Eating disorders and attachment: the effects of hidden family processes on eating disorders

Ringer, Francoise; Crittenden, Patricia M.

doi:10.1002/erv.761

Cited by 103 publications

(150 citation statements)

References 22 publications

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“…Among other factors, bulimic symptoms and body dissatisfaction are related to attachment insecurity accompanied by ambivalent or fearful relationships (Elgin & Pritchard 2006;Ringer & Crittenden, 2007). In cases of bulimia, preoccupied attachment may be predominant, while in anorexia dismissive attachment may predominate (Ringer & Crittenden, 2007;Zachrisson & Skå rderud, 2010). However, specific relationships between attachment patterns and subgroups of eating symptomology are inconsistent (Gander et al, 2015).…”

Section: Attachment and Eating Disordersmentioning

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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Section: Attachment and Eating Disordersmentioning

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 functioning can be insecure in all types of eating disorder (Ward et al, 2010); however the predominant pattern in anorexia nervosa is dismissive attachment whilst in bulimia nervosa preoccupied adult attachment is the predominant pattern (Elgin & Pritchard, 2006;Ringer & Crittenden, 2007;Zachrisson & Skårderud, 2010). Bulimic patients often have ambivalent relationships characterized by anger, distrust, fear of losing the object and a strong wish for approval (Becker, Belle, & Bellington, 1987).…”

Section: Attachment and Eating Disordersmentioning

confidence: 99%

Cognitive-behavioral and attachment interventions in the transdiagnostic treatment of bulimia nervosa and binge eating disorder

Szalai

2016

Menté name=

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Background: The transdiagnostic model of eating disorders provides an evidence-based cognitive-behavioral treatment approach, emphasizing the maintaining factors of low selfesteem, perfectionism, mood intolerance and interpersonal difficulties. Although attachment quality is associated with these factors, there is no treatment model focusing on both attachment-related and cognitive-behavioral maintaining factors of the symptoms. Aims: The aim was to construct and test a multilevel treatment model, which integrates attachment interventions into the transdiagnostic treatment of eating disorders. Methods: Relevant aspects of attachment functioning were joined together with the four cognitivebehavioral maintaining factors of the symptoms, and attachment interventions were incorporated into an extended transdiagnostic treatment of a bulimia nervosa and a binge eating disorder patient. Results: Attachment domains could be integrated into the transdiagnostic model of eating disorders at both the case conceptualization and treatment level. The improvement of attachment functioning was related to treatment outcomes at a one month follow-up. Conclusions: When attachment dysfunctions contribute to precipitating or maintaining mechanisms of eating disorder symptoms a multilevel treatment targeting both the relevant aspects of attachment and cognitive-behavioral functioning can be suggested. Randomized controlled studies with different intervention groups are required to confirm the result of these case studies.

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“…Despite this, the study confirms the risks of parental psychiatric illness for bulimia nervosa. Ringer and Crittenden (2007) examined patterns of attachment in a cohort of 62 women with EDs. They found that most of their sample was struggling with attachment figures and that parents' history and relationship problems were causal factors in the development of an ED.…”

Section: Psychological and Familialmentioning

confidence: 99%

“…The sought after goal in child development, is to achieve adequate harmony between the mother and child in order to enable the child to become autonomous and achieve separation (Ringer & Crittenden 2007). Part of the aetiology of an eating disorder lies in low self-esteem, lack of autonomy, dependence and a failure to separate and become an independent person (Garner 2002).…”

Section: Separationmentioning

confidence: 99%

“…Robinson (2009) believes that one of the most remarkable aspects of treating EDs is that it is possible for patients to recover, sometimes after as long as a 20 year duration. However when assessing recovery, what also needs to be addressed is whether or not the underlying issues of attachment, autonomy, individuation, maturation and separation, have all been adequately dealt with, to support the physical aspects of recovery (Ringer & Crittenden 2007).…”

Section: Outcome and Recoverymentioning

confidence: 99%

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Eating disorders from parent to child: Mothers’ perceptions of transgenerational effect

Barnett

2005

Couns and Psychother Res

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Primary prevention focuses on the reduction of risk factors. Children of mothers with an eating disorder are a proven “at risk” group, because children internalise their experiences. Prevention in the field of eating disorders has as yet only addressed children of seven or eight upwards and only in school‐based programs which did not incorporate mothers. This project targeted mothers with an eating disorder who had children under the age of thirteen. The hypothesis is that if these mothers can be encouraged to change damaging behaviour that their children are likely to model, we can attempt to break the cycle of dysfunction. This is a qualitative and quantitive research project, carried out with standardised measures and semi‐structured interviews before and after a nineteen week therapy group, with six and twelve month follow ups. The group consisted of eight mothers. This paper describes the group and provides a case study of one participant. The initial analysis suggests that the support of a therapeutic group allowed this mother enough space for reflection. She became aware of her dysfunctional behaviour and was able to begin to understand the underlying reasons behind it. This led to an improvement in her own Eating Disorder (ED) and she was subsequently able to make change in her responses to her children's needs.

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Eating disorders and attachment: the effects of hidden family processes on eating disorders

Cited by 103 publications

References 22 publications

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

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

Cognitive-behavioral and attachment interventions in the transdiagnostic treatment of bulimia nervosa and binge eating disorder

Eating disorders from parent to child: Mothers’ perceptions of transgenerational effect

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