In theorizing the relation of disorganized attachment to the risk of psychopathology, Liotti (1,2) and Main and Morgan (3) have advanced the hypothesis that early attachment disorganization may render the individual vulnerable to the later development of dissociative psychopathology. The line of reasoning is as follows: Based on a phenotypic similarity between some behaviour patterns in disorganized infants (for example, stilling or dazed expressions) and trancelike states, Liotti proposed that frightening or frightened behaviour on the part of the primary caregiver is likely to lead to a failure of the integrative functions of memory and the emergence of multiple and incompatible working models of self and the attachment figure. According to Liotti, when caregiver–child interactions are markedly contradictory (that is, encompass experiences of fear or aggression, as well as comfort), the development of multiple and unintegrated working models is necessarily inevitable. Such incompatible models, in which relatively complete forms of defensive exclusion operate, are liable to interfere with the

Manuscript received January 2001, revised, and accepted July 2001.
¹Professor, Department of Psychiatry, University of Calgary, Calgary, Alberta.
²Professor (retired), Department of Psychiatry, University of Toronto, Toronto, Ontario.
³Research Associate, Jewish General Hospital, Montreal, Quebec.
⁴Associate Professor, Department of Community Health Sciences, University of Calgary, Calgary, Alberta.
Address for correspondence: Dr M West, Peter Lougheed Centre, #3645, 3500–26 Avenue NE Calgary, AL  T1Y 6J4
e-mail: malcolm.west@crha-health.ab.ca

disorganized child’s ability to establish a coherent sense of self, thereby leaving him or her vulnerable to the development of dissociative symptomotology in the face of traumatic circumstances in later life.

Evidence for the linkage hypothesis between early attachment disorganization and later dissociative symptomotology comes from 2 recent studies. In 1 study, infants at ages 12 and 18 months were assessed for attachment using the Strange Situation Procedure (4) and then evaluated for later adjustment through to age 17.5 years (5). An infant history of attachment disorganization was significantly correlated with adolescents’ self-report of dissociative episodes, as assessed by a scale representing dissociative symptoms derived from the teacher version of the Child Behavior Checklist (CBCL) (6).

Using additional data from the same longitudinal sample, Ogawa and others assessed dissociative symptomotology in young adults (7). In this study, dissociative symptoms were determined by the Dissociation Experience Scale (DES;8). Compared with young adults classified as disorganized during infancy who had not been exposed to trauma and young adults not previously classified as disorganized, young adults classified as disorganized during infancy who had been exposed to trauma scored significantly higher on the DES.