A contribution to the validation of the Earned Secure Attachment Questionnaire (ESA-Q)

This doctoral dissertation advances the conceptual and empirical understanding of Earned Secure Attachment (ESA)—the process by which individuals develop attachment security in adulthood despite adverse early caregiving. Rooted in attachment theory, ESA represents a key construct at the intersection of continuity and change, reflecting processes of adaptation, reflective elaboration, and relational repair. Despite its theoretical relevance, ESA has lacked conceptual clarity and standardized measurement. This work addresses these gaps through three complementary investigations combining theoretical synthesis and empirical validation. The first part presents a preregistered scoping review of 24 empirical studies on ESA. The review mapped how ESA has been defined and assessed, revealing a shift from categorical models—viewing ESA as a discrete classification derived from the Adult Attachment Interview—to dimensional perspectives conceptualizing it as a developmental process of reorganization of attachment representations. Converging evidence emphasized the role of reflective elaboration of early experiences and corrective attachment relationships as pathways toward earned security. The second study reports the development and validation of the Earned Secure Attachment Questionnaire (ESA-Q), a novel self-report tool designed to assess ESA in adulthood. A community sample of 1,148 adults completed the ESA-Q and related measures. Confirmatory factor analysis supported a nine-factor structure encompassing Childhood Attachment, Elaboration of Early Experiences, and Adult Attachment. The ESA-Q showed good internal consistency, convergent validity, and measurement invariance across age groups, showing theoretically coherent associations with related constructs. The third study examined the ESA-Q’s network structure in 2,053 adults, including 536 with clinically significant posttraumatic symptoms. Network analysis revealed a consistent structure across groups and significant item-level differences, with clinical symptomatic participants reporting lower security. Elaboration items emerged as peripheral nodes, suggesting a distinct reflective dimension. Overall, the dissertation conceptualizes ESA as a dynamic, multidimensional process of attachment reorganization, offering a psychometrically robust and clinically informative tool for studying earned security in adulthood.