Attachment in eating-disordered outpatients with and without borderline personality disorder

Pace, Cecilia Serena; Guiducci, Valentina; Cavanna, Donatella

doi:10.1177/1359105316636951

Cited by 16 publications

(22 citation statements)

References 40 publications

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“…Research has shown that bodily changes following pregnancy, birth, and breastfeeding can predispose women to exacerbations of eating disorder symptoms and the development of mood symptoms during the postpartum period (Astrachan-Fletcher, Veldhuis, Lively, Fowler, & Marcks, 2008;Koubaa, Hallstrom, & Hirschberg, 2008;Micali, Simonoff, & Treasure, 2011). Prior studies also found disproportionately high incidences of unresolved attachment in women with eating disorders (Gander, Sevecke, & Buchheim, 2015;Kuipers, van Loenhout, van der Ark, & Bekker, 2016;Pace, Guiducci, & Cavanna, 2017). As an expression of a "disorder of the self" (Amianto, Northoff, Abbate Daga, Fassino, & Tasca, 2016), this result merits further examination in the postpartum period.…”

Section: Discussionmentioning

confidence: 94%

Randomized controlled trial of the Circle of Security-Intensive intervention for mothers with postpartum depression: maternal unresolved attachment moderates changes in sensitivity

Ramsauer

Mühlhan

Lotzin

et al. 2019

Attachment & Human Development

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Postpartum depression is related to inadequately sensitive caregiving, putting infants at risk for insecure attachment. Therefore, promoting sensitive maternal caregiving and secure child attachment is particularly important in postpartum depressed mothers and their infants. In this randomized-controlled-trial, we evaluated the efficacy of the Circle of Security-Intensive (COS-I)-intervention in supporting maternal sensitivity and mother-infant-attachment compared to treatment-as-usual (TAU) with unresolved-maternal attachment as a moderator of treatment effect. Eligible mothers with infants (N=72) 4-9 months-old were randomly assigned to treatment (n=36 dyads). Infant attachment was rated at follow-up (child age 16-18 months) (Strange-Situation-procedure). Maternal sensitivity was measured at baseline and follow-up (Mini-Maternal-Behavior-Q-sort). Maternal-unresolved-attachment was assessed at baseline (Adult-Attachment-Interview). We found no significant differences between treatments in infant attachment nor changes in mothers' sensitivity. However, in COS-I, unresolved-mothers exhibited significantly more change in sensitivity than non-unresolvedmothers, whereas in TAU, the opposite was true. These findings may help to optimize clinical use of COS-I.

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Section: Discussionmentioning

confidence: 94%

Randomized controlled trial of the Circle of Security-Intensive intervention for mothers with postpartum depression: maternal unresolved attachment moderates changes in sensitivity

Ramsauer

Mühlhan

Lotzin

et al. 2019

Attachment & Human Development

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“…Zudem offenbaren sich beiihneneingeringerSelbstwertund eine eingeschränkte Emotionsregulationsfähigkeit (Hartmann et al 2014). Ferner berichten Studien über ein unsicheres Bindungsverhalten (Pace et al 2016). Zu dem Zusammenhang zwischen Essstörungen, deren Ausprägung und OPD-Struktur liegen bisher allerdings sehr wenige empirische Befunde vor.…”

Section: Theoretischer Hintergrundunclassified

Selbstberichtete anorektische Essstörungssymptomatik und psychische Struktur

Obbarius

2020

Psychotherapeut

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Zusammenfassung Hintergrund Bei verschiedenen psychischen Störungsbildern, wie beispielsweise Essstörungen, zeigen sich Einschränkungen in der psychischen Struktur, die sowohl bei Erwachsenen als auch Adoleszenten beschrieben wurden. Bisher liegen jedoch keine empirischen Untersuchungen zur psychischen Struktur bei Adoleszenten bzw. jungen Erwachsenen mit typischen oder subklinischen Formen von Essstörungen vor. Ziele der Arbeit Die vorliegende Studie zielt auf die Untersuchung und den Vergleich verschiedener Strukturdimensionen gemäß Operationalisierter Psychodynamischer Diagnostik bei weiblichen Adoleszenten und jungen Erwachsenen mit unterschiedlicher Ausprägung selbstberichteter anorektischer Essstörungssymptomatik ab. Material und Methoden Es gingen Daten von 141 weiblichen Adoleszenten und jungen Erwachsenen mit keiner, gering oder ausgeprägter selbstberichteter anorektischer Essstörungssymptomatik ein. Die Probandinnen wurden über die sozialen Netzwerke Facebook und Instagram rekrutiert und mithilfe einer Onlineerhebung befragt. Zum Einsatz kamen der Fragebogen zur Strukturachse der Operationalisierten Psychodynamischen Diagnostik (OPD-SF) sowie das Eating Disorder Inventory‑2 (EDI-2). Ergebnisse Adoleszente und junge Erwachsene mit ausgeprägter selbstberichteter anorektischer Essstörungssymptomatik zeigen auf fast allen Skalen des OPD-SF sowie auf sämtlichen Skalen des EDI‑2 signifikant höhere Werte als Adoleszente und junge Erwachsene ohne bzw. mit geringer Symptomatik. Diese Unterschiede bleiben auch nach Kontrolle für das Alter sowie Vorliegen von Vordiagnosen und psychotherapeutischen (Vor)Behandlungen bestehen. Es zeigen sich deutliche Zusammenhänge zwischen den Skalen des OPD-SF und denen des EDI‑2. Schlussfolgerung Einschränkungen in der psychischen Struktur scheinen sich bereits bei subklinischen Formen gestörten Essverhaltens zu zeigen, zumindest, wenn diese selbstberichtet ist. Die Ergebnisse unterstützen die Notwendigkeit der frühzeitigen Erkennung von Problemen mit dem Essverhalten und des Einbezugs struktureller Aspekte in die psychotherapeutische Behandlung.

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“…On the basis of these findings, the relationship between parental adult attachment characteristics and the severity of maladaptive eating behaviors including emotional eating, and binge and purge symptoms shall be investigated within a framework of complex symptoms in both ED and SM individuals (Polivy & Herman, 2002;Pace et al, 2016;Tereno et al, 2008). Since the extent of attachment's contribution on diagnosed EDs varies across studies, this aspec t shall also be examined, especially in Eastern and Central European regions, where related data are lacking.…”

Section: Attachment Emotion Regulation and Emotional Eatingmentioning

confidence: 99%

Parental and Adult Attachment and Eating Symptomology in Eating Disorder Patients and Sine Morbo Individuals

Szalai¹,

Czeglédi²

2017

IJSSS

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Attachment can contribute to eating disorder symptomology through various paths, including emotion regulation. However, the relationship between parental and adult attachment and emotional eating and other eating disorder symptoms have been barely investigated on comparative samples. This cross-sectional, questionnaire-based online survey aimed to assess the relationship between parental and adult attachment qualities with the eating behavior severity, emotional eating, and the level of depression in 67 female anorexia nervosa, bulimia nervosa, and binge eating disorder patients, compared to 67 female sine morbo individuals. Eating disorder patients less frequently had secure attachment, and were more often fearful or preoccupied than sine morbo individuals. In sine morbo individuals lower adult attachment security, but in patients, lower parental care was related to eating disorder symptoms. In sine morbo individuals, higher preoccupation, but in patients, higher fearfulness and lower care was related to emotional eating. Lower attachment security (OR = 0.54), younger age (OR = 0.93) and higher depression (OR = 1.04) explained 36.6% of the variance of diagnosed eating disorders. A complex interplay could be highlighted between dysfunctional attachment dimensions and eating symptomology in both groups-but with different patterns. Perceived parental care may be influential for eating disorder patients, whilst the degree of adult attachment security can be influential for sine morbo individuals. Lower attachment security was a predictor of eating disorders, which suggests the protective value of enhancing attachment security. However, further attachment-based interventions are required.

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Attachment in eating-disordered outpatients with and without borderline personality disorder

Cited by 16 publications

References 40 publications

Randomized controlled trial of the Circle of Security-Intensive intervention for mothers with postpartum depression: maternal unresolved attachment moderates changes in sensitivity

Randomized controlled trial of the Circle of Security-Intensive intervention for mothers with postpartum depression: maternal unresolved attachment moderates changes in sensitivity

Selbstberichtete anorektische Essstörungssymptomatik und psychische Struktur

Parental and Adult Attachment and Eating Symptomology in Eating Disorder Patients and Sine Morbo Individuals

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