The Attachment and Clinical Issues Questionnaire (ACIQ): scale development

In line with dynamic systems and dialectical theories of development, it was theorized that a psychopathology such as an addiction could have several causes (equifinality) and that more specific diagnoses and treatments of the most salient clinical issues for individuals coming from different developmental paths could increase the success rates of most therapies. Further, the issues from a developmental dynamic systems perspective should include not only individual clinical issues, but also relational, familial, peer, and organizational functioning. The Attachment and Clinical Issues Questionnaire (ACIQ) was developed as a research and clinical instrument relevant to these concerns. The 29 scales were based on naturalistic observations of patients in treatment and 12-step groups, attachment theory, and the clinical literature dealing with the addictions. The attachment scales were taken from classic attachment theory but, in line with more recent formulations, included relations to mother, father, and partner. Study 1 found the ACIQ to have good coefficient alphas (.79), and factor analyses revealed that the eight factors loaded on different attachment figures and sets of clinical issues rather than attachment styles per se. Study 2 found test-retest reliability to be, on average, .79. The results were in line with the developmental hypothesis that partner and father attachments are different than attachments to mother, and that family and peer relations as well as clinical issues need to be considered separately.