The Bielefeld Attachment Questionnaires: Overview and Empirical Results of an Alternative Approach to Assess Attachment

[Measurement Invariance and Validity of the Short Form of the Bielefeld Partnership Expectations Questionnaire (BPEQ12)]

The short form of the Bielefeld Partnership Expectations Questionnaire (BPEQ12) measures three partner-related attachment scales: fear of rejection, readiness for self-disclosure and conscious need for care. In addition to factor structure and reliability, the present study examined measurement invariance and validity using a non-clinical and a clinical sample of college students (N=208). Besides the BFPE12, the following Questionnaires were assessed: Short Form of Experiences in Close Relationships - Revised (ECR-RD8), Outcome Questionnaire (OQ-30), revised Beck Depression Inventory (BDI-II), Social Phobia Inventory (SPIN), and Test Anxiety Inventory (TAI-G). The factor structure is tested using confirmatory factor analysis (CFA), the internal consistency of the scales is quantified using McDonald's ω, the measurement invariance is investigated with two-group structural equation models, and the validity is examined using correlation and regression analyses. In both samples, the factor structure was confirmed (CFI>0.93; TLI>0.93; RMSEA<0.08; SRMR<0.08) and the reliability of all three scales was acceptable (ω>.7) - with the exception of need for care in the non-clinical group. We found configurational, metric and scalar measurement invariance regarding to the assignment in the clinical and non-clinical sample. In terms of convergent validity, fear of rejection and conscious need for care were associated with attachment-related anxiety (r=0.771 and r=0.539, p<0.001) and low readiness for self-disclosure was correlated with attachment-related avoidance (measured with ECR-RD8, r=- 0.704, p<0.001). Overall, the present study supports the factor structure, measurement invariance, reliability, and validity of the BPEQ12 in clinical and non-clinical samples.

Factor Structure and Convergent Validity of the Short Version of the Bielefeld Partnership Expectations Questionnaire in Patients With Anxiety Disorder and Healthy Controls

The short version of the Bielefeld Partnership Expectations Questionnaire (BPEQ-12) assesses the partner-related attachment dimensions fear of rejection, readiness for self-disclosure, and conscious need for care. The presented study investigated the factor structure in two samples and evaluated the convergent validity of scales. The sample included N = 175 patients with panic disorder and/or agoraphobia and N = 143 healthy controls. Besides, the BPEQ, the Experiences in Close Relationships Questionnaire (ECR), and the Brief Symptom Inventory (BSI) were assessed as well, and the Adult Attachment Prototype Rating (AAPR) was conducted. A confirmatory factor analysis of the three factor model (using a WLSMV estimator) revealed an acceptable model fit for the entire sample, patients and controls in terms of low RMSEA and SRMR (< 0.08) and high CFI and TLI (> 0.95). We found metric, scalar, and strict measurement invariance for the presence of anxiety disorder (ΔCFI ≤ –0.01 and ΔRMSEA ≥ 0.01). However, only for fear of rejection and readiness for self-disclosure the reliability was acceptable (Cronbach’s α > 0.7), and convergent validity in terms of large correlations (r > 0.7) with the ECR scales was found in both samples. The scale conscious need for care had a questionable reliability (Cronbach’s α > 0.6) and correlated only slightly with ECR-R scales. We conclude that fear of rejection and readiness for self-disclosure of the BPEQ-12 are reliable and valid scales for measuring partner-related attachment in healthy and clinical samples.

Is there an elephant in the room? A study of convergences and divergences of adult attachment measures commonly used in clinical studies

Objective: In view of the persisting conceptual confusion related to the convergence of attachment measures, we investigated several common measures within a clinical and a non-clinical sample, tested the convergence/divergence of different measures, and tried to find a dimensional model. Method: 175 patients with panic disorder/agoraphobia and 143 matched non-clinical individuals completed seven self-report attachment measures/ clinical self-reports and were interviewed by applying the Adult Attachment Interview (AAI), the Adult Attachment Rating (AAR) and the Adult Attachment Projective (AAP). Results: The categorical and most dimensional attachment measures differentiated between the samples. The convergence of the categorical measures was low, whereas we found moderate to high correlations between similar scales in the dimensional self-report measures. Expectedly, the convergence of dimensional and categorical attachment measures was low. In a factorial (exploratory as well as confirmatory) model, four independent dimensions were extracted reflecting self-rated attachment anxiety and avoidance, the categories of the AAI and those of the AAP, indicating significant differences between the measures. Discussion: Measures of adult attachment are only partially convergent, underlining the need for clarification of which aspect of attachment is actually being assessed in individual clinical investigations. The question remains whether the different measures are in fact related to one construct.

Patient's and the Therapist's Attachment Representations, Attachment to Therapists, and Self-Esteem-Change Through Psychotherapy

Objectives: The present naturalistic study aims to investigate the differential effects of the patient’s and the therapist’s attachment representations on the attachment to the therapist as perceived by the patient, and their impact on self-esteem-change through psychotherapy.

Methods: Attachment variables of N = 573 patients as well as N = 16 therapists were assessed. Attachment representations were measured for therapists and patients via the Bielefelder Questionnaire for Client Attachment Exploration, the Relationship Specific Attachment to Therapist Scales and the Adult Attachment Interview. The patient’s attachment to therapists was evaluated and patients’ self-esteem was measured via the Frankfurter Selbstkonzeptskalen at the beginning and end of psychotherapy.

Results: Although there were significant effects of the patient’s attachment representations on the perceived attachment to the therapist as well as between the perceived attachment to the therapist and the amount of self-esteem-change, the therapist’s attachment style had no significant influence on the perceived attachment to the therapist.

Conclusion: Self-esteem-change through psychotherapy is influenced by the actually formed attachment relationship as perceived by the patient. The patient’s attachment representations but not the therapist’s attachment style contributes to the actual patient’s attachment to the therapist.

Differential effects of adult attachment in cognitive-behavioural and psychodynamic therapy in social anxiety disorder: A comparison between a self-rating and an observer rating

Different measures of attachment are usually weakly correlated. In a subsample of an RCT comparing short-term cognitive-behavioural therapy (CBT) and psychodynamic therapy (PDT), we examined the association between attachment and outcome using two attachment measures. The sample comprises 148 patients with social anxiety disorder who were treated in the SOPHO-NET trial. Pretreatment attachment was assessed using the Adult Attachment Prototype Rating (AAPR) and the Bielefeld Questionnaire of Client Expectations (BQCE). Regression models were used to predict the therapeutic alliance (HAQ) at session 8, the Liebowitz Social Anxiety Scale (LSAS) at the end of therapy and a 6-month follow-up. Attachment groups (secure, avoidant, and ambivalent) classified with the AAPR and the BQCE were not significantly correlated (Cohen's κ = 0.08). Only the BQCE was associated with the HAQ indicating avoidantly attached patients showing lower HAQ scores than securely attached (Cohen's d = 0.722). Regarding the AAPR, we found an interaction effect of treatment and attachment related to the post-treatment LSAS scores. Post hoc tests revealed that securely attached patients in CBT had lower scores than securely attached in PDT (d = 0.922) and, on a trend level, avoidantly attached in CBT (d = 0.782). We conclude that attachment-outcome associations are affected by the applied measure. The identified differential effects suggest that psychotherapists should adapt the interventions on the attachment of their patients.

Kurzversion des Bielefelder Fragebogens zu Partnerschaftserwartungen (BFPE-12)

Zusammenfassung. Die Kurzfassung des Bielefelder Fragebogens zu Partnerschaftserwartungen (BFPE-12) ist ein Selbstrating zur Messung partnerschaftsbezogener Bindungsaspekte. Neben der Messung der Dimensionen Akzeptanzprobleme, Öffnungsbereitschaft und Zuwendungsbedürfnis können Personen Bindungsmustern zugewiesen werden. Die vorliegende Studie evaluiert Faktorenstruktur und psychometrische Eigenschaften des Instruments anhand einer aktuellen bevölkerungsrepräsentativen Stichprobe. Die Stichprobe umfasst N = 1574 Personen. Es wurden soziodemographische Variablen, der BFPE-12, die Kurzform des Depressive Experiences Questionnaire Self-Criticism sowie der Patient Health Questionnaire-4 erhoben. Es wurden explorative und konfirmatorische Faktorenanalysen durchgeführt und interne Konsistenz, Itemstatistiken und Korrelationen mit Außenkriterien bestimmt. Explorative und konfirmatorische Faktorenanalyse bestätigten die angenommene Faktorenstruktur (RMSEA < .08). Die interne Konsistenz der drei Skalen war akzeptabel (α > .7). Starke Akzeptanzprobleme und geringe Öffnungsbereitschaft korrelierten hypothesenkonform mit Selbstkritik, Ängstlichkeit und Depressivität. z-Werte, t-Werte und Prozentränge werden berichtet. Insgesamt kann für den BFPE-12 konstatiert werden, dass er eine mehrfach evaluierte Faktorenstruktur und akzeptable psychometrische Eigenschaften aufweist.

Social anxiety as a potential mediator of the association between attachment and depression

OBJECTIVE

The study represents a conceptual replication of the study by Eng et al. (2001) in a sample of adult patients diagnosed with social anxiety disorder as primary diagnosis.

METHODS

Two different attachment questionnaires (Bielefeld Questionnaire of Client Expectations (BQCE) and Experiences in Close Relationships (ECR-RD)) were applied to examine whether the effect of attachment on depression (measured by the BDI) is mediated by social anxiety (measured by the LSAS) in a cross-sectional study.

RESULTS

The data confirms such a mediation. The effect of attachment measured with the BQCE on depression was completely mediated, whereas the effect of both scales of the ECR-RD (attachment related avoidance and anxiety) on depression was only partially mediated by social anxiety disorder.

CONCLUSION

The study supports the association of attachment, social anxiety, and depressive symptoms and the need to consider different perspectives on attachment.

Parental dyadic coping in families of children and adolescents with type 1 diabetes

BACKGROUND

The strains of type 1 diabetes mellitus in children and adolescents pose a challenge to the minor and his/her parents.

OBJECTIVE

The objective of this study was to identify parental dyadic coping patterns and explore their relation to psychosocial and disease variables.

SUBJECTS

Parents (n=44 dyads) of children/adolescents with type 1 diabetes.

METHODS

Cluster analysis employing Ward's method was conducted as a multivariate classification procedure without predetermined cluster centers.

RESULTS

Three parental coping clusters were identified and labeled: avoiders, negotiators, and doers. Although not reaching statistical significance, the HbA1c levels of children/adolescents with parental dyads exhibiting the negotiator coping pattern were consistently lower than the levels of children with parents classified as avoiders or doers.

CONCLUSIONS

Parental dyads were distinguishable based on their dyadic coping patterns with a substantial proportion employing avoidant coping and suboptimal communication strategies. These parental dyads may benefit from minimal psychosocial intervention.

Effects of adult inpatient group psychotherapy on attachment characteristics: an observational study comparing routine care to an untreated comparison group

This study investigated the changes in attachment characteristics of patients undergoing inpatient group psychotherapy in routine care. We collected data from 265 consecutively recruited patients and 260 non-clinical control persons using self-report measures of attachment, depression, and socio-demographic characteristics. The effects of treatment on patients were analyzed using propensity score techniques (propensity strata and logit-transformed propensity scores) in combination with a generalized analysis of covariance. A moderate increase of attachment security was found which could be attributed to a decrease both in attachment anxiety and avoidance. Pre-post improvements in attachment with regard to romantic partnerships were stable after a 1-year follow-up. Furthermore, we found significant treatment-covariate interactions indicating that subjects with particularly high treatment propensities (propensities were highly correlated with depression and attachment anxiety) improved the most in terms of attachment security. Our results are encouraging for psychotherapeutic practice in that they provide evidence that long-term attachment improvements can be reached via psychotherapy. Our results will also provide a sound basis for future studies in the field of clinical attachment research, e.g., studies examining whether improved attachment security is correlated to symptom improvements in different psychological disorders.

Standard values and relationship-specific validity of the Bielefeld Relationship Expectations Questionnaire (BFPE)

BACKGROUND

The Bielefeld Partnership Expectations Questionnaire (BFPE) is a tool to assess attachment in the romantic relationships of adults. The attachment styles are operationalized as configuration patterns of scale scores. While convergent validity has already been investigated, discriminant validity is still lacking confirmation.

METHODS

The present sample (n = 1509) is representative for the German population aged 18 to 50. The mean age was 34.6 years. Most of the participants lived in a relationship (77.3 %). Discriminant validity was analyzed using a marital quality questionnaire (PFB), a social support questionnaire (F-Soz-U K-14), and a life satisfaction questionnaire (FLZ).

RESULTS

All the BFPE scales have a satisfying internal consistency between r = .79 and .86. Those individuals who showed a secure pattern, i.e. increased "Readiness for Self-Disclosure" and "Conscious Need for Care" as well as reduced "Fear of Rejection" experienced their partner as socially supportive, reported higher marital quality in all of its facets, and were more satisfied within the life-domains "family/children" and "relationship/sexuality". Standard values for each scale are presented.

CONCLUSIONS

The BFPE has repeatedly been verified as a short, reliable, and valid instrument applicable to research practice with healthy individuals as well as within clinical contexts.