The Role of Schema Processes in the Eating Disorders

Abstract

This study tested a new schema-based cognitive-behavioural model of eating disorders. The model is predicated on the assumption that important differences between bulimic and restrictive psychopathology exist at the level of schema processing. To test this model, 134 females with eating disorders and 345 non-eating disordered females were recruited. Factor analyses validated the measures used. Three factors emerged for primary avoidance of affect (strategies to avoid the activation of emotion), and two for secondary avoidance of affect (strategies to reduce the experience of emotion once it has been triggered). As predicted, primary and secondary avoidance of affect were found in anorexia, where anorexics of the binge/purge subtype displayed the highest levels. In contrast, secondary avoidance of affect was found to characterise bulimia nervosa, and this avoidance was confined to the behavioural/somatic domain. These findings cannot be explained by existing models of eating disorders, but offer some support for the proposed schema-based model. Treatment implications are discussed, and it is suggested that cognitive-behavioural treatments might be extended to address schema processes in order to help those who suffer from eating-disorders to change their behaviours.Despite differences in the physical and behavioural characteristics of anorexia nervosa and bulimia nervosa, studies show similarities in cognitive and emotional profiles across the disorders (e.g.

The influence of eating psychopathology on autobiographical memory specificity and social problem-solving

“…Given that eating disorders are associated with repeated attempts to avoid and moderate negative affect (Lampard et al, 2010;Luck et al, 2005) it is plausible that the AMS deficit observed in the current study could relate to attempts by those with elevated scores on the EDI to control negative affect (it is notable that these participants also reported higher anxiety and depression scores than did low EDI scorers). However, as the current study was not specifically designed to examine this proposal, such speculations must be considered with caution.…”

“…Furthermore, ruminating (repetitive abstract thinking) about these concerns increases the likelihood of the memory search being captured at the general conceptual level (Watkins & Teasdale, 2001, 2004Watkins et al, 2000). As there is evidence of negative self-schema in patients with eating disorders (Luck et al, 2005;Stein & Corte, 2008) and in subclinical groups who could be considered at risk of developing an eating disorder (Morris, Goldsmith, Roll, & Smith, 2001) a deficit in AMS would be expected. Furthermore, it would be anticipated that this deficit would be greater when memory cues were closely related to the content of the negative self-schema.…”

Do schema processes mediate links between parenting and eating pathology?

“…The original model underpinning this measure suggested that schema compensation is a single construct (Young, 1999b). However, preliminary validation of the YCI among eating-disordered and non-clinical samples (Luck et al, 2005) suggests three robust scales, with good psychometric propertiessocial control (avoiding emotional activation through control of others); personal control (avoidance of emotional activation through controlling the self); and individuality (avoidance of emotional activation through independence and rebellion against society). The scales have acceptable levels of internal consistency (Cronbach's alpha > 0.70 for all three scales for eatingdisordered and non-eating-disordered women) and have discriminant validity, showing differences between eating-disordered and non-eating-disordered groups and between different eating-disordered groups (Luck et al, 2005).…”

Neural response to angry and disgusted facial expressions in bulimia nervosa

“…To date, these processes have been captured only on self-report measures (e.g. Luck et al 2005 ;Corstorphine et al 2007). They have typically been conceptualized using schema models, in which avoidance of affect maintains the associated core or negative beliefs (e.g.…”