Chan Clarice, Donnelly Cecily, Eshetu Aphrodite, Nicholls Dasha
Faculty of Medicine, Imperial College London, London, UK.
Division of Psychiatry, Department of Brain Science, Faculty of Medicine, Imperial College London, 2nd Floor Commonwealth Building, Du Cane Road, London, W12 0 NN, UK.
J Eat Disord. 2025 Jul 8;13(1):130. doi: 10.1186/s40337-025-01273-3.
Adolescence is a critical period in the development of eating disorders (ED) and the influence of peers becomes increasingly evident in shaping behaviour. Insecure attachment to parents is associated with higher ED risk, but the impact of attachment to peers is unknown. This systematic review aims to ascertain the role of peer attachment in ED symptoms and body dissatisfaction in adolescents.
Electronic databases Medline, Embase, PsychINFO, and Scopus were searched using the search terms related to adolescents, eating disorders, peers, and attachment.
Out of the 19 included studies (n = 15 cross-sectional, n = 4 Longitudinal), most (n = 17) used the Peer subscale of the 'Inventory of Parent and Peer Attachment (IPPA)' to measure peer attachment. The prevalence of insecure attachment was higher in populations with ED symptoms compared to those without. Lower attachment scores were associated with higher ED symptomology and body dissatisfaction. Out of the 3 subscales of the IPPA, alienation emerged as the most significant predictor of symptomology.
Insecure attachment to peers may be a risk factor in the development of ED symptoms and body dissatisfaction, but the protective role of secure attachment remains unclear. More longitudinal research is required to disentangle this relationship and ascertain the clinical significance of peer attachment in prognosis or intervention.
青春期是饮食失调（ED）发展的关键时期，同伴在塑造行为方面的影响日益明显。与父母的不安全依恋与更高的饮食失调风险相关，但与同伴的依恋影响尚不清楚。本系统评价旨在确定同伴依恋在青少年饮食失调症状和身体不满中的作用。
使用与青少年、饮食失调、同伴和依恋相关的搜索词，对电子数据库Medline、Embase、PsychINFO和Scopus进行检索。
在纳入的19项研究中（n = 15项横断面研究，n = 4项纵向研究），大多数（n = 17）使用“父母与同伴依恋量表（IPPA）”的同伴分量表来测量同伴依恋。与没有饮食失调症状的人群相比，有饮食失调症状的人群中不安全依恋的患病率更高。较低的依恋分数与更高的饮食失调症状和身体不满相关。在IPPA的3个分量表中，疏离感是症状最显著的预测因素。
与同伴的不安全依恋可能是饮食失调症状和身体不满发展的一个危险因素，但安全依恋的保护作用仍不清楚。需要更多的纵向研究来理清这种关系，并确定同伴依恋在预后或干预中的临床意义。
