Attachment insecurities, maladaptive perfectionism, and eating disorder symptoms: A latent mediated and moderated structural equation modeling analysis across diagnostic groups

Antonios Dakanalis, C. Alix Timko, M. Assunta Zanetti, Lucio Rinaldi, Antonio Prunas, Giuseppe Carrà, Giuseppe Riva, Massimo Clerici

Research output: Contribution to journalArticle

Abstract

Although 96-100% of individuals with eating disorders (EDs) report insecure attachment, the specific mechanisms by which adult insecure attachment dimensions affect ED symptomatology remain to date largely unknown. This study examined maladaptive perfectionism as both a mediator and a moderator of the relationship between insecure attachment (anxiety and avoidance) and ED symptomatology in a clinical, treatment seeking, sample. Insecure anxious and avoidant attachment, maladaptive perfectionism, and ED symptomatology were assessed in 403 participants from three medium size specialized care centres for EDs in Italy. Structural equation modeling indicated that maladaptive perfectionism served as mediator between both insecure attachment patterns and ED symptomatology. It also interacted with insecure attachment to predict higher levels of ED symptoms - highlighting the importance of both insecure attachment patterns and maladaptive aspects of perfectionism as treatment targets. Multiple-group comparison analysis did not reveal differences across diagnostic groups (AN, BN, EDNOS) in mediating, main and interaction effects of perfectionism. These findings are consistent with recent discussions on the classification and treatment of EDs that have highlighted similarities between ED diagnostic groups and could be viewed through the lens of the Trans-theoretical Model of EDs. Implications for future research and intervention are discussed.

Original languageEnglish
Pages (from-to)176-184
Number of pages9
JournalPsychiatry Research
Volume215
Issue number1
DOIs
Publication statusPublished - Jan 30 2014

Keywords

  • Attachment anxiety
  • Attachment avoidance
  • Eating disorders
  • Mediator
  • Moderator
  • Perfectionism
  • Structural equation modeling

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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