There is a basic assumption in clinical psychology and psychiatry: the quality of interactions with attachment figures has a significant impact on the future normal and pathological development (Bowlby, 1988).
The attachment theory, which arises from the works of Bowlby, has received increasing attention from researchers who try to understand the relationship between attachment and eating disorders.
From the analysis of some studies on the subject, it emerges that the types of insecure attachment are very common among the women they have Eating behavior disordersbut no specific hypotheses are provided on the mechanisms underlying this association.
Some authors think of the symptoms of eating disorders as a direct expression of psychological and emotional processes of specific attachment patterns. For example, the typical dietary restriction of anorexia nervosa is read as the expression of a distancing from the self, a central feature of the avoidant attachment patterns. On the contrary, the typical behavior of bulimia nervosa is considered an expression of the scarce emotional regulation typical of anxious attachment.
According to other authors (Orzolek-Kronner, 2002) i eating disorders they have the function of seeking the feeling of physical and emotional proximity with the caregiver. The search for proximity was initially described by Bowlby as the primary nature of attachment.
According to Ward’s hypothesis, et al., (2001), on the other hand, there is a trans-generational transmission of attachment patterns: the insecure attachment of the daughters with Anorexia Nervosa It is explained by the attachment models of the mothers.
Ringer and Crititenden (2007) who use a perspective focused on family systems, suggest that hidden family conflicts or parents of parents of parents can cause the development of insecure attachment models e eating disorders.
Currently there is no strong scientific support for any of the hypotheses listed above, but it is possible to say that models of insecure attachment are a risk factor noodly for eating disorders. The ethical question deriving from the connection between attachment and psychopathology is also not to be underestimated: the risk is to induce faults and accuse parents of being responsible for the development of the psychopathology of their own or daughter.
In a recent study, Tasca (2009) hypothesizes that the influence of attachment to eating disorders both indirect, that is, operating through third variables.
The interactions repeated with a caregiver In childhood, they are codified by the implicit memory system and constitute mnestic units. Starting from these, the internal operating models are formed, that is, of the mental representations of oneself, of others and of relationships with themselves and others. In addition to influencing the way in which we perceive and foresee certain events, the internal operating models also influence affective regulation skills.
There affective regulation and the reflective operationrepresent functions that can particularly influence the psychopathology of eating disorder.
Bateman and Fonagy (2012) argue that unhew of attachments can interrupt or limit the ability to mentalize which in turn affects emotional regulation. Behaviors such as binge or strong food restrictions can be connected to a low or excessive control of emotional regulation respectively.
More and more research are studying the role of reflective operation in eating disorders. In a review of three empirical studies, Kuipers and Bekkel (2012) showed that reflective operation was significantly lower in a sample of people with eating disorders with a prevalence of Anorexia Nervosa.
In conclusion, there are still few studies that have evaluated the possible mechanisms through which an insecure attachment can influence the psychopathology of eating disorder. However, evaluate and understand the quality of attachment in patients with eating disordersit can be useful at a clinical level as it provides important indications to customize the therapy and thus optimize the results. Patients with avoidant or anxious attachment have in fact, different approaches of emotional regulation and different interpersonal styles that can influence the progress and continuation of the therapy itself.
