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Joshua PR, Lewis V, Simpson S, Kelty SF, Boer DP. What role do early life experiences play in eating disorders? The impact of parenting style, temperament and early maladaptive schemas. Clin Psychol Psychother 2023. [PMID: 37654072 DOI: 10.1002/cpp.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE Given that most eating disorders develop in adolescence and early adulthood, early life experiences are said to play a key role in the aetiology of eating disorders. There are well-documented relationships between early maladaptive schemas and eating disorders, early maladaptive schemas and temperament and temperament and perceived parenting style. The present study aimed to test a hypothesis that perceived parenting style predicts temperament, which predicts early maladaptive schemas, which predict eating disorder symptoms in young people. METHOD An online survey measured perceived parenting style, temperament, early maladaptive schemas and eating disorder symptoms in 397 people with disordered eating between the ages of 18 and 29. Path analysis was used to investigate the relationship between these elements. RESULTS The results found support for this hypothesis. Perceived maladaptive parenting ratings for mothers were a stronger predictor of temperament, and only two temperament factors were adequate predictors of early maladaptive schemas. CONCLUSIONS Overall, the present study found preliminary support for a linear relationship where perceived parenting style predicts temperament, which predicts early maladaptive schema levels, which predicts eating disorder symptoms. The present study was the first to propose and test this model; however, further research is required to confirm the nature and extent of this relationship.
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Affiliation(s)
- Phoebe R Joshua
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Vivienne Lewis
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Susan Simpson
- University of South Australia, Adelaide, South Australia, Australia
- NHS Forth Valley, Stirling, UK
| | - Sally F Kelty
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Douglas P Boer
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
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Watterson RL, Crowe M, Jordan J, Lovell S, Carter JD. A Tale of Childhood Loss, Conditional Acceptance and a Fear of Abandonment: A Qualitative Study Taking a Narrative Approach to Eating Disorders. QUALITATIVE HEALTH RESEARCH 2023; 33:270-283. [PMID: 36655325 PMCID: PMC10061620 DOI: 10.1177/10497323231152142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Eating disorders (EDs) are serious mental health illnesses, yet there is a need to better understand the illness experience to improve treatment outcomes. Qualitative research, and narrative approaches in particular, can elicit life stories that allow for the whole illness journey to be explored. This study aimed to explore the experiences of women with a history of an ED, identifying the life events they perceived were relevant to the onset of their ED through to recovery. Interviews were conducted with 18 women with lived experience of an ED. Through structural narrative analysis, an overarching storyline of childhood loss contributing to a belief of conditional acceptance, fear of abandonment and struggle to seek emotional support due to the fear of being a burden was identified. Negative experiences with the health sector were common. These findings have implications for the way medical professionals respond to help seeking and deliver treatment.
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Affiliation(s)
| | - Marie Crowe
- University of Otago, Christchurch, New Zealand
| | | | - Sarah Lovell
- University of Canterbury, Christchurch, New Zealand
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3
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Huckstepp TJ, Allen A, Maher AL, Houlihan C, Mason J. Factor structure of the Young Positive Schema Questionnaire in an eating disorder sample. Eat Weight Disord 2023; 28:13. [PMID: 36800100 PMCID: PMC9938060 DOI: 10.1007/s40519-023-01549-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/02/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE The Young Positive Schema Questionnaire (YPSQ) measures early adaptive schemas (EAS) which could be used to develop positive psychology and schema-based interventions to benefit the treatment of eating disorders (EDs). METHODS The present study investigated the factor structure of the YPSQ in a sample of 826 participants (18-73 years; n = 753 women) with ED symptomatology (e.g., restricting, binging, and purging). The sample was randomly split into two groups for exploratory and confirmatory factor analyses. Full sample analysis using Pearson correlations was conducted to explore convergent validity of the new YSPQ factor structure with ED symptomatology, emotional regulation, and cognitive flexibility. RESULTS A nine-factor model was found, demonstrating good fit indices and internal consistency (α = 0.77-0.92). The YPSQ showed an inverse relationship to ED symptomatology and emotional suppression, and a positive relationship with cognitive flexibility and emotion reappraisal. CONCLUSION Further research is needed to explore the clinical benefits of the YPSQ to identify EAS deficits in individuals with EDs to improve treatment outcomes. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Tyrone J Huckstepp
- The Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
- Discipline of Psychology, School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Andrew Allen
- The Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.
- Discipline of Psychology, School of Health, University of the Sunshine Coast, Sunshine Coast, Australia.
| | - Anthea L Maher
- Discipline of Psychology, School of Health, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Catherine Houlihan
- Wandi Nerida, Residential Eating Disorders Facility, Mooloolah Valley, Sunshine Coast, QLD, Australia
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Early Maladaptive Schemas and Mental Disorders in Adulthood: a Systematic Review and Meta-analysis. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AbstractEarly maladaptive schemas (EMSs) are broad and pervasive themes regarding oneself and one’s relationships with others originating from adverse childhood experiences. Although the concept of EMSs was initially developed for the treatment of personality disorders, the associations of EMSs with a variety of other mental disorders have been investigated. The goal of the present study was to summarize and analyze the EMSs-disorder associations in studies in which patients with specific psychiatric diagnoses were compared to healthy controls. Of the 28 studies that met the inclusion criteria, 27 were included in a meta-analysis. Across diagnoses, all EMSs were elevated in the clinical groups. The largest effect sizes were observed for the social isolation, the negativity/pessimism, the defectiveness/shame, and social undesirability schemas. Depression (n = 8), borderline personality disorder (n = 5), and obsessive–compulsive disorder (n = 5) were the most frequently studied mental disorders. Heterogeneity between studies was high. Results suggest that mental disorders are not characterized by specific EMSs.
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5
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Zyoud SH, Shakhshir M, Abushanab AS, Koni A, Shahwan M, Jairoun AA, Al-Jabi SW. Mapping the landscape and structure of global research on binge eating disorder: Visualization and bibliometric analysis. World J Psychiatry 2022; 12:982-994. [PMID: 36051594 PMCID: PMC9331445 DOI: 10.5498/wjp.v12.i7.982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/22/2022] [Accepted: 06/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Binge-eating disorder (BED) is a clinical syndrome and is considered the most common type of eating disorder. However, our understanding of the global performance and progress of BED research is limited. AIM To describe and perform a bibliometric analysis of the state of BED research. METHODS The term 'Binge eating' was searched in the title throughout the previous year's up to December 31, 2020. We searched the Scopus and Reference Citation Analysis for publications on Binge eating. The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author, collaborative relationships between countries/regions, and to determine the hotspots related to binge eating research. In addition, conventional bibliometric indicators were generated. RESULTS The search strategy found 2713 total articles and an average of 62 articles per year. Among them, 'Article' represented 82.49% of the publications (n = 2238 articles) and was the most frequent type, followed by reviews (n = 243; 8.96%). The number of publications increased steadily during the last decade of the study period. One hundred and thirty-two countries contributed to binge eating research, with 1495 (55.11%) articles published in the United States, followed by Italy with 256 (9.44%), the United Kingdom with 183 (6.75%), and Germany with 182 (6.71%). Currently, the main hot topics related to BED are 'type of treatment and management and treatment provided to BED"; "processes and pathways to binge eating"; and 'diagnosis, signs and symptoms, comorbidities and prevalence and associated factors with BED'. CONCLUSION The number of publications has increased noticeably during the previous decade. There are indeed relatively few publications on BED from low-and middle-income nations, so much is to be learned from the experience of all countries. Studies on this topic are critical in all countries to discover risk factors and effective intervention measures. Although our findings are preliminary, they imply that the future prospects for interventions aimed at BED management are bright, focusing on complex models of care and long-term maintenance of therapeutic gains.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Poison Control and Drug Information Center, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Amani S Abushanab
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Amer Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Division of Clinical Pharmacy, Hematology and Oncology Pharmacy Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Moyad Shahwan
- Department of Pharmacy, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | | | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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Hatoum AH, Burton AL, Abbott MJ. Assessing negative core beliefs in eating disorders: revision of the Eating Disorder Core Beliefs Questionnaire. J Eat Disord 2022; 10:18. [PMID: 35144689 PMCID: PMC8830168 DOI: 10.1186/s40337-022-00542-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Increased theoretical and empirical attention has been given to examining the role of core beliefs in both the development and maintenance of eating disorders (EDs). The Eating Disorder Core Beliefs Questionnaire (ED-CBQ) is self-report measure designed to assess five dimensions of core beliefs relating to eating disorders; self-loathing, unassertive/inhibited, demanding/needing help and support, abandoned/deprived, and high standards for the self. The present study aimed to evaluate the psychometric properties of the ED-CBQ and to develop a revised and improved version of the original measure after evaluating its factor structure and related properties. METHODS A sample of undergraduate university students (N = 763) completed an online test battery of questionnaires. Putative ED-symptomatic (n = 384) and non-ED (n = 379) subgroups were created from self-reported responses from the Eating Disorder Examination Questionnaire (EDEQ). Confirmatory factor analyses (CFAs) were performed, and internal consistency, construct validity, group differences and clinical utility was examined. RESULTS An initial CFA did not support the original five-factor 40-item ED-CBQ. A revised version was developed that possessed equal or superior psychometric properties to the original 40-item measure. The ED-CBQ-R demonstrated superior model fit, similar levels of reliability and construct validity, and the ability to discriminate between putative ED diagnostic groups. CONCLUSIONS Our results suggest that the ED-CBQ-R is a valid, reliable, but more importantly an efficient and accessible measure with the potential to be utilised both clinically and in research settings.
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Affiliation(s)
- Amaani H Hatoum
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia
| | - Amy L Burton
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, NSW, Australia.
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Krug I, Arroyo MD, Giles S, Dang AB, Kiropoulos L, De Paoli T, Buck K, Treasure J, Fuller-Tyszkiewicz M. A new integrative model for the co-occurrence of non-suicidal self-injury behaviours and eating disorder symptoms. J Eat Disord 2021; 9:153. [PMID: 34809723 PMCID: PMC8607624 DOI: 10.1186/s40337-021-00508-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample. METHOD 123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used. RESULTS Invariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39). CONCLUSION We conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms. A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.
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Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia.
| | - Mercedes Delgado Arroyo
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia.,Department of Psychiatry, University Hospital Vall de' Hebron, Barcelona, Spain
| | - Sarah Giles
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - An Binh Dang
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Litza Kiropoulos
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Tara De Paoli
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Kim Buck
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry and Neuroscience, Section of Eating Disorders, King's College London, London, UK
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
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8
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Rania M, Aloi M, Caroleo M, Carbone EA, Fazia G, Calabrò G, de Filippis R, Staltari F, Segura-Garcia C. 'Impaired Autonomy and Performance' predicts binge eating disorder among obese patients. Eat Weight Disord 2020; 25:1183-1189. [PMID: 31302882 DOI: 10.1007/s40519-019-00747-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/03/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The present study examined the predictive value of early maladaptive schema (EMS) domains on the diagnosis of binge eating disorder (BED). METHODS Seventy obese patients seeking treatment for weight loss were recruited and allocated to either group 1 (obese) or group 2 (BED-obese) according to clinical diagnosis. Both groups underwent psychometric assessment for EMS (according to the latest four-factor model), eating and general psychopathologies. Logistic regression analysis was performed on significant variables and BED diagnosis. RESULTS In addition to showing higher values on all clinical variables, BED-obese patients exhibited significantly higher scores for all four schema domains. Regression analysis revealed a 12-fold increase in risk of BED with 'Impaired Autonomy and Performance'. Depression did not account for a higher risk. CONCLUSIONS Impaired Autonomy and Performance is associated with BED in a sample of obese patients. Schema therapy should be considered a potential psychotherapy strategy in the treatment of BED. LEVEL OF EVIDENCE Level III, case-control study.
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Affiliation(s)
- Marianna Rania
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Mariarita Caroleo
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Elvira Anna Carbone
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Gilda Fazia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Giuseppina Calabrò
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Filippo Staltari
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro, Italy.
- Center for Clinical Research and Treatment of Eating Disorders, Azienda Ospedaliera Universitaria Mater Domini, Via Tommaso Campanella, Catanzaro, Italy.
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Aloi M, Rania M, Caroleo M, Carbone EA, Fazia G, Calabrò G, Segura-Garcia C. How are early maladaptive schemas and DSM-5 personality traits associated with the severity of binge eating? J Clin Psychol 2019; 76:539-548. [PMID: 31733127 DOI: 10.1002/jclp.22900] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The present study aimed to (a) assess and compare personological traits and early maladaptive schemas (EMSs) of obese women with and without binge eating disorder (BED) and (b) identify the variables associated with the binge severity. METHOD One hundred women (55 BED-obese and 45 non-BED-obese) completed psychopathological and personological self-report questionnaires. A forward stepwise linear regression analysis was performed to assess variables associated with binge eating severity. RESULTS Not only psychopathological but also personological differences were evident between BED and non-BED-obese women. BED severity was significantly associated with depressivity, emotional deprivation, and defectiveness. CONCLUSIONS Our preliminary findings suggest that BED patients exhibit some EMSs that could be linked to the construct of emotional neglect and specific personological traits closely related to depressive dimensions, emotional lability, and impulsivity. In particular, binge severity is associated with the pervasiveness of depressogenic cognitive schemas, as well as those of emotional deprivation and defectiveness.
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Affiliation(s)
- Matteo Aloi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Mariarita Caroleo
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Elvira A Carbone
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Gilda Fazia
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Giusy Calabrò
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Outpatient Unit for Clinical Research and Treatment of Eating Disorders, Psychiatric Unit, University Hospital Mater Domini, Catanzaro, Italy
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10
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Early maladaptive schemas in overweight and obesity: A schema mode model. Heliyon 2019; 5:e02361. [PMID: 31687536 PMCID: PMC6819863 DOI: 10.1016/j.heliyon.2019.e02361] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 08/02/2019] [Accepted: 08/20/2019] [Indexed: 12/20/2022] Open
Abstract
Obesity is a growing burden in our societies and, although different kinds of treatments are effective in the short time, weight gain often reoccurs in the longer period. One possible explanation might rely on the little comprehension of obese maladaptive schemas, as developed from early life experiences, which might interfere with treatment enduring efficacy. The aim of this study was to investigate early maladaptive schemas, their associated current schema-modes and dysfunctional coping strategies in overweight and obese individuals (N = 48). Results showed that overweight and obese subjects reported more severe insufficient self-control, abandonment, dependence and subjugation schemas, and actual schema-modes (i.e., impulsive and vulnerable child, detached protector), compared against normal-weight controls (N = 37). As well, the former displayed higher dysfunctional eating habits (i.e., bingeing and bulimic symptoms) and more emotional-avoidant coping strategies. Above all schemas, insufficient self-control predicted higher BMI, binge frequency and bulimic symptoms' severity. Furthermore, avoidant coping mediated between specific maladaptive schemas and frequency of bingeing and bulimic symptoms. Our findings illustrate that overweight and obese display more dysfunctional early maladaptive schemas and schema-modes, compared against normal-weight individuals, exhibiting more emotion-avoidant strategies such as over-eating and bingeing, which might stand for a detached self-soother coping mode. The insufficient self-control schema develops from a lack in self-discipline and an inability to tolerate frustration and might be embodied by the impulsive child mode. A deeper comprehension of schemas and modes, as addressed within the Schema Therapy model, might help to understand dysfunctional personality features that might interfere with the long-lasting efficacy of treatment interventions in obesity.
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11
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Burton AL, Abbott MJ. Processes and pathways to binge eating: development of an integrated cognitive and behavioural model of binge eating. J Eat Disord 2019; 7:18. [PMID: 31183111 PMCID: PMC6554957 DOI: 10.1186/s40337-019-0248-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/12/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There are a number of factors commonly believed to be important to the development and maintenance of binge eating that have been identified across multiple models and theories in the psychological literature. In the present study, we sought to develop and test a psychological model for binge eating that incorporated the main variables identified in the literature to drive binge eating behaviour; specifically, core low self-esteem, negative affect, difficulty with emotional regulation, restricted eating and beliefs about eating. METHODS Questionnaire data was collected from 760 unselected participants. The proposed model of binge eating was developed, bivariate relationships between the included variables were assessed, and the goodness-of-fit of this new model was evaluated using structural equations modelling. RESULT The results identified significant bivariate relationships between all the included variables. While the originally proposed model did not provide a good fit to the data, the revised version of the model provided a good fit to the data. CONCLUSIONS Supporting, integrating and building upon the current existing psychological models of binge eating, this study presents a new integrated cognitive and behavioural model of binge eating. The dual-pathway to binge eating identified in the new model provides a different way to understand transdiagnostic binge eating.
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Affiliation(s)
- Amy L Burton
- School of Psychology, The University of Sydney, Camperdown, NSW Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Camperdown, NSW Australia
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12
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Pauwels E, Dierckx E, Schoevaerts K, Santens E, Peuskens H, Claes L. Early maladaptive schemas: Similarities and differences between female patients with eating versus substance use disorders. EUROPEAN EATING DISORDERS REVIEW 2018; 26:422-430. [PMID: 29882613 DOI: 10.1002/erv.2610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 05/06/2018] [Accepted: 05/23/2018] [Indexed: 11/10/2022]
Abstract
Personality features are considered to be important factors in the pathogenesis of both eating disorder (ED) and substance use disorder (SUD). This study investigates similarities and differences between these early maladaptive schemas (EMSs) (a) between female patients with ED (N = 179) or SUD (N = 169) and (b) between ED subtypes of the restrictive (N = 52), bulimic type (N = 127), or SUD. In total, 348 female patients (Mage = 29.95; SDage = 8.40) completed the Young Schema Questionnaire. Multivariate analyses of covariance with EMS scales as dependent variables and (a) ED versus SUD and (b) ED subtypes versus SUD as independent variables and age and psychopathology as control variables revealed that ED patients scored significantly higher on Unrelenting Standards, Defectiveness, Social Undesirability, and Failure than did SUD patients. Additionally, when comparing ED subtypes and SUD, bulimic and SUD patients scored significantly higher on Insufficient Self-Control than did restrictive patients. These results confirm the role of EMSs in ED (subtypes) and SUD.
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Affiliation(s)
- Els Pauwels
- Faculty of Psychology and Educational Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Alexian Brother's Psychiatric Hospital, Tienen, Belgium.,Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Dierckx
- Alexian Brother's Psychiatric Hospital, Tienen, Belgium.,Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Els Santens
- Alexian Brother's Psychiatric Hospital, Tienen, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | | | - Laurence Claes
- Faculty of Psychology and Educational Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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13
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Simpson SG, Pietrabissa G, Rossi A, Seychell T, Manzoni GM, Munro C, Nesci JB, Castelnuovo G. Factorial Structure and Preliminary Validation of the Schema Mode Inventory for Eating Disorders (SMI-ED). Front Psychol 2018; 9:600. [PMID: 29740379 PMCID: PMC5928750 DOI: 10.3389/fpsyg.2018.00600] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 04/10/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to examine the psychometric properties and factorial structure of the Schema Mode Inventory for Eating Disorders (SMI-ED) in a disordered eating population. Method: 573 participants with disordered eating patterns as measured by the Eating Disorder Examination Questionnaire (EDE-Q) completed the 190-item adapted version of the Schema Mode Inventory (SMI). The new SMI-ED was developed by clinicians/researchers specializing in the treatment of eating disorders, through combining items from the original SMI with a set of additional questions specifically representative of the eating disorder population. Psychometric testing included Confirmatory Factor Analysis (CFA) and internal consistency (Cronbach's α). Multivariate Analyses of Covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed an acceptable 16-related-factors solution for the SMI-ED, thus providing preliminary evidence for the adequate validity of the new measure based on internal structure. Concurrent validity was also established through moderate to high correlations on the modes most relevant to eating disorders with EDE-Q subscales. This study represents the first step in creating a psychometrically sound instrument for measuring schema modes in eating disorders, and provides greater insight into the relevant schema modes within this population. Conclusion: This research represents an important preliminary step toward understanding and labeling the schema mode model for this clinical group. Findings from the psychometric evaluation of SMI-ED suggest that this is a useful tool which may further assist in the measurement and conceptualization of schema modes in this population.
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Affiliation(s)
- Susan G Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia.,Regional Eating Disorders Unit, St. John's Hospital, NHS Lothian, Livingston, United Kingdom
| | - Giada Pietrabissa
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Alessandro Rossi
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania, Italy
| | - Tahnee Seychell
- Psychology Department, University of Adelaide, Adelaide, SA, Australia
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Department, University of Adelaide, Adelaide, SA, Australia.,Faculty of Psychology, eCampus University, Como, Italy
| | - Calum Munro
- Department of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Julian B Nesci
- Spectrum: Personality Disorder Service, Victoria, Melbourne, VIC, Australia
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
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14
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Abstract
Binge eating is a distressing symptom common to bulimia nervosa (BN), anorexia nervosa binge/purge subtype (AN-BP) and binge-eating disorder (BED). Over the last 40 years, many attempts have been made to conceptualise this symptom in terms of its antecedents, function, triggers, consequences, and maintaining factors. Cognitive theories of binge eating have evolved as new evidence has emerged. This literature review summarises the main and most influential cognitive models of binge eating across different eating disorder presentations. Many theories have examined binge eating in the context of restriction or compensatory behaviours, as is often observed in cases of BN. Few theories have examined binge eating as it occurs in BED specifically. The long-term efficacy of cognitive behavioural therapy (CBT) treatment based on these models leaves much to be desired, and indicates that there may be maintaining factors of binge eating not addressed in the typical CBT treatment for eating disorders. More recent cognitive models of binge eating propose possible maintaining beliefs, but further study is required to validate these models. Suggestions for future research are presented.
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15
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Burton AL, Hay P, Kleitman S, Smith E, Raman J, Swinbourne J, Touyz SW, Abbott MJ. Confirmatory factor analysis and examination of the psychometric properties of the eating beliefs questionnaire. BMC Psychiatry 2017; 17:237. [PMID: 28673268 PMCID: PMC5496235 DOI: 10.1186/s12888-017-1394-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Eating Beliefs Questionnaire (EBQ) is a 27-item self-report measure that assesses positive and negative beliefs about binge eating. It has been validated and its factor structure explored in a non-clinical sample. This study tested the psychometric properties of the EBQ in a clinical and a non-clinical sample. METHOD A sample of 769 participants (573 participants recruited from the university and general community, 76 seeking treatment for an eating disorder and 120 participating in obesity research) completed a battery of questionnaires. A subset of clinical participants with a diagnosis of Bulimia Nervosa or Binge Eating Disorder completed the test-battery before and after receiving a psychological treatment (n = 27) or after allocation to a wait-list period (n = 28), and a subset of 35 community participants completed the test battery again after an interval of two-weeks. Confirmatory Factor Analysis (CFA) was performed. RESULTS CFA found a two-factor structure that provided a good fit to the data, supporting the solution presented in the development paper. Items with poor psychometric properties were removed, resulting in a 16 item measure. EBQ scores were found to correlate with binge eating episode frequency, increases in body mass index (BMI), and measures of eating disorder behaviours and related psychopathology. The EBQ was found to have excellent internal consistency (α = .94), good test-retest reliability (r = .91) and sensitivity to treatment. CONCLUSION These findings indicate that the EBQ is a psychometrically sound and clinically useful measure.
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Affiliation(s)
- Amy L. Burton
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Sydney, NSW Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, NSW, Australia. .,Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Sabina Kleitman
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Sydney, NSW Australia
| | - Evelyn Smith
- 0000 0004 1936 834Xgrid.1013.3School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW Australia
| | - Jayanthi Raman
- 0000 0004 1936 834Xgrid.1013.3School of Medicine, Western Sydney University, Sydney, NSW Australia
| | - Jessica Swinbourne
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney, NSW Australia
| | - Stephen W. Touyz
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Sydney, NSW Australia
| | - Maree J. Abbott
- 0000 0004 1936 834Xgrid.1013.3School of Psychology, University of Sydney, Sydney, NSW Australia
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16
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De Paoli T, Fuller-Tyszkiewicz M, Krug I. Insecure attachment and maladaptive schema in disordered eating: The mediating role of rejection sensitivity. Clin Psychol Psychother 2017; 24:1273-1284. [PMID: 28488365 DOI: 10.1002/cpp.2092] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 11/06/2022]
Abstract
AIM The current study aimed to assess insecure attachment and the disconnection and rejection domain of maladaptive schema in the context of disordered eating. Rejection sensitivity (RS) was proposed as a mediator between maladaptive schema and disordered eating. METHOD The sample consisted of 108 female participants with a lifetime eating disorder diagnosis and 508 female control participants. Participants were asked to complete a number of self-report measures related to insecure attachment (anxious and avoidant), maladaptive schema (emotional deprivation, abandonment, mistrust, social isolation, and defectiveness), RS (interpersonal and appearance-based), and disordered eating. RESULTS Path analysis indicated that anxious attachment was associated with disordered eating through multiple pathways involving emotional deprivation, abandonment, interpersonal RS, and appearance-based RS. Avoidant attachment was not related to disordered eating behaviours. CONCLUSION The results indicate that both interpersonal and appearance-based RS are important mediators for the relationships between insecure attachment, maladaptive schema, and disordered eating. KEY PRACTITIONER MESSAGE The results from the current study suggest that insecure attachment leads to maladaptive schema, which in turn leads to sensitivity to rejection and subsequent disordered eating behaviour. Attachment anxiety, but not attachment avoidance, was related to greater endorsement of all five schemas in the disconnection and rejection domain. Path analysis revealed that, of the schema in the disconnection and rejection domain, only emotional deprivation and abandonment were related to disordered eating. Interpersonal and appearance-based rejection sensitivity were significant mediators of the relationship between emotional deprivation and disordered eating as well as the relationship between abandonment and disordered eating. Differentiating between schemas within schema domains has clinical value in further understanding the pathway to disordered eating. The schemas of emotional deprivation and abandonment are implicated in disordered eating, suggesting the need to target these schemas in schema therapy.
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Affiliation(s)
- Tara De Paoli
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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17
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Singlehurst H, Corr S, Griffiths S, Beaulieu K. The Impact of Binge Eating Disorder on Occupation: A Pilot Study. Br J Occup Ther 2016. [DOI: 10.1177/030802260707001108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Brown JM, Selth S, Stretton A, Simpson S. Do dysfunctional coping modes mediate the relationship between perceived parenting style and disordered eating behaviours? J Eat Disord 2016; 4:27. [PMID: 27822374 PMCID: PMC5094088 DOI: 10.1186/s40337-016-0123-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/25/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Preliminary studies suggest that both childhood experiences and coping behaviours may be linked to eating disorder symptoms. METHODS In this study maladaptive schema coping modes were investigated as mediators in the relationship between perceived negative parenting and disordered eating. A total of 174 adults with eating and/or body image concerns completed questionnaires measuring parenting experiences, schema modes, and disordered eating behaviours. RESULTS Perfectionistic Overcontroller, Self-Aggrandiser, Compliant Surrenderer, Detached Protector and Detached Self-Soother coping modes partially explained the variance in the relationships between perceived negative parenting experiences and the behaviours of restricting and compensation (purging and overexercising). CONCLUSIONS Our findings suggest that Overcompensatory, Avoidant and Surrender coping mechanisms all appear to play a role in the maintenance of eating disorder symptoms, and that there are multiple complex relationships between these and Early Maladaptive Schemas that warrant further investigation.
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Affiliation(s)
- Jessica M. Brown
- School of Psychology, University of Adelaide, North Tce, Adelaide, 5005 SA Australia
| | - Stephanie Selth
- Psychology Clinic, School of Psychology, Social Work, and Social Policy, University of South Australia, Magill Campus, GPO Box 2471, Adelaide, 5001 SA Australia
| | - Alexander Stretton
- School of Education, Arts and Social Sciences, University of South Australia, Adelaide, SA Australia
| | - Susan Simpson
- Psychology Clinic, School of Psychology, Social Work, and Social Policy, University of South Australia, Magill Campus, GPO Box 2471, Adelaide, 5001 SA Australia
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19
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Tao Z, Wu G, Wang Z. The relationship between high residential density in student dormitories and anxiety, binge eating and Internet addiction: a study of Chinese college students. SPRINGERPLUS 2016; 5:1579. [PMID: 27652152 PMCID: PMC5025399 DOI: 10.1186/s40064-016-3246-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/06/2016] [Indexed: 11/13/2022]
Abstract
Context Although various studies have indicated that high residential density may affect health and psychological outcomes, to our knowledge, there have been no studies regarding the predictive nature of crowded living conditions on binge eating and the use of the Internet as coping strategies. Methods A total of 1048 Chinese college students (540 males and 508 females) were randomly selected and asked to complete a battery of questionnaires that included the Zung’s Self-Rating Anxiety Scale, the Internet Addiction Test, and Rosenbaum’s Self-Control Scale. Binge eating behaviors and compensatory behaviors were also reported, and variables about residential density were measured. Results Among female participants, binge eating scores were significantly predicted by anxiety caused by high-density living conditions (P = 0.008), and similarly, the frequency of compensatory behaviors was significantly predicted by anxiety caused by high-density living conditions (P = 0.000) and self-control (P = 0.003). Furthermore, the Internet Addiction Test scores were significantly predicted by the anxiety caused by high -density living conditions (P = 0.000) and self-control (P = 0.000). Among male participants, not only were the binge eating scores significantly predicted by the anxiety caused by high-density living conditions (P = 0.000) and self-control (P = 0.000), but the frequency of compensatory behaviors was also significantly predicted by the anxiety caused by high-density living conditions (P = 0.000) and self-control (P = 0.01). Furthermore, Internet Addiction Test scores were significantly predicted by anxiety caused by high-density living conditions (P = 0.000) and self-control (P = 0.000). It was further found that for both genders, subjective factors such as self-control, and the anxiety caused by high-density living conditions had a stronger impact on Internet addiction than objective factors, such as the size of the student’s dormitory room. Moreover, self-control was found to act as a moderator in the relationship between anxiety and Internet addiction among male participants. Conclusion Binge eating and Internet use could be considered coping strategies for Chinese college students facing high residential density in their dormitories.
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Affiliation(s)
- Zhuoli Tao
- Department of Medical Humanities, School of Humanities, Southeast University, 87#, Ding Jia Qiao, Nanjing, 210009 China
| | - Gao Wu
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, China
| | - Zeyuan Wang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
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20
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McIntosh VVW, Jordan J, Carter JD, Frampton CMA, McKenzie JM, Latner JD, Joyce PR. Psychotherapy for transdiagnostic binge eating: A randomized controlled trial of cognitive-behavioural therapy, appetite-focused cognitive-behavioural therapy, and schema therapy. Psychiatry Res 2016; 240:412-420. [PMID: 27149410 DOI: 10.1016/j.psychres.2016.04.080] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/05/2016] [Accepted: 04/23/2016] [Indexed: 10/21/2022]
Abstract
Cognitive-behavioural therapy (CBT) is the recommended treatment for binge eating, yet many individuals do not recover, and innovative new treatments have been called for. The current study compares traditional CBT with two augmented versions of CBT; schema therapy, which focuses on early life experiences as pivotal in the history of the eating disorder; and appetite-focused CBT, which emphasises the role of recognising and responding to appetite in binge eating. 112 women with transdiagnostic DSM-IV binge eating were randomized to the three therapies. Therapy consisted of weekly sessions for six months, followed by monthly sessions for six months. Primary outcome was the frequency of binge eating. Secondary and tertiary outcomes were other behavioural and psychological aspects of the eating disorder, and other areas of functioning. No differences among the three therapy groups were found on primary or other outcomes. Across groups, large effect sizes were found for improvement in binge eating, other eating disorder symptoms and overall functioning. Schema therapy and appetite-focused CBT are likely to be suitable alternative treatments to traditional CBT for binge eating.
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Affiliation(s)
- Virginia V W McIntosh
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Canterbury District Health Board, Christchurch, New Zealand.
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Canterbury District Health Board, Christchurch, New Zealand
| | - Janet D Carter
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | | | - Janice M McKenzie
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Janet D Latner
- Psychology Department, University of Hawaii at Manoa, Hawaii, USA
| | - Peter R Joyce
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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21
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Pauwels E, Dierckx E, Schoevaerts K, Claes L. Early Maladaptive Schemas in Eating Disordered Patients With or Without Non-Suicidal Self-Injury. EUROPEAN EATING DISORDERS REVIEW 2016; 24:399-405. [PMID: 27349211 DOI: 10.1002/erv.2460] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 05/09/2016] [Accepted: 05/18/2016] [Indexed: 11/09/2022]
Abstract
This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non-suicidal self-injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self-Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self-control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Els Pauwels
- Department of Psychology, University of Leuven, Leuven, Belgium.,Psychiatric Hospital Alexianen Tienen, Tienen, Belgium.,Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Dierckx
- Psychiatric Hospital Alexianen Tienen, Tienen, Belgium.,Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Laurence Claes
- Department of Psychology, University of Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Wilrijk, Belgium
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22
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Kittel R, Brauhardt A, Hilbert A. Cognitive and emotional functioning in binge-eating disorder: A systematic review. Int J Eat Disord 2015; 48:535-54. [PMID: 26010817 DOI: 10.1002/eat.22419] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 03/30/2015] [Accepted: 03/31/2015] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating and is associated with eating disorder and general psychopathology and overweight/obesity. Deficits in cognitive and emotional functioning for eating disorders or obesity have been reported. However, a systematic review on cognitive and emotional functioning for individuals with BED is lacking. METHOD A systematic literature search was conducted across three databases (Medline, PubMed, and PsycINFO). Overall, n = 57 studies were included in the present review. RESULTS Regarding cognitive functioning (CoF), individuals with BED consistently demonstrated higher information processing biases compared to obese and normal-weight controls in the context of disorder-related stimuli (i.e., food and body cues), whereas CoF in the context of neutral stimuli appeared to be less affected. Thus, results suggest disorder-related rather than general difficulties in CoF in BED. With respect to emotional functioning (EmF), individuals with BED reported difficulties similar to individuals with other eating disorders, with a tendency to show less severe difficulties in some domains. In addition, individuals with BED reported greater emotional deficits when compared to obese and normal-weight controls. Findings suggest general difficulties in EmF in BED. Thus far, however, investigations of EmF in disorder-relevant situations are lacking. DISCUSSION Overall, the cross-sectional findings indicate BED to be associated with difficulties in CoF and EmF. Future research should determine the nature of these difficulties, in regards to general and disorder-related stimuli, and consider interactions of both domains to foster the development and improvement of appropriate interventions in BED.
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Affiliation(s)
- Rebekka Kittel
- Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Anne Brauhardt
- Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Anja Hilbert
- Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig, Germany
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23
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Pugh M. A narrative review of schemas and schema therapy outcomes in the eating disorders. Clin Psychol Rev 2015; 39:30-41. [PMID: 25932958 DOI: 10.1016/j.cpr.2015.04.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 03/02/2015] [Accepted: 04/15/2015] [Indexed: 12/25/2022]
Abstract
Whilst cognitive-behavioural therapy has demonstrated efficacy in the treatment of eating disorders, therapy outcomes and current conceptualizations still remain inadequate. In light of these shortcomings there has been growing interest in the utility of schema therapy applied to eating pathology. The present article first provides a narrative review of empirical literature exploring schemas and schema processes in eating disorders. Secondly, it critically evaluates outcome studies assessing schema therapy applied to eating disorders. Current evidence lends support to schema-focused conceptualizations of eating pathology and confirms that eating disorders are characterised by pronounced maladaptive schemas. Treatment outcomes also indicate that schema therapy, the schema-mode approach, and associated techniques are promising interventions for complex eating disorders. Implications for clinical practice and future directions for research are discussed.
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Affiliation(s)
- Matthew Pugh
- Vincent Square Eating Disorders Service, Central and North West London NHS Foundation Trust, Royal Holloway, University of London, London, England, United Kingdom.
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24
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Damiano SR, Reece J, Reid S, Atkins L, Patton G. Maladaptive schemas in adolescent females with anorexia nervosa and implications for treatment. Eat Behav 2015; 16:64-71. [PMID: 25464069 DOI: 10.1016/j.eatbeh.2014.10.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 09/20/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
Recent research has highlighted the presence of Young's Early Maladaptive Schemas (EMSs) in individuals with an eating disorder (ED). This study assessed the EMSs reported by adolescent females with Anorexia Nervosa (AN) compared with a community group. Thirty-six adolescent females diagnosed with AN or subthreshold AN and 111 female secondary school students completed a questionnaire that included the Young Schema Questionnaire, the Behavior Assessment System for Children Self-report of Personality, and the Eating Disorder Screen for Primary Care. Two independent AN subtypes and two community subtypes were derived from responses to the questionnaire, and significant differences between the four comparison groups were found. High Pathology AN participants reported the highest level of psychological maladjustment. Social Isolation and Emotional Inhibition appeared to be most characteristic of adolescent AN in this sample. The results suggest that EMSs may require attention in the treatment of AN in adolescent females, and that different AN subtypes may require individualized treatment approaches.
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Affiliation(s)
- Stephanie R Damiano
- Discipline of Psychology, RMIT University, Bundoora 3083, Australia; Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville 3052, Australia; School of Psychological Science, La Trobe University, Melbourne 3086, Australia.
| | - John Reece
- Discipline of Psychology, RMIT University, Bundoora 3083, Australia
| | - Sophie Reid
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville 3052, Australia
| | - Linsey Atkins
- Hope Family Clinic, Bluff Road, Hampton 3188, Australia
| | - George Patton
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville 3052, Australia
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25
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Attention Biases of Undergraduate Women with Fat Negative Physical Self: Orienting or Maintenance. ACTA PSYCHOLOGICA SINICA 2010. [DOI: 10.3724/sp.j.1041.2010.00779] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Cockram DM, Drummond PD, Lee CW. Role and treatment of early maladaptive schemas in Vietnam Veterans with PTSD. Clin Psychol Psychother 2010; 17:165-82. [PMID: 20486158 DOI: 10.1002/cpp.690] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The role of early maladaptive schemas in understanding and treating post-traumatic stress disorder (PTSD) was investigated. The first study examined the role of perceived adverse parenting and early maladaptive schemas in the development of PTSD in Australian and New Zealand Vietnam war veterans (n = 220). Veterans diagnosed with PTSD scored higher on the Young Schema Questionnaire (L3) and had higher scores on the Measure of Parental Style than veterans not diagnosed with PTSD. The results suggest that early maladaptive schemas have an important role in the development or maintenance of PTSD in Vietnam veterans. The second study measured at baseline, termination and 3 months the early maladaptive schemas, PTSD, anxiety and depression of war veterans (n = 54) participating in a PTSD group treatment programme that included schema-focused therapy. Scores on the PTSD Checklist, the Hospital Anxiety and Depression Scale, and 17 schemas decreased significantly after treatment. Change scores for the schema treatment were compared with change scores of war veterans (n = 127) who had completed a manualized cognitive-behavioural therapy programme without schema-focused therapy. Pre-treatment measures were similar in both groups. Nevertheless, PTSD and anxiety improved more significantly for the schema-focused therapy group. Together, these findings support the feasibility of schema-focused therapy to assist veterans with PTSD.
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Affiliation(s)
- David M Cockram
- School of Psychology, Murdoch University, Perth, WA, Australia.
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van Son GE, van Hoeken D, van Furth EF, Donker GA, Hoek HW. Course and outcome of eating disorders in a primary care-based cohort. Int J Eat Disord 2010; 43:130-8. [PMID: 19308996 DOI: 10.1002/eat.20676] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To study the course and outcome of patients with eating disorder detected in primary care. METHOD General practitioners (GP's) provided information on the course and outcome of eating disorders in patients (n = 147) diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) identified during a Dutch nationwide primary care-based incidence study. The research team determined the outcome based on the data provided by the GP's. The mean duration of the follow-up was 4.8 years. RESULTS About 57% of the patients initially diagnosed with AN and 61% of those diagnosed with BN were fully recovered. AN binge/purge subtype (ANBP) demonstrated the most extended median survival time of all diagnostic subgroups (the point at which half of the group has reached full recovery). Diagnostic crossover was low. A younger age at detection predicted recovery at outcome for AN and BN. One patient (AN) died. DISCUSSION The results of this study on differences in outcome and low crossover support the diagnostic distinction between AN and BN in the DSM-IV. Early detection is of major importance for a favorable outcome.
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Van Vlierberghe L, Braet C, Goossens L. Dysfunctional schemas and eating pathology in overweight youth: a case-control study. Int J Eat Disord 2009; 42:437-42. [PMID: 19115366 DOI: 10.1002/eat.20638] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to investigate in overweight adolescents the association of dysfunctional schemas (negative basic beliefs about the self and one's relationships with others) on one hand and eating disorder (ED) symptoms and depression on the other hand. METHOD Participants were 32 overweight adolescents experiencing loss of control over eating (LC) and 32 overweight youngsters experiencing no loss of control over eating (NoLC), matched on referral status, age, gender, and degree of overweight. Adolescents were interviewed with the Eating Disorder Examination-Child version and completed the Young Schema Questionnaire and the Children's Depression Inventory. RESULTS The LC group displayed a greater severity of dysfunctional schemas than the NoLC group. Maladaptive schemas were related to ED cognitions, dietary restraint attitudes, and depressive symptoms. DISCUSSION In overweight youngsters, ED symptoms are associated with dysfunctional thinking patterns and negative affect.
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Affiliation(s)
- Leen Van Vlierberghe
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
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Saules KK, Collings AS, Hoodin F, Angelella NE, Alschuler K, Ivezaj V, Saunders-Scott D, Wiedemann AA. The contributions of weight problem perception, BMI, gender, mood, and smoking status to binge eating among college students. Eat Behav 2009; 10:1-9. [PMID: 19171310 DOI: 10.1016/j.eatbeh.2008.07.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 05/23/2008] [Accepted: 07/29/2008] [Indexed: 11/16/2022]
Abstract
College student participants (N=1063; 77.8% response rate) completed a web-based survey assessing demographics, depression, anxiety, body image, cigarette smoking, and weight history. Among overweight participants, 42.6% of those who believed they were overweight admitted to binge eating, while only 30.1% who did not feel overweight did so (p<.05). Among non-overweight participants, 43.2% of those who believed they were overweight admitted to binge eating, while only 32.9% of those who did not feel overweight did so (p<.05). Weight Problem Perception (WPP) mediated the contribution of BMI on binge eating outcomes, and WPP contributed significantly to the prediction of binge eating, beyond the risk conferred by established correlates of binge eating (e.g., gender, mood, and cigarette smoking). Results suggest that when assessing risk for binge eating, a one-question assessment of whether or not an individual believes s/he is overweight has significant predictive power. Findings are consistent with literature on the importance of the "fat self-schema" [Stein, K.F., & Corte, C. (2007). Identity impairment and the eating disorders: Content and organization of the self-concept in women with anorexia nervosa and bulimia nervosa. European Eating Disorders Review, 15 (1), 58-69] in disordered eating and theory implicating identity in the maintenance of addictive behavior [West, R.W. (2006). Theory of Addiction. Malden, MA: Blackwell Publishing, Inc.].
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Affiliation(s)
- Karen K Saules
- Eastern Michigan University, Psychology Department, Ypsilanti, Michigan, USA.
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Passos TCBM, Yazigi L, Claudino AM. Aspectos ideativos no transtorno da compulsão alimentar periódica: estudo com o Rorschach. PSICO-USF 2008. [DOI: 10.1590/s1413-82712008000100009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pessoas com diagnóstico de transtorno da compulsão alimentar periódica (DSM-IV) são descritas como propensas a distúrbios nos processos de pensamento que são relevantes para a manutenção do quadro e para o tratamento. Este é um estudo exploratório visando avaliar o funcionamento cognitivo de sujeitos com o diagnóstico citado, sendo escolhido como instrumento o método de Rorschach, que permite acessar aspectos psicológicos menos sujeitos ao controle consciente do que os aferidos por escalas e auto-relatos. Foram selecionadas variáveis do Rorschach associadas ao funcionamento ideacional. A amostra constitui-se de 43 mulheres (média de 37,2 anos de idade), que, no Rorschach, evidenciam dificuldades na atividade ideativa, com predominância de um nível concreto e imaturo de ideação, perda dos limites da realidade e dos limites entre os eventos. Também há tendência a cognições de tom negativo. O uso defensivo de intelectualizações frágeis predispõe a sobrecargas emocionais. Mas também é observada a capacidade para pensar de forma flexível e construtiva, recurso associado a bom prognóstico em psicoterapias.
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Legenbauer T, Vocks S, Schütt-Strömel S. Dysfunktionale Kognitionen bei Essstörungen: Welche Inhaltsbereiche lassen sich unterscheiden? ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2007. [DOI: 10.1026/1616-3443.36.3.207] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Dysfunktionale Kognitionen tragen häufig zur Entstehung und Aufrechterhaltung einer Essstörung bei und sind zentral in der Behandlung selbiger. Fragestellung: Können dysfunktionale Kognitionen spezifischen Bereichen zugeordnet werden und differenzieren diese zwischen den unterschiedlichen Essstörungstypen? Methode: Es wurde eine Fragebogen (FEDK) entwickelt, der spezifische Bereiche dysfunktionaler Kognitionen bei Essstörungen erfasst. Zur Bestimmung der Faktorenstruktur wurden zwei Studien durchgeführt (n = 856; n = 120). Gruppenunterschiede (AN, BN, BED) und Zusammenhänge zur Essstörungspathologie (EDI-2, EDE-Q) wurden berechnet. Ergebnisse: Durch eine Faktorenanalyse konnten die drei Inhaltsbereiche “Körper und Selbstwert“, “Restriktion und Diätregeln“ und “Essen und Kontrollverlust“ bestimmt werden. Inhaltliche Validität (EDI-2, EDE-Q) und Reliabilität (FEDK) lassen sich als gut beschreiben. Schlussfolgerungen: Essstörungsspezifische Kognitionen liegen nicht nur hinsichtlich Essen (Restriktion und Verlangen), Figur und Gewicht (Körper) vor, sondern auch hinsichtlich des Selbstwertes.
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Jones CJ, Leung N, Harris G. Father-daughter relationship and eating psychopathology: the mediating role of core beliefs. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2007; 45:319-30. [PMID: 17147099 DOI: 10.1348/014466505x53489] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The study aimed to establish the relationships between recalled paternal rearing behaviours, core beliefs and eating symptomatology and to test whether core beliefs play a mediating role between the father-daughter relationship and eating psychopathology. DESIGN Associations between eating psychopathology, core beliefs and recalled parental rearing behaviours were examined in women with and without eating disorders. Regression analyses were used to test whether core beliefs played a mediating role in the relationship between paternal rearing behaviours and eating psychopathology. METHOD Sixty-six eating-disordered women and fifty female controls completed three self-report questionnaires measuring parental rearing behaviours, core beliefs and eating psychopathology. RESULTS In eating-disordered women, paternal rejection and overprotection were found to predict aspects of eating psychopathology via the mediating role of abandonment, defectiveness/shame and vulnerability to harm core beliefs. DISCUSSION Core beliefs relating to feelings of abandonment and inherent defectiveness appear to be important in the relationship between unhealthy father-daughter relationships and eating disorder symptoms.
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Affiliation(s)
- Ceri J Jones
- School of Psychology, University of Birmingham, UK.
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Van Vlierberghe L, Braet C. Dysfunctional schemas and psychopathology in referred obese adolescents. Clin Psychol Psychother 2007. [DOI: 10.1002/cpp.546] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Blissett J, Meyer C. The mediating role of eating psychopathology in the relationship between unhealthy core beliefs and feeding difficulties in a nonclinical group. Int J Eat Disord 2006; 39:763-71. [PMID: 16868996 DOI: 10.1002/eat.20315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine whether maternal eating psychopathology mediates the relationship between unhealthy core beliefs and reports of child feeding difficulties. METHOD A community sample of 114 mothers of 65 male children and 49 female children between 4 months and 5 years completed the Eating Disorders Inventory-II, (Garner, Eating Disorder Inventory-2 Professional Manual, Odessa, 1991) the Child Feeding Assessment Questionnaire, (Harris and Booth, Monographs in Clinical Pediatrics, Vol 5, 1992) and the Young Schema Questionnaire (Short Form) (Young, Young's Schema Questionnaire: Short Form, Available in electronic form at, http://www.schematherapy.com, 1998). RESULTS Drive for thinness significantly mediated the relationship between maternal defectiveness/shame beliefs and food refusal in mothers of daughters, but no mediational relationships were found for mothers of sons in this nonclinical group. CONCLUSION Maternal drive for thinness mediates the effect of unhealthy beliefs on mothers' tendencies to report feeding difficulties in their daughters.
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Affiliation(s)
- Jackie Blissett
- School of Psychology, University of Birmingham, United Kingdom.
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Dingemans AE, Spinhoven P, van Furth EF. Maladaptive core beliefs and eating disorder symptoms. Eat Behav 2006; 7:258-65. [PMID: 16843229 DOI: 10.1016/j.eatbeh.2005.09.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2005] [Revised: 09/26/2005] [Accepted: 09/29/2005] [Indexed: 11/25/2022]
Abstract
This study compared maladaptive core beliefs of eating-disordered groups (full and subthreshold syndrome) and healthy controls and investigated the association between eating disorder symptoms and core beliefs. Participants were compared on self-report measures of core beliefs (YSQ) and eating disorder psychopathology (BITE). Anorexia nervosa (AN; both subtypes) and bulimia nervosa (BN) patients had significantly more core beliefs than healthy controls. Binge eating disorder (BED) patients had intermediate scores between AN and BN on the one hand and healthy controls on the other hand. No correlation was found between core beliefs and frequency of binge eating. Frequency of vomiting, laxative misuse and fasting was positively associated with all domains of core beliefs. Patients with eating disorders have some core beliefs which are not directly related to eating, weight or shape. Frequency of purging and fasting behaviors is associated with more severe maladaptive core beliefs. Our data demonstrate the importance of identifying purging and fasting as significant clinical markers.
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Affiliation(s)
- A E Dingemans
- National Center for Eating Disorders, PO Box 422, 2260 AK Leidschendam, The Netherlands.
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Anderson K, Rieger E, Caterson I. A comparison of maladaptive schemata in treatment-seeking obese adults and normal-weight control subjects. J Psychosom Res 2006; 60:245-52. [PMID: 16516655 DOI: 10.1016/j.jpsychores.2005.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The aims of this study were to determine whether treatment-seeking obese adults display a greater severity of maladaptive schemata than normal-weight adults and to investigate the possible correlates of maladaptive schemata among obese individuals. METHODS The sample included 52 obese adults participating in a weight loss treatment and 39 normal-weight adults. Participants in the obese and normal-weight control groups completed standardized self-report questionnaires designed to assess attitudes and behaviors regarding eating and weight (Questionnaire on Eating and Weight Patterns-Revised and Binge Eating Scale), maladaptive schemata (Young Schema Questionnaire-Short Version), mood disturbance (Profile of Mood States-Adolescents) and socially desirable responding (Balanced Inventory of Desirable Responding). RESULTS The obese patients reported a significantly greater severity of maladaptive schemata (after controlling for demographic variables and binge eating disorder status) than the normal-weight control subjects. In addition, within the obese group, there were significant positive correlations between the severity of maladaptive schema scores and both mood disturbance and problem eating scores. CONCLUSION The present findings suggest that obesity may be associated with a higher severity of maladaptive schemata, at least among those obese individuals who have sought treatment. Possible etiological and treatment implications of the findings are discussed.
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Affiliation(s)
- Kate Anderson
- School of Psychology, University of Sydney, NSW 2006, Australia
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Jones C, Harris G, Leung N. Core beliefs and eating disorder recovery. EUROPEAN EATING DISORDERS REVIEW 2005. [DOI: 10.1002/erv.642] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Compulsive Eating and Substance Abuse Factors Among African-American Community College Students. J Ethn Subst Abuse 2004. [DOI: 10.1300/j233v02n04_05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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