Eating disorders have been related to losing an attachment figure, and certain ways of interacting with important persons in one’s life (attachment styles) have been shown in research to be related to eating disorder symptoms. Specifically, fearful-avoidant and anxious-preoccupied attachment were related to greater body dissatisfaction and restriction of food. In people without eating disorders, those with insecure attachment styles tended to have more psychiatric symptoms, including anxiety and depression. Yet, the relationship between attachment style, anxiety/depression and disordered eating symptoms in people engaging treatment has not been well explored.
Our study found that the most common attachment styles in people with eating disorders in our treatment center were Dismissing and Fearful, while Secure attachment was the least common. Patients with Insecure attachment had greater depression, body dissatisfaction, and eating disorder symptoms. Those with Fearful attachment had higher depression symptoms as well as higher body dissatisfaction and eating disorder risk. Preoccupied attachment was weakly correlated with risk of binging and purging (e.g., vomiting after eating), while Dismissing attachment was related with depression.
These findings emphasize the need for assessing attachment style and specifically addressing it in treatment for patients suffering from eating disorders. Helping patients become more secure in their attachments to loved ones may improve positive treatment outcomes, and could help to reduce depression, the drive to be extremely thin, body dissatisfaction, and/or binging and purging symptoms.
Tadrous, S., Barsuglia, J., Arentsen, T., Smith, S., Sandy, C., Keiper, C., Pitts, P., & Abernethy, A., (2014, August). Attachment dynamics and eating disorder symptoms in a clinical treatment group. Poster session presented at the 2014 American Psychological Association annual convention, Washington, DC.
Research has shown that eating disorder patients can exhibit high levels of self-harm. The most common forms of self-harm in eating disorder patients includes: self-mutilation (i.e. cutting), abusive relationships and self-punitive thinking (hating one’s self). These patients share another commonality, tumultuous family dynamics. Their family dynamics have often been described as having high conflict, being critical, and being less cohesive than patients without self-harming behaviors (Lane, 2002; Claes et al., 2012).
However, the relationship between balanced emotional responsiveness (too little or too much as well as incorrect emotional response), family involvement (level of how much each family member is involved and interested in the other family member’s activities) and self harm have not been explored.
Our results showed that when looked at separately, emotional responsiveness impacted self-harm engagement and family involvement impacted engagement in self-harm. When looked at together, family involvement was a stronger dynamic in the level of self-harm engagement.
These findings suggest inappropriate emotional responsiveness and family involvement is associated with engagement in self-harm behaviors, such as self-mutilation, abusive relationships and self-punitive thinking. Therefore, emotional responsiveness and family involvement may have an influence on self-harm behaviors, thus such dynamics would be helpful to address in family treatment.
Tadrous, S., Barsuglia, J., Arentsen, T., Smith, S., Sandy, C., Keiper, C., Pitts, P., & Abernethy, A., (2014, August). Association of family functioning with self-harm in eating disorder patients. Poster session presented at the 2014 American Psychological Association annual convention, Washington, DC.
*All research presented was conducted in collaboration with Fuller Graduate School of Psychology.