Struggling with an eating disorder can relate to many aspects of an individual’s life, but can it be related to attachment style? A study published in International Journal of Eating Disorders It explores the existing literature suggesting that people with eating disorders have high levels of maladaptive attachment styles.

Eating disorders are particularly debilitating mental illnesses associated with significant morbidity and mortality. Attachment style is a topic of interest in eating disorders, as early caregiver interactions are thought to be a factor in the development of eating disorders.

Anxious and avoidant attachment styles are two insecure behavioral and emotional responses that individuals may develop in intimate relationships. These patterns reflect the different strategies people use to navigate emotional intimacy and seek safety in relationships.

Anxious people seek constant reassurance and fear rejection or abandonment. They can be overly dependent and have high emotional reactions. Aloof individuals prioritize independence, fear intimacy, and may seem emotionally distant or unavailable. They value personal space and struggle with faith.

Attachment is considered an important consideration in treatment, as family and friends can play a key role in recovery. The new study sought to better understand the relationship between attachment and eating disorders by conducting an improved meta-analysis and including moderators.

In a meta-analysis, researchers collect data from different studies, analyze them collectively, and combine the results based on them. This method allows for larger sample sizes, increased statistical power, and the ability to detect patterns or trends that may not be apparent in individual studies.

Tom Jewell and his colleagues searched for relevant studies in a variety of databases, including Google Scholar, SciInfo, and others with no date restrictions. The researchers screened studies and inclusion criteria included having a healthy control group, using clinically validated diagnostic or disordered eating measures, and being grounded in attachment theory.

Studies using infantile anorexia nervosa were excluded because it is not included in the DSM or ICD, and studies using a parent attachment instrument were also excluded because they were not part of attachment theory. Publication bias was assessed and estimates adjusted accordingly.

Jewell and colleagues conducted eight meta-analyses, including interview-assessed and self-reported attachment security, self-reported attachment avoidance in eating disorder samples, anorexia nervosa samples and bulimia nervosa samples, and self-reported attachment distress in eating disorder samples, anorexia nervosa samples and bulimia nervosa samples. Nervosa specimens.

Of the eight meta-analyses, higher rates of attachment insecurity were found in eating disorder samples. These interactions all showed moderate to large effect sizes. This study found no significant moderating effects of age, sample, or group matching.

The absence of a significant moderating effect of age may indicate that the relationship between attachment insecurity and disordered eating may not change significantly across developmental stages.

One significant moderator found in this meta-analysis was blinding of reviewers to studies that used interviews. Although researchers expected to see large effect sizes in studies that did not use blinders, most of them had small populations. Only one study used a group of people who had recovered from an eating disorder, but the study found that they did not differ significantly from a control group.

This study takes important steps toward better understanding the body of literature linking attachment insecurity and eating disorders. Despite this, there are limitations to recall, and meta-analyses are bound by the limitations of many of the original studies. A significant limitation of this study is that they did not consider autism spectrum disorders, although the prevalence of ASD is particularly high in eating disorders.

However, the findings have some important clinical implications.

The researchers concluded, “Understanding insecure attachment patterns in the context of therapy may help clinicians identify or anticipate therapeutic breakdowns, and actively seek to repair these.” “Additionally, attachment can be an important therapeutic target. For example, helping patients understand their own attachment history and ways of responding to stress in their current intimate relationship can play an important role and is consistent with evidence-based models such as focal psychodynamic therapy.”

The study “Attachment in individuals with eating disorders compared to community controls: a systematic review and meta-analysis.Authored by Tom Jewell, Eleni Apostolidou, Kevser Sadikovic, Kirsty Tahta-Wright, Sarah Liston, Mima Simic, Evan Isler, Peter Fonagy, and Isabel York.

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