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Diagnostic Inclusion of Attachment Trauma: A Commentary on Farina and Schimmenti (2025)

C. Dalenberg,Kenneth J Thompson

Published 2025 in Clinical Neuropsychiatry

ABSTRACT

Farina and Schimmenti (2025) offer an intriguing reconceptualization of attachment trauma as a developmental process arising from relational failures, even in the absence of identifiable traumatic events. We support their emphasis on clinical symptom constellations—such as dissociation, emotional dysregulation, and interpersonal detachment—as markers of attachment-related dysfunction. However, we suggest a change in emphasis. We argue that any diagnostic change might target dysfunction in the attachment system itself, rather than infer the presence of trauma. This distinction aligns with diagnostic frameworks that prioritize functional patterns over historical assumptions. We also encourage the development of trauma-informed principles specific to attachment disruptions. These refinements, we believe, would increase diagnostic clarity and better support treatment planning. We believe that the enhanced focus on attachment-related psychopathologies, as proposed by Farina and Schimmenti, is of value but would benefit from further attention to the issue of reliable measurement.

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