Body image disturbance, parental bonding and alexithymia in patients with eating disorders

To evaluate if body image disturbance and alexithymia, two major clinical features of eating disorders (ED), are predicted by an altered parental bonding.

64 female ED outpatients and 68 female healthy controls were assessed by means of the Parental Bonding Instrument (PBI), the Body Uneasiness Test (BUT), and the Toronto Alexithymia Scale (TAS-20). Pearson's correlations and multiple stepwise regression analysis were applied to explore the contribution of PBI factors on BUT and TAS scores.

BUT weight phobia, body image concerns, avoidance, depersonalization, Global Severity Index and positive symptom total were predicted by low parental care, while compulsive self-monitoring was predicted by parental overprotection. TAS total score and difficulty in describing feelings were predicted by low maternal care.

Body image disturbance in ED may be conceptualized as a deficit in self-development, resulting from failures in parent-child interactions which impaired the ability to distinguish bodily needs from emotional experiences.