Book Review
Patterns of Attachment: A Psychological Study of the
Strange Situation
Mary D. Salter Ainsworth, Mary C. Blehar, Everett Waters, Sally N. Wall, New York, NY, Psychology Press, 2015,
417 pp, paperback, $52.95.
This is the classic edition of an in-
fluential psychological study performed
and written by nationally recognized ex-
pert and her associates that has
revolutionized the current knowledge of
attachment behavior. It would be
impossible for developmental psycholo-
gists to not have come across Ainsworth’s
contribution to Bowlby-Ainsworth de-
velopmental attachment theory. The pur-
pose of this volume is to educate and
deepen understanding of researchers, pri-
mary and allied heath care providers, and
trainees through reporting methods and
key results of Mary Ainsworth’s landmark
Baltimore longitudinal study from obser-
vation of infant-mother interaction and at-
tachment behavior. In addition to 1978
edition, this book features new in-
formation on the 4 caregiving and in-
teraction scales developed by Mary
Ainsworth from observations of 9-month-
old to 12-month-old infants making them
easily accessible to interested individuals.
The Baltimore project beautifully il-
lustrated the nature of the child’s re-
lationship to his or her primary caregiver
and emphasized the importance of early
experience. In a meticulous yet succinct
volume, the authors provide a compre-
hensive resource to researchers and
practitioners that addresses available re-
search studies that have used the
Strange-Situation Procedure (SSP). The
logic, flow, and comprehensive cover-
age of chapters with great analogies used
to demonstrate theoretical background
enable readers, even those who are
beginners to attachment theory, to build
a foundation in attachment theory,
viewed as a secure base relationship.
The SSP is described as a laboratory-
Vol. 37, No. 6, July/August 2016
Copyright Ó 2016 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
based unfamiliar situation used to ob-
serve the child’s response to his/her
mother’s and stranger’s behaviors.
Children’s behaviors are then organized
and grouped into classificatory system.
Normative patterns of behavior
linked to different social situations, types
of statistical analyses used, and the rea-
soning behind these decisions are fur-
ther explained. Individual differences are
also addressed in detail. Review of other
studies that had conducted SSP to address
various variables such as neonatal sepa-
ration, twins versus singletons, de-
mographics, low birth weight, maternal
attitudes and mother-infant interaction,
and working versus nonworking mothers
provide broader understanding of the
ways patterns of attachment may or may
not differ in these populations. These
findings would also be of interest for infant
and developmental psychologists, early
childhood education specialists, primary
care and developmental-behavioral pedia-
tricians, family therapists, social workers
with counseling roles, and early in-
tervention in-home specialists/therapists.
Readers, especially researchers and
practitioners, will appreciate wide-
ranging components, including in-
struction to the mother, coding in-
struction, scoring systems, and maternal
caregiving and interaction scales. This
volume contains clear tables of quanti-
tative research findings and perfect il-
lustration of the Strange Situation.
The gaps in this otherwise out-
standing volume are due to the authors’
decision to focus on their main samples
and review of studies that directly
addressed one-year-olds and pre-
schoolers. Undoubtedly, this innovative
work has had a significant impact on
prevention and intervention beyond the
scope of what could be included in this
volume. An additional section on clini-
cal implication and a review of how
patterns of attachment apply to adopted
children would have improved clinical
utility.
In conclusion, Ainsworth and team
have provided an excellent framework
describing attachment theory and how
attachment behaviors are quantitatively
measured through SSP. This is a “must
have” for pediatricians, psychologists,
social workers, and in-home therapists
whose clinical care and research focuses
on early childhood development, partic-
ularly social development. This book will
also be of special interest to trainees,
residents, fellows, and graduate students
from various professional disciplines who
will gain a deeper appreciation of at-
tachment patterns, which can influence
clinical encounters with young children
and enhance the way care is provided in
lieu of the importance of attachment fig-
ure and the child’s interaction with that
attachment figure.
Disclosure: The author declares no con-
flict of interest.
Pon Trairatvorakul, MD
Division of Developmental and
Behavioral Pediatrics,
Department of Pediatrics, Cincinnati
Children’s Hospital Medical Center,
Cincinnati, OH
ACKNOWLEDGMENTS
The author thanks Dr. Pamela High for
her helpful revision and editing of this book
review.
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