Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients

G.S. Kuipers, Z. van Loenhout, L.A. van der Ark, M.H.J. Bekker

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective:
To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients.
Method:
We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires.
Results:
Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables.
Discussion:
Eating disorder patients’ low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.
Original languageEnglish
Pages (from-to)250-272
JournalAttachment & Human Development
Volume18
Issue number3
DOIs
Publication statusPublished - 2016

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Neuroticism
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Kuipers, G.S. ; van Loenhout, Z. ; van der Ark, L.A. ; Bekker, M.H.J. / Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients. In: Attachment & Human Development. 2016 ; Vol. 18, No. 3. pp. 250-272.
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abstract = "Objective: To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. Method: We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Results: Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Discussion: Eating disorder patients’ low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.",
author = "G.S. Kuipers and {van Loenhout}, Z. and {van der Ark}, L.A. and M.H.J. Bekker",
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Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients. / Kuipers, G.S.; van Loenhout, Z.; van der Ark, L.A.; Bekker, M.H.J.

In: Attachment & Human Development, Vol. 18, No. 3, 2016, p. 250-272.

Research output: Contribution to journalArticleScientificpeer-review

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N2 - Objective: To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. Method: We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Results: Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Discussion: Eating disorder patients’ low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.

AB - Objective: To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. Method: We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Results: Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Discussion: Eating disorder patients’ low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.

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