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    How our attachment styles can predict whether we develop a personality disorder in adulthood

    When psychologists talk about attachment style, they refer to how humans relate to others in relationships.

    Attachment style theory

    Attachment theory was first developed by psychologists Mary Ainsworth and John Bowlby in the 1950s.

    The attachment style model is based on the paradigm that our early attachments to primary caregivers profoundly influence how we respond to and conceptualise our adult relationships.

    Four main attachment styles

    According to psychologists, four main attachment styles determine how we bond with our primary caregivers and how these early attachments impact our relationship with the self and others:

    • Secure attachment
    • Anxious attachment
    • Avoidant attachment
    • Fearful – avoidant attachment

    Note – anxious, avoidant, and fearful-avoidant attachment styles are considered forms of insecure attachment.

    Attachment patterns

    We all have different attachment patterns depending on how we bonded with our parents or caregivers in infancy.

    Broadly, attachment styles determine how we respond emotionally to others and can dominate our interactions and behaviours.

    Psychologists measure an individual’s attachment style based on the amount of anxiety or avoidance present within their relationships.

    The four attachment styles

    To get a clearer insight into how our attachment styles can impact our emotional and psychological development, psychologists Bowlby and Ainsworth developed the following attachment model:

    1. Secure attachment style

    Foundational Attachment Research found that around 56% of adults have secure attachment styles.

    Secure attachment styles describe a person’s ability to form loving and close relationships with others.

    Securely attached

    Securely attached people do not experience agitation or anxiety if their partner requires space or time away from them.

    Those securely attached can easily trust others and be trusted; they can accept and give love without anxiety or conflict and can develop close relationships with others quickly.

    2. Anxious attachment style

    According to research by Hazan and Shaver, around 19% of adults have an anxious attachment style.

    Anxious attachment style describes a form of anxious attachment which features a profound fear of abandonment.

    The main indications an individual presents in the anxious attachment style group are neediness or clingy behaviour.

    Anxious attachment styles

    For example, people with an anxious attachment style experience profound anxiety when a partner doesn’t text them back fast enough and may feel incredibly insecure in their relationships, and are constantly looking for validation.

    Such individuals may worry that their partner will leave them or lose interest in the relationship.

    The anxious attachment style sometimes gets referred to as anxious – preoccupied attachment or anxious – resistant attachment style.

    Individuals anxiously attached may believe that their significant other doesn’t love or care about them enough.

    3. Avoidant attachment style

    Further research conducted by Hazan and Shaver suggests that approximately 25% of adults have the avoidant attachment type.

    Avoidant attachment style describes an insecure attachment style, which indicates a fear of closeness and intimacy.

    Individuals in the avoidant attachment group prefer to maintain a level of distance from their partners and feel comfortable relying on themselves and being independent.

    Intimacy and trust issues

    Avoidant attachment types are usually emotionally unavailable and struggle to form close bonds and develop trust towards others.

    People with an avoidant attachment style may also feel suffocated in their relationships.

    Another term to describe the anxious-avoidant attachment style is dismissive-avoidant attachment.

    4. Fearful – avoidant attachment style

    The fearful-avoidant attachment type is the least understood and under-researched attachment style.

    Sometimes referred to as disorganised attachment, the fearful attachment style is a mixture of avoidant and anxious.

    Although research into the fearful attachment style is limited, psychologists say that people with this attachment type are often reluctant to form close bonds, accompanied by a profound desire to be loved by others.

    Individuals with fearful – attachment styles crave and avoid attention simultaneously and may feel tremendous ambivalence in their relationships.


    An integral aspect of the literature on fearful attachment is the profound relational and psychological risks associated with the fearful attachment type.

    The above may include an increased risk for violence in the fearfully attached individual’s relationships, heightened sexual behaviour, and difficulty regulating one’s emotions.

    Attachment styles and personality disorders

    Personality disorders - White River Manor

    A large body of research explores the correlation between attachment theory and personality disorders.

    A short review conducted by Nicolas Lorenzi, M.Sc, M. Phil., and Peter Fonagy, PhD, F.B.A. on ”Attachment and Personality Disorders” explored the connection between personality disorders and attachment theory.

    The above includes mainly Cluster B personality disorders.

    The study’s premise was ”based on the understanding that an infant’s interactions with their primary caregivers will establish a base for personality development which can mould close relationships, social acceptance and attitudes to rejection” (Lorenzi, Phil, and Fonagy, April 2013).

    Insecure attachment versus personality disorders

    The researchers noted that many of the indications of insecure attachment in adulthood mirror some of the signs and symptoms of specific personality disorders.

    According to the literature, people with Cluster B personality disorders (i.e., narcissistic, histrionic, borderline, and antisocial) demonstrate increased rates of insecure attachment styles than the rest of the population.

    The researchers also noted that Borderline Personality Disorder and Antisocial Personality Disorder are rarely linked to secure attachment styles.

    Preoccupied attachment styles

    A core aspect of the research was the association the researchers found between preoccupied attachment styles and personality disorders such as:

    • Histrionic Personality Disorder
    • Avoidant Personality Disorder
    • Borderline Personality DisorderĀ 
    • Dependent Personality Disorder

    Unresolved trauma

    Lorenzi’s study illustrated that Borderline Personality Disorder (BPD) is strongly correlated with preoccupied or anxiously attached individuals with unresolved trauma and unresolved attachment patterns.

    Generally, patients with Borderline Personality Disorder tend to exhibit fluctuations in their emotions and behaviour – frequently oscillating from angry withdrawal to compulsive – care-seeking.

    Lorenzi’s study found that over 50 – 80% of Borderline Personality Disorder patients have unresolved trauma or unresolved attachment patterns.

    An inability to form new attachments

    Additionally, patients with BPD generally struggle to form new attachments due to a lack of relief from forming new bonds, harming the therapeutic relationship.

    People with Borderline Personality Disorder tend to be hyper-aware of the therapist’s shortcomings and failures and not the benefits of such a relationship.

    Early childhood trauma

    The researchers noted a higher prevalence of childhood trauma in personality disorders and insecurely attached individuals.

    Childhood traumatic experiences are associated with disorganised/incoherent adult attachment styles than in the general group of insecure attachment styles.

    Statistics show that personality disorder patients are four times more likely to have experienced childhood trauma with early physical abuse putting people at higher risk of developing disorders in adulthood such as:

    • Dependent Personality Disorder
    • Borderline Personality Disorder and Antisocial Personality Disorder
    • Depressive, Passive, and Schizoid Personality Disorders

    Infant neglect

    Additionally, the researchers explored the emotional and psychological impact associated with infantile neglect.

    The above study found that adverse childhood experiences involving neglect can lead to specific personality disorders such as antisocial, borderline, narcissistic, and passive-aggressive.

    Moreover, Borderline Personality Disorder is more consistently associated with neglect and childhood abuse than any other personality disorder.

    Mental health implications of early attachments

    The researchers were clear about the negative impact surrounding early attachment bonding and trauma.

    However, they also explained that not everyone who experiences childhood trauma would develop psychiatric conditions in adulthood.

    Lorenzi et al. were clear about the effects of emotional trauma and specific influences such as attachment styles and genetic dispositions and how such factors determine how a person copes with their experiences.

    Attachment style implications

    The review highlighted how those with anxious attachment styles and who are also victims of childhood abuse and neglect are at greater risk of mental health disorders such as post-traumatic stress disorder.

    The above suggests that the attachment style is the precursor to the mental health conditions that a person may develop due to adverse experiences. 

    Lorenzi and colleagues explained that:

    ”If traumatic events provoke activation of the attachment system, then individuals who respond through the inhibitions of mentalising function and emotional regulation are less likely to respond to these events and more likely to manifest personality pathology in later life” (Attachment and Personality Disorders: A Short Review, April 2013).


    The above study suggests that although attachment styles can predict the development of personality disorders in later life, attachment styles influence how people respond to adverse life experiences.

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