attachment, and social disconnection in adolescents. This study
examined perfectionistic self-presentation, attachment style, and experience of disconnection
from social environment in a sample of 178 adolescents. Results indicated that perfectionistic
self-presentation facets were significantly correlated with social disconnection and fearful
attachment was associated with the nondisclosure of imperfection. Moreover, nondisclosure of
imperfection partially mediated the relationship between fearful attachment and social
disconnection. The current study is the first to examine the link between insecure attachment and
perfectionistic self-presentation and provides some evidence supporting the PSDM.
Abstract 4: Kim (2019)
Background: This study aimed to examine the effect of anxious attachment on social anxiety in
college students and to identify the mediation effects of self-esteem, shame and narcissistic
vulnerability in using structural equation modeling.
Methods: College students participated in this study.
Results: First, all variables in this study had statistically significant correlation. Second, the
relationship of anxious attachment and social anxiety was significantly mediated by self –esteem
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and shame, respectively. Finally, the two serial multiple mediation effects were also significant
from anxious attachment to self-esteem, shame and narcissistic vulnerability or social anxiety
successively.
Conclusions: These results suggest that students’ unstable attachment can affect social anxiety or
narcissistic vulnerability by mediating negative affect such as low self-esteem and shame. An
intervention for students’ social anxiety is important in controlling their mental health.
Article 5: Loeb et al (2020)
Attachment theory suggests that insecurely attached individuals will have more difficulty
seeking and receiving support from others. Such struggles in adolescence may reinforce negative
expectations of others and contribute to relationship difficulties into adulthood. Using a diverse
community sample of 184 adolescents followed from age 13 to 27, along with friends and
romantic partners, this study found that more insecure states of mind regarding attachment at age
14 predicted relative decreases in teens’ abilities to seek and receive support from close friends
from ages 14–18. In addition, greater attachment insecurity predicted greater observed negative
interactions with romantic partners and relative increases in hostile attitudes from ages 14 to 27.
The effect of attachment insecurity on observed negativity was mediated by difficulty
seeking/receiving support in friendships during adolescence. Results suggest a type of self-
fulfilling prophecy as insecure adolescents confirm their negative expectations of others through
ongoing struggles to obtain support.
Abstract 6: Lee & Hankin (2009)
This study extends the existing adult literature on insecure attachment as a predictor of
depression and anxiety by examining these pathways in a sample of adolescents. In addition,
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dysfunctional attitudes and low self-esteem were tested as mediators of the association between
insecure attachment and symptoms of depression and anxiety. Youth (N =350; 6th–10th graders)
completed self-report measures of attachment, dysfunctional attitudes, self-esteem, and
symptoms of depression and anxiety in a 4-wave prospective study. Results indicate that anxious
and avoidant attachment each predicted changes in both depression and anxiety (after controlling
for initial symptom levels). The association between anxious attachment, but not avoidant
attachment, and later internalizing symptoms was mediated by dysfunctional attitudes and low
self-esteem. Effects remained even after controlling for initial co-occurring symptoms.
Abstract 7: Menon, Moyes & Bradley (2018)
We hypothesized that in adolescence, maladaptive narcissism interacts with low self-
esteem to predict a preoccupied attachment style (attachment for self-affirmation hypothesis),
and with high self-esteem to predict an avoidant attachment style (attachment for self-
enhancement hypothesis). We expected gender differences in narcissistic adolescents’
attachment strategies, with girls more likely to be motivated to self-affirm, and boys more likely
to self-enhance. Early adolescents in England (N = 306, 156 girls, 150 boys, X age = 13.38
years) responded to self-report measures of narcissism, self-esteem, and attachment styles to
mother and a friend. Results supported the attachment for self-enhancement hypothesis only. For
adolescent boys (but not girls) with high self-esteem, narcissism was associated with higher
avoidant attachment toward the mother and a friend. The results suggest that maladaptive
narcissism might derail normative separation-individuation processes in adolescent boys, thus
contributing to their adoption of an avoidant attachment style with close relationship partners.
Abstract 8: Umemura et al. 2018
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Using 212 adolescents from a central-European country (mean age = 14.02, SD = 2.05,
ranged from 11 to 18 years; females = 54%) and a multi-informant method to measure
adolescents’ behavioral and emotional adjustments, the present study explored three aspects
regarding the attachment hierarchy. (1) The three types of behavioral systems of Rosenthal and
Kobak’s important people interview (IPI) were initially validated using an exploratory factor
analysis with a US sample. Using a confirmatory factor analysis with a Czech sample, we
replicated these three behavioral systems: attachment bond, support seeking, and affiliation. (2)
We found that adolescents who developed attachment bond to multiple primary attachment
figures were likely to score lower on both teacher-rated and parent-rated internalizing problems
compared to those who had a single primary attachment figure. These multiple primary
attachment figures tended to be family members (not peers). (3) Early adolescents who placed
parents low in their attachment hierarchy scored higher on self-reported negative affect and
lower on self-reported positive affect compared to early adolescents who placed parents high.
The present study highlights multiple (vs. single) primary attachment figures as a protective
factor and the premature reorganization of attachment hierarchy as a risk factor for adolescents’
emotional and affective adjustments.
Abstract 9: Venta, Shmueli-Goetz & Sharp, 2013
Research has established the quality of attachment as an important correlate and predictor
of psychological well-being. Adolescence represents an important transitional period and is
associated with considerable changes in psychosocial functioning and centrally in attachment
relationships. However, measures of attachment are rarely examined for their psychometric
properties in adolescence. In an attempt to address this limitation, the current study reports on the
use of the Child Attachment Interview (CAI) in adolescents. Our broad aim was to explore the
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psychometric properties of the CAI classifications and subscales among adolescents with
psychiatric disorder in the United States by (a) evaluating inter-rater reliability of the CAI, (b)
examining the factor structure of the CAI subscales in adolescents, (c) examining relations
between CAI classifications and subscales, (d) evaluating concurrent validity by assessing
relations between the CAI and established questionnaire-based measures of attachment routinely
used in adolescent samples, and (e) evaluating convergent validity by exploring relations
between the CAI and parent- and self-reported psychopathology and peer relations. One hundred
ninety-four inpatient adolescents were recruited. Analyses revealed adequate inter-rater
agreement and revealed 3 factors that generally mirror those associated with the Adult
Attachment Interview. Concurrent and convergent evidence to support the use of CAI attachment
classifications and subscale scores in adolescents was provided.
