Abstract
<title>Abstract</title> <p>Background This paper aimed to present Bowlby's psychological theory of attachment considering recent neuroscientific developments. Evidence indicates intricate, bidirectional associations between early attachment-related difficulties, borderline personality disorder, and eating disorders. Methods We aimed to consider attachment styles and emotion regulation (ER) strategies in two clinical groups: anorexia nervosa (AN, n = 32), borderline personality disorder (BPD, n = 46) and healthy controls (HC, n = 41). Further, we focused on assessing brain cortical volume and its relationship with attachment. All participants underwent brain magnetic resonance imaging (MRI) combined with clinical and psychological measures (ASQ, PBI, EDS, CERQ, RESS-24 ALS-18, HADS, EAT-26, BPD Checklist and SCID-5-PD). Results The HCs appeared to predominantly exhibit a secure attachment style, whereas the clinical groups tended to display comparatively more insecure patterns, particularly of the anxious and avoidant types. In the clinical groups, maternal and paternal care correlated negatively with maladaptive ER and positively with adaptive ER strategies. For AN group maternal control correlated negatively with the volume of brain structures such as right insula and thalamus (bilateraly) but in the BPD group, we observed the opposite pattern; maternal control correlated positively with right insula and what is interesting with other brain structures such as: right and left lateral OFC or left medial OFC. Moreover, mother care correlated negatively with the volume of left amygdala, left and right rostral ACC, right caudal ACC in BPD group. Conclusions These findings appeared promising in understanding both distinct and transdiagnostic features of dysregulation/ attachment mechanisms in AN and BPD in view of improving diagnostic and therapeutic processes.</p>