Attachment research has repeatedly shown the inşuence of early social interactions on developing inner working models and object representations that substantially impact on bonding behavior, subject-environment-interactions and psychopathology in later life. According to Bowlby’s conceptual description, interactions of genetic, neurobiological, and developmental factors contribute to the establishment of neuronal networks involved in the regulation of stress resilience, anxiety sensitivity and personality development. All three variables must therefore be supposed to contribute to the development of certain psychopathologies or even psychiatric disorders under certain circumstances. Ainsworth et al. first described different behavioral patterns, so-called “attachment styles” which have subsequently been implemented in various reliable and valid rating scales for the differentiation between individual attachment styles (secure, insecure avoidant, insecure anxious, insecure ambivalent and disorganized). Several reports indicate a higher prevalence of insecure compared to secure attachment styles in alcohol and substance addiction and other psychiatric disorders. If this available and reliable attachment is experienced insufficiently, the individuals coping of stress or anxiety is therefore less effective and this may activate epigenetic mechanisms promoting onset of psychiatric disorders later on. Additionally, insecure attachment styles may go along with the development of distinct potentially dysfunctional behaviors in social interactions promoting the development of dysfunctional personality styles or personality disorders. This dysfunctionality is related to a higher incidence of addictive disorders. Wedekind et al. found in alcohol-addicted inpatients, a correspondence of insecure attachment styles with high trait anxiety, more dysfunctional anxiety coping and dysfunctional personality styles. Their results imply the potentially high importance of attachment style in the characterization of alcohol dependency because of its possible high relevance for psycho- therapeutic strategies, individual therapeutic abilities and comorbid conditions. By separation into attachment styles, significant differences in potentially dysfunctional personality styles can be observed, giving a more differentiated characterization of groups than by diagnosing personality disorders exclusively. Clinical routine may profit from attachment style assessments. Insecure attachment styles in alcohol dependence may contribute to poorer outcome due to dysfunctional personality styles and anxiety coping behavior. Earlier studies on attachment and substance use disorders using the Hazan and Shaver self-report mainly indicate a link with “avoidant” attachment styles. Schindler et al. found that, fearful attachment was predominant in drug dependent adolescents, while controls were predominantly secure. Severity of drug use was positively correlated with fearful attachment, but negatively correlated with dismissing attachment. The presence of comorbid psychiatric disorders was associated with fearful attachment but not with addiction severity. In another study, Schindler et al. found that, opioid abusers were mainly fearful-avoidant, ecstasy abusers were preoccupied, fearful-avoidant and dismissing-avoidant, cannabis abusers were mainly dismissing and secure, and controls were mainly secure. Based on the self-medication hypothesis, they concluded that the preferences for specific substances were inşuenced by specific attachment strategies. Opioid seems to be used as an emotional substitute for lacking coping strategies. Cannabis seems to be used to support existing deactivating and distancing strategies. Ecstasy abuse was related to insecure attachment but not to a specific attachment strategy.