Alexithymia Mediates the Relationship Between Insecure Attachment and Eating Disorder Symptoms
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Alexithymia Mediates the Relationship Between Insecure Attachment and Eating Disorder Symptoms Iratxe Redondo1 · Patrick Luyten2 Accepted: 15 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Insecure attachment and alexithymia have traditionally been associated with eating disorders. However, research has recently started to examine the specific mechanisms by which attachment insecurity affect disordered eating. The aim of this study was therefore to investigate the hypothesis that alexithymia mediates the relationships between insecure attachment patterns and eating disorders (EDs) and to test the relative contribution of each component of alexithymia. 323 female university students and 38 anorexic patients completed questionnaires on attachment, alexithymia and ED symptoms within a structural equation modeling approach. Insecure attachment was related to alexithymia, specifically difficulty identifying feelings (DIF) and difficulty describing feelings (DDF) subscales of the Toronto Alexithymia Scale. Furthermore, alexithymia scores were associated with eating disorder symptoms. However, only DIF mediated the relationship between attachment insecurity and ED symptoms. Despite the limitations of the cross-section design, attachment and alexithymia seem to be an important focus when preventing and treating EDs. Keywords Attachment · Alexithymia · Eating disorders · Anorexia · Mediation
Introduction Eating disorders (EDs) are one of the most common chronic mental health conditions among adolescents and young adults, with studies showing a lifetime prevalence of around 0.9% for anorexia nervosa, 0.9–1.5% for bulimia nervosa and 1.9% for binge eating disorder (Smink et al. 2012). The negative health correlates associated with EDs such as its high mortality rate (Arcelus et al. 2011) and the high * Iratxe Redondo [email protected] 1
University of the Basque Country (UPV/EHU), Barrio Sarriena s/n office number: 3S12B, 48940 Leioa, Bizkaia, Spain
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Department of Clinical Psychology, University of Leuven (KU Leuven), Tiensestraat 102, Box 3722, 3000 Louvain, Belgium
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cost of their treatments (Bardach et al. 2014) ask for further investigation of factors implicated in their etiology and maintenance of EDs (Keating et al. 2013). Several theoretical approaches in relation to EDs have received empirical support (Stein et al. 2001). Over the past decades, attachment theory (Bowlby 1973) has emerged as one of the most important frameworks for those seeking a cognitiveaffective and relational understanding of eating disorders (Kuipers and Bekker 2012; O’Shaughnessy and Dallos 2009). Attachment theory asserts that the quality of the interactions between the children and the caregiver become encoded in the implicit memory system and these develop into internal working models of attachment (Fariborz et al. 1996). Internal working models become the bases for consistent ways in which children and adults interact with the world
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