Vulnerable Attachment Style Questionnaire (VASQ)

Author of Tool: 

Prof Antonia Bifulco

Key references: 

Bifulco, A., Mahon, J., Kwon, J.-H., Moran, P., & Jacobs, C. (2003). The Vulnerable Attachment Style Questionnaire (VASQ): An interview-derived measure of attachment styles that predict depressive disorder. Psychological Medicine, 33, 1099-1110.

Bifulco, A., Moran, P. M., Ball, C., & Bernazzani, O. (2002). Adult attachment style. I:Its relationship to clinical depression. Social Psychiatry & Psychiatric Epidemiology, 37, 50-59.

Primary use / Purpose: 

For screening for insecure attachment styles in community samples, particularly in relation to emotional disorder in adults from age 16 onwards. As a self-report validated against the Attachment Style Interview.


The Vulnerable Attachment Style Questionnaire (VASQ) was developed to provide a brief self-report tool to assess adult attachment style in relation to depression and validated against an existing investigator-based interview (Attachment Style Interview – ASI). Items for the VASQ reflected behaviours, emotions and attitudes relating to attachment relationship style, drawn directly from the ASI. The VASQ was validated against the ASI for 262 community-based subjects. Test–retest was determined on 38 subjects.

Factor analysis derived two factors, labelled ‘insecurity ’ and ‘proximity-seeking’. The VASQ insecurity dimension had highest mean scores for those with interview-based Angry dismissive and Fearful styles and was significantly correlated with degree of interview-based insecurity. The proximity-seeking VASQ scores had highest mean for those with Enmeshed interview attachment style and was uncorrelated with ASI insecurity. VASQ scores were highly correlated with a well-known self-report measure of insecure attachment (Relationship Questionnaire) and text–retest reliability of the VASQ was satisfactory. The total VASQ score and the insecurity subscale proved highly related to poor support and to depressive disorder. This was not the case for the proximity-seeking subscale.


INTERNAL RELIABILITY: Cronbach’s alpha for the 12 insecurity scale items was 0.82 and for the 10 proximity-seeking items was 0.67. The test–retest reliability was 0.73 (Pearsons r, P<0.001) for the insecurity scale and 0.65 (P<0.0001) for the proximity seeking scale. Correlation for the total score at retest was 0.65 (P<0.0001). Validation against the Attachment Style Interview: Median scores on the two VASQ subscales were used as cut-off points (>30 for the insecurity scale, >27 for the proximity-seeking scale) for examining VASQ in relation to the vulnerable attachment categories of the ASI. These included Fearful, Angry-dismissive or Enmeshed styles at ‘marked/moderate’ levels of insecurity. High scorers on the VASQ insecurity scale were most discriminated in the Fearful and Angry-dismissive ASI subtypes. In contrast, high scorers on the VASQ proximity-seeking scale were most highly differentiated in the Enmeshed interview subtype.

The total VASQ score (median cut-off >57) discriminated all the vulnerable ASI styles. For those with high VASQ insecurity and high proximity-seeking scores (VASQ Anxious attachment) 53% (19/17) had insecure Enmeshed interview style compared with 23% (53/233) of other categories combined (P<0.01). When those with high VASQ insecurity and low proximity-seeking were identified ('VASQ Avoidant) these accounted for 49% (33/67) of interview insecure Fearful/Dismissive categories compared with 28% of remaining categories (P<0.005). Finally, when those with low VASQ insecurity and any proximity-seeking score were examined, these reflected 53% (88/166) of those rated Secure on the ASI compared with 17% (14/82) of remaining categories (P<0.0001).

VALIDATION AGAINST THE RELATIONSHIP QUESTIONNAIRE: A high level of association was found between these two measures: the seven-point insecure RQ score and the VASQ insecurity score was correlated at r=0.53 (P<0.001) and the VASQ total score at r=0.43 (P<0.01). The VASQ proximity-seeking score was significantly correlated with the RQ preoccupied subtype (r=0.33, P<0.01) and negatively with the RQ dismissive subtype (r=x0.14, P<0.05). The criterion validity of the VASQ was examined in relation to major depression. High VASQ insecurity scores and total scores were associated with higher rates of depression in the 12 months before contact. Odds ratios of 2.82 (P<0.001) and 3.17 (P<0.001) were obtained for VASQ insecure and total score respectively. When lifetime chronic or recurrent depression was examined the respective odds ratios were both 2.05 (P<0.007). The VASQ proximity-seeking scale was not significantly associated with depression.<p/>



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