Self-Other Working Models and Eating Disorders
Friedberg, Naomi L., Lyddon, William J., Journal of Cognitive Psychotherapy
In this study, Bartholomew's (1990) four-category model of attachment (secure, preoccupied, dismissing, and fearful) was used to test Guidano's (1987) notion that the personal cognitive organization (P.C. Org.) of individuals with eating disorders is characterized by an enmeshed, preoccupied working model of attachment. Consistent with this characterization, Bartholomew's preoccupied and secure attachment dimensions were found to significantly discriminate a clinical eating disorder sample (n = 17) from normal subjects (n = 27).
In recent years, cognitive constructivists (particularly those with a developmental emphasis) have found attachment theory to be a viable conceptual framework for understanding individual differences in persons' theories of self and others (Guidano, 1991; Liotti, 1991; Lyddon & Alford, 1993; Mahoney, 1991; Safran & Segal, 1990). Attachment theory is based on the assertion that formative child-caregiver interactions have a significant influence on the child's emerging self-image and the way in which he or she relates to others (Ainsworth, 1989; Bowlby, 1973, 1988). In particular, attachment theorists hypothesize that experiences with caregivers become represented in the form of expectations or "internal working models" of self and others, which may persist into adolescence and adulthood, shaping one's developmental experiences and behaviors (Ainsworth, 1989; Bowlby, 1988; Weiss, 1982).
Recently, attachment researchers have begun to focus on the way in which individual differences in adolescent and adult attachment may be related to psychological difficulties and adjustment (Bartholomew & Horowitz, 1991; Collins & Read, 1990; Fonagy, Steele, & Steele, 1991; Hazen& Shaver, 1987, 1990; Main & Cassidy, 1988; Main, Kaplan, & Cassidy, 1985; Sperling, Berman & Fagen, 1992; West & Sheldon, 1988). In particular, a significant line of attachment research has begun to connect the onset, development, and maintenance of eating disorders to early insecure attachment experiences, separation and individuation from the attachment figure during adolescence, and perpetuation of insecure attachments in adult relationships (Armstrong & Roth, 1989; Friedlander & Siegel, 1990; Heesacker & Neimeyer, 1990; Humphrey, 1987; Kenny & Hart, 1992). While this research is significant in that it points to an association between persons' level of attachment security (in a general sense) and eating disorder symptomatology, no research to date has identified the personal styles of insecure attachment that may be related to disordered eating phenomena. Guidano (1987) has suggested that the personal cognitive organization (P.C. Org.) of individuals with eating disorders is characterized by a "loose" demarcation between self and others whereby personal identity is organized around a strong need for approval by significant others coupled with a fear of being rejected by significant others. In attachment terms, this working model of attachment has been termed "enmeshed" (Guidano, 1987) or "preoccupied" (Bartholomew & Horowitz, 1991). The purpose of this paper is to test Guidano's contention. Toward this end, we (a) review recent research on adult attachment styles, with a focus on the Bartholomew model (Bartholomew, 1990), (b) review relevant developmental and personality literature related to disordered eating, and (c) present a study designed to investigate hypothesized relationships between attachment style and disordered eating.
In recent years, the study of attachment has been extended to the developmental periods of adolescence and adulthood (for a review, see Lyddon, Bradford, & Nelson, 1993). The research seeking to empirically classify typologies of adult attachment was pioneered by Mary Main and her colleagues (Main Kaplan, & Cassidy, 1985; Main & Goldwyn, 1984, 1990). Specifically, the development of the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) allowed for studies on the intergenerational transmission of internal working models and attachment. …