The mediating role of mentalizing between attachment and eating disorders

Redondo, Iratxe; Luyten, Patrick

doi:10.1521/bumc.2018.82.3.202

Cited by 9 publications

(12 citation statements)

References 49 publications

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“…Reduced mindfulness capacity (i.e., inability to be fully aware of current experience or present reality) [106] was also identified as one of the mediating mechanisms [51,63]. This result is not surprising as the associations between insecure attachment and mindfulness [106–108] and between mindfulness and eating pathology [109,110] have been previously established.…”

Section: Discussionmentioning

confidence: 95%

“…Eleven studies used clinical samples, including Pepping’s et al [51] work referred to patients and three studies that combined samples of patients with EDs and healthy participants when performing the mediating analyses [59,61,63]. Three studies compared clinical and healthy samples.…”

Section: Resultsmentioning

confidence: 99%

“…Mindfulness . Overall, 44% of the total effect was explained by the indirect effect [51,63]. Among non-clinical samples, 35% of the total effect was explained by its indirect effect [51].…”

Section: Resultsmentioning

confidence: 99%

“…Among non-clinical samples, 35% of the total effect was explained by its indirect effect [51]. Mindfulness was also a significant mediator between insecure attachment and ED symptoms among patients with ED [63]. The percentage of the total effect that was explained by the indirect effect was 36%.…”

Section: Resultsmentioning

confidence: 99%

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Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis

et al. 2019

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In the last two decades, the number of studies focused on the mediators connecting insecure attachment with Eating Disorders (EDs), at both clinical and sub-clinical level, has considerably increased. However, there has not been a systematic synthesis of this literature to date. To fill this gap, the current meta-analytic review aimed at identifying and quantifying the extent to which mediators contribute to the explanation of this relationship. The present study was registered with PROSPERO (CRD42017076807). A comprehensive search process in seven different electronic databases retrieved 24 studies that examined how insecure attachment leads to ED symptoms through mediation analysis. Standardized regression coefficients of the indirect and total paths of 21 mediation models were pooled. Studies were coded and ranked for quality. We found evidence to show that maladaptive emotion regulation and depressive symptoms had the highest effect size for mediation (mediation ratio [ P M ] = 0.71). Further, body dissatisfaction, neuroticism, perfectionism, mindfulness and social comparison had significant, but moderate to low mediating effects ( P M = 0.21–0.58). The methodological quality of these studies was mostly low to moderate and potential areas for development were highlighted. Our findings support the direct targeting of these psychological constructs in prevention programs and treatment of EDs. Future investigations addressing the time sequence between the variables will provide valuable clues to untangle the prospective contribution of each variable on the development and maintenance of eating pathology.

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Section: Discussionmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

“…Mindfulness . Overall, 44% of the total effect was explained by the indirect effect [51,63]. Among non-clinical samples, 35% of the total effect was explained by its indirect effect [51].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis

et al. 2019

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“…In addition to predicting the development of ED symptoms [42,51], degree of mentalization has been associated with the formation of physical complaints and somatization [48,52,53] that have been identified as potential core predictors of obesity [54][55][56]. Numerous studies have confirmed the existence of insecure attachment and impaired RF in people with EDs [50,[57][58]. The prevalence of insecure attachment among obese patients is also reported to be higher than the general population [59][60].…”

Section: Introductionmentioning

confidence: 99%

Obese Adolescents Have Reduced Mentalizing Ability

Taheri¹,

Mazaheri²,

Zabihzadeh³

et al. 2021

Preprint

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Purpose: Obesity affects both mental health and the quality of life, and it also causes diseases associated with increased mortality. The aetiology of obesity is thought to be multifactorial with biological, psychological and social elements. The psychological realm includes the capacity to be aware of one’s own and others’ mental states, that is mentalizing. We hypothesized that poor mentalizing might contribute to the development and/or persistence of obesity among adolescents. The present study aims to investigate the components of the mentalization model to better identify the psychological status of obese adolescents. Methods: This study was carried out on 100 adolescent girls aged 15 to 19 years who were either obese (N=50, Mean age=17.04, Mean BMI=30.24) or normal weight (N=50, Mean age=16.94, Mean BMI=20.95). All completed the reflective functioning questionnaire (RFQ), reading the mind in the eyes test (RMET), difficulties in emotional regulation scale (DERS), and Toronto alexithymia scale (TAS). Results: Multivariate analysis of variance, univariate analysis of variance, and independent t-test were used. Lower certainty and higher uncertainty on the RFQ were confirmed in the OB group indicating reduced mentalizing ability. Misperception and misinterpretation of emotional states conveyed in the eyes in the RMET were consistent the RFQ results. Alexithymia, including difficulty recognizing, expressing and reflecting on emotions, was also found and this also fits with poor mentalizing capacity. The OB group had difficulty in all components of DERS, apart from the “Strategies” subscale. Conclusion: Mentalization or reflective function is significantly poorer in obese, compared to normal weight adolescents. Poor mentalizing could be a cause of obesity, a factor leading to its persistence, or a consequence of obesity. Further research is required to differentiate these possibilities.Level of evidence Level III: case-control analytic study.

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Reported history of childhood trauma, mentalizing deficits, and hypersomnia in adulthood: A mediational analysis in a nonclinical sample

Kalantar‐Hormozi,

Mohammadkhani

2024

Brain and Behavior

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Background and objectiveExisting research has confirmed the link between childhood trauma and poor sleep quality in adulthood. This study focused on the relationship between childhood trauma and hypersomnia specifically, which is understudied. Additionally, childhood maltreatment has been related to mentalizing deficits. The current study examined the role of mentalizing deficits as mediators between childhood trauma and hypersomnia.MethodThe study sample of this cross‐sectional study consisted of 496 individuals, who participated in the online survey, which contained the following measures: Persian version of the Mini Sleep Questionnaire, Reflective Functioning Questionnaire (RFQ‐8), and Childhood Trauma Questionnaire (CTQ).ResultsThe results from structural equation modeling indicated that emotional abuse positively predicts hypersomnia. Mediation analysis confirmed that hypo‐mentalizing partially mediates the association between emotional abuse and hypersomnia.ConclusionThe present study provides primary evidence that experiencing emotional abuse during childhood is associated with hypersomnia in adulthood. This association underlines the importance of prevention. The result from mediation analysis suggests addressing mentalizing impairments in patients with hypersomnia and a history of emotional abuse may be helpful.

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The mediating role of mentalizing between attachment and eating disorders

Cited by 9 publications

References 49 publications

Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis

Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis

Obese Adolescents Have Reduced Mentalizing Ability

Reported history of childhood trauma, mentalizing deficits, and hypersomnia in adulthood: A mediational analysis in a nonclinical sample

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