title: Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients.
abstract: OBJECTIVE
  To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients.
  
  
  METHODS
  We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires.
  
  
  RESULTS
  Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables.
  
  
  CONCLUSIONS
  Eating disorder patients' low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.
authors.affiliation: a GGZ Breburg, Unit for Eating Disorders , Tilburg , The Netherlands.
authors.forename: Greet S
authors.initials: GS
authors.lastname: Kuipers
authors.affiliation: a GGZ Breburg, Unit for Eating Disorders , Tilburg , The Netherlands.
authors.forename: Zara
authors.initials: Z
authors.lastname: van Loenhout
authors.affiliation: b Research Institute of Child Development and Education , University of Amsterdam , Amsterdam , The Netherlands.
authors.forename: L Andries
authors.initials: LA
authors.lastname: van der Ark
authors.affiliation: c Department of Medical and Clinical Psychology , Tilburg University , Tilburg , The Netherlands.
authors.forename: Marrie H J
authors.initials: MH
authors.lastname: Bekker
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D001068:Feeding and Eating Disorders; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D009426:Netherlands; D009769:Object Attachment; D010554:Personality Disorders; D057566:Self Report; D013315:Stress, Psychological; D056345:Theory of Mind; D055815:Young Adult
keywords: AAI; attachment; co-morbidity; eating disorders; mentalization