Szalai Tamás Dömötör
Semmelweis University, Institute of Behavioural Sciences, Budapest, Hungary, E-mail:
Psychiatr Hung. 2020;35(3):307-321.
The transdiagnostic model provides a framework for a flexible, evidence-based cognitivebehavioral treatment for eating disorders, emphasizing low self-esteem, perfectionism, mood intolerance and inter - personal difficulties. Although attachment has a strong influence on these factors there is no treatment which focuses concurrently on both the cognitive-behavioral and the attachment-related maintaining factors underlying eating disorder symptoms. Thus, the aim was to test a short, multilevel treatment for eating disorders which integrates cognitive-behavioral and attachment interventions.
A 20-year-old female displayed mild binge eating disorder, anxious avoidant attachment style, critical body checking and high success-perfectionism demand. Symptom-relevant aspects of attachment were incor - porated into the personalized case model, and attachment interventions were integrated to the transdiagnostic cognitive-behavioral treatment framework. The improvement of the patient's attachment security and reflective functioning, and the decrease of social avoidance in low moods were associated with cessation of symptoms at a one month follow-up.
When attachment dysfunctions play a part in triggering or maintaining eating disorder symptoms a multi - level treatment targeting both attachment functioning and the cognitive-behavioral factors underlying symptoms.
跨诊断模型为饮食失调提供了一个灵活的、基于证据的认知行为治疗框架，强调低自尊、完美主义、情绪不耐受和人际困难。尽管依恋对这些因素有很大影响，但目前尚无一种治疗方法能同时关注饮食失调症状背后的认知行为和依恋相关维持因素。因此，本研究旨在测试一种整合了认知行为和依恋干预的短期、多层次饮食失调治疗方法。
一名20岁女性表现出轻度暴饮暴食症、焦虑回避型依恋风格、过度的身体检查以及对成功的完美主义要求。与症状相关的依恋方面被纳入个性化病例模型，并将依恋干预整合到跨诊断认知行为治疗框架中。在一个月后的随访中，患者依恋安全性和反思功能的改善以及情绪低落时社交回避的减少与症状的缓解相关。
当依恋功能障碍在引发或维持饮食失调症状中起作用时，一种针对依恋功能和症状背后认知行为因素的多层次治疗方法可能有效。
