Parental bonding and eating disorders: A systematic review

Abstract

Objective: This article systematically reviews studies of parental bonding in people with eating disorders. Method: MEDLINE, PsychINFO, EMBASE and CINAHL were searched to identify studies that compared parental bonding in people diagnosed with an eating disorder relative to non-clinical controls. Results: Twenty-four studies were identified. Women with eating disorders typically reported lower parental care and higher parental protection compared to non-clinical, but not psychiatric, controls.Interestingly, these relationships were mediated by avoidant problem solving style and several schemas from the Young Schema Questionnaire (YSQ 1 ). Discussion:While there are methodological limitations associated with the reviewed studies, they do offer some support for the proposal that difficulties in parent-child relationships predispose women to eating disorders and other psychiatric diagnoses. suggesting that difficult relationships between parents and children could be implicated in the onset of eating disorders. Using attachment theory 5 as an explanatory framework, it has been suggested that insecure attachments to caregivers are common in those with eating disorders. The symptoms of their eating disorder are assumed to represent an attempt to maintain physical and psychological proximity to a caregiver 6,7 . Likewise, psychodynamic theories suggest that parents of those who develop eating disorders are demanding/over-controlling and emotionally unresponsive. This is assumed to result in either; 1) a need for the adolescent to remain child-like to avoid abandonment, 2) a refusal to eat to subdue the internalised controlling parent, or 3) weight-control behaviours to maintain closeness to the parent 8,9 . Parental bonding and eating disorders 4It is important to assess the empirical support for the hypothesised link between early parent-child relationships and eating disorders. To date, four systematic literature reviews have sought to synthesise data on this empirical question 6,10,7,11 .Before considering their conclusions, it is important to note that they conceptualise existing empirical studies as either considering the "attachment construct" as defined by Bowlby 5,12 , or considering "parental bonding" as defined by Parker and colleagues 12 .Briefly, the "attachment construct" referred to in these reviews is defined by Bowlby's attachment theory 5 . This suggests that children respond to caregiver's behaviour in ways that most effectively achieve care and security.

Transgenerational aspects of former Swiss child laborers: do second generations suffer from their parents’ adverse early-life experiences?

“…One potential process responsible for the transgenerational conveyance of parentally experienced early-life adversity on offspring's mental health could be parenting style. On one hand, parenting style has repeatedly been found to be associated with offspring psychopathology, such as depression and anxiety (Lima, Mello, & Mari, 2010; Rapee, 1997), schizophrenia (Skagerlind, Perris, & Eisemann, 1996), personality disorders (Giakoumaki et al, 2013), and eating disorders (Tetley, Moghaddam, Dawson, & Rennoldson, 2014). On the other hand, parenting style has also been related to adverse childhood experiences.…”

Identifying predictors associated with the severity of eating concerns in females with eating disorders

“…Similarly, Minuchin et al (1975) have described family characteristics of enmeshment, overprotective, rigidity, and lack of conflict resolution. A body of research has focused on perceived parental bonding, [generally assessed by the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979)] as risk factors in the development of eating disorder-related symptoms, concerns and behaviors (Tetley, Moghaddam, Dawson, & Rennoldson, 2014). Particularly, a parenting style based on low care-high control has been shown to predict body image disturbance in female ED outpatients (De Panfilis, Rabbaglio, Rossi, Zita, & Maggini, 2003) and to be the most frequent type amongst ED patients (Jáuregui Lobera, Bolaños Ríos, & Garrido Casals, 2011).…”

Epidemiology of eating disorders part III: social epidemiology and case definitions revisited

“…Reviews of this literature (Ward, Ramsay & Treasure, 2000;Tetley, Moghaddam, Dawson & Rennoldson, 2014) supports attachment findings in the sense that overall, eating disorder patients across diagnostic groups tend to remember their parents as less affectionate and more controlling compared to normal controls. However, this may seem like a general vulnerability as the same pattern apply to other mental disorders as well, as it is related to perfectionism, but also to a poor self-concept and cognitive beliefs like being internally flawed and defective (Ward et al, 2000;Perry et al, 2008).…”