Attachment, motivational systems and anorexia nervosa: A systematic review and proposed framework for eating disorders

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2023-03-02 DOI:10.1002/cpp.2845

José Miguel Budia, Carlos María Alcover, Juan José Fernández-Muñoz, Ascensión Blanco-Fernández, Miriam P. Félix-Alcántara

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Abstract

Introduction

There is a direct association between patients with insecure attachment style (IAS), behavioural inhibition (BIS) and behavioural activation (BAS) motivational systems, and anorexia nervosa (AN). However, the possible direct relationships between these three variables have not been studied.

Objective

The main objective of this study is to analyse the relationship between these variables and propose a framework for analysing and understanding these relationships.

Methodology

A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, searching the following terms: ‘anorexia’, ‘attachment’ and those related to motivational systems. The final search was limited to publications in English dated between 2014–2022 for ‘anorexia and attachment’ and 2010–2022 for ‘anorexia and BIS/BAS’.

Results

Of the 587 articles retrieved, 30 were included in this study for the textual data analysis of the relationship between anorexia and attachment (17), anorexia and motivational systems (10) and anorexia, attachment and motivational systems (3). An association between avoidant IAS, AN and hypersensitivity to punishment of the BIS was observed in the analysis. A relationship was also observed with hyperreinforcement sensitivity of the BAS. After reviewing the articles, a possible relationship between the three factors, along with other mediating factors, was found.

Discussion

AN is directly related to the avoidant IAS and to BIS. Similarly, bulimia nervosa (BN) was directly related with anxious IAS and BAS. However, contradictions were found in the BN–BAS relationship. This study proposes a framework for analysing and understanding these relationships.

Abstract Image

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依恋、动机系统和神经性厌食症：饮食失调的系统综述和拟议框架。

引言：具有不安全依恋风格（IAS）、行为抑制（BIS）和行为激活（BAS）动机系统的患者与神经性厌食症（AN）之间存在直接联系。然而，这三个变量之间可能存在的直接关系尚未得到研究。目的：本研究的主要目的是分析这些变量之间的关系，并提出分析和理解这些关系的框架。方法：根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价，搜索以下术语：“厌食症”、“依恋”和与动机系统相关的术语。最终搜索仅限于2014-2022年期间的英文出版物“厌食症与依恋”和2010-2022年期间的英语出版物“厌食病与BIS/BAS”。结果：在检索到的587篇文章中，有30篇被纳入本研究，用于分析厌食症与附件（17）、厌食症与动机系统（10）与厌食症之间的关系，依恋和动机系统（3）。在分析中观察到回避型IAS、An和对BIS处罚的敏感性之间的关联。还观察到BAS的超强化敏感性之间的关系。在回顾这些文章后，发现了这三个因素以及其他中介因素之间的可能关系。讨论：AN与回避型IAS和BIS直接相关。同样，神经性贪食症（BN）与焦虑性IAS和BAS直接相关。然而，在BN-BAS关系中发现了矛盾。本研究提出了一个分析和理解这些关系的框架。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.