title: Structural relationships among attachment insecurity, alexithymia, and body esteem in women with eating disorders.
abstract: Patients with eating disorders tend to experience low levels of body esteem. To assess the psychosocial processes that may predict low body esteem in these individuals, we assessed the structural interrelations among attachment anxiety, attachment avoidance, alexithymia, and body esteem in a cross-sectional sample of patients with eating disorders. We tested a model in which alexithymia mediates the relationship between attachment insecurity and body esteem. Participants were 300 women with anorexia nervosa (n = 109), bulimia nervosa (n = 130), and eating disorders not otherwise specified (n = 61) who completed pretreatment self-report questionnaires at intake for a day hospital treatment program. We found a direct and negative relationship between attachment anxiety and body esteem. Additionally, attachment avoidance had an indirect negative relationship to body esteem through alexithymia. These results indicate that therapists may attend to attachment insecurity and affective regulation strategies when addressing body image issues in patients with eating disorders.
authors.affiliation: Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada. lkeating@yorku.ca
authors.forename: Leah
authors.initials: L
authors.lastname: Keating
authors.forename: Giorgio A
authors.initials: GA
authors.lastname: Tasca
authors.forename: Robert
authors.initials: R
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy; D001007:Anxiety; D001828:Body Image / Q000523:psychology*; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy; D003430:Cross-Sectional Studies; D001068:Feeding and Eating Disorders / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009769:Object Attachment; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ASQ; Alexithymia; Attachment Styles Questionnaire; Attachment anxiety; Attachment avoidance; BESAA; Body Esteem Scale for Adolescents and Adults; Body esteem; Body image; CFI; Comparative Fit Index; Eating disorders; RMSEA; SCDT; TAS; Toronto Alexithymia Scale; root mean square error of approximation; sequential chi-square difference test