State self‐esteem ratings in women with bulimia nervosa and bulimia nervosa in remission

Daley, Karen; Jimerson, David C.; Heatherton, Todd F.; Metzger, Eran D.; Wolfe, Barbara E.

doi:10.1002/eat.20447

Cited by 25 publications

(31 citation statements)

References 35 publications

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“…Limitations in assessment of their own emotions are seen in the elevated levels of alexithymia reported in both AN and BN (46, 60, 67–69). Problems in self-esteem are also present and often precede the development of both AN and BN (20–22, 70, 71). The presence of negative self-beliefs unrelated to shape and weight has been proposed as a core component of eating disorders (26, 27).…”

Section: Discussionmentioning

confidence: 99%

“…Self-esteem is a term used to describe one’s overall sense of one’s own value as a person, and is generally considered a fairly stable psychological characteristic (20). Although the diagnostic criteria in eating disorders connect self-esteem specifically to physical appearance, similarly unrealistic social expectations are reported and observed in eating disorder patients (21, 22). Self-knowledge, as used in MRI tasks, relates to the ability to evaluate oneself, and is expected to be a process that involves self-esteem as well as other criteria.…”

Section: Introductionmentioning

confidence: 96%

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Neural Responses during Social and Self-Knowledge Tasks in Bulimia Nervosa

McAdams¹,

Krawczyk²

2013

Front. Psychiatry

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Self-evaluation closely dependent upon body shape and weight is one of the defining criteria for bulimia nervosa (BN). We studied 53 adult women, 17 with BN, 18 with a recent history of anorexia nervosa (AN), and 18 healthy comparison women, using three different fMRI tasks that required thinking about self-knowledge and social interactions: the Social Identity task, the Physical Identity task, and the Social Attribution task. Previously, we identified regions of interest (ROI) in the same tasks using whole-brain voxel-wise comparisons of the healthy comparison women and women with a recent history of AN. Here, we report on the neural activations in those ROIs in subjects with BN. In the Social Attribution task, we examined activity in the right temporoparietal junction (RTPJ), an area frequently associated with mentalization. In the Social Identity task, we examined activity in the precuneus (PreC) and dorsal anterior cingulate (dACC). In the Physical Identity task, we examined activity in a ventral region of the dACC. Interestingly, in all tested regions, the average activation in subjects with bulimia was more than the average activation levels seen in the subjects with a history of anorexia but less than that seen in healthy subjects. In three regions, the RTPJ, the PreC, and the dACC, group responses in the subjects with bulimia were significantly different from healthy subjects but not subjects with anorexia. The neural activations of people with BN performing fMRI tasks engaging social processing are more similar to people with AN than healthy people. This suggests biological measures of social processes may be helpful in characterizing individuals with eating disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Neural Responses during Social and Self-Knowledge Tasks in Bulimia Nervosa

McAdams¹,

Krawczyk²

2013

Front. Psychiatry

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“…According to the enhanced CB version (CB-E) [13], the difficulties in establishing and/or maintaining interpersonal relationships may directly precipitate episodes of binge eating, affect all of the other maintenance factors and/or amplify OSW [12,15]. The pervasive low self-esteem that often persists after recovery [16] is thought to lead to attempts to control shape and weight and similarly contribute to negative affect [13,17]. Despite adverse consequences, when clinical perfectionism or over-evaluation of striving for and achieving personally demanding standards [18] is present, it might encourage increased striving to achieve unrealistic high standards in the valued domain of shape and weight and foster dietary restraint [13,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Testing the cognitive-behavioural maintenance models across DSM-5 bulimic-type eating disorder diagnostic groups: a multi-centre study

Dakanalis

Carrà

Calogero

et al. 2014

Eur Arch Psychiatry Clin Neurosci

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(2014) Testing the cognitive-behavioural maintenance models across DSM-5 bulimic-type eating disorder diagnostic groups: A multi-centre study. European Archives of Psychiatry and Clinical Neuroscience, 265 (8 to the data, the CB-E model accounted for a greater proportion of variance in eating-disordered behaviours than the original one, (b) interpersonal problems, clinical perfectionism and low self-esteem were indirectly associated with dietary restraint through over-evaluation of shape and weight, (c) interpersonal problems and mood intolerance were directly linked to binge eating, whereas restraint only indirectly affected binge eating through mood intolerance, suggesting that factors other than restraint may play a more critical role in the maintenance of binge eating. In terms of strength of the associations, differences across DSM-5 bulimic-type eating disorder diagnostic groups were not observed. The results are discussed with reference to theory and research, including neurobiological findings and recent hypotheses.Keywords DSM-5 · Bulimic-type eating disorders · Binge eating · Maintenance factors · Cognitive-behavioural theory · Latent variable structural equation modelling Abstract The original cognitive-behavioural (CB) model of bulimia nervosa, which provided the basis for the widely used CB therapy, proposed that specific dysfunctional cognitions and behaviours maintain the disorder. However, amongst treatment completers, only 40-50 % have a full and lasting response. The enhanced CB model (CB-E), upon which the enhanced version of the CB treatment was based, extended the original approach by including four additional maintenance factors. This study evaluated and compared both CB models in a large clinical treatment seeking sample (N = 679), applying both DSM-IV and DSM-5 criteria for bulimic-type eating disorders. Application of the DSM-5 criteria reduced the number of cases of DSM-IV bulimic-type eating disorders not otherwise specified to 29.6 %. Structural equation modelling analysis indicated that (a) although both models provided a good fit Electronic supplementary material The online version of this article

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“…In addition to binge eating and purging, individuals with bulimia nervosa (BN) frequently report concurrent psychological symptoms such as depression, anxiety, low self-esteem, and cognitive eating disorder pathology (e.g., weight and shape concerns) at more severe levels than non-psychiatric controls (Cockerham, Stopa, Bell, & Gregg, 2008; Daley, Jimerson, Heatherton, Metzger, & Wolfe, 2008; Joiner, Schmidt, & Wonderlich, 1997). Some research also suggests that psychological symptom severity increases with bulimic symptom severity (Krug et al, 2008; Daley et al, 2008).…”

mentioning

confidence: 99%

“…Some research also suggests that psychological symptom severity increases with bulimic symptom severity (Krug et al, 2008; Daley et al, 2008). Although most research in this area has focused on adults, the presence of co-occurring psychological symptoms has also been documented in adolescents with BN (Binford & Le Grange, 2005).…”

mentioning

confidence: 99%

Predictors and moderators of psychological changes during the treatment of adolescent bulimia nervosa

Ciao

Accurso

Fitzsimmons‐Craft

et al. 2015

Behaviour Research and Therapy

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This study examined predictors of psychological change among 80 adolescents with bulimia nervosa (BN) participating in a randomized-controlled trial comparing family-based treatment (FBT) to supportive psychotherapy (SPT). Psychological outcomes (cognitive eating disorder pathology, depression, and self-esteem) were explored at baseline, post-treatment, and 6-month follow-up. Multi-level growth models examined predictors of rate of change in psychological outcomes and moderators of treatment effects. All psychological outcomes improved through 6-month follow-up (moderate to large effect sizes) across both treatments. Overall, few significant predictors were identified. Older adolescents had faster change in self-esteem relative to younger adolescents (p=.03). Adolescents taking psychotropic medication at baseline had faster change in eating concerns relative to adolescents not taking medication (p=.02). Age (p=.02) and baseline purging severity (p=.03) moderated the relationship between treatment condition and change in eating concerns, where younger adolescents and individuals with high baseline purging had greater change when treated with FBT relative to SPT. Age and purging did not significantly moderate change in other psychological outcomes. Bulimic symptom improvement did not predict change in psychological symptoms. Generally, FBT and SPT were equally efficacious with respect to psychological improvement, although FBT may be more efficacious in younger adolescents and those with more frequent purging.

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State self‐esteem ratings in women with bulimia nervosa and bulimia nervosa in remission

Abstract: This study provides new evidence for persistent low self-esteem following recovery from BN. Follow-up studies are needed to assess whether low self-esteem contributes to recurrent dieting and risk for relapse.

Cited by 25 publications

References 35 publications

Neural Responses during Social and Self-Knowledge Tasks in Bulimia Nervosa

Neural Responses during Social and Self-Knowledge Tasks in Bulimia Nervosa

Testing the cognitive-behavioural maintenance models across DSM-5 bulimic-type eating disorder diagnostic groups: a multi-centre study

Predictors and moderators of psychological changes during the treatment of adolescent bulimia nervosa

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