title: Attachment and mentalization and their association with child and adolescent eating pathology: A systematic review.
abstract: OBJECTIVE
  Insecure attachment and mentalizing difficulties have been associated with eating pathology in adulthood. However, it is unclear whether eating pathology is associated with attachment or mentalization in children. The aim of this study is to systematically review the literature in this emerging field.
  
  
  METHODS
  Electronic databases were used to search for articles.
  
  
  RESULTS
  Twenty-two studies were identified. In the 15 studies investigating attachment, an association with eating pathology was found in all studies. Mentalizing difficulties and eating pathology were found to be correlated in the seven studies which examined their association.
  
  
  CONCLUSIONS
  In keeping with the adult literature, cross-sectional studies of children and adolescents consistently report associations with eating pathology. There is some evidence from prospective studies that insecure attachment may be a risk factor for the development of eating pathology in adolescence. The literature on mentalization and eating pathology suggests that adolescents with anorexia nervosa may have difficulties in recognizing emotions. Further research using clinical samples and well-validated measures of attachment and mentalization are required to shed further light on this area.
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Jewell
authors.affiliation: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Collyer
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
authors.forename: Tessa
authors.initials: T
authors.lastname: Gardner
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom.
authors.forename: Kate
authors.initials: K
authors.lastname: Tchanturia
authors.affiliation: Child and Adolescent Eating Disorders Service, South London and Maudsley NHS Foundation Trust, United Kingdom.
authors.forename: Mima
authors.initials: M
authors.lastname: Simic
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Fonagy
authors.affiliation: Child and Adolescent Eating Disorders Service, South London and Maudsley NHS Foundation Trust, United Kingdom.
authors.forename: Ivan
authors.initials: I
authors.lastname: Eisler
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D004644:Emotions; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009769:Object Attachment; D011446:Prospective Studies; D012307:Risk Factors; D056345:Theory of Mind; D055815:Young Adult
keywords: adolescents; attachment; children; eating pathology; mentalization