Attachment and separation difficulties in eating disorders: A preliminary investigation

Abstract

Disruptions in normal attachment, signaled by intense separation distress, can be conceptualized as a central risk factor underlying the development of anorexia and bulimia nervosa. In a preliminary study of the hypothesis, Hansburg's Separation Anxiety Test, derived from Bowlby's attachment theory, was administered to eating-disordered inpatients. These patients evidenced significantly more severe separation and attachment difficulties than is normal in adolescence and in adults undergoing developmentally based relationship crises. They appear to make no cognitive distinction between brief, everyday leavetakings and more permanent breaks. The implications of these findings, and of Bowlby's attachment theory, for the understanding and treatment of eating disorders is discussed.