Attachment, Mentalization and Eating Disorders: A review of studies using the Adult Attachment Interview

Objective: To examine the role of attachment and mentalization in eating disorders, as investigated using the Adult Attachment Interview. Method: A review of literature has been conducted in the Medline, Psychinfo, Embase and Cochrane databases. Results: Ten empirical research articles were found. Outcomes show a higher frequency of insecure attachment classifications in patients compared to a non-clinical population. No correlations were found between specific insecure attachment classifications and specific eating disorder diagnoses or symptoms. Mentalizing capacity was found to be lower in eating disorder patients than in controls. Discussion: Different outcomes on the frequency of specific attachment classifications in patient groups might be due to differences in sample size and in co-morbidity. All studies were cross-sectional. Insecure attachment and low mentalization might call for specific therapeutic interventions. Longitudinal cohort research on the relation between attachment, mentalization, symptoms and treatment outcome of eating disordered patients is required.