Using multilevel polynomial regression and response surface analysis, we studied the association between Time 1 (T) and Time 2 (T + 1) attachment anxiety and attachment avoidance, and T + 1 psychological distress in 253 nine-session time periods for 65 adult community clients working with 13 doctoral student therapists in open-ended psychodynamic psychotherapy. Results indicated that when client attachment anxiety was consistent and higher from the beginning (T) to the end (T + 1) of a nine-session time period, clients tended to report higher distress at the end of the period; when attachment anxiety was consistent and lower across a time period, clients tended to report lower distress. When attachment anxiety decreased across a time period, clients reported lower distress at the end of the period; when attachment anxiety increased across a time period, clients reported higher distress. Neither within-client consistency nor change in attachment avoidance in a time period was significantly related to client distress at the end of the period. Limitations and implications of the present research are discussed. [ABSTRACT FROM AUTHOR]