ABSTRACT

Research shows that the Unresolved-disorganized attachment representation (U), resulting from experiences of loss or abuse, is associated with a range of psychiatric conditions. However, clinical implications of U are yet unclear.

Objective: To investigate how U is related to symptoms and recovery of eating disorder (ED) patients.

Method: First, 38 ED patients starting psychotherapeutic treatment were compared to 20 controls without ED on the prevalence of U, assessed with the Adult Attachment Interview. Second, in the patient group relations between U and ED symptoms, depression, anxiety and subjective experience of symptoms were investigated. Third, we compared, 1 year afterwards, recovery of patients with and without U.

Results: The prevalence of U was higher in ED patients than in controls. Symptom severity was not related to U. ED patients with U at the start of treatment improved significantly more regarding anxiety, depression and subjective experience of symptoms than did patients without U.

Discussion: The differential recovery of ED patients with or without U confirms the trauma-related heterogeneity of patients found in other diagnostic groups and calls for further investigation into the treatment needs of patients with different attachment representations.

摘要

研究表明，由于失去或虐待的经历而导致的未解决的混乱依恋表征 (U) 与一系列精神疾病有关。然而，U 的临床意义尚不清楚。

目的：研究 U 与饮食失调 (ED) 患者的症状和恢复之间的关系。

方法：首先，将 38 名开始心理治疗的 ED 患者与 20 名没有 ED 的对照组比较 U 的患病率，并通过成人依恋访谈进行评估。其次，在患者组中，调查了 U 和 ED 症状、抑郁、焦虑和症状的主观体验之间的关系。第三，我们比较了 1 年后有和没有 U 的患者的恢复情况。

结果： ED 患者 U 的患病率高于对照组。症状严重程度与 U 无关。在治疗开始时 U 的 ED 患者在焦虑、抑郁和症状的主观体验方面比没有 U 的患者改善得更多。

讨论：有或没有 U 的 ED 患者的不同恢复证实了在其他诊断组中发现的患者与创伤相关的异质性，并呼吁进一步调查具有不同依恋表现的患者的治疗需求。