Attachment to parents and friends and body dissatisfaction in adolescents with eating disorders

Abstract

The study of attachment is a valuable theoretical framework to understand the influence of parents and friends on the evolution and development of adolescents. This study aimed to determine parents’ and peers’ attachment style, the relationship between parents’ and peers’ attachment and body dissatisfaction in adolescents with eating disorders (ED), and to compare it with a control group. The sample consisted of 260 adolescents ( Mage = 15.35, SDage = 1.461): a control group consisting of 129 non-clinical subjects and an ED group composed by 131 adolescents diagnosed with ED who attended five ED units located in different regions of Spain. They completed the Body Shape Questionnaire (BSQ-34) and the Inventory of Parent and Peer Attachment (IPPA). Adolescents with ED have less trust with their parents, worse communication with their parents and peers, and greater alienation with fathers and peers. The results showed a statistically significant relationship between parents’ attachment and body dissatisfaction in both groups. In ED group, peers’ alienation was positively correlated to body dissatisfaction. Parental attachment and alienation feelings with peers could influence body dissatisfaction in ED adolescents.

Family, friends, and feelings: the role of relationships to parents and peers and alexithymia in adolescents with anorexia nervosa

“…Our study suggests that for eating disorder psychopathology friendships to peers play a particularly important role. This is in line with Cunha et al [22] but contrasts the results of others [23,25] who found eating disorder psychopathology to be related more strongly to relationship quality to mothers and/or fathers than to relationship quality to peers.…”

“…The groups differed not only in all three relationships but also on all subscales of relationship quality: adolescents with AN reported lower Trust, lower Communication, and higher Alienation in their relationships than healthy adolescents. In addition, relationship quality scores were negatively correlated with eating disorder symptoms (in line with [19,23,25]). Effect sizes for group differences were largest for relationships to peers and the correlation with eating disorder symptoms was significantly larger for relationships to peers than for relationships to parents, suggesting that peer relationships might be particularly impaired in adolescents with AN.…”

“…Maybe this is because peer relationships not only influence alexithymia but are also influenced by alexithymia: Alexithymia may not only result from inadequate relationships, especially to parents [64], but may also lead to difficulties in establishing and sustaining friendships with peers, as the inability to recognize and communicate one's feelings interferes with intimacy within relationships and might contribute to individuals being perceived as emotionally distant and withdrawn [39]. This lack of good friendships with peers might then influence eating disorder psychopathology in different ways: (1) peers have been suggested to be an important source for "normative" standards, especially regarding appearance [23,67] and the lack of the normalizing influence 7 of the peer group might lead to a greater endorsement of problematic eating attitudes and behaviors in adolescents [25,70], (2) poor peer relationships might involve teasing about weight and physical appearance, which has been found to be a predictor for unhealthy eating attitudes and behaviors [71], (3) relatedly, difficulties in peer relations might lead adolescents to engage in disordered eating behaviors as an attempt to gain social approval and acceptance [67], and (4) importantly, social isolation and the lack of good friendships could cause or be accompanied by low self-esteem or depressive symptoms [25,67,72] that might trigger disordered eating behavior as a means to either achieve positive self-worth or deal with negative affect [25,66,72]. These multiple pathways might explain the particularly important role that peer relationships seem to play for eating disorder psychopathology.…”

“…The studies investigating attachment and parental relationship quality in adolescents with AN yielded heterogeneous results: Some found no differences in perceived parental care, overprotection, or relationship quality to parents between adolescents with AN and healthy adolescents [16][17][18], while others found adolescents with AN to report attachment insecurity and lower relationship quality in the relationships to both their mothers and fathers ( [19][20][21]; see [12] for a review). Despite friendships with peers gaining importance in adolescence, only few studies have also investigated peer relationships in adolescents with AN: Two studies found adolescents with AN or other eating disorders to report lower relationship quality not only in their relationships to parents but also to peers in comparison to controls [22,23] while another study found lower relationship quality in eating disordered adolescents only for relationships to mothers but not peers [24]. Pelletier Brochu et al [25] found alienation in the relationship to mothers as well as peers, but not fathers, to be positively associated with eating disorder symptom severity in adolescents with AN.…”

The Impact of Unhealthy Behaviors on Personalized Well-Being Index in a Sample of School Dropout Adolescents

“…Family meals may promote a model of healthy eating behaviors and create a communication of cohesion, developing a healthier perception of self, and thus, accordingly to our approach, a better well-being perception [ 9 , 24 ]. On the contrary, negative family experiences that induce lower confidence are associated with an increase in eating disorders [ 25 ]. Another important result concerns the relationship between psychotropic drugs use and the well-being perception.…”