“…Furthermore, the finding that individuals may engage in DE behaviors to cleanse or purify oneself, “to disappear,” and to avoid intimacy provides further support for the idea that DE behaviors may arise to help an individual cope with trauma [ 33 , 45 ]. Strong correlations between trauma history and EDs have been well-documented, with posttraumatic stress symptoms [ 46 , 47 ] and accompanying maladaptive beliefs about oneself being potential maintenance factors of DE behaviors [ 48 ]. In particular, body shame, low self-esteem, and avoidance of intimacy or future violence may mediate the relation between sexual trauma and DE behaviors [ 49 , 50 ], and the behaviors may also serve to reduce tension associated with the trauma [ 50 ].…”
Background
One method to improve treatment outcomes for individuals with eating disorders (EDs) may be understanding and targeting individuals’ motives for engaging in DE behaviors—or the functions of DE behaviors. The goal of this study was to investigate and categorize the various functions of DE behaviors from the perspectives of adults who engage in DE behaviors and clinicians who treat EDs.
Methods
Individuals who engage in DE behaviors (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of DE behaviors.
Results
Four main functions of DE behaviors were identified by the authors: (1) alleviating shape, weight, and eating concerns; (2) regulating emotions; (3) regulating one’s self-concept; and (4) regulating interpersonal relationships/communicating with others.
Conclusions
Differences in participant responses, particularly regarding the relevance of alleviating shape and weight concerns as an DE behavior function, highlight the importance of individualized conceptualizations of DE behavior functions for any given client.
“…Furthermore, the finding that individuals may engage in DE behaviors to cleanse or purify oneself, “to disappear,” and to avoid intimacy provides further support for the idea that DE behaviors may arise to help an individual cope with trauma [ 33 , 45 ]. Strong correlations between trauma history and EDs have been well-documented, with posttraumatic stress symptoms [ 46 , 47 ] and accompanying maladaptive beliefs about oneself being potential maintenance factors of DE behaviors [ 48 ]. In particular, body shame, low self-esteem, and avoidance of intimacy or future violence may mediate the relation between sexual trauma and DE behaviors [ 49 , 50 ], and the behaviors may also serve to reduce tension associated with the trauma [ 50 ].…”
Background
One method to improve treatment outcomes for individuals with eating disorders (EDs) may be understanding and targeting individuals’ motives for engaging in DE behaviors—or the functions of DE behaviors. The goal of this study was to investigate and categorize the various functions of DE behaviors from the perspectives of adults who engage in DE behaviors and clinicians who treat EDs.
Methods
Individuals who engage in DE behaviors (n = 16) and clinicians who treat EDs (n = 14) were interviewed, and a thematic analysis was conducted to determine key functions of DE behaviors.
Results
Four main functions of DE behaviors were identified by the authors: (1) alleviating shape, weight, and eating concerns; (2) regulating emotions; (3) regulating one’s self-concept; and (4) regulating interpersonal relationships/communicating with others.
Conclusions
Differences in participant responses, particularly regarding the relevance of alleviating shape and weight concerns as an DE behavior function, highlight the importance of individualized conceptualizations of DE behavior functions for any given client.
“…Trauma exposure and other severe adverse childhood experiences (such as emotional abuse) are heavily associated with EDs and can profoundly affect patients throughout the lifespan (Brewerton, 2007(Brewerton, , 2022Burdo et al, 2023;Trottier & MacDonald, 2017). Recent meta-analyses by Convertino and Mendoza (2023) and Day et al (2023) suggest a high likelihood of dropouts and relapse within this patient population.…”
BackgroundMost network analyses on central symptoms in eating disorders (EDs) have been cross‐sectional. Longitudinal within‐person analyses of therapy processes are scarce. Our aim was to investigate central change processes in therapy in a transdiagnostic sample, considering the influence of childhood maltreatment.MethodWe employed dynamic time warping analyses to identify clusters of symptoms that tended to change similarly across therapy on a within‐person level. Symptoms were measured by a 28‐item Eating Disorder Examination Questionnaire (EDE‐Q). Furthermore, we examined the temporal direction of symptom change to identify symptoms that tended to precede and predict other symptoms. Finally, we estimated two directed, temporal networks in patients with and without a history of childhood maltreatment.ResultsOur analysis included 122 ED patients (mean age = 30.9, SD = 9.7; illness duration = 14.2 years, SD = 8.9; prior treatment = 5.6 years, SD = 5.1). The initial network revealed three robust clusters of symptoms over time: (1) ED behavior, (2) inhibition, and (3) cognitions and feelings about body and weight. Overvaluation of shape had the highest out‐strength preceding and predicting other symptoms. Dissatisfaction with weight preceded and predicted other symptoms in the maltreatment network. The non‐maltreatment network showed a similar structure to the transdiagnostic network.ConclusionTargeting and monitoring feelings and cognitions related to shape may be crucial for achieving lasting symptom improvement in a transdiagnostic sample. Furthermore, our findings highlight the need for further investigation into the different processes driving EDs based on maltreatment status.Public significanceThere is limited understanding of the processes that occur for patients with eating disorders between admission and discharge in therapy, especially for patients with a history of childhood maltreatment. Our analyses suggest that changes in cognitions regarding shape precede and predict changes in cognitions about weight. Different processes may be driving the eating disorder according to maltreatment status, which might further illuminate the riddle of dropout and relapse in therapy for patients with a history of childhood maltreatment. These findings suggest the need for further investigation into the specific dynamics occurring during therapy for individuals with a history of childhood maltreatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.