title: Attachment Insecurity Predicts Punishment Sensitivity in Anorexia Nervosa.
abstract: Individuals with anorexia nervosa (AN) experience insecure attachment. We investigated whether insecure attachment is associated with punishment and reward sensitivity in women with AN. Women with AN (n = 24) and comparison women (n = 26) (CW) completed The Eating Disorder Examination Questionnaire, Depression Anxiety Stress Scale, The Attachment Style Questionnaire, and Sensitivity to Punishment/Sensitivity to Reward Questionnaire. Participants with AN returned higher ratings for insecure attachment (anxious and avoidant) experiences and greater sensitivity to punishment (p = 0.001) than CW. In AN, sensitivity to punishment was positively correlated with anxious attachment and negative emotionality but not eating disorder symptoms. Regression analysis revealed that anxious attachment independently predicted punishment sensitivity in AN. Anxious attachment experiences are related to punishment sensitivity in AN, independent of negative emotionality and eating disorder symptoms. Results support ongoing investigation of the contribution of attachment experiences in treatment and recovery.
authors.affiliation: *Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Art and Design, Swinburne University of Technology, Hawthorn; †Department of Psychiatry, St. Vincent's Hospital, Melbourne; ‡Department of Psychiatry, The University of Melbourne, Melbourne; §Austin Health, Heidelberg; ∥The Melbourne Clinic, Melbourne; and ¶Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Keating
authors.forename: David J
authors.initials: DJ
authors.lastname: Castle
authors.forename: Richard
authors.initials: R
authors.lastname: Newton
authors.forename: Chia
authors.initials: C
authors.lastname: Huang
authors.forename: Susan L
authors.initials: SL
authors.lastname: Rossell
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D005260:Female; D006801:Humans; D009769:Object Attachment; D011678:Punishment / Q000523:psychology*; D012201:Reward; D055815:Young Adult