Attachment Insecurity Predicts Eating Disorder Symptoms and Treatment Outcomes in a Clinical Sample of Women

@article{Illing2010AttachmentIP,
  title={Attachment Insecurity Predicts Eating Disorder Symptoms and Treatment Outcomes in a Clinical Sample of Women},
  author={Vanessa Illing and Giorgio A. Tasca and Louise Balfour and Hany Bissada},
  journal={The Journal of Nervous and Mental Disease},
  year={2010},
  volume={198},
  pages={653-659}
}
We examined the extent to which attachment insecurity was related to eating disorder (ED) symptoms, and predictive of treatment outcomes. Women diagnosed with anorexia nervosa (AN) restricting subtype (ANR), AN binge purge subtype (ANB), or bulimia nervosa (BN) completed an attachment scale pretreatment, and ED symptom scales pretreatment (N = 243) and post-treatment (N = 157). A comparison sample of 126 non-ED women completed attachment scales on 1 occasion. Those with EDs had significantly… 
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Attachment Insecurity Predicts Punishment Sensitivity in Anorexia Nervosa
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Attachment and eating disorders: a review of current research.
  • G. Tasca, L. Balfour
  • Psychology, Medicine
    The International journal of eating disorders
  • 2014
OBJECTIVE Attachment insecurity may confer risk for developing an eating disorder. We describe domains of attachment functioning that are relevant to eating disorders including: affect regulation,
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Structural equation modeling indicated that maladaptive perfectionism served as mediator between both insecure attachment patterns and ED symptomatology and interacted with insecure attachment to predict higher levels of ED symptoms - highlighting the importance of both insecure attachments patterns and mal Adaptive aspects of perfectionism as treatment targets.
Implications of attachment theory and research for the assessment and treatment of eating disorders.
TLDR
A framework for assessing and treating attachment functioning in patients with an eating disorder is suggested and case examples are presented to illustrate assessment, case formulation, and group psychotherapy of eating disorders that are informed by attachment theory.
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Results indicate that therapists may attend to attachment insecurity and affective regulation strategies when addressing body image issues in patients with eating disorders.
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Eating disorder patients’ low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.
Effect of intrapersonal emotional competences on the relationship between attachment insecurity and severity of eating disorder symptoms in patients with restrictive anorexia.
TLDR
Lower intrapersonal EC played an important mediating role in the effects of attachment insecurity on the severity of eating disorders, and the joint use of therapeutic programs that target both EC and attachment processes constitutes a promising approach.
Recovery from eating disorder 1 year after start of treatment is related to better mentalization and strong reduction of sensitivity to others
TLDR
A focus on enhancing mentalization in eating disorder treatment might be useful to increase the chances of successful treatment, and improvement of autonomy might be the mechanism of change in recovering from AN or BN.
Attachment insecurity mediates the relationship between childhood trauma and eating disorder psychopathology in a clinical sample: a structural equation model.
TLDR
Attachment insecurity, characterized by affect dysregulation and interpersonal sensitivities may help to explain why eating disorder symptoms may be one consequence of childhood maltreatment in a clinical sample.
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