Mental representations of attachment in Eating Disorders: a pilot study using the Adult Attachment Interview

Abstract

Mental representations of attachment in a sample of adults with Eating Disorders (ED) were assessed using the Adult Attachment Interview (AAI). Sixty subjects participated in the study: 30 non-clinical and 30 clinical. The results obtained showed a specific distribution of attachment patterns in the clinical sample: 10% Free/Autonomous (F), 47% Insecure-Dismissing (Ds), 17% Insecure-Entangled/Preoccupied (E) and about 26% disorganized (CC/U). The two samples differed in their attachment pattern distribution and were significantly different on some coding system scales. Further information was obtained by analyzing differences between the three ED subtypes considered (i.e. Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder) and by investigating the differential role of the two parental figures in the definition of attachment representations. Results showed potential benefits in using the AAI coding system scales in addition to the main classifications in order to understand better the developmental issues involved in these disorders. Implications for developmental research and clinical nosology are discussed.

Attachment mental states and inferred pathways of development in borderline personality disorder: a study using the Adult Attachment Interview

“…If one looks only at past AAI studies of individuals with BPD, we find they represent 200 (or 2%) of the 10,000 AAI classifications reviewed by Bakermans-Kranenburg and van IJzendoorn (2009). Ten studies to date have considered the specific links between attachment and BPD utilizing the AAI (Barone, 2003;Barone, Borellini, Madeddu, & Maffei, 2000;Diamond, Stovall-McClough, Clarkin, & Levy, 2003;Fonagy, Leigh, Steele, Steele, Kennedy, Matoon, et al, 1996;Levy, Mehan, Kelly, Reynoso, Weber, Clarkin, et al, 2006;Lyons-Ruth, Melnick, Patrick, & Hobson, 2007;Patrick, Hobson, Castle, Howard, & Maughan, 1994;Rosenstein & Horowitz, 1996;Stalker & Davies, 1995;Stovall-McClough & Cloitre, 2003;van IJzendoorn, Feldbruggen, Derks, de Ruiter, Verhagen, Philipse, et al, 1997). While these studies do have some of the common methodological shortcomings mentioned above (often relying on small samples from in and out-patient sources, and various diagnostic criteria), they share the merit of having used the AAI, a highly reliable assessment method which allows more conclusive inquiry into the developmental issues implied in the disorder.…”

“…The Adult Attachment Interview (AAI; 452 L. Barone et al 2009;Hesse, 2008;Main, Goldwyn, & Hesse, 2002) is backed up by a solid set of results from clinical and non-clinical samples utilizing a coding system able to identify the constellation of developmental antecedents recalled by subjects, and can thus shed light on the specific emotional regulation strategies built up during the course of life and currently mainly used (Mikulincer & Shaver, 2007). It also captures the mental states and interpersonal strategies related to attachment.…”

Feelings of insecurity: Review of attachment and eating disorders

“…This category includes those papers that theoretically refer to psychoanalytical concepts and models. Our review found nine representatives of this retrospective approach (Barone & Guiducci, 2009;Chassler, 1997;Latzer, Hochdorf, Bachar, & Canetti, 2002;Pearlman, 2005;Ramacciotti et al, 2001;Salzman, 1997;Sharpe et al, 1998;Troisi, Di Lorenzo, Alcini, Nanni, Di Pasquale, & Siracusano, 2006;Troisi, Massaroni, & Cuzzolaro, 2005).…”

Exploring the Association between Adult Attachment Styles in Romantic Relationships, Perceptions of Parents from Childhood and Relationship Satisfaction

“…Therefore, future research could benefit from the use of longitudinal studies which may offer insight into how early parenting behaviours act as predictors of later relationship functioning while also monitoring changes in an individual's internal working model of attachment over time [13] [21]. Furthermore, while Hazan and Shaver's [12] Adjective Checklist was useful for gaining an insight into more general positive or negative perceptions of parents in childhood, future research could incorporate the use of the AAI to provide a more in-depth examination of participants' mental representations of early attach-ment experiences with parents [22].…”

“…To date, there has been limited attachment research examining how the differential roles played by the mother and father may impact on individual differences in attachment mental representations [22]. Over the past few years, studies have incorporated this aspect into research on adult attachment styles [14] [23].…”