Newman Leung

Core beliefs in anorexic and bulimic women.

There is research evidence to suggest the presence of dysfunctional cognitions in anorexia nervosa and bulimia nervosa that are not related to food, weight, or shape. These maladaptive cognitions have not been addressed by the conventional cognitive behavioral models of etiology or therapy. This study aimed to assess the impact of unhealthy core beliefs on eating disorders and their symptoms. Twenty restricting anorexics, 10 bulimic anorexics, 27 bulimics, and 23 normal controls completed Youngs Schema Questionnaire. Eating behaviors and attitudes were also measured. The results indicate that both anorexic and bulimic women had significantly higher levels of unhealthy core beliefs than comparison women, but the clinical groups only differed on one individual core belief (entitlement). However, there were different patterns of association between core beliefs and eating psychopathology in anorexic and bulimic women. It is suggested that future clinical practice should incorporate core beliefs as a potential element in the assessment and treatment of eating disorders.

The relationship between parental bonding and core beliefs in anorexic and bulimic women

OBJECTIVE The role of core beliefs in the psychopathology of eating disorders has been considered in recent years. Young (1994) hypothesized that unhealthy core beliefs originate from the experience from the first few years of life. The aim of the present study was to consider whether perceived parental bonding might explain the development of such beliefs in eating disordered women. METHOD The participants were 30 anorexics, 27 bulimics and 23 comparison women who completed measures of core beliefs and perceived parental bonding. RESULTS There were significant differences in perceived parental bonding behaviours across groups. The association between parental bonding and core beliefs were much stronger in the anorexic group than that in either the bulimic or the control group. In particular, a perceived low level of parental care was predictive of the presence of some unhealthy core beliefs in anorexic women. CONCLUSION Longitudinal research is needed to confirm these findings among anorexic and bulimic women. Clinically, these findings provide insight into the possible origins or core beliefs, and hence might aid their challenge in schema-focused cognitive therapy.

Outcome of group cognitive-behavior therapy for bulimia nervosa : the role of core beliefs

It is hypothesized that individuals who benefit less from CBT will be those who have more pathological core beliefs (unconditional beliefs, unrelated to food, shape and weight). Twenty bulimic women were treated using 12 sessions of conventional group CBT. Eating behavior and attitudes were assessed pre- and posttreatment. Core beliefs were assessed at the beginning of the programme, and were used as predictors of change across treatment (once any effect of pretreatment psychopathology was taken into account). Group CBT was effective, with reductions of over 50% in bulimic symptoms. Outcome on most indices was associated with pretreatment levels of pathological core beliefs. Possible reasons for these findings are discussed.

Father‐daughter relationship and eating psychopathology: The mediating role of core beliefs

OBJECTIVE The study aimed to establish the relationships between recalled paternal rearing behaviours, core beliefs and eating symptomatology and to test whether core beliefs play a mediating role between the father-daughter relationship and eating psychopathology. DESIGN Associations between eating psychopathology, core beliefs and recalled parental rearing behaviours were examined in women with and without eating disorders. Regression analyses were used to test whether core beliefs played a mediating role in the relationship between paternal rearing behaviours and eating psychopathology. METHOD Sixty-six eating-disordered women and fifty female controls completed three self-report questionnaires measuring parental rearing behaviours, core beliefs and eating psychopathology. RESULTS In eating-disordered women, paternal rejection and overprotection were found to predict aspects of eating psychopathology via the mediating role of abandonment, defectiveness/shame and vulnerability to harm core beliefs. DISCUSSION Core beliefs relating to feelings of abandonment and inherent defectiveness appear to be important in the relationship between unhealthy father-daughter relationships and eating disorder symptoms.

Dysfunctional Core Beliefs in Eating Disorders: A Review

Until recently, it was widely accepted that eating-disordered symptoms are caused and maintained by patterns of maladaptive thinking (negative automatic thoughts and dysfunctional assumptions) regarding body size, shape, and weight. However, current research and clinical investigations suggest that broader patterns of maladaptive thinking exist in cognitive organization of eating psychopathology and that cognitive therapy for eating disorders might benefit from in-depth consideration of the individual’s cognitive content. For these reasons, research into the impact of core beliefs in eating disorders has increased in recent years. This article provides a review and critique of the existing findings. The main methodological problems of examining core beliefs in eating disorders are discussed, and the conceptual issues that arise in this area are also reviewed. Finally, suggestions for the directions of future research are also made.

Somatoform dissociation in eating-disordered patients

This study investigated the role of somatoform dissociation in eating disorders and pathological eating behaviour, relative to the established association of eating pathology with psychological dissociation. The participants were 131 women with DSM-IV diagnoses of anorexic or bulimic disorders and 75 women who had no such disorder. Each woman completed measures of psychological and somatoform dissociation, as well as a measure of bulimic attitudes. The current presence or absence of specific bulimic behaviours was identified during the clinical interview. Levels of both forms of dissociation were higher in the women who had diagnoses of disorders with a bulimic component (bulimia nervosa; anorexia nervosa of the binge/purge subtype) than in the non-clinical or restrictive anorexic women. Somatoform dissociation showed particularly strong links with the presence of bulimic behavioural features (excessive exercise, laxative abuse, diet pill abuse, diuretic abuse) and with bulimic attitudes. The formulation and treatment of cases where there are bulimic features is likely to be enhanced by the assessment of somatoform dissociation.

Group cognitive‐behavioural therapy for anorexia nervosa: a case for treatment?

Objectives There is a lack of empirical data regarding the efficacy of cognitive behavioural therapy (CBT) in anorexia nervosa. In addition, the narrow focus of traditional CBT on food- and weight-related negative thoughts and dysfunctional assumptions has been questioned. This study aimed to investigate the effectiveness of a CBT group for anorexic individuals, and to determine whether or not treatment outcome is associated with non-specific underlying cognitions (core beliefs). Method Twenty anorexic women participated in a 10-week cognitive-behavioural group programme. Eating cognitions and behaviours were assessed at the beginning and end of the programme. Core beliefs were assessed at the beginning of the group and were used as predictors of changes in anorectic cognitions and symptoms. Results Group CBT was found to be ineffective in symptom reduction, and core beliefs were irrelevant to outcome. These findings do not appear to be methodological artefacts. Conclusion It is suggested that group CBT in its current short form is insufficient to induce changes, due to its failure to address some process issues central to anorexia nervosa (such as poor motivation, lack of insight, and ambivalence towards treatment). Copyright

The personal meaning of eating disorder symptoms: An interpretative phenomenological analysis

The current study aimed to explore the personal meaning of eating difficulties. Eight women with a variety of eating issues were interviewed. These conversations were then analysed using Interpretative Phenomenological Analysis to construct a framework for understanding the personal world of the interviewees. Three overarching themes identified in participants’ accounts of their experiences are reported here: the experience of the eating difficulties as functional; negative effects of having eating difficulties; ambivalence towards the eating difficulties. These themes add to our knowledge of the potential role of personal experiences in the aetiology and maintenance of eating difficulties.

The effect of induced stress on the relationship between perfectionism and unhealthy eating attitudes

It has previously been shown that stress situations reveal an association between perfectionism and unhealthy eating attitudes in nonclinical females. The present study aimed to extend these findings by also measuring psychological and physiological reactions to induced stress. Forty-two female university students completed measures of state anxiety, perfectionism and unhealthy eating attitudes on two occasions: an average day and after a task designed to induce stress. Physiological responses to stress were measured before, and immediately after the task. Whilst Body Dissatisfaction was associated with aspects of perfectionism both at baseline and immediately after the stress task, Drive for Thinness was only associated with Concern over Mistakes and Personal Standards after the task. These findings confirm previous work showing that stress encourages a relationship between disturbed eating behaviours and perfectionism and therefore, have implications for prevention and early intervention programmes for eating disorders.

Women’s recovery from anorexia nervosa: a systematic review and meta-synthesis of qualitative research

ABSTRACT Anorexia nervosa (AN) is a complex and challenging condition and recovery can be a slow and difficult process. Predicting factors remain largely unknown. This paper aims to systematically review qualitative studies which have investigated female service users’ experiences of recovering from AN and carry out a meta-synthesis of the themes they identified. Meta-ethnography was used to select and synthesize the studies. Articles published between 2002 and 2017 were searched in PsycInfo, EMBASE, CINAHL and Medline. Studies were included if they explored recovery from AN using a qualitative methodology. The methodological quality of the studies was systematically and critically appraised. Fourteen studies were selected for inclusion. Common themes reported by participants describe the process of recovery from AN as dealing with a fragmented sense of self, a turning point where insight and commitment to recovery is developed, and, in recovery, a reclamation of self through meaningful relationships, rebuilding identity and self-acceptance. Recovery from AN is experienced as a complex psychological process with many contributing factors. Findings highlight the need to reconsider clinical practice and treatment provision to incorporate the psychological components of self-identity into recovery programs.