Top

Gepubliceerd in:

01-12-2006 | Original Paper

A Preliminary Study of Negative Self-Beliefs in Anorexia Nervosa: A Detailed Exploration of Their Content, Origins and Functional Links to “Not Eating Enough” and Other Characteristic Behaviors

Auteurs: Rachel A. Woolrich, Myra J. Cooper, Hannah M. Turner

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2006

Abstract

Objective: The study explored the semantic content and origins of negative self-beliefs, and their functional links to “not eating enough” and other behaviors, in participants with anorexia nervosa (AN). Method: Fifteen women meeting DSM-IV criteria for AN were compared with 17 dieting and 18 non-dieting women matched on age and number of years of education. The main outcome measure was a semi-structured interview. Results: Six themes were identified in the beliefs of participants with AN. These were, in order of decreasing frequency, powerlessness (present in all but three AN participants), failure, defectiveness, unattractiveness, worthlessness and emptiness. Importantly, powerlessness and failure beliefs were consistently present independent of Beck Depression Inventory-II scores. The negative early life experiences associated with these beliefs had high distress and responsibility ratings. Participants with AN reported that they employed specific behaviors, particularly ‘not eating enough,’ and ‘placating others,’ to try to reduce the cognitive and emotional impact of their negative self-beliefs. Discussion: The findings are discussed in relation to the role of powerlessness and the function of “not eating enough” in cognitive theory and therapy for AN.

vorige artikel A Prospective Test of Cognitive Vulnerability to Obsessive-compulsive Disorder

volgende artikel Social Anxiety and Positive Outcome Expectancies on Risk-Taking Behaviors

We use the term “not eating enough” to describe the key behavioral feature of AN, rather than dieting or restricting as others have sometimes done. This reflects our belief that “not eating” is the key feature, and that it is distinctively and qualitatively different from both these other behaviors (as bingeing is from overeating). Our clinical experience is that patients also report a qualitative difference and make a similar distinction when describing the key features of their problematic AN behavior.

We choose to use the term ‘powerlessness’ as it seems that patients use this term more than ‘personal ineffectiveness,’ and the use of the word ‘control’ seems to us to be ambiguous (see below).

It is interesting to note, however, that Serfaty suggests that enhanced personal effectiveness may be an important mechanism effecting change in his study of CBT for AN (Serfaty et al., 1999).

Rationally=extent to which you believe this rationally, when considering all the evidence; emotionally=extent to which you feel that this is true, regardless of the evidence.

Body Mass Index (BMI): weight (kg)/height (m²).

American Psychiatric Association (1994). Diagnostic and Statistical Manual, 4th Edn.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). The Beck Depression Inventory–(II) Manual. San Antonio: The Psychological Corporation, Harcourt Brace and Co.

Bers, S. A., Blatt, S. J., & Dolinsky, A. (2004). The sense of self in Anorexia Nervosa patients: A psychoanalytically informed method for studying self-representation. The Psychoanalytic Study of the Child.

Bradford, R., & Rutherford, D. (2001). The Eating Disorder Belief Questionnaire: In-patient adolescent Scores. Clinical Child Psychology and Psychiatry, 6(4), 513–518.CrossRef

Bruch, H. (1973). Eating Disorders: Obesity, Anorexia Nervosa and the Person Within. New York: Basic Books.

Bruch, H. (1979). The Golden Cage: The Enigma of Anorexia Nervosa. New York: Vintage.

Bruch, H. (1982). Anorexia Nervosa: Therapy and Theory. American Journal of Psychiatry, 139, 1531.PubMed

Burns, D. D. (1980). Feeling good: The Mood Therapy Book. New York: New American library.

Cohen, J. A. (1960). A co-efficient of agreement for nominal scales. Educational Psychology Measurement, 20, 37–46.

Cooper, M. J. (1997). Cognitive theory in anorexia nervosa: a review. Behavioural and Cognitive Psychotherapy, 25, 113–145.CrossRef

Cooper, M. J. (2003). The Psychology of Bulimia Nervosa: A cognitive perspective. Oxford: Oxford University Press.

Cooper, M. J., Cohen-Tovée, E., Todd, G., Wells, A., & Tovée, M. (1997). A questionnaire to assess assumptions and beliefs in eating disorders: preliminary findings. Behaviour Research and Therapy, 35, 381–388.PubMedCrossRef

Cooper, M. J., Rose, K. S., & Turner, M. (2005). The specific content of core beliefs and schema in adolescent girls high and low in eating disorder symptoms. International Journal of Eating Disorders, 38, 60–64.

Cooper, M. J., Todd, G., Woolrich, R., Somerville, K., & Wells, A. (resubmission invited). Assessing eating disorder thoughts and behaviours: the development and preliminary evaluation of two questionnaires. Cognitive Research and Therapy.

Cooper, M. J., Todd, G., & Wells, A. (1998). Content, origin and consequences of dysfunctional beliefs in anorexia nervosa and bulimia nervosa. Journal of Cognitive Psychotherapy: An international Quarterly, 12(3), 213–230.

Cooper, M. J., & Fairburn, C. G. (1992). Thoughts about eating, weight and shape in anorexia nervosa and bulimia nervosa. Behaviour Research and Therapy, 30(5), 501–511.PubMedCrossRef

Fairburn, C. G., Shafran, R., & Cooper, Z. (1999). A cognitive-behavioural theory of anorexia nervosa. Behaviour Research and Therapy, 37, 1–13.PubMedCrossRef

Fleiss, J. L. (1981). Statistical Methods for Rates and Proportions. New York: Wiley, pp. 223.

Garner, D. M., & Bemis, K. M. (1982). A cognitive-behavioural approach to anorexia nervosa. Cognitive Therapy and Research, 6, 123–150.CrossRef

Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273–279.PubMedCrossRef

Glaser, B. A., Campbell, L. F., Calhoun, G. B., Bates, J. M., & Petrocelli, J. V. (2002). The Early Maladaptive Schema Questionnaire-Short Form: A Construct Validity Study. Measurement and Evaluation in Counselling and Development, 35, 2–12.

Guidano, V. F., & Liotti, G. (1983). Cognitive Processes and Emotional Disorders: A Structured Approach to Psychotherapy. New York: Guilford Press.

Jansen, A. (2001). Towards effective treatment of eating disorders: Nothing is as practical as good theory. Behaviour Research and Therapy, 39, 1007–1022.PubMedCrossRef

Krippendorff, K. (1980). Content analysis: An introduction to its methodology. Newbury Park, London: Sage.

Leung, N., Thomas, G. V., & Waller, G. (2000). The relationship between parental bonding and core beliefs in anorexia and bulimic women. British Journal of Clinical Psychology, 39, 205–213.PubMedCrossRef

Leung, N., Waller, G., & Thomas, G. V. (1999). Core-beliefs in anorexic and bulimic women. Journal of Nervous and Mental Disease, 187, 736–741.PubMedCrossRef

Liotti, G. (1987). The Resistance to Change of Cognitive Structures: A counter proposal to psychoanalytic metapsychology. Journal of Cognitive Psychotherapy: An international quarterly, 1(2), 87–104.

Pike, K. M., Walsh, B. T., Vitousek, K., Wilson, G. T., & Bauer, J. (2003). Cognitive Behaviour Therapy in the post hospitalisation treatment of anorexia nervosa. American Journal of Psychiatry, 160, 2046–2049.PubMedCrossRef

Rosenberg, M. (1965). Society and Adolescent Self-image. Princeton, NJ: Princeton University Press.

Selvini-palazzoli (1978). Self-starvation. New York: Aronson.

Serfaty, M. A., Turkington, D., Heap, M., Ledsham, L., & Jolley, E. (1999). Cognitive Therapy Versus Dietary Counselling in the Outpatient Treatment of Anorexia Nervosa: Effects of the Treatment Phase. European Eating Disorders Review, 7, 334–350.CrossRef

Slade, P. (1982). Towards a functional analysis of anorexia nervosa and bulimia nervosa. British Journal of Clinical Psychology, 21, 167–169.PubMed

Somerville, K., & Cooper, M. J. (2004). Spontaneous imagery in women with Bulimia Nervosa: An investigation into content, characteristics and links to early memories. EABCT Conference, Manchester, UK.

Spangler, D. L. (2002). Testing the cognitive model of Eating Disorders: The role of dysfunctional beliefs about appearance. Behaviour Therapy, 33, 97–105.

Spitzer, R., Williams, J., & Gibbons, M. (1996). Instruction Manual for the Structured Clinical Interview for DSM-IV. New York: New York State Psychiatric Institute.

SPSS Inc. (1997). SPSS Version 10.0. Advanced Statistics. Chicago: SPSS Inc.

Stopa, L., Thorne, P., Waters, A., & Preston, J. (2001). Are the Short and Long Forms of the Young Schema Questionnaire Comparable and How Well does Each Version Predict Psychopathology Scores? Journal of Cognitive Psychotherapy: An International Quarterly, 15(3), 253–272.

Turner, H., & Cooper, M. J. (2002). Cognitions and their origins in Women with Anorexia Nervosa, Normal Dieters and Female Controls. Clinical Psychology and Psychotherapy, 9, 242–252.CrossRef

Van Strien, T., Fritjers, J. E. R., Berger, G. P. A., & Defares, P. B. (1986). The Dutch Eating Behaviour Questionnaire (DEBQ) for assessment of restrained emotional and external eating behaviours. International Journal of Eating Disorders, 5, 295–315.

Waller, G., Kennerley, H., & Ohanian, V. (2005). Schema-focused cognitive behaviour therapy with eating disorders. In L. P. Riso, P. T. du Toit, and J. E. Young (Eds.), Cognitive Schemas and Core Beliefs in Psychiatric Disorders: A Scientist-Practitioner Guide. New York: American Psychological Association.

Williamson, D. A., Cubic, B. A., & Gleaves, D. H. (1993). Equivalence of body image disturbances in anorexia nervosa and bulimia nervosa. Journal of Abnormal Psychology, 102, 1–4.CrossRef

Wolff, G., & Serpell, L. (1998). A cognitive model and treatment strategies for Anorexia Nervosa. In H. W. Hoek, J. Treasure & M. A. Katzman (Eds.), Neurobiology in the Treatment of Eating Disorders. Chichester: John Wiley and Sons.

Young, J. E. (1998). Young Schema Questionnaire—Short Form (1st edn). New York: Cognitive Therapy Center.

Titel: A Preliminary Study of Negative Self-Beliefs in Anorexia Nervosa: A Detailed Exploration of Their Content, Origins and Functional Links to “Not Eating Enough” and Other Characteristic Behaviors
Auteurs: Rachel A. Woolrich
Myra J. Cooper
Hannah M. Turner
Publicatiedatum: 01-12-2006
Uitgeverij: Kluwer Academic Publishers-Plenum Publishers
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 6/2006
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-006-9024-y

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 6/2006

Social Anxiety and Positive Outcome Expectancies on Risk-Taking Behaviors

Frustration Intolerance Beliefs: Their Relationship with Depression, Anxiety, and Anger, in a Clinical Population

Specificity in Personality and Cognitive Factors Associated with Drinking and Depressive Symptoms

The Hopelessness Theory of Depression: A Prospective Multi-Wave Test of the Vulnerability-Stress Hypothesis

Conceptualization and Measurement of Adaptive and Maladaptive Aspects of Performance Perfectionism: Relations to Personality, Psychological Functioning, and Academic Achievement

Specificity of Hopelessness about Resolving Life Problems: Another Test of the Cognitive Model of Depression