[The role of dissociation, childhood maltreatment, and early attachment in the development and maintenance of anorexia nervosa].

Anorexia nervosa (AN) is a chronic, life-threatening psychiatric disorder that typically begins in adolescence and imposes a considerable psychological and socioeconomic burden on atients, families, and healthcare systems. Although biological, psychological, and social factors have been identified, the mechanisms underlying the development and maintenance of AN remain only partially understood. This review examines the role of dissociation, childhood maltreatment, and early attachment patterns in the pathogenesis of AN. Evidence from the literature indicates that dissociative phenomena are particularly prevalent among eating disorder patients and are strongly associated with emotional abuse, and insecure attachment. These findings suggest that both dissociation and attachment disturbances contribute to the development, and maintenance of AN symptom, where impaired emotional regulation may play a mediating role. Recognizing and addressing these mechanisms in psychotherapy may play a crucial role in facilitating recovery and improving therapeutic outcomes in individuals with severe and chronic forms of AN. Keywords: noexia nervosa, dissociation, childhood trauma, emotional abuse, early attachment, emotion regulation, psychotherapy.