Attachment types and stigma affecting eating disorders patients’ help-seeking behaviors in families: A mixed-methods study.

Abstract

Eating Disorders (ED) are increasingly common mental illnesses. This study explored the link between ED stigma and attachment styles using grounded theory, combining self-report questionnaires adapted from the Adult Attachment Scale (AAS) with semi-structured interviews analyzed through Nvivo 14. Among 12 Chinese young female adults and adolescents aged over 15, about 83.33% were insecurely attached, often resulting in stigmatization of EDs, particularly within their family context, leading them to conceal their disorders from parents. Over 90% of those with stigma exhibited insecure attachment, predominantly of the preoccupied type. The analysis identified 2 Selective Codes, 4 Axial Codes, and 7 Open Codes related to ED stigma formation. The findings suggest that insecure family dynamics contribute to ED-related stigma, hindering help-seeking. Healthy family environments should promote open communication and support without body shaming. This research could inform future family therapy approaches and stigma-reduction strategies, though its online recruitment and small sample size limit generalizability. Further research with larger, more diverse samples is recommended.