High Anxiety Attachment in Eating Disorders: Intergenerational Transmission by Mothers and Fathers

Attili, Grazia; Pentima, Lorenza Di; Toni, Alessandro; Roazzi, Antônio

doi:10.1590/1982-4327e2813

Cited by 17 publications

(10 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Meanwhile, in studies employing interview measures of attachment, significant differences between adolescent eating disorder and control groups were found by Pace et al (2016), who used the Adult Attachment Interview (George, Kaplan and Main, 1985), in a sample of 25 adolescents with AN, and 25 HC individuals; and also by Attili et al (2018) who used the Separation Anxiety Test in a sample of 55 adolescents with eating disorders, and 80 HC adolescents. Overall, these studies were rated as having a low risk of bias in most domains (e.g.…”

Section: Studies Of Attachment In Adolescent Eating Disorder Samplesmentioning

confidence: 99%

Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa (Thesis)

Jewell¹

2021

Preprint

View full text Add to dashboard Cite

Family therapy for adolescent anorexia nervosa (FT-AN) is the first line treatment for the disorder, but little is known about who the treatment works for, or how it works. This thesis investigates the potential value of the constructs of attachment and mentalization as predictors of outcome in family therapy for adolescent AN. The thesis presents a systematic review of attachment and mentalization and their association with child and adolescent eating pathology in which 22 relevant studies were found. In keeping with the evidence base for adults with eating disorders, both attachment and mentalization were found to be correlates of eating pathology in childhood and adolescence. However, evidence for these constructs in the process of treatment in child and adolescent eating disorders is scarce. In a second systematic review, the psychometric properties of attachment measures in middle childhood and adolescence were investigated across 53 studies. The overall conclusion of the study is that there is a lack of evidence of adequate psychometric properties for attachment measures in this age group.In the main study, attachment and mentalization were investigated as predictors of outcome in a sample of adolescents and their parents (n = 192) receiving FT-AN across three specialist outpatient eating disorder services. Mentalization, but not attachment, was found to predict poor clinical outcome at nine months after starting of treatment, with the strongest predictive effect being excessive certainty about mental states as assessed in parents. Therapeutic alliance scores at one month were predictive of outcome but did not play a mediating role in relation to baseline attachment or mentalization. In a further empirical study, definitions of eating disorder recovery were investigated through a qualitative analysis of comments on recovery-focused social media forums. Two super-ordinate themes emerged: firstly, recovery was defined as encompassing broad psychosocial domains of wellbeing; secondly, recovery was understood to be an ongoing process. Social connectedness to others was regarded as important both to the process and definition of eating disorder recovery. The final chapter of the thesis integrates findings from across the studies with emerging theoretical developments in the fields of attachment and mentalization. It is argued that attachment and mentalization represent worthwhile constructs for further FT-AN research, with a particular emphasis on the need to better understand the mechanisms by which excessive mental state certainty might lead to poor clinical outcomes.

show abstract

Section: Studies Of Attachment In Adolescent Eating Disorder Samplesmentioning

confidence: 99%

Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa (Thesis)

Jewell¹

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Para Meyer (1987), esses sentimentos estão diretamente relacionados ao que o indivíduo pôde internalizar de suas relações familiares, que se organizam ao longo de seu desenvolvimento emocional. A família é entendida como o legado de uma intrincada trama vincular intersubjetiva, constituída por objetos internos e fantasias inconscientes que são transmitidas intergeracionalmente (Attili, Pentima, Toni, & Roazzi, 2018). O esforço do pesquisador se volta para o encontro de palavras que traduzam os sentidos inconscientes elaborados por essas famílias em suas interações, de modo que as experiências compartilhadas possam ganhar novos significados (Mandelbaum, 2008).…”

Section: Introductionunclassified

Relações Familiares Na Bulimia Nervosa

et al. 2021

View full text Add to dashboard Cite

Transtornos alimentares, como a bulimia, são psicopatologias de etiologia multifatorial que têm nas relações familiares um dos principais fatores desencadeadores e mantenedores dossintomas. Este estudo teve por objetivo analisar as vivências das relações familiares na perspectiva de uma jovem diagnosticada com bulimia, de sua mãe e seu pai. Trata-se de um estudo de caso qualitativo, descritivo e transversal, cujo delineamento abarca a tríade pai-mãe-filha. Foram entrevistados três membros de uma família (pai, mãe e filha diagnosticada com bulimia). Os dados foram coletados por meio de roteiros de entrevista semiestruturada e analisados pela perspectiva do referencial teórico psicanalítico, a partir da construção de categorias temáticas. Os resultados mostraram que, assim como a filha, os pais também apresentaram fragilidades no seu desenvolvimento emocional, culminando em dificuldades no estabelecimento da diferenciação eu-outro nos membros da família. Essas dificuldades culminaram em vivências familiares de instabilidade, com vínculos de dependência impregnados por sensações paradoxais de invasão da intimidade e sentimentos de desamparo. Os resultados encontrados trazem avanços para o conhecimento da área, em especial no nível da compreensão das relações familiares no contexto da bulimia, e oferecem subsídios para o planejamento de ações e intervenções dos profissionais envolvidos na assistência a pacientes e familiares.

show abstract

“…Previous research has highlighted the presence of abuse and lack of affectionate nurturing in families where BN occurs [7]. It has also brought to light the potential significance of the father-daughter relationship in the development of BN and there have been calls for a study that would make this relationship its focus [14,15,16,17,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

Subtle Breaks In Attachment: Invisible Trauma And The Emergence Of Bulimia Nervosa

Saunokonoko¹,

Mars²,

Sattmann-Frese³

2021

Preprint

View full text Add to dashboard Cite

Background: It is known that complex traumatic experience contributes to the emergence of bulimia nervosa (BN). Yet cognitive behavioural therapy, with or without medication, remains the western medical model’s treatment of choice, regardless of its poor long-term outcomes. Incidence of BN is rising, whilst treatment success eludes most sufferers. This research set out to dig deep into the lived experience of BN in order to uncover new clues linking BN’s aetiology to treatment options; and the research argues for the adoption of trauma-informed protocols for BN, as these fit more effectively with causation. Taking the previously under-researched, but known-to-be significant father-daughter relationship as its starting point, the research reveals a raft of new findings pointing to the pervasive consequences of subtle attachment trauma in this relationship. In light of this, the research informs a clear recommendation for a trauma-informed treatment approach and provides hope for those living with the condition. Methods: A hermeneutic phenomenological, detail-rich study of women in recovery from BN was carried out. A qualitative study was considered to be in sufficient contrast to existing research approaches as to offer up the greatest possibility of new insights into BN. Results: Subtle attachment failures, present in the father-daughter relationship, strongly contribute to complex traumatic experience and are instrumental in the development of BN. Many of these attachment failures lack the overtly dramatic nature of abuses such as physical violence, yet create powerful pre-conditions for the development of bulimic symptomatology. They are rooted in safety-seeking and survival aspects of the attachment bond, causing confusion in aspects of self-worth and anxiety about belonging. The resulting uncertain search for secure nurturing is directly reflected in the push-pull dynamic of the binge/compensation cycle of BN. Conclusions: BN arises in response to complex traumatic experience as a survival mechanism aimed at ensuring psychological and physical protection. Complex traumatic experience is, however, a multi-faceted concept in which subtle breaks in father-daughter attachment play a pivotal role. Therefore, adopting a staged, multi-modal complex trauma treatment model, aimed at building safety, agency and relationship skills for those seeking help, may offer hope for more successful treatment outcomes.

show abstract

High Anxiety Attachment in Eating Disorders: Intergenerational Transmission by Mothers and Fathers

Cited by 17 publications

References 22 publications

Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa (Thesis)

Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa (Thesis)

Relações Familiares Na Bulimia Nervosa

Subtle Breaks In Attachment: Invisible Trauma And The Emergence Of Bulimia Nervosa

Contact Info

Product

Resources

About