Eating Disorders and Attachment: A Contemporary Psychodynamic Perspective

Journal title MALTRATTAMENTO E ABUSO ALL’INFANZIA
Author/s Giorgio A. Tasca, Louise Balfour
Publishing Year 2015 Issue 2015/1
Language English Pages 18 P. 55-72 File size 110 KB
DOI 10.3280/MAL2015-001005
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

A contemporary psychodynamic framework can add much to our understanding of eating disorders. Eating disorders are associated with complex comorbidities, high levels of mortality, and therapist countertransferences that can complicate psychological treatments. Mainstream models currently focus on cognitive, biological, or cultural factors to the near exclusion of attachment functioning, and the individual’s dynamics. As such, standard models appear to exclude person-centred and developmental considerations when providing treatments. In this article, we describe a contemporary psychodynamic model that understands eating disorder symptoms as a consequence of vulnerability to social pressures to be thin and biological predispositions to body weight. Individual vulnerabilities are rooted in unmet attachment needs causing negative affect, and subsequent maladaptive defenses and eating disorder symptoms as a means of coping. We describe how this model can inform transdiagnostic eating disorder treatment that focuses on symptoms as well as specific attachment functions including: interpersonal style, affect regulation, reflective functioning, and coherence of mind. Two clinical examples are presented to illustrate case formulations and psychological treatments informed by these conceptualizations.

Keywords: Attachment behavior, eating disorders, anorexia nervosa, bulimia, binge eating disorder.

  1. Abidin, R. R. (1990). Parenting Stress Index (Short Form). Pediatric Psychology Press.
  2. Agostini, F., Neri, E., Dellabartola, S., Biasini, A., & Monti, F. (2014). Early interactive behaviours in preterm infants and their mothers: Influences of maternal depressive symptomatology and neonatal birth weight. Infant Behavior and Development, 37, 1, 86-93, DOI: 10.1016/j.infbeh.2013.12.003
  3. Ammaniti, M. (1992). La gravidanza tra fantasia e realtà. Roma: Il Pensiero Scientifico Editore.
  4. Ammaniti, M., Lucarelli, L., Cimino, S., & D’Olimpio, F. (2006). Scala di Valutazione dell'Interazione Alimentare Madre-Bambino - S.V.I.A. Manoscritto non pubblicato. Roma: Sapienza Università degli Studi.
  5. Beck, A.T., Steer, R. A., & Brown, G.K. (1996). Beck Depression Inventory – II (BDI-II ). San Antonio: Psychological Corporation.
  6. Beebe, B., & Lachmann, F. M. (2002). Infant research and adult treatment: Coconstructing interactions. New York: The Analytic Press/Taylor & Francis Group.
  7. Bozzette, M. A. (2007). Review of research on premature infant-mother interaction. Newborn and Infant Nursing Reviews, 7, 1, 49-55, DOI: 10.1053/J.NAINR.2006.12.002
  8. Brandon, D. H., Tully, K. P., Silvia, S. G., Malcom, W. F., Murtha, A. P., Turner, B. S., & Holditch-Davis, D. (2011). Emotional responses of mothers of late preterm and term infants. Journal of Obstetric, Gynecologc & Neonatal Nursing, 40, 6, 719-731, DOI: 10.1111/j.1552-6909.2011.01290
  9. Burklow, K. A., McGrath, A. M., & Kaul, A. (2002). Management and prevention of feeding problems in young children with prematurity and very low birth weight. Infants and Young Children, 14, 19-30, DOI: 10.1097/00001163-200204000-00004
  10. Bydlowski, M. (2004). Sognare un figlio. L’esperienza interiore della maternità. Bologna: Pendragon.
  11. Carter, J. D., Mulder, R. T., Frampton, C. M. A., & Darlow, B. A. (2007). Infants admitted to a neonatal intensive care unit: Parental psychological status at 9 months. Acta Pediatrica, 96, 9, 1286-1289, DOI: 10.1111/j.1651-2227.2007.00425
  12. Cerro, N., Zeunert, S., Simmer, K. N., & Daniels, L. (2002). Eating behaviour of children 1.5-3.5 years born preterm: Parents’ perceptions. Journal of Paediatrics and Child Health, 38, 1, 72-80, DOI: 10.1046/j.1440-1754.2002.00728
  13. Chatoor, I., Loeffler, C., McGee, M., & Menvielle, E. (1998). Observational scale for mother-infant interaction during feeding. Washington, DC: Children’s National Medical Center.
  14. Cnattingius, S., Hultmen, C. M., Dahl., M., & Sparen, P. (1999). Very preterm birth, birth trauma, and the risk of anorexia nervosa among girls. Archives of General Psychiatry, 56, 634-638.
  15. Crockenberg, S., & Litman, C. (1990). Autonomy as competence in 2-year-olds: Maternal correlates of child defiance, compliance, and self-assertion. Developmental Psychology, 26, 6, 961-971, DOI: 10.1037//0012-1649.26.6.96
  16. De Campora, G., D’Onofrio, E., & Zavattini, G. C. (2014). Fattori di rischio precoci nello sviluppo del sovrappeso in età pediatrica. Una rassegna della letteratura. Giornale Italiano di Psicologia, 2, 265-294, DOI: 10.3280/rip2013-004001
  17. Dodrill, P., McMahon, S., Ward, E., Weir, K., Donovan, T., & Riddle, B. (2004). Long-term oral sensitivity and feeding skills of low-risk pre-term infants. Early Human Development, 76, 1, 23-37, DOI: 10.1016/j.earlhumdev.2003.10.001
  18. Feldman, R. (2007). Maternal versus child risk and the development of parentchild and family relationships in five-high risk populations. Development and Psychopathology, 19, 2, 293-312, DOI: 10.1017/s0954579407070150
  19. Ferrara Mori, G. (2008). Un tempo per la maternità interiore. Roma: Borla.
  20. Forcada-Guex, M., Pierrehumbert, B., Borghini, A., Moessinger, A., & Muller-Nix, C. (2006). Early dyadic patterns of motherinfant interactions and outcomes of prematurity at 18 months. Pediatrics, 118, 1, 107-114, DOI: 10.1542/peds.2005-1145
  21. Ghisi, M., Flebus, G. B., Montano, A., Sanavio, E., & Sica, C. (2006). Beck Depression Inventory II Italian Version. Firenze: Giunti O. S.
  22. Goyal, N. K., Attanasio, L. B., & Kozhimannil, K. B. (2014). Hospital care and early breastfeeding outcomes among late preterm, early term and term infants.
  23. Birth, 41, 4, 330-338, DOI: 10.1111/birt.12135.Golse,B.(2003).Lapsichiatriaperinatale:prospettive,acquisizionieproblemiaperti.Imago,4,299-330
  24. Granieri, A., & Schimmenti, A. (2014) Mind-body splitting and eating disorders: A psychoanalytic perspective. Psychoanalytic Psychotherapy, 28, 1, 52-70, DOI: 10.1080/02668734
  25. Griffiths, R. (1996). The Griffiths Mental Development Scales from birth to two years. Henley: The test Agency Limited.
  26. Guarini, A., & Sansavini, A. (2010). Sviluppo cognitive e competenze linguistiche orali e scritte nei nati pretermine: traiettorie evolutive a rischio o atipiche? Psicologia Clinica dello Sviluppo, 14, 3-32, DOI: 10.1449/32002
  27. Guarino, A., Di Blasio, P., D’Alessio, M., Camisasca, E., & Serantoni, G. (2008). PSI Parenting Stress Index - Forma breve. Firenze: Giunti O. S.
  28. Imbasciati, A., Debrassi, F., & Cena, L. (2007). Psicologia Clinica Perinatale. Padova: Piccin.
  29. Kemmler, L. (1957). Untersuchungen über den frühkindlichen Trotz. Psychologische Forschung, 25, 279-338.
  30. Kuczynski, L., & Kochanska, G. (1990). Development of children’s noncompliance strategies from toddlerhood to age 5. Developmental Psychology, 26, 3, 398-408, DOI: 10.1037//0012-1649.26.3.398
  31. Latmiral, S., & Lombardo, C. (2000). Pensieri prematuri. Roma: Borla.
  32. Lichtenberg, J. D. (1995). Psicoanalisi e sistemi motivazionali. Milano: Raffaello Cortina. Lucarelli, L., Cimino, S., Perucchini, P., Speranza, A. M., Ammaniti, M., & Ercolani,
  33. A. P. (2002). I disturbi alimentari nella prima infanzia: validazione di uno strumento osservativo dell’interazione madre-bambino. Infanzia e adolescenza, 2, 113-124.
  34. Magrini, M. (2002). La questione del trauma nella relazione genitoriale e professionale con il neonato prematuro. In E. Trombini (Ed.), Il dolore mentale nel percorso evolutivo. Urbino: Quattroventi.
  35. Martelli, M., & Impagliazzo, S. (2013). La continuità delle cure ospedale-territorio: aspetti clinici ed organizzativi. In A. Sansavini & G. Faldella (Eds.), Lo sviluppo dei bambini nati pretermine (pp. 304-310). Milano: FrancoAngeli.
  36. Mathisen, B., Worrall, L., O’Callagan, M., & Wall, C. (2000). Feeding problems and dysplagia in six-moths-old extreamly low birth weight infants. International Journal of Speech-Language Pathology, 2, 9-17,
  37. 10.3109/14417040008996782.
  38. Metzger, W. (1959). Die Entwicklung der Erkenntnisprozesse. In H. Thomae (Eds.), Entwicklungspsychologie. Handbuch der psychologie (3 ed., Vol. 2., pp. 404-441). Göttingen: Hogrefe.
  39. Monti, F., Agostini, F., & Neri, E. (2013a). Il trauma della nascita pretermine e la sintomatologia ansiosa-depressiva materna. In A. Sansavini & G. Faldella (Eds.), Lo sviluppo dei bambini nati pretermine (pp.137-146). Milano: FrancoAngeli. Monti, F., Neri, E., Trombini, E., Aureliano, F., Biasini, A., & Agostini, F.
  40. (2013b). Prematurity: Parental stress, temperament and child development. European Journal of Child Development, Education and Psychopathology, 1, 3, 139-153, DOI: 10.2307/1131931
  41. Muller-Nix, C., Forcada-Guex, M., Pierrehumbert, B., Jaunin, L., Borghini, A., & Ansermet, F. (2004). Prematurity, maternal stress and mother-child interactions. Early Human Development, 79, 2, 145-158, DOI: 10.1016/j.earlhumdev.2004.05.002
  42. Padovani, F. H., Duarte, G., Martinez, F. E., & Linhares, M. B. (2011). Perception of breastfeeding in mothers of babies born preterm in comparison to mothers of full-term babies. The Spanish Journal of Psychology, 11, 2, 581-592, DOI: 10.5209/rev_sjop.2011.v14.n2.35
  43. Papousek, M. (2007). Communication in early infancy: An arena of intersubjective lerning. Infant Behaviour and Development, 30, 258-266, DOI: 10.1016/j.infbeh.2007.02.003
  44. Pedrabissi, L., & Santinello, M. (1989) Inventario per l’Ansia di “stato” e di “tratto”: Nuova Versione Italiana dello STAI. Forma Y: Manuale. Firenze: Giunti O.S.
  45. Perricone, G., & Morales, M. R. (2011). The temperament of preterm infant in preschool age. Italian Journal of Pediatrics. 37, 4, 1-7, DOI: 10.1186/1824-7288-37-4
  46. Pierrehumbert, B., Nicole, A., Muller-Nix, C., Forcada-Guex, M., & Ansermet, F. (2003). Parental post-traumatic reactions after premature birth: Implications for sleeping and eating problems in the infant. Archives of Disease in Childhood. Fetal and Neonatal Edition, 88, 5, F400-4, DOI: 10.1136/fn.88.5.f400
  47. Potharst, E. S., Schuengel, C, Last, B. F., van Wassenaer, A. G., Kok, J. H., & Houtzager, B. A. (2012). Difference in mother-child interaction between preterm-and term-born preschoolers with and without disabilities. Acta Paediatrica, 101, 6. 597-603, DOI: 10.1111/j.1651-2227.2012.02599.x
  48. Riva Crugnola, C. (2007). Il bambino e le sue relazioni. Milano: Raffaello Cortina.
  49. Samara, M., Johnson, S., Lamberts, K., Marlow, N., & Wolke, D. (2010). Eating problems at 6 year of age in a whole population sample of extreamly preterm children. Developmental Medicine & Child Neurology, 52, e16-e22, DOI: 10.1111/j.1469-8749.2009.03512.x
  50. Sameroff, A. J., & Emde, R. N. (1991). I disturbi delle relazioni nella prima infanzia. Torino: Bollati Boringhieri.
  51. Sansavini, A., Guarini, A., Savini, S., Broccoli, S., Justice, L., Alessandroni, R., et al. (2011). Longitudinal trajectories of gestural and linguistic abilities in very preterm infants in the second year of life. Neuropsychologia, 49, 13, 3677-3688, DOI: 10.1016/j.neuropsychologia.2011.09.023
  52. Schädler, G., Süss-Burghart, H., Toschke, A. M., von Voss, H., & von Kries, R. (2007). Feeding disorders in ex-prematures: Causes-response to therapy-long term outcome. European Journal of Pediatrics, 166, 8, 803-808, DOI: 10.1007/s00431-006-0322-x
  53. Schmid, G., Schreier, A., Meyer, R., & Wolke, D. (2011). Predictors of crying, feeding and sleeping problems: A prospective study. Child: Care, Health and Development. 37, 4, 493-502, DOI: 10.1111/j.1365-2214.2010.01201
  54. Silberstein, D., Geva, R., Feldman, R., Gardner, J. M., Karmel, B. Z., Rozen, H., & Kuint, J. (2009). The transition to oral feeding in low-risk premature infants: Relation to infant neurobehavioural funtioning and mother-infant feeding interaction. Early Human Development, 85, 157-162, DOI: 10.1016/j.earlhumdev.2008.07.006
  55. Spielberger, C. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists.
  56. Spitz, R. A. (1957). No and yes: On the genesis of human communication. Madison, CT: International Universities Press.
  57. Stern, D. N. (1987). Il mondo interpersonale del bambino. Torino: Bollati Boringhieri.
  58. Thoyre, S. M. (2007). Feeding outcomes of extremely premature infants after neonatal care. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 36, 4, 366-376, DOI: 10.1111/j.1552-6909.2007.00158
  59. Trombini, E. (2002). L’opposizione infantile. Ostinazione e protesta psicosomatica. Quaderni di scienze dell’interazione. 2.
  60. Trombini, E. (2010). Il cibo rifiutato. I disturbi alimentari precoci e la Giocoterapia Focale con bambini e genitori. Bologna: Pendragon.
  61. Trombini, E. (2013). Lo psicologo clinico e l’intervento di sostegno a genitori e bambini prematuri. In A. Sansavini & G. Faldella (Eds.), Lo sviluppo dei bambini nati pretermine (pp. 254-264). Milano: FrancoAngeli.
  62. Trombini, E., Surcinelli, P., Piccioni, A., Alessandroni, R., & Faldella, G. (2008). Environmental factors associated with stress in mothers of pretrem newborns. Acta Pediatrica, 97, 894-898, DOI: 10.1111/j.1651-2227.2008.00849
  63. Trombini, G. (1969). Sull’esistenza e comparsa della motivazione a fare-da-solo nel campo alimentare ed evacuatorio. Rivista di Psicologia, 2, 111-113, DOI: 10.1007/bf02415322
  64. Vallino, D., & Macciò, M. (2004). Essere neonati. Roma: Borla.
  65. Veggetti Finzi, S. (1990). Il bambino della notte. Divenire donna. Divenire madre. Milano: Mondadori.
  66. Voegtline, K. M., Stifter, C. A., & Family Life Project Investigators (2010). Latepreterm birth, maternal symptomatology, and infant negativity. Infant Behavior and Development, 33, 545-554, DOI: 10.1016/j.infbeh.2010.07.006
  67. Zanardo, V., Freato, F., & Zacchello, F. (2003). Maternal anxiety upon NICU discharge of high risk infants. Journal of Reproductive and Infant Psychology, 21, 1, 69-75, DOI: 10.1080/02646830306147
  68. Zanardo, V., Gambina, I., Begley, C., Litta, P., Cosmi, E., Giustardi, A., et al. (2011). Psychological distress and early lactation performance in mothers of late preterm infants. Early Human Development, 87, 4, 321-330. DOI: 10.1016/j.earlhumdev.2011.01.035
  69. Zeanah, C. H., Anders, T. F., Seifer, R., & Stern, D. N. (1989). Implications of research on infant development for psychodynamic theory and practice. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 5, 657-668, DOI: 10.1097/00004583-198909000-00004

  • Eating Disorders Katie Rowlands, Janet Treasure, Valentina Cardi, pp.1 (ISBN:978-3-030-97416-9)
  • Disregolazione affettiva, disorganizzazione dell'attaccamento e disturbi alimentari: fattori di rischio individuali e familiari Valentina Guiducci, Fabiola Bizzi, Antonio Ferro, Donatella Cavanna, in MALTRATTAMENTO E ABUSO ALL'INFANZIA 2/2018 pp.65
    DOI: 10.3280/MAL2018-002005

Giorgio A. Tasca, Louise Balfour, Eating Disorders and Attachment: A Contemporary Psychodynamic Perspective in "MALTRATTAMENTO E ABUSO ALL’INFANZIA" 1/2015, pp 55-72, DOI: 10.3280/MAL2015-001005