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A series of recent research findings has begung to supply strong evidence of a highly significant correlation between borderline psychopathology and experiences of repeated childhood trauma including sexual abuse (especially incest), physical abuse, and the witnessing of severe domestic violence (Bryer et al. 1987; Herman et al. 1989; Western et al. 1990; Zanarini et al. 1989). The replication of these results with different research samples is in contrast to the inconsistent findings associated with earlier etiological theories, in which the roots of borderline pathology were variously linked to schizophrenic or affective illnesses (Akiskal 1981; Akiskal et al. 1985; Klein 1977; Perry 1985), to derailments in the separation-individuation process (Kernberg 1975, 1976; Mahler and Kaplan 1977; Masterson and Rinsley 1975), to actual early losses and separations (Bradley 1979; Paris et al. 1988; Soloff and Millward 1983a, 1983b), to severe empathic failures during the first years of life (Adler and Buie 1979), or to more general family-based pathologies (Frank and Hoffman 1980; Frank and Paris 1981; Grinker et al. 1968; Gunderson and Englund 1981; Gunderson et al. 1980; Links 1990; Walsh 1977; Zinner and Shapiro 1975). Not only do current findings regularly identify 50% to 80% of subjects as victims of childhood abuse and trauma, but also several studies show that factors such as age of onset, severity, and type of abuse reliably discriminate between borderline and other diagnostic groups (Herman et al. 1989; Zanarini et al. 1989).

Objective: This article describes development and initial validation studies of the Primary Attachment Style Questionnaire (PASQ), a brief self-report for delineating six styles of attachment to a primary caregiver. Theoretically cued to Ainsworth's original infant classifications, the questionnaire is designed to map attachment patterns during two developmental periods (before and after age 12) and is intended for use in both clinical and non-clinical populations. Method: Pilot studies of the PASQ were conducted with a total of 441 college undergraduates. Over this period, test-retest analyses and factor analyses reduced the number of questionnaire items to the current 42-item version. Participants also responded to a variety of additional measures intended to assess the PASQ's validity. Results: In the first of three validity studies, investigators found moderate correlations between 120 college undergraduates' predominant attachment styles on the PASQ Before 12 and romantic attachment styles on Brennan, Clark, and Shaver's ECR. In the second study, 167 respondents' Axis I and Axis II scores on the Millon Clinical Multiaxial Inventory supported the hypothesis that particular insecure attachment styles before age 12 would be related to specific personality disorders and to PTSD. The third validity study demonstrated the PASQ's sensitivity to shifts in attachment security between childhood and adolescence in the presence of three types of events that might generate attachment-related distress: mother's death, parents' divorce, and disruption of mother's ability to provide adequate caregiving. Conclusion: Findings support the utility of the PASQ for use in attachment research and in clinical practice.

Adults with histories of severe childhood abuse often experience considerable difficulties with interpersonal trust. At the same time, they may strongly desire to be less alone with the painful aftereffects of their traumatic pasts. Psychotherapy groups have often been recommended as important components of treatment for reducing survivors' feelings of isolation and shame. We propose that an understanding of attachment styles and of traumatic bonding helps to clarify the specific manifestations of interpersonal distrust as they may emerge in a survivors' group. In addition, we suggest guidelines for determining what kind of group may be appropriate for a given individual at a particular point in treatment.