Caractéristiques associées à l’attachement insécure dans l’anorexie mentale

Abstract

ObjectivesThe aim of the study is to assess whether insecure attachment based on the model developed by Bartholomew and Horowitz (1991) is associated with more severe symptoms in anorexia nervosa, including self-esteem, personal concerns and disease severity. This attachment-based model, inspired by the theory of Bowlby, is conceptualized on two dimensions: Thoughts of self and thoughts of others. MethodOnly patients with anorexia nervosa have been taken in the study, with a screening using the Mini International Neuropsychiatric Interview (MINI). Based on Bartholomew and Horowitz attachment theory, all new patients with anorexia nervosa at the Nantes University Hospital addiction service were classified according to their mode of attachment (secure versus insecure) and scores on the Relationship Scales Questionnaire (RSQ). Scores assessing bodily concerns (Body Shape Questionnaire), self-esteem (Rosenberg scale) and disease severity (Morgan-Russell Scale) were then compared with a Wilcoxon test. In addition, we took into account body mass index (BMI), age and type of anorexia because these parameters could affect our variables. ResultsThe prevalence of insecure attachment was high (82.8%) in our sample with a higher value for the preoccupied attachment style. Patients in the insecure group have a particular profile and have a more severe psychopathology: Lower self-esteem, more important bodily concerns and lower scores on Russell and Morgan Scale. Statistical analysis showed no significant difference between the two groups on the variables BMI, age and type of anorexia. DiscussionThese results highlight the high prevalence of insecure attachment among patients with anorexia nervosa. They also invite clinicians to therapeutic strategies focusing on attachment and how to help these patients to work on their relationship difficulties.