This cross-cultural comparison study examined the direct and indirect effects (via several cognitive-affective pathways) of insecure attachment on bulimic behaviors and explored cultural similarities and differences in all pathways of the indirect effect model between female university students from the U.S. and Korea. Our findings from the two cultural samples (N = 421 for the Korean sample, N = 271 for the U.S. sample) generally indicated that both insecure attachment variables were associated with bulimia through three-sequential mediational functions of maladaptive perfectionism, lowered self-esteem, and heightened depression. However, the results also highlighted several culturally specific nuances in the indirect effect paths through which adult attachment insecurity affects bulimic behavior (e.g., adult attachment was indirectly associated with bulimia via maladaptive perfectionism and self-esteem only for the U.S. group). Findings are discussed from the perspectives of adult attachment theory, trans-diagnostic theory, and local cultural context. Limitations, future research directions, and counseling implications are presented.

这项跨文化比较研究检查了不安全依恋对暴食行为的直接和间接影响（通过几种认知-情感途径），并探讨了美国和韩国女大学生之间间接影响模型所有途径的文化异同。我们从两个文化样本中的发现（韩国样本N  = 421，N = 美国样本 = 271）通常表明，两个不安全依恋变量都通过适应不良完美主义、自尊心降低和抑郁加剧的三个连续中介功能与贪食症相关。然而，研究结果还强调了成人依恋不安全感影响暴食行为的间接影响路径中的几个文化特定的细微差别（例如，成人依恋通过适应不良的完美主义和自尊与贪食症间接相关，仅适用于美国群体）。从成人依恋理论、跨诊断理论和当地文化背景的角度讨论了研究结果。提出了局限性、未来的研究方向和咨询意义。