Conference Agenda

Deliberate self-harm has been shown to be influenced by attachment status in numerous studies. The mechanisms mediating this relationship and accompanying attitudes and feelings towards the body are less well understood. This is partly due to a lack of assessment measures capable of evaluating underlying attitudes and feelings about the body. Available assessment measures tend to rely either on self-report or evaluation of body characteristics such as height or weight.

The mirror Interview is an innovative technique where the subject stands looking at their body image in front of a full-length mirror. An interview asks a standard set of questions, while standing out of sight. The interview is video recorded. Being confronted with one’s own body image whilst being asked questions about how one feels seems to be a powerful experience that has the potential to reveal deep seated attitudes and feelings towards the body. A coding system has been devised, and previous research has shown that the Mirror Interview can be rated reliably and can distinguish adolescents with and without personality disorder.

This research presents results of the Adult Attachment Interview and the Mirror Interview in 36 adolescents with self-harm and compares them to a similar group of adolescents with personality disorder but no self-harm as well as to a normative cohort.

More interestingly, a qualitative analysis was undertaken to identify mechanisms linking attachment status with feelings and attitudes to the body as assessed by the Mirror Interview. The results indicate that adolescents with self-harm are characterized by insecure attachment status and a sense of alienation towards their bodies, often accompanied by an underlying loathing or disgust.

Possible mechanisms underlying these associations will be explored.

Approximately 61 million adults in the United States live with some form of physical disability (CDC, 2020). Despite the size and diversity of this population, attachment research remains limited with respect to people with physical disabilities (PWPD) (Huebner et al., 1999; Hwang et al., 2009). Existing attachment literature has largely relied on able-bodied samples, demonstrating robust associations between attachment security and positive psychosocial outcomes, including higher self-esteem and more positive body image (Cash et al., 2004; Erdem, 2019; McBirney-Goc, 2016). The generalizability of these associations to PWPD, however, remains underexplored. This study investigates the relationship between attachment classification, disability-related variables, and dimensions of body image among PWPD. Using a mixed-methods design, 75 PWPD from across the United States were interviewed. The sample reflected a wide range of disability experiences, including congenital and acquired conditions, visible and invisible disabilities, and varying levels of functional impact. Each participant completed two semi-structured interviews: the Adult Attachment Interview (AAI; George et al., 1985) and the Mirror Interview (MI; Kernberg et al., 2006). Each participant also completed established self-report measures, including the Questionnaire on Disability Identity and Opportunity (Darling & Heckert, 2010). We hypothesized that attachment classifications among PWPD would not differ significantly from general population distributions and that attachment security would be associated with more positive disability identity and body image outcomes. Preliminary findings indicate a higher incidence of secure and unresolved attachment classifications among PWPD compared to general population samples. Attachment security was positively associated with endorsement of the social model of disability, while disability pride correlated with vocal calmness, positive maternal representations, and body esteem on the MI. This study aims to underscore the need for greater representation of PWPD in attachment research and to deepen understanding of the impact of early relational experiences on perceptions of the body, disability, and society.

Background. Body image–related difficulties are increasingly prevalent among adolescents and young adults in high-income European countries and are closely linked to attachment representations. In particular, insecure attachment has been associated with negative body representations, heightened sensitivity to interpersonal evaluation, and difficulties integrating bodily experiences within a coherent sense of self. In community samples, research in this field has relied almost exclusively on self-report questionnaires, which, despite good psychometric properties, have important limitations in capturing the embodied and relational dimensions through which attachment-related body image difficulties are expressed. Observational and interview-based methods can be alternatively recommended but are rarely used outside clinical settings due to their complexity and cost, especially in young adult populations.

This pilot study aims to explore body image–related vulnerability in Italian young adults using a multimethod approach. The main objectives are to evaluate the feasibility of the Italian authorized translation of the Mirror Interview (MI), to investigate the presence of body image, psychopathological and emotional, trauma or attachment related difficulties in a community sample.

Methods. Participants are young adults aged 18–29 recruited from the community. The MI is administered together with a set of validated self-report questionnaires assessing body image and uneasiness, internalizing symptoms, problematic social media use, attachment styles, alexithymia, and exposure to ACEs.

Results. The contribution will present preliminary findings, focusing on feasibility aspects of the MI and initial patterns of associations between interview-based dimensions and self-reported body image concerns, attachment insecurity, emotional awareness, and psychological symptoms.

Conclusions. This study addresses methodological gaps in body image research by integrating interview-based and self-report measures in a non-clinical Italian sample. Preliminary results are expected to inform future validation studies of the MI and to support attachment-informed models of body image vulnerability in young adulthood.

The transition to motherhood is a time of profound psychological and physical changes and often prompts a re-examination of early attachment experiences and caregiving histories . The perinatal period, defined as the time from pregnancy through one year postpartum, may present significant psychological challenges. An estimated 10–20% of perinatal women experience a perinatal mood and anxiety disorder (PMAD), and recent research has documented a notable increase in the prevalence of PMADs in the United States.

During this period, the body undergoes rapid and novel changes in the service of pregnancy and childbirth. Despite its clinical relevance, body image disturbance remains an underexamined dimension of PMADs. These bodily changes may intensify distress, particularly among individuals with vulnerabilities related to attachment, identity, and prior body image challenges. This study aims to examine the relationship between body image dissatisfaction, attachment classification, and perinatal mood and anxiety disorders.

Each participant will complete two semi-structured interviews: the Adult Attachment Interview (AAI; George et al., 1985) and the Mirror Interview (MI; Kernberg et al., 2006). Given the centrality of body experience in the perinatal population, this period offers a particularly meaningful opportunity to address body image directly.

This study is integrated with a therapy group within the Perinatal Psychiatry Center that is designed to address body image challenges. Preliminary clinical observations from the first 29 participants suggest that linking attachment narratives with embodied experience and body image history, supports increased reflective capacity, improved tolerance of the physical and emotional demands of the perinatal period, and insight into the intergenerational impact of body image distress and cultural body ideals. This highlights the clinical utility of integrating attachment-based assessment and group intervention to address perinatal body image disturbance and offers important insights for infant and perinatal mental health.