Understanding Anorexia Nervosa and Bulimia Nervosa from an Attachment Perspective

Using the Attachment History Questionnaire (AHQ), 30 female anorectic and bulimic inpatients were compared to a control group of 31 primarily female social work students to determine the connection between anorexia and bulimia and early childhood attachment relationships. As predicted, the results indicated that the anorectics and bulimics differed significantly from the controls on all four subfactors of the AHQ: secure attachment base (Factor 1), parental discipline (Factor 2), threats of separation (Factor 3), and peer affectional support (Factor 4). Post hoc comparisons between the eating-disordered group and the controls on the fifty-one individual items of the AHQ showed that within Factor 1, the items involving feelings of being unwanted, alone, helpless, and of shame and guilt, clearly and significantly discriminated between groups. Within Factor 3, the item addressing the child feeling responsible for parental happiness produced significance. The results of this study are interpreted in relation to John Bowlby's attachment theory and the clinical implications are discussed.