Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada.
Psychotherapy (Chic). 2011 Sep;48(3):249-59. doi: 10.1037/a0022423.
In this paper, we review the research literature on attachment and eating disorders and suggest a framework for assessing and treating attachment functioning in patients with an eating disorder. Treatment outcomes for individuals with eating disorders tend to be moderate. Those with attachment-associated insecurities are likely to be the least to benefit from current symptom-focused therapies. We describe the common attachment categories (secure, avoidant, anxious), and then describe domains of attachment functioning within each category: affect regulation, interpersonal style, coherence of mind, and reflective functioning. We also note the impact of disorganized mental states related to loss or trauma. Assessing these domains of attachment functioning can guide focused interventions in the psychotherapy of eating disorders. Case examples are presented to illustrate assessment, case formulation, and group psychotherapy of eating disorders that are informed by attachment theory. Tailoring treatments to improve attachment functioning for patients with an eating disorder will likely result in better outcomes for those suffering from these particularly burdensome disorders.
在本文中，我们回顾了有关依恋和饮食失调的研究文献，并提出了一个评估和治疗饮食失调患者依恋功能的框架。饮食失调患者的治疗效果往往是中等的。那些存在与依恋相关的不安全感的人可能最不能从当前以症状为中心的治疗中受益。我们描述了常见的依恋类别（安全型、回避型、焦虑型），然后描述了每个类别的依恋功能领域：情绪调节、人际风格、思维连贯性和反思功能。我们还注意到与丧失或创伤相关的紊乱心理状态的影响。评估这些依恋功能领域可以指导饮食失调的心理治疗中的有针对性干预。通过依恋理论，我们提出了案例示例来说明饮食失调的评估、案例制定和团体心理治疗。针对改善饮食失调患者的依恋功能量身定制治疗方法，可能会改善这些特别困扰的疾病患者的预后。
