Adult attachment, depression, and eating disorder symptoms: The mediating role of affect regulation strategies

The study examined the role of affect regulation strategies in mediating the relationship between attachment dimensions and both depressive and eating disorder (ED) symptoms. Participants were 310 women seeking treatment for an ED. Structural equation modeling indicated that attachment anxiety contributed to both depressive symptoms and ED symptoms through emotional reactivity. In contrast, only the association between attachment avoidance and depressive symptoms was mediated by emotional deactivation: whereas attachment avoidance had a direct relationship with ED symptoms not mediated by emotional deactivation. The results suggest tailored clinical interventions that take into account attachment style and accompanying affect regulation strategies. Treatment of patients who experience attachment anxiety may emphasize impulse regulation, whereas treatment of ED patients with attachment avoidance could focus on gradual exposure to affective expression. (C) 2009 Elsevier Ltd. All rights reserved.