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      Binge eating attitudes in community adolescent sample and relationships with interview-assessed attachment representations in girls: a multi-center study from North Italy


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          To compare community girls at risk and not at risk for binge eating (BE) in attachment representations through a narrative interview and to test the predictive role of attachment pattern(s) on the risk of binge eating among community girls.


          From 772 community adolescents of both sexes (33% boys) screened through the Binge Eating Scale (BES), 112 girls between 14 and 18 years, 56 placed in a group at risk for binge eating (BEG), and 56 matched peers, not at risk (NBEG), were assessed in attachment representations through the Friends and Family Interview (FFI).


          (1) Compared to NBEG, girls in the BEG showed more insecure-preoccupied classifications and scores, together with lower narrative coherence, mother’s representation as a secure base/safe haven, reflective functioning, adaptive response, and more anger toward mother. (2) Both insecure-dismissing and preoccupied patterns predicted 15% more binge-eating symptoms in the whole sample of community girls.


          Insecure attachment representations are confirmed risk factors for more binge eating, affecting emotional regulation and leading to “emotional eating”, thus a dimensional assessment of attachment could be helpful for prevention and intervention. Implications and limits are discussed.

          Level of evidence

          III. Evidence obtained from cohort or case–control analytic studies

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          Most cited references47

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          The assessment of binge eating severity among obese persons

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            Prevalence of eating disorders over the 2000–2018 period: a systematic literature review

            Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern.
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              The first 10,000 Adult Attachment Interviews: distributions of adult attachment representations in clinical and non-clinical groups.

              More than 200 adult attachment representation studies, presenting more than 10,500 Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) classifications, have been conducted in the past 25 years. In a series of analyses on the distributions of the AAI classifications in various cultural and age groups, fathers, and high-risk and clinical samples, we used the distribution of the combined samples of North American non-clinical mothers (23% dismissing, 58% secure, 19% preoccupied attachment representations, and 18% additionally coded for unresolved loss or other trauma) to examine deviations from this normative pattern, through multinomial tests and analyses of correspondence. The analyses were restricted to AAI classifications coded according to the Main, Goldwyn, and Hesse (2003) system. We did not find gender differences in the use of dismissing versus preoccupied attachment strategies, and the AAI distributions were largely independent of language and country of origin. Clinical subjects showed more insecure and unresolved attachment representations than the norm groups. Disorders with an internalizing dimension (e.g., borderline personality disorders) were associated with more preoccupied and unresolved attachments, whereas disorders with an externalizing dimension (e.g., antisocial personality disorders) displayed more dismissing as well as preoccupied attachments. Depressive symptomatology was associated with insecurity but not with unresolved loss or trauma, whereas adults with abuse experiences or PTSD were mostly unresolved. In order to find more reliable associations with clinical symptoms and disorders, future AAI studies may make more fruitful use of continuous AAI scales in addition to the conventionally used categorical classifications.

                Author and article information

                cecilia.pace@unige.it , ceciliapacequaranta@gmail.com
                Eat Weight Disord
                Eat Weight Disord
                Eating and Weight Disorders
                Springer International Publishing (Cham )
                12 April 2021
                12 April 2021
                : 27
                : 2
                : 495-504
                [1 ]GRID grid.5606.5, ISNI 0000 0001 2151 3065, Department of Educational Sciences (DISFOR), , University of Genoa, ; Corso Andrea Podestà, 2, 16128 Genova, GE Italy
                [2 ]GRID grid.7563.7, ISNI 0000 0001 2174 1754, Department of Psychology, , University of Milano-Bicocca, ; Piazza dell’Ateneo Nuovo, 1, Milan, Italy
                Author information
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                : 11 June 2020
                : 26 March 2021
                Funded by: Università degli Studi di Genova
                Original Article
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                © Springer Nature Switzerland AG 2022

                binge eating,attachment,adolescence,friends & family interview,community sample


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