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Jin L, Zamudio G, Wang CD, Lin S. Insecure attachment and eating disorder symptoms: Intolerance of uncertainty and emotion regulation as mediators. J Clin Psychol 2024; 80:1673-1688. [PMID: 38573170 DOI: 10.1002/jclp.23685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/08/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Literature on eating disorder (ED) symptoms of Black, Indigenous, and People of Color (BIPOC) group is extremely scarce. This study aimed to understand the mechanisms underlying the associations between insecure attachment and ED symptoms and examine whether these mechanisms differed between White and BIPOC groups. METHOD The study investigated direct and indirect relationship between attachment anxiety/avoidance and ED symptoms via intolerance of uncertainty (IU) and emotion regulation strategies of suppression and reappraisal. Further, we examined whether the proposed mechanisms equally represented White versus BIPOC using Multigroup Structural Equation Model (MG-SEM). A total of 1227 college students (48.50% BIPOC and 51.50% White) completed research questionnaires. RESULTS Results showed that IU and suppression mediated the relations between insecure attachment and ED symptoms for both White and BIPOC groups. Uniquely, reappraisal mediated the relations between insecure attachment and ED symptoms for the White group, but not for the BIPOC group. DISCUSSION The implications of the findings for culturally informed practice are discussed, including targeting increasing tolerability of uncertainties and improving emotion regulation to mitigate ED symptoms for those with insecure attachment.
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Affiliation(s)
- Ling Jin
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Gabriel Zamudio
- Werklund School of Education, University of Calgary, Calgary, Alberta, Canada
| | - Chiachih Dc Wang
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Stacy Lin
- Adult Eating Disorders Program, School of Medicine, Stanford University, Stanford, California, USA
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Carfagno M, Barone E, Arsenio E, Bello R, Marone L, Volpicelli A, Cascino G, Monteleone AM. Mediation role of interpersonal problems between insecure attachment and eating disorder psychopathology. Eat Weight Disord 2024; 29:43. [PMID: 38904743 PMCID: PMC11192810 DOI: 10.1007/s40519-024-01673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/16/2024] [Indexed: 06/22/2024] Open
Abstract
PURPOSE Although insecure attachment and interpersonal problems have been acknowledged as risk and maintaining factors of eating disorders (EDs), the mediating role of interpersonal problems between attachment style and ED psychopathology has been poorly explored. The purpose of this study was to investigate the mediating role of interpersonal problems between insecure attachment and ED psychopathology. METHODS One-hundred-nine women with anorexia nervosa and 157 women with bulimia nervosa filled in the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships (ECR) revised scale to assess ED core symptoms and attachment styles, respectively. Interpersonal difficulties were evaluated by the Inventory of Interpersonal Problems (IIP-32). A mediator's path model was conducted with anxious and avoidant attachment subscores as independent variables, ED core symptoms as dependent variables and interpersonal difficulties as mediators. The diagnosis was entered in the model as a confounding factor. RESULTS The socially inhibited/avoidant interpersonal dimension was a mediator between avoidant attachment and the drive to thinness as well as between avoidant attachment and body dissatisfaction. An indirect connection was found between attachment-related anxiety and bulimic symptoms through the mediation of intrusive/needy score. CONCLUSIONS Social avoidance and intrusiveness mediate the relationships between avoidant and anxious attachment styles and ED psychopathology. These interpersonal problems may represent specific targets for psychotherapeutic treatments in individuals with EDs and insecure attachment. LEVEL OF EVIDENCE Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Marco Carfagno
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Eugenia Barone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Eleonora Arsenio
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosaria Bello
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Marone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Volpicelli
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
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Martin AJ, Bostwick KCP, Burns EC, Munro-Smith V, George T, Kennett R, Pearson J. A healthy breakfast each and every day is important for students' motivation and achievement. J Sch Psychol 2024; 104:101298. [PMID: 38871415 DOI: 10.1016/j.jsp.2024.101298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/10/2023] [Accepted: 02/23/2024] [Indexed: 06/15/2024]
Abstract
Breakfast is often cited as the most important meal of the day and vital for students' academic functioning at school. Although much research has linked students' breakfast consumption to better achievement, there has been debate about why and how breakfast has academic benefits. The present study of 648 Australian high school students investigated (a) the role of breakfast consumption and breakfast quality in students' self-reported motivation and their achievement in a science test, (b) the role of motivation in mediating the link between breakfast consumption and quality and students' achievement, and (c) the extent to which breakfast consumption effects are moderated by the quality of breakfast (e.g., more vegetables, fruit, dairy/protein, wholegrains, cereals, water; less sugary drinks, processed meat, fast take-away, unhealthy snack foods). Findings indicated that beyond the effects of personal, home, and classroom factors, breakfast consumption predicted higher adaptive motivation (p < .05), breakfast quality predicted lower maladaptive motivation (p < .05), and in turn, students' adaptive (positively, p < .01) and maladaptive (negatively, p < .01) motivation predicted their achievement. Moreover, adaptive motivation significantly mediated the relationship between breakfast consumption and achievement (p < .05). The effect of breakfast consumption was moderated by the quality of breakfast such that consuming a high-quality breakfast in the morning was associated with the highest levels of adaptive motivation (p < .01) and achievement (p < .05) later in the day. Findings have implications for educational practice and policy seeking to promote a healthy start to the school day to optimize students' motivation and achievement.
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Affiliation(s)
- Andrew J Martin
- School of Education, University of New South Wales, Australia.
| | | | - Emma C Burns
- School of Education, Macquarie University, Australia
| | | | | | - Roger Kennett
- School of Education, University of New South Wales, Australia
| | - Joel Pearson
- School of Education, University of New South Wales, Australia
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Richardson E, Beath A, Boag S. The Development of the Attachment Defenses Questionnaire (ADQ-50): A Preliminary Examination of Reliability, Validity, and Factor Structure. J Pers Assess 2024:1-15. [PMID: 38776445 DOI: 10.1080/00223891.2024.2353142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 04/28/2024] [Indexed: 05/25/2024]
Abstract
This paper marks the initial phase in the development of the Attachment Defenses Questionnaire (ADQ-50), a self-report tool crafted to assess defense mechanisms associated with attachment processes, catering to both clinical and research contexts. Anchored in the theoretical framework of attachment theory, the ADQ posits that an individual's internalized attachment style plays a influential role in predicting their defense mechanisms. The paper outlines the comprehensive development and refinement process of the ADQ-50. In Study 1 a preliminary 176-item version of the ADQ was examined. Data was collected online drawing from participants sourced from Prolific and undergraduate students (N = 1994). Study 2 further refined the ADQ, evaluating its initial convergent validity with a diverse participant pool (N = 726), including undergraduates, Prolific contributors, general practice medical patients, and individuals from social media. Exploratory factor analysis revealed a robust ten-factor structure, resulting in a 50-item scale aligning with theoretical expectations and demonstrating good psychometric properties. Findings, limitations, strengths and future research directions are discussed. We posit that the ADQ holds great potential to deepen our comprehension of defense mechanisms linked to attachment, with wide-ranging implications for clinical practices.
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Affiliation(s)
- Emma Richardson
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Alissa Beath
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Simon Boag
- School of Psychological Sciences, Macquarie University, Sydney, Australia
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Belloli A, Saccaro LF, Landi P, Spera M, Zappa MA, Dell’Osso B, Rutigliano G. Emotion dysregulation links pathological eating styles and psychopathological traits in bariatric surgery candidates. Front Psychiatry 2024; 15:1369720. [PMID: 38606413 PMCID: PMC11006956 DOI: 10.3389/fpsyt.2024.1369720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Objectives Approximately one-third of bariatric surgery patients experience weight regain or suboptimal weight loss within five years post-surgery. Pathological eating styles and psychopathological traits (e.g., emotion dysregulation) are recognized as potential hindrances to sustain weight loss efforts and are implicated in obesity development. A comprehensive understanding of these variables and their interplays is still lacking, despite their potential significance in developing more effective clinical interventions for bariatric patients. We investigate the prevalence of and interactions between pathological eating styles and psychopathological traits in this population. Materials and methods 110 bariatric surgery candidates were characterized using the Binge Eating Scale (BES), Hamilton Depression/Anxiety Scales (HAM-D/A), Barratt Impulsiveness Scale (BIS-11), Experiences in Close Relationships (ECR), Difficulties in Emotion Regulation Scale (DERS). We analyzed these variables with multiple logistic regression analyses and network analysis. Results Patients with pathological eating styles showed more pronounced anxiety/depressive symptoms and emotion dysregulation. Network analysis revealed strong connections between BES and DERS, with DERS also displaying robust connections with HAM-A/D and ECR scales. DERS and attention impulsivity (BIS-11-A) emerged as the strongest nodes in the network. Discussion Our findings demonstrate the mediating role of emotion dysregulation between pathological eating styles and psychopathological traits, supporting existing literature on the association between psychopathological traits, insecure attachment styles, and pathological eating behaviors. This research emphasizes the significance of emotion regulation in the complex network of variables contributing to obesity, and its potential impact on bariatric surgery outcomes. Interventions focusing on emotion regulation may thus lead to improved clinical outcomes for bariatric patients.
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Affiliation(s)
- Arianna Belloli
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Luigi F. Saccaro
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Paola Landi
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Milena Spera
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Marco Antonio Zappa
- Department of General Surgery, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Bernardo Dell’Osso
- Department of Psychiatry, Azienda Socio Sanitaria Territoriale (ASST) Fatebenefratelli-Sacco, Milan, Italy
| | - Grazia Rutigliano
- Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
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Lo Coco G, Brugnera A, Salerno L, Compare A, Tasca GA, Kivlighan DM. Group member attachment style interacts with actor and partner helping alliance to predict decreasing binge eating episodes. Psychother Res 2024:1-15. [PMID: 38451851 DOI: 10.1080/10503307.2024.2325509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE An individual's attachment style may impact how they interact with their therapy group. This study examined the moderating role of a group member's attachment on the dynamic relationships between that group member's (actor) and other group members' (partner) therapeutic alliances and symptom outcomes. Method: This is a secondary analysis of data from a trial testing the outcome of emotionally-focused group therapy for binge-eating disorder. The sample consisted of 2,360 sessions nested within 118 group members who attended a 20-session treatment. Patients recorded binge eating episodes (BEE), their body weight and an alliance measure session-by-session. RESULTS Dynamic structural equation modelling showed decreases in BEE and weight over the therapy. When attachment style was not included in the model, higher-than-average partner's alliance scores in the previous session were related to decreases in BEE in the current session. Attachment style moderated these actor and partner effects. For patients with preoccupied attachments, higher-than-average actor alliance in the previous session was related to subsequent decreases in BEE. For patients with dismissing or disorganized attachments, higher partner alliance in the previous session was related to subsequent decreases in BEE. CONCLUSION Group members' attachment characteristics can play a role in the development of alliance-outcome patterns in group therapy.
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Wang Y, Luo Y, Zhao J, Cui Y, Chen H. Peer Teasing and Restrained Eating among Chinese College Students: The Chain Mediating Role of Negative Coping Styles and Negative Physical Self. Nutrients 2024; 16:163. [PMID: 38201993 PMCID: PMC10780784 DOI: 10.3390/nu16010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to determine whether negative coping styles and negative physical self sequentially mediate the relationship between peer teasing and restrained eating among Chinese university students. In total, 1127 participants (66.9% women, average age = 18.43 years; age range, 14-26 years) completed the Perception of Teasing Scale, Coping Style Questionnaire, Negative Physical Self Scale, and the Chinese version of the Restraint Scale. The mediational analysis showed that, after controlling for age, sex, and body mass index (BMI), peer teasing was related to restrained eating behaviors through (a) the mediating effect of negative coping styles, (b) the mediating effect of negative physical self, and (c) the chain-mediating effect of negative coping styles and negative physical self. This study showed for the first time that negative coping styles and negative physical self may chain mediate the association between peer teasing and restrained eating. It also provides suggestions for clinical practices as to strategies for controlling restrained eating.
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Affiliation(s)
- Yuwansu Wang
- Faculty of Psychology, Southwest University, Chongqing 400715, China; (Y.W.); (Y.L.); (J.Z.); (Y.C.)
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
- China Research Center of Psychology and Social Development, Chongqing 400715, China
| | - Yijun Luo
- Faculty of Psychology, Southwest University, Chongqing 400715, China; (Y.W.); (Y.L.); (J.Z.); (Y.C.)
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
- China Research Center of Psychology and Social Development, Chongqing 400715, China
| | - Jie Zhao
- Faculty of Psychology, Southwest University, Chongqing 400715, China; (Y.W.); (Y.L.); (J.Z.); (Y.C.)
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
- China Research Center of Psychology and Social Development, Chongqing 400715, China
| | - Yicen Cui
- Faculty of Psychology, Southwest University, Chongqing 400715, China; (Y.W.); (Y.L.); (J.Z.); (Y.C.)
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
- China Research Center of Psychology and Social Development, Chongqing 400715, China
| | - Hong Chen
- Faculty of Psychology, Southwest University, Chongqing 400715, China; (Y.W.); (Y.L.); (J.Z.); (Y.C.)
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China
- China Research Center of Psychology and Social Development, Chongqing 400715, China
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Pyykkö JE, Hinnen C, Aydin Ö, Nieuwdorp M, De Brauw LM, Bruin SC, van Olst N, Gerdes VEA, Sanderman R, Hagedoorn M. Attachment style and post-bariatric surgery health behaviours: the mediating role of self-esteem and health self-efficacy. BMC Psychol 2023; 11:248. [PMID: 37626349 PMCID: PMC10464092 DOI: 10.1186/s40359-023-01273-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Attachment avoidance and anxiety have been linked to overweight and poor health behaviours, yet the mechanisms that underpin the relationship between attachment and health behaviours are not fully understood. Self-esteem and self-efficacy have been found to differ between attachment styles, rendering these variables potential mediators of the relationship. This longitudinal study investigated the serial mediation between preoperative attachment and 2-year post-operative health behaviours through self-esteem and health self-efficacy. METHODS Participants were 263 bariatric surgery patients (75.7% females, aged 47.7 ± 10.4 years, BMI 38.9 ± 3.6 kg/m2) assessed before the operation and again one and two years after the surgery. Patients completed the Experiences for Close Relationships Brief Scale, Rosenberg Self-esteem scale, Weight Efficacy Lifestyle Questionnaire, Bariatric Surgery Self-Management Questionnaire, Exercise Self-Efficacy Scale and the Exercise Behaviour Scale. RESULTS Higher preoperative attachment anxiety and avoidance were associated with lower self-esteem one year after bariatric surgery and poorer health self-efficacy two years after the surgery. Self-esteem and health self-efficacy mediated the relationships between preoperative anxious and avoidant attachment and 2- year post-operative diet adherence and physical activity. CONCLUSIONS Helping patients to feel more worthy and reinforcing their beliefs about their own competences could lead to higher engagement with healthy lifestyle and adherence to treatment protocols, ultimately helping patients to achieve their goals for bariatric surgery. CLINICAL TRIAL REGISTRATION BARIA: Netherlands Trial Register: NL5837 (NTR5992) https://www.trialregister.nl/trial/5837 . Diabaria: ClinicalTrials.gov identifier (NCT number): NCT03330756.
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Affiliation(s)
- Johanna Eveliina Pyykkö
- Department of Health Psychology, Faculty of Medical Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands.
| | - Chris Hinnen
- LUMC Oncology Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ömrüm Aydin
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - L Maurits De Brauw
- Department of Metabolic and Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Sjoerd C Bruin
- Department of Metabolic and Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Nienke van Olst
- Department of Metabolic and Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Victor E A Gerdes
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, Faculty of Medical Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, Faculty of Medical Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands
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Lamourette M, Ligier F, Guillemin F, Epstein J. Short version of the Inventory of Parental Representations, a self-report for attachment assessment among adolescents. BMC Psychiatry 2023; 23:221. [PMID: 37005563 PMCID: PMC10068148 DOI: 10.1186/s12888-023-04704-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 03/21/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND The Inventory of Parental Representations (IPR), a self-administered questionnaire, was developed primarily to identify styles of attachment in adolescence. However, it did not present stable psychometric properties in the various American studies carried out. The aim of this study was to adapt the IPR in French and to provide a shorter version with improved psychometric properties and sound content. METHODS The cross-cultural adaptation and content validity were carried out based on qualitative analysis by an Expert Committee and 10 non-clinical adolescents. For the quantitative analyses a cohort of 535 adolescent volunteers was enrolled, corresponding to 1070 responses, and divided into two groups: development and validation. The study of the metric properties of the adapted version of the IPR was realized in the development group, a sample of 275 responses. In case of mediocre results in the Confirmatory Factor Analysis, the development of a new and reduced IPR structure was planned using a mixed method including Classical Test Theory and Rasch Modelling in the development group. Subsequently, the study of the psychometric properties of the short, adapted version was confirmed in an independent sample of 795 responses (validation group). RESULTS Out of 62 items translated, 13 needed adaptations. The analysis of their metric properties produced mediocre results. Content and psychometric property analyses generated two Short version of the IPR in the development group: a paternal scale for Fathers (Short IPRF) with 15 items and a maternal scale for Mothers (Short IPRM) with 16 items. The sound content and good psychometric properties were confirmed in the validation group (Short IPRF: Comparative Fit Index = 0.987, Tucker-Lewis Index = 0.982, Root Mean Square Error of Approximation = 0.027; Short IPRM: Comparative Fit Index = 0.953, Trucker-Lewis Index = 0.927, Root Mean Square Error of Approximation = 0.068). Using Rasch modelling, the attachment was correctly measured overall especially for insecure attachment. CONCLUSIONS A step-by-step process involving led to the generation of two questionnaires: a paternal scale, the Short IPRF, and a maternal scale with the Short IPRM providing opportunities to use this self-questionnaire to assess attachment among adolescents. Further work will provide a solid rating for this new tool.
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Affiliation(s)
- Marilou Lamourette
- Pôle Universitaire de Psychiatrie de L'Enfant Et de L'Adolescent, Centre Psychothérapique de Nancy, 54521, Laxou, France.
- Université de Lorraine, EA 4360 Apemac, Nancy, 54000, France.
- PUPEA, 1, Rue du Dr Archambault, 54530, Laxou, France.
| | - Fabienne Ligier
- Pôle Universitaire de Psychiatrie de L'Enfant Et de L'Adolescent, Centre Psychothérapique de Nancy, 54521, Laxou, France
- Université de Lorraine, EA 4360 Apemac, Nancy, 54000, France
| | - Francis Guillemin
- Université de Lorraine, EA 4360 Apemac, Nancy, 54000, France
- CHRU Nancy, Inserm, Université de Lorraine, CIC-1433 Épidémiologie Clinique, Nancy, 54000, France
| | - Jonathan Epstein
- Université de Lorraine, EA 4360 Apemac, Nancy, 54000, France
- CHRU Nancy, Inserm, Université de Lorraine, CIC-1433 Épidémiologie Clinique, Nancy, 54000, France
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Jewell T, Apostolidou E, Sadikovic K, Tahta-Wraith K, Liston S, Simic M, Eisler I, Fonagy P, Yorke I. Attachment in individuals with eating disorders compared to community controls: A systematic review and meta-analysis. Int J Eat Disord 2023; 56:888-908. [PMID: 36916409 DOI: 10.1002/eat.23922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Individuals with eating disorders are known to have higher rates of insecure attachment compared to community controls, but the factors underlying this finding are poorly understood. We conducted the first meta-analysis comparing attachment in eating disorder samples compared to community controls that included quality assessment, publication bias and moderation analysis. METHOD We pre-registered our meta-analysis (CRD42019146799) and followed PRISMA guidelines. We searched PsychINFO, Embase, Medline, CINAHL, and Scopus for publications. Attachment scores were extracted, and Cohen's d calculated for each study using a random effects model. RESULTS In total, 35 studies were included in the meta-analysis and six studies were summarized in a narrative review. Eating disorder samples showed higher rates of insecure attachment compared to community controls, with a large effect size, across measurement methods and different attachment dimensions. Blinding of assessors moderated effect sizes for attachment interview studies, but no other moderators were significant. DISCUSSION Risk of insecure attachment is elevated in individuals with eating disorders, albeit heterogeneity is high and largely unexplained. Clinicians may need to take this into account in their work, particularly given the association between attachment insecurity and challenges to therapeutic alliance. Future studies comparing eating disorder samples with community samples should control for general psychopathology. PUBLIC SIGNIFICANCE Attachment is a broad concept referring to a person's thoughts, feelings and behaviors in relation to close others. This systematic review and meta-analysis found that individuals with eating disorders are lower in attachment security than community controls, regardless of attachment construct or measurement approach. Attachment may be relevant in influencing eating disorder recovery, the development of therapeutic alliance, and potentially clinical outcomes, although more research is needed.
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Affiliation(s)
- Tom Jewell
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Eleni Apostolidou
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kevser Sadikovic
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | | | - Sarah Liston
- Leicestershire Partnership NHS Foundation Trust, Leicester, UK
| | - Mima Simic
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ivan Eisler
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud Centre, London, UK
| | - Isabel Yorke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Kim JH, Bost KK. Self-regulation linking the quality of early parent-child relationship to adolescents' obesity risk and food consumption. Pediatr Obes 2023; 18:e12993. [PMID: 36479850 DOI: 10.1111/ijpo.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/29/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The quality of parent-child relationships has been examined as a contributor to children's healthy behaviours and weight outcomes, but the mechanisms accounting for associations remain understudied. OBJECTIVE This study examined whether the quality of early parent-child relationship is associated with adolescent obesity risk and whether self-regulation and (un)healthful food consumption mediate these associations. METHODS Employing structural equation modelling, two theory-driven models were examined using a large sample (N = 1237) drawn from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Indicators of the quality of parent-child relationship included assessments of child attachment security and observational assessments of maternal sensitivity (15, 24, and 36 months). Self-regulation at 54 months was assessed using behavioural and computerized tasks and, at ages 11-12 and 15 years, using parental ratings of self-control. Food consumption was self-reported at age 11-12. Height and weight measures in early/middle childhood and adolescence were used to compute BMI z-scores. RESULTS No direct associations between the quality of parent-child relationship and adolescent obesity risk were found in either model. Instead, child self-regulation was found to mediate the associations between the quality of parent-child relationship and both unhealthy food consumption and higher adolescent BMI status. CONCLUSION The findings highlight how the nature of parent-child relationships impacts developing regulatory processes in children which, in turn, have implications for obesity-related behaviours and outcomes. Interventions to reduce childhood obesity should consider self-regulation skills across multiple domains, and early parenting practices that foster these capacities.
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Affiliation(s)
- Joo Hyun Kim
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Kelly K Bost
- Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, Illinois, USA
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12
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Craba A, Mazza M, Marano G, Crosta ML, Moroni F, Di Pietro S, Balocchi M, Della Casa S, Rinaldi L, Janiri L, Sani G. Defense Mechanisms and Parenting Styles in Patients With Anorexia and Bulimia. J Nerv Ment Dis 2023; 211:174-181. [PMID: 36827633 DOI: 10.1097/nmd.0000000000001597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
ABSTRACT Dysfunctional parenting styles are risk factors for eating disorders (EDs). In this observational study, we examined 57 women with ED, a psychiatric control group (n = 26), and healthy participants (n = 60). Several instruments were administered: Defense Style Questionnaire (DSQ-40) to examine the type of defense mechanism used, Parental Bonding Instrument (PBI) to investigate the perception of the relationship with parents, Eating Disorder Examination Questionnaire and Eating Disorder Inventory-3 to assess the severity of the ED, and Body Shape Questionnaire to investigate the perception of their body shape. In patients with anorexia and bulimia, neurotic factor (p = 0.007) and immature factor (p = 0.002) are associated with perception of relationship with their own parents. In the PBI, maternal care was associated with higher scores in the DSQ-40 in the immature factor (p = 0.012), whereas paternal overprotection was associated with lower scores in the DSQ-40 in the mature factor (p = 0.016). Patients with anorexia and bulimia overutilize more neurotic and primitive defense mechanisms compared with nonclinical subjects, and this use is associated with greater severity of eating symptomatology. This can be related to diversified ego forces, can inform about the nature and severity of disease, and can characterize prognostic and psychotherapeutic value.
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Affiliation(s)
- Ambra Craba
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Marianna Mazza
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Giuseppe Marano
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Maria Luigia Crosta
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Federica Moroni
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Salvatore Di Pietro
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Marta Balocchi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Silvia Della Casa
- Department of Endocrinology, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lucio Rinaldi
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
| | - Gabriele Sani
- Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience, and Orthopedics
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13
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ERP and attachment dimensions as predictors of seeking care or food comfort in stressful situations. Sci Rep 2023; 13:3170. [PMID: 36823203 PMCID: PMC9950445 DOI: 10.1038/s41598-023-29493-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
In this study, we aimed to test the association of the Late Positive Potential (LPP) response and attachment dimensions in the choice of care/food pictures and its reaction time (RT) in threatening versus neutral conditions. Fifty-two participants (38 females, Mage 22.62) responded to the ECR questionnaire and were exposed to adequate visual stimuli, during EEG recording. Results showed that threatening stimuli increase the choice of care, decrease RT, and increase LPP magnitude in centro-parietal areas (Cpz, Pz, P3 and P4). Food choice was lower, with increased RT. Furthermore, larger LPP magnitude in centro-parietal cluster was associated with increased RT in the choice of care. Considering the dimensions of attachment, in threatening conditions, while anxiety was not associated with RT and care/food choice, avoidance was associated with an increase in care choice and RT. In conclusion, the specific association of increased RT in care choice with high LPP magnitude centro-parietal cluster may be explained in terms of a functional interference of these areas in the choice of care, but not of food. Further, we postulate that the increased RT of avoidant individuals may reflect a more articulated choice process.
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14
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Uccula A, Mercante B, Barone L, Enrico P. Adult Avoidant Attachment, Attention Bias, and Emotional Regulation Patterns: An Eye-Tracking Study. Behav Sci (Basel) 2022; 13:bs13010011. [PMID: 36661583 PMCID: PMC9855192 DOI: 10.3390/bs13010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/06/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Proximity-seeking in distress situations is one of attachment theory's primary strategies; insecure individuals often also develop secondary strategies. The mechanisms implied in attachment deactivation constitute a key issue in the current debate related to their role in support-seeking. The main aim of this study is to investigate the attachment deactivation strategy and the processes of proximity/support-seeking under distress conditions by analyzing the attentional processes (i.e., an essential emotion-regulation strategy), using eye-tracking techniques. Seventy-two participants (45 female; Mage 23.9 ± 3.97) responded to the ECR-R questionnaire in order to identify their attachment style. They participated in an experimental situation in which they had to choose between pictures of care or pictures of food, following the presentation of threatening or neutral prime conditions (via the pictures' stimuli). Results showed that a care-consistency response pattern was the most frequent pattern of response, particularly under a threatening condition; on the contrary, only avoidant individuals showed a lower care-consistency response pattern by choosing food pictures. The overall findings demonstrate that avoidant individuals used the deactivation strategy to process comfort-related attachment pictures, suggesting that they considered these stimuli to be threatening. The implications for attachment theory and particularly for avoidant strategies are discussed.
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Affiliation(s)
- Arcangelo Uccula
- Department of History, Human Sciences and Education, University of Sassari, 07100 Sassari, Italy
- Correspondence:
| | - Beniamina Mercante
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Lavinia Barone
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Paolo Enrico
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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15
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Fennig MW, Weber E, Santos B, Fitzsimmons-Craft EE, Wilfley DE. Animal-assisted therapy in eating disorder treatment: A systematic review. Eat Behav 2022; 47:101673. [PMID: 36206618 PMCID: PMC9770014 DOI: 10.1016/j.eatbeh.2022.101673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 09/08/2022] [Accepted: 09/26/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are deadly illnesses with high relapse rates, highlighting need for better interventions. Animal-assisted therapy (AAT) has been implemented supplementally for EDs, with horses utilized at many residential facilities. AAT shows promise with meta-analyses of randomized control trials (RCTs) showing significant decreases in depression, anxiety, and negative affect; however, no review to date has evaluated efficacy for EDs. Therefore, this study conducted a systematic review of primary literature to investigate the efficacy of AAT for EDs. METHOD A systematic review was conducted via PubMed, PsycInfo, and Google Scholar, up to and including September 2021, yielding 10 studies. Therapy animals included horses (n = 8), dogs (n = 1), and dolphins (n = 1). Populations included AAT ED therapists and patients (ages 11 to adult). The PRISMA methodology was used (registration PROSPERO CRD42021256239). Risk of bias assessment used Cochrane method for quantitative studies, Critical Appraisal Skills Programme checklist for qualitative studies, and JBI Critical Appraisal Checklist for Case Reports. Given study type heterogeneity, neither synthesis nor certainty assessments were conducted. RESULTS Case and qualitative studies reported improvement in cognitive flexibility, ability to relinquish control, and confidence. Quantitative studies demonstrated an inverse relationship between AAT utilization and ED symptoms post-treatment. Effect sizes, when reported, were mostly moderate. All but one study had low, or unclear, risk of bias. Limited randomization and a lack of RCTs measuring ED symptomology directly makes drawing conclusions difficult. CONCLUSION While preliminary research indicates possible benefits of AAT as a complement to traditional ED treatment, more research is needed to establish efficacy. Future studies should employ randomized control trials and examine key mechanisms of change.
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Affiliation(s)
- Molly W Fennig
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA; Department of Psychological and Brain Sciences, Washington University in St. Louis, MO, USA.
| | - Elise Weber
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | - Bolade Santos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, MN, USA
| | | | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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16
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Cortés-García L, Rodríguez-Cano R, von Soest T. Prospective associations between loneliness and disordered eating from early adolescence to adulthood. Int J Eat Disord 2022; 55:1678-1689. [PMID: 36482149 PMCID: PMC10087379 DOI: 10.1002/eat.23793] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Despite findings from numerous cross-sectional studies suggesting a substantial association between loneliness and different types of disordered eating, much remains unknown about the impact of confounding, the order of cause and effect, and gender differences in the relationship. Thus, this study followed a large, population-based, mixed-gender sample through adolescence and young adulthood, applying a random intercept cross-lagged panel model (RI-CLPM) approach to examine the bidirectional prospective associations between loneliness and disordered eating while ruling out the effect of unmeasured time-invariant confounders. METHOD A Norwegian sample of N = 2933 adolescents (54.2% female) was examined across four time points (T1, Mage = 15.44, grades 7-12; T2, Mage = 16.93; T3, Mage = 21.84; and T4, Mage = 28.33) from 1992 to 2005 using RI-CLPMs for overall disordered eating and specific forms for disordered eating (dieting and bulimic symptoms). Multigroup structural equation models were used to assess gender differences. RESULTS For male participants, high levels of loneliness at T1 predicted more overall disordered eating and more dieting at T2. Meanwhile, among female participants, disordered eating and bulimic symptoms at T2 predicted more loneliness at T3, whereas loneliness at T3 predicted more disordered eating and bulimic symptoms at T4, and vice versa. DISCUSSION The findings suggest a pattern of bidirectional associations between loneliness and disordered eating that varies by time points, gender, and type of eating problem. Preventive interventions and treatment should consider social factors involved in the onset and maintenance of eating problems in male adolescents and young adult women. PUBLIC SIGNIFICANCE This study contributes to the existing knowledge by examining for the first time the dynamic nature of the association between loneliness and disordered eating while accounting for all time-invariant confounding. Our findings reveal a pattern of bidirectional associations between loneliness and disordered eating that appears to vary by developmental period, gender, and type of eating problem. Our findings suggest that social factors have to be taken into account when designing prevention strategies aimed at disordered eating.
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Affiliation(s)
- Laura Cortés-García
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Rubén Rodríguez-Cano
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
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17
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State of Mind Assessment in Relation to Adult Attachment and Text Analysis of Adult Attachment Interviews in a Sample of Patients with Anorexia Nervosa. Eur J Investig Health Psychol Educ 2022; 12:1760-1779. [PMID: 36547025 PMCID: PMC9777650 DOI: 10.3390/ejihpe12120124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/14/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Attachment theory represents one of the most important references for the study of the development of an individual throughout their life cycle and provides the clinician with a profound key for the purposes of understanding the suffering that underlies severe psychopathologies such as eating disorders. As such, we conducted a cross-sectional study with a mixed-methods analysis on a sample of 32 young women with anorexia nervosa (AN); this study was embedded in the utilized theoretical framework with the following aims: 1. to evaluate the state of mind (SoM) in relation to adult attachment, assuming a prevalence of the dismissing (DS) SoM and 2. to analyze the linguistic attachment profile emerging from the transcripts of the AAIs. METHODS Interviews were transcribed verbatim, coded, and analyzed using the linguistic inquiry and word count (LIWC) method. RESULTS The results were observed to be consistent with the referenced literature. The prevalence of a DS SoM (68.75%) is observed in the study sample, whereas the results of the lexical analysis of the stories deviate from expectations. Notably, the lexical results indicate the coexistence of the dismissing and entangled aspects at the representational level. CONCLUSIONS The study results suggest a high level of specificity in the emotional functioning of patients with AN, with a focusing on a pervasive control of emotions that is well illustrated by the avoidant/ambivalent (A/C) strategy described in Crittenden's dynamic-maturational model. These findings and considerations have important implications for clinical work and treatment, which we believe must be structured on the basis of starting from a reappraisal of emotional content.
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18
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Farářová A, Papežová H, Gricová J, Štěpánková T, Čapek V, Reedtz C, Lauritzen C, van Doesum K. ChildTalks+: a study protocol of a pre-post controlled, paired design study on the use of preventive intervention for children of parents with a mental illness with focus on eating disorders. BMC Psychiatry 2022; 22:715. [PMID: 36384579 PMCID: PMC9670502 DOI: 10.1186/s12888-022-04349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Children of parents with a mental illness are at high risk of developing a mental disorder as a result of transgenerational transmission. Without effective intervention, they could form the next generation of psychiatric patients. ChildTalks+ is a preventive intervention involving four structured psychoeducational sessions designed for parents affected by a mental disorder and their children. Its aim is to reduce the risk of mental disorders in children of parents with mental illness. This study draws on our clinical practice and involves a group of patients with eating disorders. The aim of the project, which will run in the Czech Republic, is to evaluate the effectiveness of ChildTalks+ methodology. METHODS ChildTalks+ therapists (professionals from health, social, and educational facilities) will recruit 66 families where a parent is treated for a mental disorder and the family includes children aged 6-18. Paired allocation into an intervention group (N = 33) and a control group (N = 33) will be based on the number of risk factors identified in the family. Both groups will complete questionnaires at the baseline, post-test, and follow-up assessments after six and 12 months. The intervention group will receive the ChildTalks+ intervention within 2 months of the baseline assessment; the control group after the last assessment. Questionnaires will be completed by parents and children aged 12+ and, in two cases, 15+ years. Quantitative data will be supplemented with qualitative data from ChildTalks+ therapists working with patients with eating disorders. DISCUSSION The ChildTalks+ intervention is expected to strengthen parenting competencies and family protective factors, improve family communication, increase awareness of parental mental health issues, and improve the wellbeing of children of parents with mental illness with long-term sustainable outcomes. The study should contribute to the evidence base for the ChildTalks+ program and help identify key themes in the implementation of similar preventive interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05554458. Registered 26 September 2022. Retrospectively registered.
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Affiliation(s)
- Adéla Farářová
- First Faculty of Medicine, Charles University, Prague, Czech Republic. .,Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Hana Papežová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Gricová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Štěpánková
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Václav Čapek
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Charlotte Reedtz
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Camilla Lauritzen
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Karin van Doesum
- grid.5590.90000000122931605Department of Clinical Psychology, Radboud University, Nijmegen, Netherlands
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Klein EM, Benecke C, Kasinger C, Brähler E, Ehrenthal JC, Strauß B, Ernst M. Eating disorder psychopathology: The role of attachment anxiety, attachment avoidance, and personality functioning. J Psychosom Res 2022; 160:110975. [PMID: 35763941 DOI: 10.1016/j.jpsychores.2022.110975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although the relationship between insecure attachment patterns and eating disorder (ED) psychopathology has repeatedly been demonstrated, the underlying mechanisms of this association are not fully understood. Therefore, the current study aimed to examine personality functioning, defined as an impairment in self and interpersonal functioning, as a mediator between attachment insecurity and ED psychopathology. METHODS In a representative population-based sample (N = 2508; age range 14-92 years) ED symptomatology, personality functioning, and attachment insecurity (anxiety and avoidance) were assessed. Besides descriptive uni-/bivariate analysis, path analysis was used to test a mediation model while controlling for the effects of age, gender, mental distress, and BMI. RESULTS ED symptomatology was associated with lower levels of personality functioning (r = 0.22) and higher levels of attachment anxiety (r = 0.14) but did not correlate with attachment avoidance (r = 0.02). Path analysis revealed that personality functioning fully mediated the effect of attachment anxiety on ED symptomatology: The indirect effect via personality functioning (β = 0.04, p < .001) accounted for 77% of the total effect. Fit indices were excellent. Sensitivity analyses revealed that the main results were mainly applicable to women and the middle age group. CONCLUSION The present findings contribute to the growing body of research using dimensional conceptualizations of personality functioning, suggesting that it provides an informative, overarching framework for understanding and treating ED psychopathology. Findings indicate that underlying individual differences, e.g., with respect to insecure attachment configurations, have relevant implications for symptom manifestations. Potential clinical implications and avenues for future research are discussed.
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Affiliation(s)
- Eva M Klein
- DFG Research Training Group "Life Sciences, Life Writing", University Medical Center of the Johannes Gutenberg-University Mainz, Am Pulverturm 13, 55131 Mainz, Germany.
| | - Cord Benecke
- Department of Psychology, University of Kassel, Holländische Straße 36-38, 34127 Kassel, Germany
| | - Christoph Kasinger
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacherstr. 8, 55131 Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacherstr. 8, 55131 Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig 04103, Germany
| | - Johannes C Ehrenthal
- Department of Psychology, University of Cologne, Bernhard-Feilchenfeld-Str. 11, 50969 Cologne, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Stoystr. 3, 07740 Jena, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacherstr. 8, 55131 Mainz, Germany
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20
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Uccula A, Enna M, Mulatti C. Responding to Distress Choosing Between Care and Food: Attachment Orientation and Emotion Regulation. Front Psychol 2022; 13:930168. [PMID: 35936249 PMCID: PMC9350510 DOI: 10.3389/fpsyg.2022.930168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022] Open
Abstract
According to attachment theory, care-seeking is the primary coping strategy in threatening situations. However, anxious and avoidant individuals often use secondary regulation strategies. The purpose of this study was to test whether, in a potentially threatening situation, the participants' attachment orientation affects whether they prefer to resort to care or food to regulate their negative emotions. Ninety-two participants took part in an experimental situation in which they had to choose between pictures of care or food, following the presentation of threatening images randomly alternating with neutral ones. Results showed that care pictures were chosen to a greater extent in the threatening condition compared to the food pictures and the neutral condition, without distinction of attachment orientation. In addition, in threatening condition, anxious individuals chose to care less than non-anxious individuals. Finally, avoidant participants chose care pictures to a lesser extent than individuals low on avoidance in the neutral condition, but not in the threatening condition. In conclusion, attachment anxiety was associated with more difficulty in the choice of representation of care in a threatening condition, while avoidant individuals show their defensive strategies in the neutral condition rather than in the threatening condition.
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Affiliation(s)
- Arcangelo Uccula
- Department of History, Human Sciences and Education, University of Sassari, Sassari, Italy
- *Correspondence: Arcangelo Uccula
| | - Mauro Enna
- Department of History, Human Sciences and Education, University of Sassari, Sassari, Italy
| | - Claudio Mulatti
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
- Department of Developmental Psychology and Socialisation, University of Padova, Padova, Italy
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21
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Cortés-García L, Martínez Calvo C, Senra C. Mediational Effect of Fairburn's Transdiagnostic Mechanisms Between Attachment to the Mother and Eating Disorder Symptoms in a Clinical Sample. Front Psychol 2022; 13:852977. [PMID: 35519625 PMCID: PMC9062175 DOI: 10.3389/fpsyg.2022.852977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Research has supported a link between insecure attachment and eating disorders (EDs); however, little is known about how this influence is exerted in young female EDs patients. This study tested, for the first time, a multiple mediational model, wherein the four Fairburn’s transdiagnostic mechanisms mediated the relationship between attachment to the mother and ED symptoms. Methods A total of 101 female young EDs patients aged 15–24 were administered the Inventory of Parent and Peer Attachment, Eating Disorder Inventory-3 and Eating Attitudes Test-26 to assess attachment, the four transdiagnostic maintaining mechanisms and ED symptoms, respectively. Results Comparison analyses showed that there were no significant differences between the diagnostic groups in terms of attachment and the transdiagnostic variables. Multiple mediational analyses indicated that low self-esteem and clinical perfectionism were significant mediators between insecure attachment to the mother and ED symptoms, while controlling for depressive symptoms. Conclusion These findings suggest that the distal risk influence of insecure attachment to the mother in the development of ED symptoms might be explained by low self-esteem and high clinical perfectionism, controlling for depressive symptoms. Further investigation into the efficacy of cognitive-behavioral treatments targeting insecure attachment representations for young EDs patients is recommended.
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Affiliation(s)
- Laura Cortés-García
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Carmen Martínez Calvo
- Unit of Eating Disorders, Provincial Hospital of Conxo, Santiago de Compostela, Spain
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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22
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Strahler J, Wachten H, Neuhofer S, Zimmermann P. Psychological Correlates of Excessive Healthy and Orthorexic Eating: Emotion Regulation, Attachment, and Anxious-Depressive-Stress Symptomatology. Front Nutr 2022; 9:817047. [PMID: 35356731 PMCID: PMC8959669 DOI: 10.3389/fnut.2022.817047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/04/2022] [Indexed: 01/13/2023] Open
Abstract
Orthorexia nervosa, the pathological obsession with eating healthy, shares risks and significant comorbidity with other mental disorders. Based on a behavioral conceptualization of the overlap, emotion regulation, attachment style, and anxious-depressive-stress symptomatology are prominent but insufficiently researched endophenotypes for orthorexia nervosa. This study aimed at identifying ways in which difficulties in emotion regulation and attachment-related anxiety and avoidance become apparent in orthorexia nervosa and healthy orthorexia. Additionally, the moderating role of anxious, depressive, and stress symptoms was explored. A convenience sample of 399 adults (266 women) completed questionnaires to measure orthorexia nervosa and healthy orthorexia, difficulties in emotion regulation, partnership-related bond, and anxious-depressive-stress symptomatology. The healthy orthorexia subscale was negatively associated with lack of emotional awareness but no other subscale of difficulties in emotion regulation or attachment-related anxiety and avoidance. Orthorexia nervosa scores were positively linked to difficulties in emotion regulation as well as attachment-related anxiety and avoidance. Multiple linear regression indicated non-acceptance of emotional responses and impulse control difficulties to be the strongest predictors for orthorexia nervosa. Both subscales also mediated the effects of attachment style on orthorexia nervosa with anxious-depressive-stress symptomatology moderating some of these effects. Individuals with higher orthorexia nervosa tendencies showed difficulties in emotion regulation, a common feature also of affective and eating disorders. Improvement in understanding the psychological features of orthorexia nervosa can enable a better differentiation from other disorders, advances in the development of treatment approaches and treatment planning, and outlines directions for future research on mechanisms.
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Affiliation(s)
- Jana Strahler
- Department of Sport Psychology, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany
- Department of Health Psychology and Applied Diagnostics, University of Wuppertal, Wuppertal, Germany
- *Correspondence: Jana Strahler
| | - Hanna Wachten
- Department of Sport Psychology, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany
- Department of Psychotherapy and System Neuroscience, Justus Liebig University Giessen, Giessen, Germany
| | - Shanna Neuhofer
- Department of Psychotherapy and System Neuroscience, Justus Liebig University Giessen, Giessen, Germany
| | - Peter Zimmermann
- Department of Developmental Psychology, University of Wuppertal, Wuppertal, Germany
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23
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Pace CS, Muzi S, Parolin L, Milesi A, Tognasso G, Santona A. Binge eating attitudes in community adolescent sample and relationships with interview-assessed attachment representations in girls: a multi-center study from North Italy. Eat Weight Disord 2022; 27:495-504. [PMID: 33846936 PMCID: PMC8933298 DOI: 10.1007/s40519-021-01183-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/26/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare community girls at risk and not at risk for binge eating (BE) in attachment representations through a narrative interview and to test the predictive role of attachment pattern(s) on the risk of binge eating among community girls. METHODS From 772 community adolescents of both sexes (33% boys) screened through the Binge Eating Scale (BES), 112 girls between 14 and 18 years, 56 placed in a group at risk for binge eating (BEG), and 56 matched peers, not at risk (NBEG), were assessed in attachment representations through the Friends and Family Interview (FFI). RESULTS (1) Compared to NBEG, girls in the BEG showed more insecure-preoccupied classifications and scores, together with lower narrative coherence, mother's representation as a secure base/safe haven, reflective functioning, adaptive response, and more anger toward mother. (2) Both insecure-dismissing and preoccupied patterns predicted 15% more binge-eating symptoms in the whole sample of community girls. CONCLUSIONS Insecure attachment representations are confirmed risk factors for more binge eating, affecting emotional regulation and leading to "emotional eating", thus a dimensional assessment of attachment could be helpful for prevention and intervention. Implications and limits are discussed. LEVEL OF EVIDENCE III. Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Cecilia Serena Pace
- Department of Educational Sciences (DISFOR), University of Genoa, Corso Andrea Podestà, 2, 16128, Genova, GE, Italy.
| | - Stefania Muzi
- Department of Educational Sciences (DISFOR), University of Genoa, Corso Andrea Podestà, 2, 16128, Genova, GE, Italy
| | - Laura Parolin
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milan, Italy
| | - Alberto Milesi
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milan, Italy
| | - Giacomo Tognasso
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milan, Italy
| | - Alessandra Santona
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milan, Italy
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Barberis N, Cannavò M, Calaresi D, Verrastro V. Reflective functioning and Alexithymia as mediators between attachment and psychopathology symptoms: cross-sectional evidence in a community sample. PSYCHOL HEALTH MED 2022; 28:1251-1262. [PMID: 35193443 DOI: 10.1080/13548506.2022.2045331] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study sought to examine the role of Reflective Functioning and Alexithymia as mediators in the association between Attachment and Psychopathology. Questionnaires were administered to 1099 adults aged between 18 and 30 years. Results showed relations between Attachment Anxiety, Reflective Functioning, Alexithymia and Psychopathology. Moreover, Alexithymia was a mediator between Attachment, Reflective Functioning and Psychopathology.Current results provided evidence of the role of both Reflective Functioning and Alexithymia in the relationship between Attachment and Psychopathology. Implications are discussed.
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Affiliation(s)
- Nadia Barberis
- Dipartimento Di Scienze Della Salute, Università Degli Studi Magna Graecia Di Catanzaro, Catanzaro, Italy
| | - Marco Cannavò
- Dipartimento Di Scienze Della Salute, Università Degli Studi Magna Graecia Di Catanzaro, Catanzaro, Italy
| | - Danilo Calaresi
- Dipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di Messina, Messina, Italy
| | - Valeria Verrastro
- Dipartimento Di Scienze Della Salute, Università Degli Studi Magna Graecia Di Catanzaro, Catanzaro, Italy
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25
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Wilkinson LL, Rowe AC, Douglas T, Thirkettle M, Nolan LJ. Adult attachment anxiety is associated with night eating syndrome in UK and US-based samples: Two cross-sectional studies. Appetite 2022; 172:105968. [PMID: 35150794 DOI: 10.1016/j.appet.2022.105968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/19/2022]
Abstract
Previous research has shown that "attachment anxiety" is a robust predictor of disinhibited eating behaviours and that this relationship is underpinned by difficulties in managing emotion. Night eating syndrome (NES), a proposed eating disorder characterized by evening hyperphagia, nocturnal awakenings to eat, and morning anorexia, is also associated with eating to manage emotion. Across two studies (N = 276 &N = 486), we considered a relationship between attachment anxiety and NES. In Study 1, we hypothesised (pre-registered) that attachment anxiety would predict NES score and that this relationship would be mediated by disinhibited eating. Participants were asked to complete questionnaire measures of attachment orientation, disinhibited eating (emotional and uncontrolled eating) and NES. Our parallel mediation model confirmed a direct relationship between attachment anxiety and NES (p < .001) and showed an indirect path via both emotional (95% CI: 0.15-0.63) and uncontrolled eating (95% CI: 0.001-0.36). In Study 2, we showed that fear of negative evaluation of eating significantly mediated a reversed relationship between attachment anxiety and NES (95% CI: 0.02-0.04). Finally, across both studies we used a novel tool to assess "eating to cope". We showed a relationship with emotional eating but failed to show a robust relationship with NES. Attachment orientation may represent a potential intervention target for night eating syndrome. Future research should consider a longitudinal approach to strengthen our understanding of directionality amongst these factors.
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Affiliation(s)
| | - Angela C Rowe
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Martin Thirkettle
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, NY, 10301, USA
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26
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Lenzo V, Sardella A, Barberis N, Isgrò C, Torrisi R, Giunta S, Petralia MC, Verrastro V, Quattropani MC. The Interplay of Attachment Styles and Defense Mechanisms on Eating Disorders Risk: Cross-Sectional Observation in the Community Population. CLINICAL NEUROPSYCHIATRY 2022; 18:296-303. [PMID: 35126531 PMCID: PMC8808290 DOI: 10.36131/cnfioritieditore20210603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Eating Disorders (Eds) are considered a broad group of pathological conditions characterized by dysregulated eating-related behaviors and habits. Attachment styles and defense mechanisms appear to be linked to the development of EDs-related unhealthy behaviors; however, these factors have been seldom investigated jointly. This study aimed at exploring the shared association between attachment styles, defense mechanisms, and EDs-related behaviors; additionally, we aimed at investigating whether defense mechanisms might be potential mediators of the association between attachment and Eds behaviors. METHOD A community-based sample was recruited (88% females, mean age= 22.33 ± 4.81 years) and underwent a comprehensive evaluation protocol assessing attachment styles, defense mechanisms, and risk of eating disorders. RESULTS Several shared associations between attachment styles, defense mechanisms, and eating disorders scores were found. Additionally, a maladaptive defense style appeared to be a significant mediator of the association between attachment styles and EDs-related symptoms. CONCLUSIONS The integrated evaluation of attachment and defense mechanisms could generate a more comprehensive framework of the psychological antecedents related to Eating Disorders, and it could be a beneficial factor involved in therapies.
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Affiliation(s)
- Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio Calabria, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Nadia Barberis
- Department of Surgical and Medical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Carmen Isgrò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Roberta Torrisi
- Department of Surgical and Medical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | | | | | - Valeria Verrastro
- Department of Surgical and Medical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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27
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Cascino G, Ruzzi V, D'Agostino G, Barone E, Del Giorno C, Monteleone P, Monteleone AM. Adult attachment style and salivary alpha-amylase and emotional responses to a psychosocial stressor in women with eating disorders. J Psychosom Res 2022; 153:110713. [PMID: 34998102 DOI: 10.1016/j.jpsychores.2021.110713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The fine-tuning of the endogenous stress response system, which includes the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system (SNS), is influenced by early attachment relationships. A higher prevalence of insecure attachment has been detected in people with eating disorders (EDs). Thus, we investigated the emotional and the SNS reactivity to the Trier Social Stress Test (TSST) in women with EDs in relation to their attachment profiles. METHODS Fifty women with EDs and 20 healthy women participated into an experimental study. Attachment was evaluated by Experience in Close Relationship questionnaire. Salivary α-amylase (sAA) levels were measured to assess the SNS reactivity to TSST while the emotional response was measured by the STAI state scale. RESULTS Compared to women with EDs and low attachment anxiety and healthy controls, women with EDs and high attachment anxiety showed lower TSST-induced sAA production without difference in anxiety scores. Women with EDs and high attachment avoidance showed similar sAA response to TSST but higher levels of anxiety scores compared to those with low attachment avoidance and healthy controls. CONCLUSIONS Our findings corroborate the idea that adult attachment may be associated with variability in emotional and biological responses to a psychosocial stressor in women with EDs.
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Affiliation(s)
- Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy.
| | - Valeria Ruzzi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulia D'Agostino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Eugenia Barone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Del Giorno
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
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28
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Sommer LM, Halbeisen G, Erim Y, Paslakis G. Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder. Nutrients 2021; 13:3813. [PMID: 34836069 PMCID: PMC8625654 DOI: 10.3390/nu13113813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.
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Affiliation(s)
- Laura Marie Sommer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
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29
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Santos AF, Martins MC, Fernandes C, Bost KK, Veríssimo M. Relation between Attachment and Obesity in Preschool Years: A Systematic Review of the Literature. Nutrients 2021; 13:nu13103572. [PMID: 34684573 PMCID: PMC8539151 DOI: 10.3390/nu13103572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 01/11/2023] Open
Abstract
Increasing evidence suggests that attachment plays an important role in obesity. However, few studies examined this relationship in preschool children. This study aimed to systematically examine the empirical, peer-reviewed evidence regarding the relationship between attachment quality and obesity in the preschool years. Using established guidelines, relevant peer-reviewed literature published between 2000 and July 2021 was searched through EBSCO. This yielded a total of 1124 records for review. Established inclusion criteria comprised: empirical studies published in peer-review journals; include at least one anthropometric measure and/or food consumption measure. Exclusion criteria comprised: attachment measures not following Bowlby-Ainsworth conceptualization of the construct; children in institutionalized settings; context of severe mental illness, documented substance use disorders, or eating disorders; include only a measure of the psychological aspects of eating; intervention programs. After exclusions, eight studies with a total of 9225 participants met the inclusion criteria. Results support the role of attachment in weight-related outcomes, suggesting that considering attachment in the risk of obesity could contribute to the elaboration of effective prevention and intervention programs. Limitations included the small number of studies, predominately cross-sectional designs, the diversity of methodologies, most samples not including fathers, and lack of evidence about the developmental mechanisms underlying the association between attachment and obesity. More evidence is needed to determine how attachment and obesity are linked, and the potential underlying mechanisms accounting for this relationship.
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Affiliation(s)
- Ana F. Santos
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
| | - Mariana C. Martins
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
| | - Carla Fernandes
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
| | - Kelly K. Bost
- Human Development and Family Studies, University of Illinois, Champaign, IL 61801, USA;
| | - Manuela Veríssimo
- William James Center for Research, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.C.M.); (C.F.)
- Correspondence:
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30
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Han W, Zheng Z, Zhang N. Three Mediating Pathways of Anxiety and Security in the Relationship between Coping Style and Disordered Eating Behaviors among Chinese Female College Students. Neural Plast 2021; 2021:7506754. [PMID: 34594373 PMCID: PMC8478589 DOI: 10.1155/2021/7506754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background According to previous studies, eating disorders and disordered eating behaviors are associated with coping style, anxiety, and sense of security. However, the specific mechanism between them has not been elucidated. The purpose of this study was to explore whether anxiety and sense of security play mediating roles in coping style and disordered eating behaviors among Chinese female college students. Method Six hundred and ninety-one female college students (mean age = 19.36; SD = 1.06) completed the Simple Coping Style Questionnaire, the Eating Disorder Inventory, the Security Questionnaire, the Hospital Anxiety and Depression Scale, and a brief demographic survey. The percentage bootstrap method of deviation correction was conducted to determine the mediating effect of anxiety and sense of security on coping style and disordered eating behaviors. Results Coping style had direct and indirect effects on disordered eating behaviors. Anxiety and sense of security were not only independent mediators in the relationship between coping style and disordered eating behaviors but also chain mediators. Conclusions The results of the current study provide preliminary evidence that preventive interventions targeting anxiety and sense of security may be feasible for young women who develop disordered eating behaviors due to stress in their lives.
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Affiliation(s)
- Wenyue Han
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China 210023
| | - Zheng Zheng
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China 210023
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China 210029
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31
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Carbonneau N, Cantin M, Barbeau K, Lavigne G, Lussier Y. Self-Compassion as a Mediator of the Relationship between Adult Women's Attachment and Intuitive Eating. Nutrients 2021; 13:3124. [PMID: 34579003 PMCID: PMC8472369 DOI: 10.3390/nu13093124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/28/2021] [Accepted: 09/02/2021] [Indexed: 12/11/2022] Open
Abstract
Despite growing interest in intuitive eating-a non-dieting approach to eating that is based on feeding the body in accordance with physiological and satiety cues-research on its determinants is scarce. The present study aimed to examine the associations between dimensions of adult attachment (i.e., anxiety and avoidance) and intuitive eating, and the mediating role of self-compassion in these relationships. The sample comprised 201 French-Canadian young adult women (M = 25.1, SD = 4.6). Participants completed self-report questionnaires through an online survey. Results of the structural equation model demonstrated that attachment-related anxiety and avoidance were negatively associated with intuitive eating, and these relationships were at least partially mediated by self-compassion. Findings suggest that women who have high levels of attachment anxiety or avoidance engage in less intuitive eating partly because they are less self-compassionate. Results highlight the importance of self-compassion in facilitating adaptive eating behaviors in adult women, especially if they have an insecure attachment style to romantic partners.
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Affiliation(s)
- Noémie Carbonneau
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (M.C.); (G.L.); (Y.L.)
| | - Mélynda Cantin
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (M.C.); (G.L.); (Y.L.)
| | - Kheana Barbeau
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Geneviève Lavigne
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (M.C.); (G.L.); (Y.L.)
| | - Yvan Lussier
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada; (M.C.); (G.L.); (Y.L.)
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32
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The Effect of Parental Attachment on Risky Alcohol Use and Disordered Eating Behaviors in College Students. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09573-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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33
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Gagliardi M. How Our Caregivers Shape Who We Are: The Seven Dimensions of Attachment at the Core of Personality. Front Psychol 2021; 12:657628. [PMID: 34276482 PMCID: PMC8280313 DOI: 10.3389/fpsyg.2021.657628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Psychology defines personality as the stable traits of an individual, and cognitive research suggests that a set of core beliefs is at the root of these traits. From this perspective, two major questions remain unanswered: (1) What are the core beliefs that make up personality? (2) How are they acquired? An interesting answer is provided by attachment theory, according to which attachment is at the basis of personality. The current theoretical formulation, however, does not sufficiently clarify the relationship between the two. Adopting a cognitive-clinical approach, we put forward a novel version of attachment theory, arguing that it can better account for the relationship between attachment and personality, thereby providing more convincing answers to questions (1) and (2). In particular, we propose that: (A) attachment information is acquired over seven dimensions; (B) the acquisition of each dimension is induced by a specific caregiving feature and (C) realized through a specific acquisition mechanism - imprinting. In a nutshell, we propose an Attachment-Personality Model (APM) according to which seven attachment dimensions constitute the knowledge core of personality. We finally discuss the significant implications of the model, especially its clinical application in terms of conception, assessment, and treatment of mental disorders. The model can be empirically tested, and we suggest three ways to do that.
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Affiliation(s)
- Marcantonio Gagliardi
- Department of Computer Science, The University of Sheffield, Sheffield, United Kingdom
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34
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Bleil ME, Spieker SJ, Booth-LaForce C. Targeting Parenting Quality to Reduce Early Life Adversity Impacts on Lifespan Cardiometabolic Risk. Front Psychol 2021; 12:678946. [PMID: 34149571 PMCID: PMC8211431 DOI: 10.3389/fpsyg.2021.678946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Mounting evidence that early life adversity (ELA) exposures confer risk for cardiometabolic disease over the lifespan motivated this narrative review to examine parenting quality as a potential intervention target to reduce ELA exposures or mitigate their impact as a way of reducing or preventing cardiometabolic disease. We describe findings from the limited number of family-based intervention studies in ELA-exposed children that have tested parenting impacts on cardiometabolic health outcomes. We then describe the implications of this work and make recommendations for future research that will move this field forward.
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Affiliation(s)
- Maria E. Bleil
- Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, United States
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35
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Parent-Infant Attachment Insecurity and Emotional Eating in Adolescence: Mediation through Emotion Suppression and Alexithymia. Nutrients 2021; 13:nu13051662. [PMID: 34068872 PMCID: PMC8153636 DOI: 10.3390/nu13051662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 01/29/2023] Open
Abstract
Emotional eating (EE), the propensity to eat in response to emotions, is thought to have its origins in the early parent–infant relationship. This study tested the hypothesis that infant attachment insecurity results in EE in adolescence through the increased use of the emotion regulation strategy suppression of emotions and subsequent alexithymia. At the age of 15 months, parent–infant attachment security (n = 129) was observed with two abbreviated attachment measures: the shortened strange situation procedure (SSSP), and the shortened attachment Q-set (S-AQS). At the age of 12 years, children completed self-report questionnaires to assess the suppression of emotions, alexithymia, and EE. At the age of 16 years, EE was measured again. The mediation models indicated that lower parent–infant attachment security predicted increased use of suppression of emotions, which was related to increased alexithymia, and in turn more EE at the age of 12 years. These results were similar and significant for both attachment measures, and also (marginal) significant with EE at the age of 16 years as an outcome. Lastly, when parental caregiving quality was included, the models with the SSSP as predictor remained significant, but the models with the S-AQS became insignificant. These results indicated that to a certain extent, infant attachment security could predict adolescent EE above and beyond parental caregiving quality.
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36
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Cortés-García L, McLaren V, Vanwoerden S, Sharp C. Attachment, mentalizing, and eating disorder symptoms in adolescent psychiatric inpatients and healthy controls: a test of a mediational model. Eat Weight Disord 2021; 26:1159-1168. [PMID: 32989688 DOI: 10.1007/s40519-020-01017-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Research has supported a link between insecure attachment and eating disorders (EDs) in adolescents; however, mechanisms accounting for this association remain unclear. Growing evidence suggests impaired mentalizing as a potential mechanism. Yet, little is known about the relationship between mentalizing and ED symptoms or how it relates to the link between attachment and EDs in adolescents. This study examined mentalizing deficits in adolescents with ED symptoms relative to psychiatric and healthy controls and tested a mediational model, wherein mentalizing capacity mediates the relationship between attachment and ED symptoms. METHOD Inpatient adolescents with EDs and other pathology (n = 568) and healthy controls (n = 184) were administered the child attachment interview, the movie for the assessment of social cognition and the diagnostic interview schedule for children to assess attachment, mentalizing and ED symptoms, respectively. RESULTS Inpatients showed lower attachment security and more hypermentalizing than healthy adolescents. Hypermentalizing explained the association between insecure attachment and ED symptoms. CONCLUSIONS These findings suggest potential utility of targeting mentalizing in prevention and treatment of EDs in adolescents. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- L Cortés-García
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela. Campus Vida, Calle Xosé María Suárez Núñez, s/n, 15782, Santiago de Compostela, A Coruña, Spain.
| | - V McLaren
- Department of Psychology, University of Houston, Houston, TX, United States
| | - S Vanwoerden
- Department of Psychology, University of Houston, Houston, TX, United States
| | - C Sharp
- Department of Psychology, University of Houston, Houston, TX, United States
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Attachment representations and alexithymia in community adolescents with binge-eating attitudes. Eat Weight Disord 2021; 26:689-693. [PMID: 32277425 DOI: 10.1007/s40519-020-00897-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The aims of the current study were: (a) to compare community adolescent groups with and without binge eating (BE) on attachment representations and alexithymia, using an age-adapted interview to assess attachment; and (b) to explore the independent role of attachment and alexithymia as potentially related to BE in community adolescents. METHODS Three hundred eighty-two community adolescents were screened with respect to BE symptoms through the Binge Eating Scale (BES). The 22 girls identified with BE (BE group) and 22 age- and gender-matched peers without BE (NBE group) were assessed with the Friends and Family Interview (FFI) and the Toronto Alexithymia Scale (TAS-20). RESULTS Binge eating group reported greater attachment preoccupation in comparison to NBE, while no difference emerged in alexithymia. More insecure attachment patterns, both preoccupied and dismissing, were significantly and independently associated with BES score in community girls. CONCLUSIONS Insecure attachment, assessed with semi-structured interview, is associated with BE among adolescents' community girls, while apparently alexithymia is not. Future prospective studies should assess the role of attachment in the development of BE in adolescents. LEVEL OF EVIDENCE III, case-control analytic study.
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Iwinski S, Cole NC, Saltzman JA, Donovan SM, Lee SY, Fiese BH, Bost KK. Child attachment behavior as a moderator of the relation between feeding responsiveness and picky eating behavior. Eat Behav 2021; 40:101465. [PMID: 33310487 PMCID: PMC10796209 DOI: 10.1016/j.eatbeh.2020.101465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/21/2020] [Accepted: 11/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Picky eating (PE) behavior is common in early childhood, but persistent PE is associated with unhealthy development and caregiver-child stress during feeding. Identifying modifiable feeding and parent-child relationship factors that impact PE is important for decreasing risks associated with PE. OBJECTIVE This study examined associations between caregiver Feeding Responsiveness (FR) and child PE behaviors using caregiver reports and observations of family mealtimes. An additional aim examined whether children's attachment behavior moderates this association. METHODS The analysis sample consisted of 110 families participating in a larger longitudinal study of nutrition and child health. Home observations were conducted when children were 18-24 months (52% females) to assess caregiver-child interactions. Caregivers were, on average, 30.9 years old and mostly White (73.6%). Family mealtimes were videotaped and coded for FR and child PE behaviors. Caregivers completed surveys regarding FR and PE behaviors. RESULTS Caregiver-reported FR was significantly correlated with observed FR, r (107) = 0.26, p = 0.007; and caregiver-reported PE was associated with observed PE, r (107) = 0.21, p = 0.029. Caregiver-reported FR was inversely related to observed PE, but only when children were characterized by observers to have more positively toned and smooth interactions with caregivers. Using observational data, child attachment significantly moderated the relationship between FR and PE behaviors. CONCLUSIONS The quality of caregiver-child interactions may impact the degree to which FR is effective in reducing PE. Future longitudinal studies that include more diverse populations, multiple caregivers, and potential mechanisms accounting for these associations are needed.
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Affiliation(s)
- Samantha Iwinski
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America.
| | - Natasha Chong Cole
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America
| | - Jaclyn A Saltzman
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America; The MITRE Corporation, Bedford, MA, United States of America
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America; Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States of America
| | - Soo-Yeun Lee
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America; Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States of America
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America
| | - Kelly K Bost
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America
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Food Addiction and Tobacco Use Disorder: Common Liability and Shared Mechanisms. Nutrients 2020; 12:nu12123834. [PMID: 33334010 PMCID: PMC7765398 DOI: 10.3390/nu12123834] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
As food addiction is being more commonly recognized within the scientific community, parallels can be drawn between it and other addictive substance use disorders, including tobacco use disorder. Given that both unhealthy diets and smoking are leading risk factors for disability and death, a greater understanding of how food addiction and tobacco use disorder overlap with one another is necessary. This narrative review aimed to highlight literature that investigated prevalence, biology, psychology, and treatment options of food addiction and tobacco use disorder. Published studies up to August 2020 and written in English were included. Using a biopsychosocial lens, each disorder was assessed together and separately, as there is emerging evidence that the two disorders can develop concurrently or sequentially within individuals. Commonalities include but are not limited to the dopaminergic neurocircuitry, gut microbiota, childhood adversity, and attachment insecurity. In addition, the authors conducted a feasibility study with the purpose of examining the association between food addiction symptoms and tobacco use disorder among individuals seeking tobacco use disorder treatment. To inform future treatment approaches, more research is necessary to identify and understand the overlap between the two disorders.
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Tamura F, Kimoto S, Yamasaki Y, Taguchi A, Tanuma N, Nakajima S, Negayama K, Kakinoki Y, Yamada H, Sato H, Sumitomo M. Developmental problems concerning children's oral functions, based on a questionnaire administered to dentists and guardians. PEDIATRIC DENTAL JOURNAL 2020. [DOI: 10.1016/j.pdj.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Amianto F, Martini M, Olandese F, Davico C, Abbate-Daga G, Fassino S, Vitiello B. Affectionless control: A parenting style associated with obesity and binge eating disorder in adulthood. EUROPEAN EATING DISORDERS REVIEW 2020; 29:178-192. [PMID: 33247868 DOI: 10.1002/erv.2809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Obesity is rising globally with a heavy health and economic burden. Early attachment experiences are relevant to the development of obesity. The purpose of this study was to investigate if parental care and attachment style experienced in childhood is associated with obesity, with or without binge eating disorder (BED), in adulthood. METHOD Parental style, personality traits, and psychopathology were assessed in 810 clinically referred adults with obesity, of whom 357 with BED and 453 without BED (non-BED), and 463 healthy subjects (HS). Assessments included the Parental Bonding Instrument, Temperament and Character Inventory, Eating Disorder Inventory-2, Symptom Checklist-90 and Beck Depression Inventory-II. RESULTS Both BED and non-BED reported lower maternal and paternal care and higher overprotection than HS. BED reported worse levels of parental care than non-BED and HS. 'Affectionless control' parenting style was more frequently reported by both BED and non-BED than HS. No significant differences in parenting style emerged between BED and non-BED. CONCLUSIONS Perception of parental 'affectionless control' was associated with obesity in adults, and lower quality of parental care was more frequently reported by participants with BED. Parental style may constitute an important target for early interventions to prevent obesity.
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Affiliation(s)
- Federico Amianto
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Matteo Martini
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Francesco Olandese
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Chiara Davico
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - Giovanni Abbate-Daga
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Secondo Fassino
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Benedetto Vitiello
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
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Mediating role of depressive symptoms linking insecure attachment and disordered eating in adolescents: A multiwave longitudinal study. Dev Psychopathol 2020; 34:115-127. [PMID: 32928329 DOI: 10.1017/s0954579420001029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Research has supported a link between insecure attachment and disordered eating in adolescents; however, how this influence is exerted remains unclear. This study explored whether depressive symptoms constitute a pathway through which insecure attachment to parents predicts subsequent development of disordered eating in the transition from childhood to adolescence. The study also examines whether there are differential effects regarding the attachment figure, child's gender, or reciprocity between variables. A community-based sample of Spanish youth (n = 904; 49.4% girls) was followed biennially from age 10 to 16 years. Attachment, depressive symptoms, and disordered eating were measured using the Inventory of Parental and Peer Attachment, Children's Depression Inventory, and Children's Eating Attitudes Test, respectively. Prospective data were analyzed using a dynamic panel model, which accounts for unmeasured time-invariant factors. Whereas insecure attachment to the father did not predict later depression or disordered eating, higher insecure attachment to the mother at ages 10 and 12 years predicted more disordered eating at ages 14 and 16 years via increased depressive symptoms at ages 12 and 14 years. No child's gender-specific or reverse mediational effects were found. This study suggests that an increase in depressive symptoms might be one mechanism by which insecure attachment exerts its influence on the development of eating disorders symptomatology in adolescence. Intervention efforts aimed at strengthening particularly the mother-child attachment relationship may reduce the vulnerability to develop depressive symptoms and disordered eating.
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Kircaburun K, Ünübol H, Sayar GH, Stavropoulos V, Griffiths MD. Measurement, prevalence, and psychological risk factors associated with addictive food consumption: Development of a new food addiction scale and evidence from a national largescale sample. J Behav Addict 2020; 9:836-852. [PMID: 32903203 PMCID: PMC8943666 DOI: 10.1556/2006.2020.00052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/28/2020] [Accepted: 08/10/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND AIMS To date, a number of studies have investigated the prevalence and correlates of addictive food consumption. However, these studies have mostly relied on models that comprised a narrow range of variables in often small and heterogenous samples. The purpose of the present study was to comprehensively examine the measurement aspects, the prevalence, and the psychological correlates of addictive eating among a largescale national sample of Turkish adults. METHOD Participants (N = 24,380, 50% men, Mage = 31.79 years, age range = 18-81 years) completed a battery of tests including the Food Addiction Risk Questionnaire (FARQ), the Brief Symptom Inventory, the Toronto Alexithymia Scale, the Positive and Negative Affect Schedule, and the Experiences in Close Relationships-Revised. RESULTS According to analyses conducted, the FARQ had a uni-dimensional factor structure. Based on Item Response Theory (IRT) calculated cut-off scores, 2.3% of the participants were at risk of addictive eating patterns, whilst criteria varied in their discriminating ability. The correlates of addictive food consumption were being male, being younger, having lower education, presenting with higher alcohol use, psychiatric symptoms, alexithymia, positive/negative affect, and anxious attachment. CONCLUSION These results suggest that a minority of Turkish community are at risk for addictive food consumption and that adverse psychological states promote this problematic behavior.
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Affiliation(s)
- Kagan Kircaburun
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK,Educational Sciences Department, Düzce University, Düzce, Turkey,Corresponding author. E-mail:
| | - Hüseyin Ünübol
- Institute of Social Sciences, Psychology Department, Üsküdar University, Istanbul, Turkey
| | - Gökben H. Sayar
- Institute of Social Sciences, Clinical Psychology Department, Üsküdar University, Istanbul, Turkey
| | | | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Uccula A, Enna M, Mulatti C. Care vs Food as an Emotional Regulation Strategy in Elementary School Children: The Role of the Attachment Style. The Journal of Genetic Psychology 2020; 181:336-347. [PMID: 32496891 DOI: 10.1080/00221325.2020.1768504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
According to attachment theory, potentially threatening stimuli tend to activate the attachment system for the search of the protective figure. In secure attachments, the experience of responsive relationships increases the probability of resorting to available figures as a strategy for regulating emotions in stressful situations. The aim of the research was to verify whether, in conditions of mild threat, children's attachment styles affect the choice between caring relationships and food as a form of emotion regulation. We used a mixed experimental design to perform this research. Here, we presented children (N = 65; Mage= 9.4) with threatening and neutral images and, afterwards, asked them to select from images of caring relationship or images of food. The results indicate that securely and ambivalently attached but not avoidantly attached children under both the neutral and threatening image conditions chose the care pictures over the food pictures. Second, only the securely attached increased their choice of care over food images in the threatening condition, and third, this difference was significant when compared with the avoidant children. In conclusion, the results show that although in general the choice of care is primary with respect to food, children with insecure attachments differ from secure children between the two options of emotional regulation.
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Affiliation(s)
- Arcangelo Uccula
- Department of History, Human Sciences and Education, University of Sassari, Sassari, Italy
| | - Mauro Enna
- Department of History, Human Sciences and Education, University of Sassari, Sassari, Italy
| | - Claudio Mulatti
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
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Pine AE, Shank LM, Burke NL, Higgins Neyland MK, Schvey NA, Quattlebaum M, Leu W, Wilfley DE, Stephens M, Jorgensen S, Olsen CH, Sbrocco T, Yanovski JA, Klein DA, Quinlan J, Tanofsky-Kraff M. Examination of the Interpersonal Model With Adolescent Military Dependents at High Risk for Adult Obesity. Am J Psychother 2020; 73:43-49. [PMID: 32050783 PMCID: PMC7286799 DOI: 10.1176/appi.psychotherapy.20190034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents' careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents. METHODS Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMIz]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional eating. Analyses were adjusted for age, sex, race-ethnicity, BMIz, and presence of reported loss-of-control eating and anxiety. RESULTS Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05). CONCLUSIONS The interpersonal model may contribute to our understanding of excess weight gain and binge eating disorder among adolescent military dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting treatment response and outcomes among this population.
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Affiliation(s)
- Abigail E Pine
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Lisa M Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Natasha L Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - M K Higgins Neyland
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Mary Quattlebaum
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - William Leu
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Denise E Wilfley
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Mark Stephens
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Sarah Jorgensen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Cara H Olsen
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Jack A Yanovski
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - David A Klein
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Jeffrey Quinlan
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein)
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Hepworth AD, Berlin LJ, Martoccio TL, Jones Harden B. Maternal attachment style, sensitivity, and infant obesity risk in low-income, Latino families. Attach Hum Dev 2020; 23:75-89. [PMID: 32126901 DOI: 10.1080/14616734.2020.1729214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Disparities in childhood obesity highlight the need for research to identify its early predictors in high-risk populations, such as low-income, Latino families. In the current study, the first of its kind in a low-income Latino sample (N = 55; M child age = 12.74 months, SD = 3.96), we investigated whether mothers' self-reported attachment style predicted their infants' weight-for-length (WFL; an early indicator of childhood obesity). We also explored whether observed maternal sensitivity, coded from a video-recorded semi-structured play assessment, mediated this association. We found a significant direct effect of maternal attachment style on infants' WFL z-scores (c' = -0.68, SE = 0.22, p = .004). Infants of mothers who classified themselves as secure had lower WFL z-scores than infants of insecure mothers (avoidant or anxious). Maternal sensitivity did not mediate this association, but was positively associated with infant WFL z-scores. We discuss implications of these findings for future research.
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Affiliation(s)
- Allison D Hepworth
- Department of Social Work, University of Maryland School of Social Work , Baltimore, MD, USA
| | - Lisa J Berlin
- Department of Social Work, University of Maryland School of Social Work , Baltimore, MD, USA
| | - Tiffany L Martoccio
- Department of Human Development and Quantitative Methodology, University of Maryland , College Park, MD, USA
| | - Brenda Jones Harden
- Department of Social Work, University of Maryland School of Social Work , Baltimore, MD, USA.,Department of Human Development and Quantitative Methodology, University of Maryland , College Park, MD, USA
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Akkuş K, Yılmaz AE. The Role of Metacognitions on the Relationship Between Adult Attachment and Mood Symptoms in Individuals with Obesity. J Clin Psychol Med Settings 2020; 28:239-251. [PMID: 32100184 DOI: 10.1007/s10880-020-09709-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In order to examine psychological mechanisms contributing to the development and maintenance of mood symptoms experienced by individuals with obesity, this study focused on the mediator role of metacognitions in the relationship between adult attachment dimensions (anxious and avoidant) and mood symptoms (depression and anxiety). A 184 individuals with Body Mass Index (BMI) of 30 or above completed a battery of instruments including measures of attachment styles, metacognitive beliefs and processes, depression, and anxiety symptoms. Multiple mediation analyses with bootstrapping demonstrated that while attachment anxiety was predictive of greater levels of depression and anxiety through the effect of beliefs about uncontrollability and dangerousness of worry, metacognitive factors have no mediator role in the relationship between avoidant attachment and mood symptoms. Findings suggest in particular that anxious attachment and metacognitive characteristics might be considered in case conceptualizations and intervention strategies for the psychological problems experienced by individuals with obesity.Level of Evidence: Level V: Descriptive (cross-sectional) study.
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Affiliation(s)
- Koray Akkuş
- Department of Psychology, Ege University, Bornova, 35030, Izmir, Turkey.
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KOBORI O, SAWAMIYA Y, YOSHINAGA N, C. ROWE A, L. WILKINSON L. INVESTIGATION OF ATTACHMENT ORIENTATION, AND AFFECT REGULATION: USE OF A NOVEL AFFECT REGULATION MAPPING TOOL IN JAPANESE ATHLETES. PSYCHOLOGIA 2020. [DOI: 10.2117/psysoc.2020-b005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Adult attachment in eating disorders mediates the association between perceived invalidating childhood environments and eating psychopathology. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00524-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Douglas TD, Stephens JW, Barry J, Lee MD, Wilkinson LL. The influence of attachment orientation on weight loss, eating behaviour and other health outcomes among patients undergoing bariatric surgery: A scoping review. Appetite 2019; 147:104504. [PMID: 31689448 DOI: 10.1016/j.appet.2019.104504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/19/2022]
Abstract
Attachment orientation is a psychological factor concerning our expectations of ourselves and others in interpersonal relationships. An emerging literature has suggested that attachment orientation may influence a range of outcomes associated with bariatric surgery. The purpose of this scoping review was to map the literature and examine the role of attachment orientation in the context of bariatric surgery. Studies conducted with patients who are undergoing or have undergone bariatric surgery, with a measure of attachment orientation and published by 21st July 2019, were located through electronic searches including Scopus, PubMed and Web of Science. 21180 studies were identified, of which 18 were retained for narrative synthesis. The major outcome themes reported were (1) post-surgery weight-loss/body mass index (k = 10), (2) eating behaviour (k = 9), (3) attachment orientation differences in bariatric surgery patients compared with control groups (k = 4) and 4) other mental and physical health outcomes (k = 12). Overall, the results showed that there was little evidence to suggest that poor attachment orientation is predictor of weight-loss following surgery. There was evidence to suggest that poorer attachment orientation relates to poorer eating behaviours both before and after surgery, that patients undergoing bariatric surgery are more likely to have a poorer attachment orientation and attachment orientation is related to mental health outcomes but not physical health outcomes for patients. However, where relationships were identified, there were considerable inconsistencies regarding the dimension of attachment orientation that drove the relationship. Future studies should consider appropriate sample sizes for studies, replication of key findings and longer durations for longitudinal studies.
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Affiliation(s)
| | | | - Jonathan Barry
- Welsh Institute of Metabolic and Obesity Surgery (WIMOS), Abertawe Bro Morgannwg University Health Board, UK
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