Anorexia and attachment: dysregulated defense and pathological mourning

The role of defensive exclusion (Deactivation and Segregated Systems) in the development of early relationships and related to subsequent manifestations of symptoms of eating disorders was assessed using the Adult Attachment Projective Picture System (AAP). Fifty-one DSM-IV diagnosed women with anorexia participated in the study. Anorexic patients were primarily classified as dismissing or unresolved. Quantitative and qualitative analyses of defensive exclusion were carried out. Results showed potential benefits of using the AAP defense exclusion coding system, in addition to the main attachment classifications, in order to better understand the developmental issues involved in anorexia. Discussion concerned the processes, such as pathological mourning, that may underlie the associations between dismissing and unresolved attachment and anorexia. Implications for developmental research and clinical nosology are discussed.

• Publication year

  2014

• Venue

  Frontiers in Psychology

• Publication date

  2014-10-28

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.3389/fpsyg.2014.01218PMID 25389412PMCID 4211560
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Anorexia and Attachment: Dysregulated Defense and Pathological

  2014cited by this paper
• Attachment the Italian way : In search of specific patterns of infant and adult attachments in Italian typical and atypical samples

  2013cited by this paper
• Unresolved Attachment Status and Trauma-Related Symptomatology in Maltreated Adolescents: An Examination of Cognitive Mediators

  2012cited by this paper
• Personality development characteristics of women with anorexia nervosa, their healthy siblings and healthy controls: What prevents and what relates to psychopathology?

  2011influential reference
• Anorexia nervosa: current status and future directions.

  2010cited by this paper
• Attachment disorganization: Genetic factors, parenting contexts and developmental transformation from infancy to adulthood

  2010cited by this paper
• Feelings of insecurity: review of attachment and eating disorders.

  2010cited by this paper
• Diagnostic and Statistical Manual

  2010cited by this paper
• Holding Harm: Narrative Methods in Mental Health Research on Refugee Trauma

  2010influential reference
• Handbook of Attachment Theory, Research, and Clinical

  2009cited by this paper
• Mental representations of attachment in Eating Disorders: a pilot study using the Adult Attachment Interview

  2009influential reference
• Attachment stability and the emergence of unresolved representations during adolescence

  2009cited by this paper
• The first 10,000 Adult Attachment Interviews: distributions of adult attachment representations in clinical and non-clinical groups

  2009cited by this paper
• The association of unresolved attachment status and cognitive processes in maltreated adolescents.

  2009cited by this paper
• Attachment styles, memories of parental rearing and therapeutic bond: a study with eating disordered patients, their parents and therapists.

  2008influential reference
• Measurement of individual differences in adolescent and adult attachment.

  2008influential reference
• Anorexia nervosa and parental bonding: the contribution of parent-grandparent relationships to eating disorder psychopathology.

  2008cited by this paper
• Attachment disorganization: Genetic factors, parenting contexts, and developmental transformation from infancy to adulthood.

  2008cited by this paper
• The caregiving system: A behavioral systems approach to parenting.

  2008influential reference
• Dissociation, Traumatic Attachments, and Self-Harm: Eating Disorders and Self-Mutilation

  2008influential reference
• Attachment and psychopathology in adulthood.

  2008cited by this paper
• The Adult Attachment Projective

  2007cited by this paper
• Unresolved attachment among immigrants: an analysis using the adult attachment projective.

  2007cited by this paper
• Eating disorders and attachment: the effects of hidden family processes on eating disorders.

  2007influential reference
• The relationship between attachment scales and group therapy alliance growth differs by treatment type for women with binge-eating disorder.

  2007influential reference
• Relationships among attachment styles, personality characteristics, and disordered eating.

  2007influential reference
• An attachment insecurity model of negative affect among women seeking treatment for an eating disorder.

  2006influential reference
• Sociocultural values of appearance and attachment processes: An integrated model of eating disorder symptomatology.

  2006influential reference
• Adult Attachment and Disordered Eating in Undergraduate Men and Women

  2006cited by this paper
• Measuring Adult Attachment Representation in an fMRI Environment: Concepts and Assessment

  2006cited by this paper
• Unresolved Attachment Among Immigrants: An Analysis Using the Adult Attachment Projective

  2006cited by this paper
• Attachment in anorexia nervosa: An exploration of associations with eating disorder psychopathology and psychiatric symptoms

  2006influential reference
• Body Dissatisfaction in Women With Eating Disorders: Relationship to Early Separation Anxiety and Insecure Attachment

  2006cited by this paper
• Attachment scales predict outcome in a randomized controlled trial of two group therapies for binge eating disorder: An aptitude by treatment interaction

  2006cited by this paper
• Immigration from an attachment perspective

  2005cited by this paper
• Validation du projectif de l'attachement adulte (AAP) : Contribution aux validités convergente et divergente du projectif de l'attachement adulte

  2005cited by this paper
• Understanding interobserver agreement: the kappa statistic.

  2005influential reference
• Early separation anxiety and adult attachment style in women with eating disorders.

  2005cited by this paper
• Measurement of Individual Differences

  2005cited by this paper
• Attachment styles in adult intimate relationships: comparing women with bulimia nervosa symptoms, women with depression and women with no clinical symptoms

  2005cited by this paper
• Attachment Predicts Treatment Completion in an Eating Disorders Partial Hospital Program Among Women With Anorexia Nervosa

  2004cited by this paper
• Young children traumatized by organized violence together with their mothers – The critical effects of damaged internal representations

  2003cited by this paper
• Risk and protective factors for juvenile eating disorders

  2003influential reference
• Holding therapy is not attachment therapy: Editor's introduction to this invited Special Issue

  2003cited by this paper
• The Effect of Attachment Theory in the Development of Eating Disorders: Can Symptoms Be Proximity-Seeking?

  2002cited by this paper
• Strategies of emotion regulation in adolescents and young adults with substance dependence or eating disorders

  2002cited by this paper
• Fearful-avoidance, disorganization, and multiple working models: Some directions for future theory and research

  2002cited by this paper
• Bowlby's secure base theory and the social/personality psychology of attachment styles: Work(s) in progress

  2002cited by this paper
• Attachment Style and Family Functioning as Discriminating Factors in Eating Disorders

  2002influential reference
• Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community.

  2001influential reference
• Attachment in mental health institutions: A critical review of assumptions, clinical implications, and research strategies

  2001cited by this paper
• Handbook of Attachment: Theory, Research, and Clinical Applications

  2001influential reference
• Attachment in anorexia nervosa: a transgenerational perspective.

  2001influential reference
• Attachment processes in eating disorders

  2001influential reference
• Attachment and the regulation of the right brain

  2001cited by this paper
• Eating disorders, attachment and interpersonal difficulties: a comparison between 18‐ to 24‐year‐old patients and normal controls

  2001cited by this paper
• Perceived control over events in the world in patients with eating disorders: A preliminary study

  2001cited by this paper
• The development and preliminary validation of a new measure of adult attachment: the Adult Attachment Projective

  2001influential reference
• Attachment and the regulation of the right brain

  2000cited by this paper
• Adult Attachment Interview : AAI

  2000cited by this paper
• Attachment research in eating disorders.

  2000cited by this paper
• The adult attachment interview: Historical and current perspectives.

  1999influential reference
• Secondary Traumatic Stress. Self Care Issues for Clinicians, Researchers, and Educators

  1998cited by this paper
• Attachment style and weight concerns in preadolescent and adolescent girls.

  1998cited by this paper
• Understanding Anorexia Nervosa and Bulimia Nervosa from an Attachment Perspective

  1997influential reference
• Eating Disorders and Obesity: a Comprehensive Handbook

  1996influential reference
• Attachment processes in eating disorder and depression.

  1996cited by this paper
• Attachment representations in mothers, fathers, adolescents, and clinical groups: a meta-analytic search for normative data.

  1996influential reference
• The relation of attachment status, psychiatric classification, and response to psychotherapy.

  1996influential reference
• Self-Other Working Models and Eating Disorders

  1996cited by this paper
• Children classified as controlling at age six: Evidence of disorganized representational strategies and aggression at home and at school

  1995influential reference
• Attachment and psychopathology.

  1995cited by this paper
• Childhood trauma, the neurobiology of adaptation, and "use-dependent" development of the brain: How "states" become "traits."

  1995cited by this paper
• Self-care for trauma therapists: Ameliorating vicarious traumatization.

  1995cited by this paper
• Eating disorders and obesity : a comprehensive handbook

  1995cited by this paper
• Patterns of Relating: An Adult Attachment Perspective

  1994influential reference
• Personality and behavioral vulnerabilities associated with risk status for eating disorders in adolescent girls.

  1993influential reference
• Relationship between Parental Attachment and Eating Disorders in an Inpatient and a College Sample.

  1992influential reference
• Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation.

  1990cited by this paper
• Romantic love conceptualized as an attachment process.

  1987influential reference
• Eating disorders.

  1987cited by this paper
• Attachment and Loss: Sadness and Depression

  1982cited by this paper
• Adolescents and Young Adults

  1979cited by this paper
• Attachment and loss: retrospect and prospect.

  1969cited by this paper
• Personality and behavior

  1963cited by this paper
• Anorexia Nervosa and Parental Bonding: the Contribution of Parent–grandparent Relationships to Eating Disorder Psychopathology M

  year unknowninfluential reference

• Personality Disorders and Attachment Trauma in Adolescent Patients with Psychiatric Disorders

  2023cites this paper
• State of Mind Assessment in Relation to Adult Attachment and Text Analysis of Adult Attachment Interviews in a Sample of Patients with Anorexia Nervosa

  2022cites this paper
• ‘In an otherwise limitless world, I was sure of my limit.’ Experiencing Anorexia Nervosa: A phenomenological metasynthesis

  2022cites this paper
• Hypercholesterolemia in Cancer and in Anorexia Nervosa: A Hypothesis for a Crosstalk

  2022cites this paper
• Pleasant touch perception in borderline personality disorder and its relationship with disturbed body representation

  2022cites this paper
• Association Between Adult Attachment Styles and Disordered Eating Among a Sample of Lebanese Adults

  2021cites this paper
• The Role of Food in the Family Relationships of Adolescents With Anorexia Nervosa and Bulimia in Northeastern Brazil: A Qualitative Study Using Photo Elicitation

  2021cites this paper
• Role of Attachment and Family Functioning in Problematic Smartphone Use in Young Adults

  2021cites this paper
• The Interplay of Attachment Styles and Defense Mechanisms on Eating Disorders Risk: Cross-Sectional Observation in the Community Population

  2021cites this paper
• Bozulmuş Yeme Örüntülerinde Bağlanmanın Yordayıcı Etkisi: Ergenler Üzerine Bir Çalışma

  2021cites this paper
• Narrative and Bodily Identity in Eating Disorders: Toward an Integrated Theoretical-Clinical Approach

  2021cites this paper
• Meaning, metaphor, and metabolization: the case of eating disorders

  2021cites this paper
• Autonomic response to the Adult Attachment Projective in anorexia nervosa

  2019cites this paper
• Use of the Adult Attachment Projective Picture System in the formulation of a case of an adolescent refugee with PTSD

  2018cites this paper
• Disorder‐specific attachment characteristics and experiences of childhood abuse and neglect in adolescents with anorexia nervosa and a major depressive episode

  2018influential citation
• Disregolazione affettiva, disorganizzazione dell'attaccamento e disturbi alimentari: fattori di rischio individuali e familiari

  2018cites this paper
• Attachment in eating-disordered outpatients with and without borderline personality disorder

  2017cites this paper
• A controlled study of attachment representations and emotion regulation in female adolescents with anorexia nervosa

  2016cites this paper
• Adult Attachment, Social Adjustment, and Well-Being in Drug-Addicted Inpatients

  2016cites this paper
• Anorexie mentale, lien parental et attachement : étude du lien parental dans l’enfance chez une population d’enfants et d’adolescents avec anorexie mentale

  2016cites this paper
• Attachment Trauma and Pathological Mourning in Adults with Intellectual Disabilities

  2016cites this paper
• When parenting fails: alexithymia and attachment states of mind in mothers of female patients with eating disorders

  2015cites this paper
• Qualitative research in adolescent psychotherapy: attachment and reflective functioning as psychotherapy’s outcomes of an adolescent with anorexia nervosa

  2015cites this paper
• Comparative validity of the Adult Attachment Interview and the Adult Attachment Projective

  2015cites this paper
• Eating disorders in adolescence: attachment issues from a developmental perspective

  2015cites this paper
• New frontiers and applications of attachment theory

  2015cites this paper