Attachment Interventions in the Treatment of a Case of Binge Eating Disorder.

Background: The transdiagnostic model provides a framework for a flexible, evidence-based cognitivebehavioral treatment for eating disorders, emphasizing low self-esteem, perfectionism, mood intolerance and inter - personal difficulties. Although attachment has a strong influence on these factors there is no treatment which focuses concurrently on both the cognitive-behavioral and the attachment-related maintaining factors underlying eating disorder symptoms. Thus, the aim was to test a short, multilevel treatment for eating disorders which integrates cognitive-behavioral and attachment interventions.

Case presentation: A 20-year-old female displayed mild binge eating disorder, anxious avoidant attachment style, critical body checking and high success-perfectionism demand. Symptom-relevant aspects of attachment were incor - porated into the personalized case model, and attachment interventions were integrated to the transdiagnostic cognitive-behavioral treatment framework. The improvement of the patient's attachment security and reflective functioning, and the decrease of social avoidance in low moods were associated with cessation of symptoms at a one month follow-up.

Conclusions: When attachment dysfunctions play a part in triggering or maintaining eating disorder symptoms a multi - level treatment targeting both attachment functioning and the cognitive-behavioral factors underlying symptoms.