Attachment and mentalization and their association with child and adolescent eating pathology: A systematic review

Jewell, Tom; Collyer, Hannah; Gardner, Tessa; Tchanturia, Kate; Simic, Mima; Fonagy, Peter; Eisler, Ivan

doi:10.1002/eat.22473

Cited by 117 publications

(109 citation statements)

References 117 publications

(212 reference statements)

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“…Recently, two different studies using dynamic causal modeling identified a relationship between left parietal regions and medial prefrontal cortex important for self-specific processing in healthy adults (Davey et al, 2016; Sui et al, 2013); disruption of this neurocircuitry may be important in the pathology of AN. In a systematic review, Jewell (Jewell et al, 2016) reported that a consistent relationship between eating pathology and mentalization difficulties has been observed in adolescents with eating disorders; here we propose neural regions that may mediate these problems.…”

Section: Discussionsupporting

confidence: 54%

Neural activations are related to body-shape, anxiety, and outcomes in adolescent anorexia nervosa

Harper

Enkevort

et al. 2017

Journal of Psychiatric Research

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Anorexia nervosa (AN) is an illness that frequently begins during adolescence and involves weight loss. Two groups of adolescent girls (AN-A, weight-recovered following AN) and (HC-A, healthy comparison) completed a functional magnetic resonance imaging task involving social evaluations, allowing comparison of neural activations during self-evaluations, friend-evaluations, and perspective-taking self-evaluations. Although the two groups were not different in their whole-brain activations, anxiety and body shape concerns were correlated with neural activity in a priori regions of interest. A cluster in medial prefrontal cortex and the dorsal anterior cingulate correlated with the body shape questionnaire; subjects with more body shape concerns used this area less during self than friend evaluations. A cluster in medial prefrontal cortex and the cingulate also correlated with anxiety such that more anxiety was associated with engagement when disagreeing rather than agreeing with social terms during self-evaluations. This data suggests that differences in the utilization of frontal brain regions during social evaluations may contribute to both anxiety and body shape concerns in adolescents with AN. Clinical follow-up was obtained, allowing exploration of whether brain function early in course of disease relates to illness trajectory. The adolescents successful in recovery used the posterior cingulate and precuneus more for friend than self evaluations than the adolescents that remained ill, suggesting that neural differences related to social evaluations may provide clinical predictive value. Utilization of both MPFC and the precuneus during social and self evaluations may be a key biological component for achieving sustained weight-recovery in adolescents with AN.

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Section: Discussionsupporting

confidence: 54%

Neural activations are related to body-shape, anxiety, and outcomes in adolescent anorexia nervosa

Harper

Enkevort

et al. 2017

Journal of Psychiatric Research

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“…Early attachment experiences increase the risk of eating disorders [76•, 77] and obesity [78]. Furthermore, adolescents [79,80] and adults [81,82] with AN have insecure patterns of attachment. A recent meta-analysis concluded that this effect was large (Cohen's d = 1.…”

Section: Early Adversity and Eating Behaviourmentioning

confidence: 99%

Emotional Eating, Binge Eating and Animal Models of Binge-Type Eating Disorders

2017

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Evidence has been found to suggest that for some high-risk individuals, obesity/binge eating may develop as an impulsive reaction to negative emotions that over time becomes a compulsive habit. Animal models highlight the neural mechanisms that might underlie this process and suggest similarities with substance use disorders. Emotional difficulties and neurobiological factors have a role in the aetiology of eating and weight disorders. Precise treatments targeted at these mechanisms may be of help for people who have difficulties with compulsive overeating.

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“…And also in eating disorders attachment was found to be a predictor of risk. (Szalai and Czegledi 2015); (Jewell et al 2016) However, there remains a paucity of research on the relationship between attachment and defenses. The few studies that have been conducted indicate an association between attachment styles and specific defense mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Defense mechanism is predicted by attachment and mediates the maladaptive influence of insecure attachment on adolescent mental health

Laczkovics

Bendixsen²,

Shpigel

et al. 2018

Curr Psychol

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There is limited research exploring attachment style and defenses in adolescents. The purpose of the current research is to explore the relationship between adolescent attachment style and development of defense mechanisms, as well as attachment style and problem behaviors. A total of 1487 students from two California high-schools completed three self-report questionnaires to establish defense mechanisms, psychiatric symptoms, and attachment style. Attachment styles characterized by a positive selfimage predict greater levels of mature defense mechanisms, and lower levels of immature defense mechanisms, both in the interpersonal and intrapsychic domains. Relationships between insecure attachment styles and psychopathology were mediated by greater levels of immature defense mechanisms. These results provide initial compelling evidence that: a) attachment style is an important determinant of the type of defense mechanisms utilized by the individual to maintain psychological stability; and b) defense mechanisms serve to transmit the detrimental effects of insecure attachment style on psychological health.

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Attachment and mentalization and their association with child and adolescent eating pathology: A systematic review

Cited by 117 publications

References 117 publications

Neural activations are related to body-shape, anxiety, and outcomes in adolescent anorexia nervosa

Neural activations are related to body-shape, anxiety, and outcomes in adolescent anorexia nervosa

Emotional Eating, Binge Eating and Animal Models of Binge-Type Eating Disorders

Defense mechanism is predicted by attachment and mediates the maladaptive influence of insecure attachment on adolescent mental health

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