Background <p>Psychotherapy can change attachment representations towards greater attachment security. Both early relationship disruptions as well as later critical life events have an influence on attachment; however, it has not yet been investigated to what extent they also affect changes in attachment security through psychotherapy.</p> Objective <p>The study examines the influence of early relationship disruptions and critical life events on changes in attachment security among women with depression during inpatient psychotherapy.</p> Material and methods <p>In this study 43&#xa0;clinically depressed women and 42&#xa0;mentally healthy female controls were included. Attachment security was assessed at the beginning and end of inpatient psychotherapy using the adult attachment interview (AAI). Early relationship disruptions were recorded with the AAI and critical life events were assessed using the adverse life events scale (ALES).</p> Results <p>Critical life events were associated with lower attachment security at baseline. Early relationship disruptions but not critical life events, predicted a&#xa0;smaller increase in attachment security through inpatient psychotherapy.</p> Conclusion <p>Early relationship disruptions may make it more difficult to integrate new relational experiences and to increase attachment security, suggesting that therapeutic interventions may need to be adapted.</p>