Are eating disorders linked to transmission by parents of high anxiety attachment models?

Grazia Attili, Emeritus Professor at Sapienza Rome University,  Rome, Italy

Lorenza Di Pentima & Alessandro Toni, Researchers at Sapienza Rome University,  Rome, Italy

Antonio Roazzi, Full Professor at Federal University of Pernambuco, Recife-PE, Brazil

In the last decades, a group of researchers from Italy and Brazil  has been carrying out a series of research on attachment and its implications on human behavior based on an International Inter-university Agreement to develop a project called “The study of attachment dynamics from childhood to adulthood” between the Department of Social Sciences DISS at Sapienza Rome University (Italy) and the Department of Psychology at Federal University of Pernambuco (Brazil) coordinated in Italy by Professor Grazia Attili and in Brazil by Professor Antonio Roazzi.

This article stems from this agreement and cooperation. In this paper “High Anxiety Attachment in Eating Disorders: Intergenerational Transmission by Mothers and Fathers” appeared in Paidéia 2018 (Vol. 28) Grazia Attili, Lorenza Di Pentima, Alessandro Toni, and Antonio Roazzi found in patients with eating disorders (ED) not only a prevalence of insecure attachment working models (IWMs), in line with what had been revealed by previous research and their own studies, but also a prevalence of IWMs characterized by very high separation anxiety (HAIWMs). These HAIWMs were found in all patients regardless of the type of IWM (i.e., in ambivalent, avoidant and disorganized patients), a result which goes beyond what was highlighted by Armstrong and Roth (1989) who found “high anxiety” just in their ambivalent patients. Furthermore, the Italian and Brazilian scholars found that patient’ parents too presented “high anxiety IWMs” and that these HAIWMs were associated to those of their children affected by ED.

Based on these results, this paper gives evidence to the particular importance that the intergenerational transmission of attachment has within this clinical population (VALDANHA; SCORSOLINI-COMIN; SANTOS, 2013), mainly in cases where parents may also reveal high anxiety IWMs. The instrument used to assess the IWMs was Klagsbrun and Bowlby’s Separation Anxiety Test (SAT) (KLAGSBRUN; BOWLBY, 1976), in the Italian validated version by Attili. This test is particularly useful when it is necessary to have data concerning the extent to which respondents reflect on beliefs and emotions connected to being away from an attachment figure. A sample of 55 patients with an ED, a control group made up of 80 participants, their mothers and fathers participated in the investigation. Indeed the two groups differed significantly, with a prevalence of HAIWMs in patients and their parents compared to controls.

The implication is that patients with an ED might benefit more from individual attachment-based therapy and/or a family therapy than from other types of psychotherapeutic approaches.


ARMSTRONG, D. M.; ROTH, J. G. Attachment and separation difficulties in eating disorders: A preliminary investigation. International Journal of Eating Disorders, v. 8, n. 2, p. 141-155, 1989. E-ISSN: 1098-108X [viewed 7 November 2018]. DOI: 10.1002/1098-108X(198903)8:2<141::AID-EAT2260080203>3.0.CO;2-E. Available from:

KLAGSBRUN, M.; BOWLBY, J. Responses to separation from parents: A clinical test for young children. British Journal of Projective Psychology & Personality Study, v. 21, n. 2, p. 7-27, 1976. ISSN: 0309-7757 [reviewed 7 November 2018]. Available from:

VALDANHA, É. D., SCORSOLINI-COMIN, F. and SANTOS, M. A. Anorexia nervosa e transmissão psíquica transgeracional. Rev. latinoam. psicopatol. fundam. 2013, v. 16, n. 1, p. 71-88, 2013. ISSN: 1415-4714 [viewed 7 November 2018].  DOI: 10.1590/S1415-47142013000100006. Available from:

To read the article, access

ATTILI, G. et al. High anxiety attachment in eating disorders: intergenerational transmission by mothers and fathers. Paidéia (Ribeirão Preto), v. 28, e2813, 2018. ISSN: 0103-863X [viewed 7 November 2018]. DOI: 10.1590/1982-4327e2813. Available from:

External link

Paidéia (Ribeirão Preto) – PAIDEIA:


How to cite this post [ISO 690/2010]:

ATTILI, G., PENTIMA, L. D., TONI, A. and ROAZZI, A. Are eating disorders linked to transmission by parents of high anxiety attachment models? [online]. SciELO in Perspective: Humanities, 2018 [viewed ]. Available from:


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