C O M M E N T A R Y

DYNAMIC-MATURATIONAL MODEL OF ATTACHMENT AND ADAPTATION VERSUS

ABC+D ASSESSMENTS OF ATTACHMENT IN CHILD PROTECTION AND TREATMENT:
REPLY TO VAN IJZENDOORN, BAKERMANS, STEELE, & GRANQVIST (2018)

PATRICIA M. CRITTENDEN
Family Relations Institute, Miami, Florida

SUSAN J. SPIEKER
University of Washington

ABSTRACT: In this brief response, we commend the commentary authors for joining a dialogue about the future of individual differences in attachment
both around person-specific forensic and clinical issues also around working together to develop theory and coding practices. We point to several areas
of explicit and implicit agreement and discuss several misunderstandings. We close with a proposal for future work together, possibly using the only
set of video-recorded Strange Situations classified by Mary Ainsworth as a starting point from which we can explore alternative means of extending
and expanding her work.

RESUMEN: En esta breve respuesta, aplaudimos a los autores del comentario por haberse unido al diálogo acerca del futuro de las diferencias
individuales en la afectividad, tanto en términos de los asuntos forenses y clı́nicos de una persona especı́fica, como en términos de trabajar en conjunto
para desarrollar prácticas teóricas y de codificación. Señalamos varias áreas en las que se dan acuerdos implı́citos y explı́citos y discutimos varios
malentendidos. Terminamos con una propuesta para el trabajo en conjunto en el futuro, posiblemente usando el único grupo de videograbaciones de la
Situación Extraña clasificada por Mary Ainsworth como un punto a partir del cual podemos explorar maneras alternativas de extender y expandir el
trabajo de Ainsworth.

RÉSUMÉ: Dans cette courte réponse, nous saluons la contribution des auteurs de commentaires pour s’être joints à un dialogue sur le futur des
différences individuelles dans l’attachement à la fois pour ce qui concerne l’expertise médico-légale et les problèmes cliniques ainsi que le travail de
concertation pour développer des théories et des pratiques de codage. Nous mettons en évidence certains domaines d’accord explicite et implicite et
discutons plusieurs malentendus. Nous concluons avec un projet de travail commun, qui pourrait utiliser le seul ensemble de Situations Etranges filmées
en vidéo par Mary Ainsworth comme point de départ à partir duquel nous pouvons explorer des moyens alternatifs d’agrandir et d’étendre le travail de
Ainsworth.

ZUSAMMENFASSUNG: In dieser kurzen Stellungnahme empfehlen wir den Kommentatoren, sich an einem Dialog über die Zukunft individueller Bindung-
sunterschiede sowohl hinsichtlich personenbezogener forensischer und klinischer Fragestellungen als auch in Bezug auf die Zusammenarbeit bei der
Entwicklung von Theorie und Kodierungspraktiken zu beteiligen. Wir weisen auf mehrere Themenfelder mit expliziter und impliziter Übereinstimmung
hin und diskutieren einige Missverständnisse. Abschließend schlagen wir eine zukünftige Zusammenarbeit vor, bei der möglicherweise die per Video
aufgezeichneten Fremden Situationen, die von Mary Ainsworth klassifiziert wurden als Ausgangspunkt verwendet werden, von dem aus wir alternative
Wege zur Erweiterung und zum Ausbau der Arbeit von Ainsworth erforschen können.

We thank Mark Baumann, J.D., for verifying Family Court standards.

Direct correspondence to: Patricia M. Crittenden, Family Relations Institute, Inc., 9481 SW 147 Street, Miami, FL 33176; e-mail: crittenden@patcrittenden.com.

INFANT MENTAL HEALTH JOURNAL, Vol. 39(6), 647–651 (2018)

C 2018 The Authors. Infant Mental Health Journal Published by Wiley Periodicals, Inc. on behalf of Michigan Association for Infant Mental Health

DOI: 10.1002/imhj.21750
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is
properly cited.
647
648 • P.M. Crittenden and S.J. Spieker
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ddddddd dddddddddddddddd, dddddddd ddddd, dddddddddddddd, dddMary
AinsworthddddddddddStrange Situationsdddd, dddddddddAinsworthdddddddd
* * *
We are pleased to have Drs. van IJzendoorn, Bakermans,
Steele, and Granqvist join a dialogue with us and other Dynamic-
Maturational Model of Attachment and Adaptation (DMM) re-
searchers about the relative contributions of the DMM and ABC+D
attachment to case-specific assessment of attachment for young
children and their families in forensic and clinical settings.
Granqvist et al. (2017) provided an opening to begin a conver-
sation about advancing attachment theory and applications. We
recognize that years of hard work on a model can result in strong
feelings when the model displays limitations and, especially, when
others point these out. Nevertheless, we think that the topics under
discussion are too important to be framed by researchers’ feelings
and commend our ABC+D colleagues for responding with their
commentary.
In this response, we will address three points: areas of ex-
plicit and tacit agreement, DMM issues that might have been mis-
understood, and steps that can be taken to address important core
differences.
AREAS OF AGREEMENT
Explicit Agreement
Attachment classifications are not evidence of maltreatment. First
and possibly most important, researchers using both the DMM
and ABC+D models of attachment agree that classifications of
attachment of parents and children do not constitute evidence of
maltreatment and should never be used to support or refute charges
of abuse, neglect, or sexual abuse.
Attachment classifications are not stand-alone information. Sec-
ond, both groups agree that classifications of attachment are not
stand-alone information and should always be presented to others
in the context of both assessments of other family members’ attach-
ment and also history of the family, often including the parents’ life
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.
history. To clarify, the assessments should be classified blindly, but
interpreted in the context of other family attachment relationships
and the family’s history of exposure to danger and, where relevant,
other professionals’ reports and experience of working with family
members.
“Disorganization” is not suitable for case-specific reporting. We
also agree that the construct of disorganization does not have suf-
ficient construct or empirical validity for use in person-specific
cases, including forensic and clinical applications.
Implicit Agreement
Ambivalent-passive (C2) has been overlooked in ABC+D clas-
sifications. In addition, van IJzendoorn, Bakermans, Steele, and
Granqvist (2018) tacitly accepted that the ABC+D classifica-
tory method has overlooked and likely misclassified as B4 the
ambivalent-passive (C2) category. Further, ABC+D researchers
have often mislabeled Type C as resistant rather than using
Ainsworth’s, Blehar, Waters, and Wall’s (1978) selected term am-
bivalent, with resistant (C1) and passive (C2) subtypes.
The need to see attachment figures in the Strange Situation Pro-
cedure (SSP) video. Similarly, our point that infant/child behavior
cannot be understood when maternal behavior is not visible points
to a problem in many video-recorded Strange Situations: They do
not include the mother, thus depending heavily on the morphol-
ogy of infant behavior without having the possibility to understand
the interpersonal function of the behavior—for each dyad. The
unfortunate result is that many researchers and clinicians think
of attachment as a characteristic of the infant/child rather than
as a description of the protective aspect of the child–attachment
figure relationship. The solution, of course, is to always include
the attachment figure in the filming, especially during departures,
reunions, and contact or refusal of contact.

Three, not four, patterns of attachment. Finally, the commentary
did not address the issue of whether there are three or four patterns
of attachment. Because the empirical data are clear, we take this
as tacit agreement that Ainsworth’s three patterns of attachment
are the patterns of attachment. That does not, however, resolve the
discussion of how to conceptualize the many cases that do not fit
Ainsworth’s et al. (1978) model for 11-month-olds. Are there other
forms of A and C? Are there variations in degree of organization?
Do psychological traumas and pervasive hyper- or hypo-arousal
affect the three patterns? The exploration of these ideas will be
exciting and, hopefully, can be carried out with insights from both
approaches to attachment theory.
Security has been overestimated in ABC+D distributions. We
made the point that epidemiologically, 25 to 30% of Western pop-
ulations warrant psychiatric diagnosis and that this supports the
DMM finding of about one third of a normative distribution being
secure and two thirds on a gradient from mildly to dangerously
insecure. Both classifying C2 as B4 and omitting the attachment
figure would tend to inflate the proportion of B classifications.
The ABC+D finding of 50% secure seems untenable in light of
population-level risks of psychiatric diagnosis, child maltreatment,
and criminality.
MISUNDERSTANDINGS
Reliability Versus Agreement
We think that the commentary authors might have confused coder
reliability (achieved on a standardized test prior to coding) with
coder agreement on a set of research data. Their lengthy discussion
of agreement in the NICHD comparison study (Spieker & Critten-
den, 2010) is accurate regarding its reported research agreement,
59%, which we discussed as a major limitation of the findings. In
our article (this issue), we stated that the Family Relations Institute
(FRI) standard for research reliability is 80% (a Level II certifi-
cate); the practice of the FRI when it undertakes blind coding of
datasets is to select reliable coders, ask them to establish intercoder
agreement on each dataset before coding the data, and for success-
ful coders, to have unpredictable agreement checks throughout the
coding process so that if agreement drops, coding can stop until
agreement is reestablished. Maintaining agreement in this way is
a time-consuming process, but it produces better data than having
reliable coders classify an entire set of SSPs, only checking agree-
ment at the conclusion of the study. The NICHD Study of Early
Child Care coders in the 1990s, when the assessments reported in
Spieker and Crittenden (2010) were classified, did not use the FRI
procedures (These had not yet been developed.) This is an example
of learning from past experience and improving procedures for the
future.
Standardized Reliability Tests
We are, of course, aware of the discussion among ABC+D re-
searchers regarding establishing standardized tests to ensure the
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.
DMM vs. ABC+D Reply • 649
equivalence of classifications from different laboratories. The
DMM uses standardized tests and, for the SSP, video-recordings
classified by Mary Ainsworth from her own laboratory form the
basis of both our teaching set and the test; these ensure that DMM
coders retain the meanings given by Ainsworth. We are not aware
of any other set of SSPs classified by Ainsworth. We have offered
these SSPs to the 42 signatories to the Granqvist et al. (2017) ar-
ticle, but have received no response. We think that these videos
could be a good starting point for a discussion of the cases that do
not fit Ainsworth’s original method.
As far as person-specific clinical and forensic reports are con-
cerned, DMM coders with Level I forensic reliability (the highest
of four levels) are required; these coders have passed the reliability
test twice at 85% or better and have completed three approved
family functional formulations (of the sort that would be in a
court report or a clinical plan). Of course, 85% is not perfect and
carries an average of 15% errors. Unfortunately, all information,
including the reading of X-rays and neuroimaging, carries risk of
error. We consider our standard stringent and appropriate to the
gravity of the application, particularly because DMM coders are
trained to provide evidence from the assessment of attachment
(e.g., screenshots or quoted speech) and not simply their statement
of the classification. Moreover, the full Strange Situation or Adult
Attachment Interview (AAI; George, Kaplan & Main, 1984–1996)
is made available to court authorities, including other experts. The
availability of evidence of attachment classification further reduces
the probability of error, makes the entire process transparent, and
enables others to examine the evidence.
Seven Billion Humans
In their commentary, van IJzendoorn et al. (2018) state that the
DMM has too many categories; they counted 24, but we think
there are more, even to the point of a unique DMM-AAI classifi-
cation for each individual person. Because we think that the DMM
assessments are relevant to mental health, we compare the four
ABC+D categories with the increasing array of DSM-5 (Amer-
ican Psychiatric Association, 2013) or International Classifica-
tion of Diseases (World Health Organization, 1993) categories of
psychiatric disorder and wonder if four categories can possibly
differentiate the types of relationship-based psychological prob-
lems faced by infants, young children, and their parents (much
less all humans of all ages and cultures). What if we constrained
doctors to four readily understood categories of physical illness,
some with high rates of misclassification? Our point is that only
a theoretically structured model with meaningful dimensions and
memorable clusters can be helpful to troubled children and their
parents. We seek a model where every peg has a place and can be
described in ways that can guide compassionate treatment. We do
not think the four-category ABC+D model can do that.
A Celebration With Colorful Confetti
An important point is what van IJzendoorn et al. (2018) dis-
miss as “a shower of colorful confetti” (p. 2) We wish they had
650 • P.M. Crittenden and S.J. Spieker
attended more thoughtfully to the structure of the DMM. The DMM
and D share the goal of describing behavior that falls outside of
Ainsworth’s original ABC model. The DMM adds the notion of
seeking evidence of the function of this behavior, specifically with
regard to receiving protection and comfort from an attachment
figure when a vulnerable person is exposed to danger. As to con-
fetti, our model is highly organized along two dimensions, both of
which were introduced by Bowlby (1980, chap. 4), albeit in a less
complete form than now appears in the DMM. One dimension is
source of information; that is, an individual’s relative reliance on
cognition (temporal contingencies) and affect (negative feelings);
this dimension ranges from A strategies (mostly cognitive) through
integrative B strategies to C strategies (mostly affective). The other
dimension is the degree of transformation of cognitive and affective
information from truly predictive through omitted, erroneous, dis-
torted, falsified, and denied to delusionally self-generated. These
dimensions free the DMM from the constraint of predefined cat-
egories while still permitting clustering of recognizable patterns.
We think this is an elegant model that is approximated in DMM
assessments by strategies, psychological traumas and losses, and
modified states of arousal. Indeed, we are pleased enough with this
achievement that we would happily celebrate with brightly colored
confetti.
Science Is Ever-Emergent
Tied to the incomplete understanding of the DMM is a complaint
that the model is “ever-emergent.” This, we think, is its strength.
We cannot think of any body of scientific thought that has been
constant for almost four decades—except ABC+D attachment.
The hallmark of all sciences is constant change, constant updat-
ing of what is known and how it is discovered. Yes, our coders
have time-limited certificates of reliability and are required to keep
up-to-date in the DMM. Psychotherapists and physicians are sim-
ilarly required to update their work. The Granqvist et al. (2017)
article could be considered recognition of the gap between what
ABC+D theory offers and delivers. Our article could be consid-
ered, in part, an invitation to ABC+D researchers to update their
work. Put another way, we are proud of the ever-emergent qual-
ity of the DMM because it keeps the theory and applications in
tune with a wide range of scientific advances in related fields from
genetics and neurobiology to family and community systems.
Assessment and Absolutes
A small point is that van IJzendoorn et al. (2018) repeatedly refer
to attachment “measures.” Attachment cannot be measured quanti-
tively; it is assessed qualitatively. That was an important distinction
Mary Ainsworth discussed with her students, and we agree with
her use of the word “assessment.” Another small point is that van
IJzendoorn et al. (2018) took several of our qualified and nuanced
comments and turned them into absolutes. Absolutes are straw
men that are easy to destroy, but the field is not advanced by that.
Looking more carefully at what we actually said about anomalous
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.
classifications, the association of DMM classifications with mal-
treatment, and court decision-making (for residency and treatment
planning) might yield productive ideas.
IMPORTANT ISSUES FOR THE FUTURE
The central purpose of our article was to explain how attachment,
as conceptualized and assessed with the DMM, could be used in
forensic and clinical settings where the consequences of an attach-
ment report could affect individual lives. As stated earlier, we agree
with Granqvist and his 42 eminent coauthors (2017) that the D cat-
egory is not suitable for this application. On the other hand, when
DMM assessments and classifications are used within the guide-
lines of the IASA Family Attachment Court Protocol (Crittenden,
Farnfield, Landini, & Grey, 2013), we believe that attachment can
contribute helpful information for solving the puzzle of family
problems. Crucial to following IASA guidelines are coder relia-
bility and report transparency. The standards for forensic coder
reliability are high (85% or more, together with approved work
on writing family functional court reports). Even so, mistakes will
always be made. For this reason, the reports must be transparent to
the point of offering both evidence (photos, texts) from the assess-
ments and the full assessments to other court-appointed experts for
their scrutiny; this meets the evidentiary requirement of Daubert
v. Merrill (1993). In addition, interpretation of the assessment re-
sults must be embedded in an array of assessments of attachment
among family members as well as professionals’ reports on the his-
tory and functioning of family members. Finally, as stated in our
original article, the purpose of DMM assessments of attachment
is to contribute to placement and treatment decisions regarding
vulnerable children, and not to be the sole source of information
upon which these decisions are made, nor the basis of decisions
regarding parental maltreatment.
Evidentiary Standards
van IJzendoorn et al. (2018) hold the DMM Preschool Assessment
of Attachment (PAA; Crittenden, 1992–2017) and other DMM as-
sessments accountable to the wrong evidentiary standard. (They
are unclear as to whether they would hold the ABC+D Strange
Situation assessment to the same standard.) Proof beyond a rea-
sonable doubt and innocent until proven guilty are standards only
applicable to criminal cases. Dependency and custody cases have
different, and lower, standards. Further, the standard for expert ev-
idence, as set out in Federal Rules of Evidence 702 (FRE, 2018),
for any type of case, is that the fact and opinion evidence must be
helpful, based on sufficient facts or data, be the product of reliable
principles and methods, and be reliably applied to the facts of the
case. The evidence must be nonspeculative, and the facts or data
and methods must be transparent (FRE 702; committee also notes
citing case law). Forensic DMM assessments, using highly reliable
coders with clear standards and transparent methods, meet the re-
quirements of FRE 702. The five factors identified in the Daubert
case have been supplemented and expanded by FRE 702, yet DMM

assessments also meet all five factors from the Daubert v. Merrill
(1993) case. DMM assessments and the IASA Court Protocol also
are consistent with forensic guidelines identified by Austin, Kirk-
patrick, and Flens (2011) for evaluator testimony using conceptual
frameworks such as attachment.
Collegial Cooperation Around Shared Goals
van IJzendoorn et al. (2018) call for unbiased joint research to com-
pare the ABC+D and DMM classificatory methods. We heartily
agree with this idea. Because bias can be hard to discern, we sug-
gest a joint committee of ABC+D and DMM researchers (in equal
numbers) and an existing dataset that meets both methods’ require-
ments. We suggest videos that include the attachment figures, SSPs
at 11 to 12 months (because Ainsworth’s et al. (1978) guidelines
were written for 11-month-old infants), and follow-up SSPs at 30
to 36 months (because this age is centered within the preschool
years and is suitable for both the PAA and the preschool assess-
ment classification system (PACS); Cassidy and Marvin, with the
MacArthur Attachment Working Group, 1992). Other validating
data should be in the dataset. Once a suitable dataset is found, all the
videos should be reclassified with the leaders in each camp choos-
ing and training the coders. The researchers should register the
study and agree to publish the results, regardless of the outcomes.
In closing, we want to emphasize the importance of a dialogue
and cross-classified datasets. This could be an opportunity to attract
the next generation of attachment scholars to build upon a half-
century of lessons learned. We appreciate Drs. van IJzendoorn,
Bakermans, Steele, and Granqvist considering and responding to
our article and look forward to collaborative work addressing the
needs of vulnerable children and their families.
REFERENCES
Ainsworth, D.S.M., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of
attachment: A psychological study of the strange situation. Hillsdale,
NJ: Erlbaum.
American Psychiatric Association (2013). Diagnostic and statistical man-
ual of mental disorders (5th ed.). Washington, DC: Author.
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.
DMM vs. ABC+D Reply • 651
Austin, W.G., Kirkpatrick, H.D., & Flens, J.R. (2011). The emerging
forensic role for work product review and case analysis in child
access and parenting plan disputes. Family Court Review, 49(4),
737–749.
Bowlby, J. (1980). An information processing approach to defense. In
J. Bowlby (Ed.), Attachment and loss: Vol. 3. Loss, sadness and
depression (pp. 44–74). New York: Basic Books.
Cassidy, J., & Marvin, R.S. (1992). Attachment organization in preschool
children: Coding guidelines (4th ed.). Charlottesville, VA: University
of Virginia.
Crittenden, P.M. (1992–2017). Preschool assessment of attachment. Un-
published manual, Family Relations Institute, Miami.
Crittenden, P.M., Farnfield, S., Landini, A., & Grey, B. (2013). Assessing
attachment for family court decision-making. Journal of Forensic
Practice, 15, 237–248.
Daubert v. Merrell Dow Pharmaceuticals (92-102), 509 U.S. 579 (1993).
Federal Rules of Evidence 702, U.S.C.S. (2018)
George, C., Kaplan, N., & Main, M. (1984–1996). Adult attach-
ment interview protocol. Berkeley, CA: University of California at
Berkeley.
Granqvist, P., Sroufe, L.A., Dozier, M., Hesse, E., Steele, M., van Ijzen-
doorn, M., . . . Duschinsky, R. (2017). Disorganized attachment in
infancy: A review of the phenomenon and its implications for clini-
cians and policy-makers. Attachment & Human Development, 19(6),
534–558. https://doi.org/10.1080/14616734.2017.1354040
Spieker, S., & Crittenden, P.M. (2010). Comparing two attach-
ment classification methods applied to preschool strange situa-
tions. Clinical Child Psychology & Psychiatry, 15(1), 97–120.
https://doi.org/10.1177/1359104509345878
Spieker, S.J., & Crittenden, P.M. (2018). Can attachment inform decision-
making in child protection and forensic settings? Infant Mental
Health Journal, 39(6), 625–641.
van IJzendoorn, M.H., Bakermans, J.J.W., Steele, M., & Granqvist, P.
(2018). Diagnostic use of Crittenden’s attachment measures in Fam-
ily Court is not beyond a reasonable doubt. Infant Mental Health
Journal, 39(6), 642–646.
World Health Organization (1993). ICD-10, the ICD-10 classification of
mental and behavioural disorders: Diagnostic criteria for research.
Geneva: Author.