Mental representations of attachment in a sample of adults with Eating Disorders (ED) were assessed using the Adult Attachment Interview (AAI). Sixty subjects participated in the study: 30 non-clinical and 30 clinical. The results obtained showed a specific distribution of attachment patterns in the clinical sample: 10% Free/Autonomous (F), 47% Insecure-Dismissing (Ds), 17% Insecure-Entangled/Preoccupied (E) and about 26% disorganized (CC/U). The two samples differed in their attachment pattern distribution and were significantly different on some coding system scales. Further information was obtained by analyzing differences between the three ED subtypes considered (i.e. Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder) and by investigating the differential role of the two parental figures in the definition of attachment representations. Results showed potential benefits in using the AAI coding system scales in addition to the main classifications in order to understand better the developmental issues involved in these disorders. Implications for developmental research and clinical nosology are discussed.
We report the outcome of an investigation on how specific attachment states of mind and corresponding risk factors related to different DSM Axis I comorbidities in subjects with BPD. Mental representations of attachment in four BPD sub-groups (BPD and Anxiety/Mood Disorders, BPD and Substance Use and Abuse Disorders, BPD and Alcohol Use and Abuse Disorders, and BPD and Eating Disorders) were assessed in 140 BPD subjects using the Adult Attachment Interview (AAI). In addition to the global attachment picture in which Insecure organized (Dismissing 51% and Enmeshed 35%) and Insecure disorganized categories (40%) were overrepresented, significant differences in attachment category were found between the four BPD sub-groups. Axis I comorbidities corresponded with attachment features on the internalizing/externalizing functioning dimension of the disorder. Furthermore, specific constellations of inferred developmental antecedents and attachment states of mind corresponded differentially with the BPD sub-groups. Implications for developmental research and clinical nosology are discussed.
This study aims at examining the attachment states of mind in 50 female outpatients with eating disorders compared with 50 matched control participants using the Adult Attachment Interview. Moreover, the differences in attachment states of mind among eating-disordered women with and without borderline personality disorders' diagnosis were explored. The results showed an over-representation of insecure-dismissing and unresolved states of mind in clinical group compared to controls. Patients with both diagnosis showed higher scores on involving anger and unresolved loss compared with those with only eating disorder. Implications for further research and clinical practice are discussed.
Introduction: In recent years alexithymia and attachment theory have been recognized as two parallel research lines trying to improve the information on the development and maintenance of eating disorders (EDs). However, no research has analyzed these constructs among patients’ families. In this study we compared alexithymia and attachment in mothers of patients with EDs and a control group. Further, we hypothesized that mothers of daughters with EDs with insecure and unresolved states of mind will reported high levels of alexithymia. Lastly, we explored the daughters’ evaluations of maternal alexithymia.Methods: 45 mothers of ED women and 48 mothers of healthy controls (N = 93) matched for age and socio-demographic variables were administered by the Toronto Alexithymia Scale-20 (TAS-20) (S), while two sub-groups of “ED” mothers (n = 20) and “non-ED” ones (n = 22) were assessed by the Adult Attachment Interview (AAI). Moreover, the Observer Alexithymia Scale (OAS) was administered to the daughters for evaluating maternal alexithymia.Results: Regarding alexithymia, no differences were found between ED and non-ED mothers according to the TAS-20, while ED mothers showed more unresolved AAI classifications than non-ED mothers. No correlations were found between the TAS-20 and the AAI. Lastly, ED mothers were evaluated more alexithymic by their daughters with the OAS than those in the control group, and their alexithymic traits were significantly correlated with dismissing states of mind (idealization and lack of memory) in the AAIs.Discussion: Our results highlighted an interesting discrepancy among mothers with ED daughters between the low level of alexithymia provided by their self-reports and the high level of alexithymia observed by their daughters, although the OAS showed severe methodological limitations. Maternal attachment states of mind characterized by the lack of resolution of past losses could be connected to a confusing and incoherent quality of parenting.
Maltreating and foster families belong to different research areas and have rarely been considered together. This exploratory study compared maltreating and foster families to demonstrate an integrated approach that overcomes the dichotomic view that often separates problematic families from those who have resources. This study had 81 participants: 48 maltreating parents and 33 foster parents and the children who were in foster care. We examined family functioning (FES), adult attachment styles (ASQ) and foster children's strengths and difficulties (SDQ) in maltreating and foster families to examine the differences and similarities between families. Both types of families had significant differences on the FES and ASQ scales. Maltreating families had a stronger orientation to succeed and a family profile that was more orientated towards independence. Maltreating parents had higher scores on the scale that measured discomfort with closeness than foster families. However, both family types had a high level of confidence. Many foster children had SDQ scores that were in the borderline and problem categories. These components may promote a theoretical view of an integrated model for family and children's problems that promotes children's welfare and supports maltreating parents. Practitioners can build on parent's strengths or protective factors and provide services to address less developed areas.
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