The prevalence of personality disorder in community mental health care appears to be substantial, but better estimates will only emerge from high quality studies with greater consistency of method. Implementing screening tools within outpatient or community services may result in high rates of personality disorder identification, with both clinical and service implications.

Attachment concepts are used in diverging ways, which has caused confusion in communication among researchers, among practitioners, and between researchers and practitioners, and hinders their potential for collaboration. In this essay we explore how attachment concepts may vary in meaning across six different domains: popular discourses, developmental science, social psychological science, psychiatric diagnosis, psychotherapy, and child welfare practice. We attempt to typify these forms of attachment discourse by highlighting points of convergence, divergence, and relay between the different domains. Our general conclusions are that diversity in the use of attachment concepts across different domains of application has been largely unrecognised, and that recognition of these differences would reduce confusion, help identify sites where infrastructure needs to be developed to support coordination, and strengthen opportunities for collaboration to mutual benefit. We suggest that academic attachment discourse would benefit from clarification of core terminology, including: "attachment", "internal working model", "trauma", and "dysregulation".

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Clinical practitioners are frequently encouraged, through literature, training, and policy, to learn, understand, refer to and use their knowledge of attachment theory and research when working to meet the needs of children and families. However, there has been very little empirical study of how practitioners understand and perceive the relevance of attachment concepts and methods. Q-methodology was used to examine the perceptions of attachment knowledge and its applications for practice among 30 UK clinicians working with children and an international group of 31 attachment researchers. Factor analysis revealed three perspectives, described as: i) pragmatic, developmental, and uncertain, ii) academic, and iii) autodidactic and therapeutic. Participants agreed on core tenants of theory, their aspirations for clinical practice and the inaccessibility of current assessment measures for practitioners. Yet they diverged on their understandings of attachment insecurity, disorganisation, and the implications of both for various aspects of child development.