Testing a maintenance model for eating disorders in a sample seeking treatment at a tertiary care center: a structural equation modeling approach

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

“…This last finding supports our hypothesis and suggests that the added hypothesized maintenance variables in the CB model improved its explanatory utility. The direct path from interpersonal problems to the other three maintaining factors, and the results regarding how each maintenance factor is inter-related with each other, as well as their associations with OSW, all are in accordance with previous findings across individuals with different DSM-IV ED diagnosis, included individuals with threshold and sub-threshold AN [15], and together provide support for the trans-diagnostic nature of the maintenance factors as they pertain to OSW [7,12,13,23]. The finding indicating that clinical perfectionism, interpersonal problems, and core low self-esteem impacted dietary restraint through OSW, highlights the importance of dysfunctional cognitions amongst bulimic-type ED patients and are consistent with CB-E theory and past research [8, 13, 17-20, 48, 51].…”

“…Apart from body image concerns, the preliminary evidence that all diagnostic groups report comparable scores in all measures used to assess the four maintaining factors (incorporated in the CB-E model) supports the suggestion that intrapersonal problems, core low self-esteem, clinical perfectionism, and mood intolerance are related to all bulimic-type EDs without differences at the diagnostic level [13,15,17,36]. On the other hand, differences between BED and the other bulimic-type ED diagnostic groups were also observed ( Table 2).…”

“…Accordingly, they reformulated the original CB theory into an enhanced version by encapsulating these factors that considered being "trans-diagnostic" as well [13]. 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].…”

“…binge eating) amongst bulimic-type ED patients. In fact, the only study with a clinical sample of individuals with DSM-IV-including sub-threshold-anorexia nervosa (AN), and BN investigated only the mutual relationships between each maintenance factor, and their associations with OSW [15]. Moreover, since the CB-E model was developed to expand and improve the original CB model [13], an empirical comparison of the two CB models, in an attempt to evaluate whether the predictive ability of the original model would be improved by the inclusion of the four additional maintenance factors (CB-E model), could potentially have implications for understanding the persistence of bulimic-type EDs and provide indirect support for the utility of the CBT-E [7,15,17,[22][23][24].…”

The Social Appearance Anxiety Scale in Italian Adolescent Populations: Construct Validation and Group Discrimination in Community and Clinical Eating Disorders Samples

“…Moreover, they revealed that: (a) SAAS discriminated community younger and older adolescent girls and boys with elevated and nonelevated (global) scores on the EAT-26 [55] (Study 1); (b) adolescent with EDs endorse higher scores on SAA latent factor than those from the community (Study 3), and; (c) the ED diagnostic groups did not differ in terms of SAAS levels. 13 The latter finding is important given increasing efforts to identify underlying aetiological and maintenance processes of eating pathology regardless of specific diagnostic categorisation, and the efforts to develop common psychological assessment and interventions [4,[71][72][73]. Further research needs to concentrate on specific eating-disordered behaviours as well as diagnostic categories and subtypes among both adolescent and adult ED cases.…”