Susceptibility to cognitive distortions: the role of eating pathology

Abstract

BackgroundThought-Shape Fusion (TSF) and Thought-Action Fusion (TAF) are cognitive distortions that are associated with eating and obsessional pathology respectively. Both involve the underlying belief that mere thoughts and mental images can lead to negative outcomes. TSF involves the belief that food-related thoughts lead to weight gain, body dissatisfaction, and perceptions of moral wrong-doing. TAF is more general, and involves the belief that merely thinking about a negative event (e.g., a loved one getting into a car accident) can make this event more likely to happen, and leads to perceptions of moral wrong-doing. However, the shared susceptibility across related cognitive distortions—TAF and TSF—has not yet been studied.MethodThe effects of TSF and TAF inductions in women with an eating disorder (n = 21) and a group of healthy control women with no history of an eating disorder (n = 23) were measured. A repeated-measures design was employed, with all participants exposed to a TSF, TAF and neutral induction during three separate experimental sessions. Participants’ cognitive and behavioral responses were assessed.ResultsIndividuals with eating disorders were more susceptible to TSF and TAF than were control participants, demonstrating more neutralization behavior after TSF and TAF inductions (i.e., actions to try to reduce the negative effects of the induction), and reporting higher levels of trait TAF and TSF than did controls.ConclusionsIndividuals with eating disorders are particularly susceptible to both TAF and TSF. Clinical implications of these findings will be discussed.

Relevance of the Thought–Shape Fusion Trait Questionnaire for healthy women and women presenting symptoms of eating disorders and mixed mental disorders

“…It could be assumed that ED patients have a better or specific understanding of the meaning of thoughts of eating fattening/forbidden foods and its consequences compared with HCs or patients presenting with other mental disorders. Future studies should investigate whether ED patients generally reveal more pronounced susceptibility to thought fusion as well as more difficulties in thought defusion than healthy individuals due to an overall behavioural and cognitive inflexibility (Coelho et al, ; Tchanturia et al, ). Interventions that specifically target the process of thought fusion and defusion (e.g., Hayes, ) may proof to be beneficial for ED patients (Manlick, Cochran, & Koon, ).…”

“…The phenomenon of thought–shape fusion (TSF) has been described as a specific cognitive distortion in eating disorders (EDs; Shafran, Teachman, Kerry, & Rachman, ) based on the findings of thought–action fusion (TAF; Shafran & Rachman, ; Shafran, Thordarson, & Rachman, ) in individuals with obsessive–compulsive disorder (OCD). It has been shown that TAF and TSF are highly correlated in clinical samples of patients suffering from an ED as well as in healthy controls (HCs; Coelho, Carter, McFarlane, & Polivy, ; Coelho, Ouellet‐Courtois, Purdon, & Steiger, ; Jauregui Lobera, Santed, Shafran, Santiago, & Estébanez, ). Nevertheless, the two concepts distinguish between EDs and OCD as patients suffering from OCD were not more susceptible to TSF than HCs (Coelho, Baeyens, Purdon, Pitet, & Bouvard, ).…”

“…Higher TSF trait values were found in individuals suffering from anorexia nervosa or bulimia nervosa compared with HCs and a clinical control sample of patients with OCD (Coelho, Baeyens, et al, ). Furthermore, women with EDs were more susceptible than HCs to the induction of TSF in the laboratory where participants were asked to think about fattening/forbidden foods and to imagine eating large amounts of these foods (Coelho et al, ). In contrast, overweight adult and adolescent females have shown to be less susceptible to a TSF induction than normal‐weight individuals (Coelho, Jansen, & Bouvard, ; Coelho, Siggen, Dietre, & Bouvard, ).…”

“…Based on existing laboratory studies, it can be assumed that TSF is triggered by thinking about fattening/forbidden food, which likely increases a distorted self‐perception. TSF is highly clinically relevant as it is not only a cognitive phenomenon but is also associated with behavioural consequences such as body checking or attempts to neutralize the undesirable thought (e.g., Coelho et al, ; Coelho et al, ; Coelho, Baeyens, et al, ; Coelho, Roefs, & Jansen, ; Kostopoulou, Varsou, & Stalikas, ). Moreover, there are preliminary data revealing associations between ED symptoms including cognitive distortions and correlates of functional dyspepsia (Jauregui Lobera, Santed, & Bolanos Rios, ).…”

Consequences of exposure to the thin ideal in mass media depend on moderators in young women: An experimental study.

“…Originally, TSF was experimentally induced via the instruction to think about high caloric/fattening food, to imagine vividly eating large amounts of this food and then to write down the sentence "I am eating" (inserting the name of the food(s) they were imagining; Coelho et al, 2008). Thereafter, feelings of fatness, perceived weight gain, feelings of guilt, of moral wrong-doing and the pressure to neutralize the effects of such cognitions increased slightly in healthy individuals but increased significantly more in individuals with eating disorders (Coelho et al, 2015;Coelho et al, 2010;Ouellet-Courtois et al, 2015).…”