Parental bonding and eating disorder symptoms in adolescents: The meditating role of core beliefs

Abstract

This study aimed to investigate the mediating role of early maladaptive schemas in the relationship between parental bonding and eating disorder symptoms in a group of female adolescents. Three hundred and sixty-seven female adolescents completed the Parental Bonding instrument [PBI; Brit. J. Med. Psychol. 52 (1979) 1–10], the Young Schema Questionnaire short version [YSQ; Young, J. E. (1998). The Young Schema Questionnaire: Short form. Available at http://home.sprynet.com/sprynet/schema/ysqs1.htm], and the Eating Attitudes Test [EAT; Psychol. Med. 9 (1979) 273–279]. Two underlying schemas, defectiveness/shame and dependence/incompetence, were perfect mediators in the relationship between parental bonding and eating disorder symptoms. Schemas relating to both shame and dependency may be important in determining the effect that parental bonding has on eating disorder symptoms in a sample of female adolescent schoolgirls.

Introduction

It has long been recognised that unhealthy family relationships may play a role in the aetiology and course of eating disorder psychopathology (e.g., Minuchin et al., 1978, Mallinckrodt et al., 1995). High maternal overprotectiveness has been associated with anorexia nervosa (Walters & Kendler, 1995), and low levels of parental care, coupled with high levels of overprotection, has been reported by women with bulimia nervosa (e.g., Callam, Waller, Slade, & Newton, 1990). It has also been suggested that the persistence of chronic anorexia nervosa may be linked to unhealthy parental bonding, particularly lower levels of maternal and paternal care (Bulik, Sullivan, Fear, & Pickering, 2000).

With mounting evidence to support the link between family functioning and eating psychopathology, researchers have begun to consider possible mediating mechanisms. To date, much of this research has focused on bulimic psychopathology and drawn upon the schema theory proposed by Young (1990) and Young, Klosko, and Weishaar (2003). In his model, Young proposes that schema develop in childhood and serve as ‘templates for the processing of later experiences’ (p. 9). Reflecting stable and enduring themes, schemas often comprise unconditional beliefs about the self.¹ Within the eating disorders field, it has been suggested that negative or traumatic early experiences lead to the formation of maladaptive schemas that are often tied to high affect and resistant to change (Cooper, 2003). For example, a child who receives a low level of maternal care may conclude that this is because they are inherently defective. It has been suggested that these beliefs may relate to eating pathology via cognitive and emotional avoidance, as well as schema compensation (Cooper, Todd, & Wells, 1998). Bulimic behaviours, for example, may serve as a means of reducing one's awareness of the intolerable emotions connected to the schema when it is repeatedly activated in day-to-day life (Heatherton & Baumeister, 1991). A cognitive model of the development and maintenance of bulimia nervosa (Cooper, Wells, & Todd, 2004) suggests that both schema avoidance and compensatory processes may contribute to the maintenance of behaviours related to bulimia nervosa and anorexia nervosa. A role for negative or traumatic early experiences is also included in this model, including early negative experiences within the family, which are hypothesised to encourage the development of unhealthy core beliefs.

To date, two studies have examined the mediating role of core beliefs in the relationship between eating disorder symptoms and parental bonding. In their study exploring the role of shame, Murray, Waller, and Legg (2000) found that internalized shame acts as a perfect mediator² in the link between paternal overprotection and bulimic attitudes in a nonclinical sample. In a more recent study, mistrust/abuse beliefs were found to act as a partial mediator in the relationship between parental overprotection and severity of bulimic attitudes (Meyer & Gillings, 2004).

The current study aims to explore whether the links between cognitive functioning and early parental relationships identified in previous studies using undergraduate students can be replicated in a group of female adolescents still living at home. In light of this, the present study had two aims. First, to determine whether any significant associations exist between eating disorder symptoms, parental bonding, and core beliefs in a group of adolescent females at school, and second, to explore whether any specific schemas mediate the relationship between perceived parental functioning and a broad range of eating disorder symptoms. Unlike previous studies, which have used a measure of bulimic psychopathology, eating dysfunction was assessed using the EAT, a generic measure of disturbed eating behaviour and attitudes applicable to both bulimic and anorexic psychopathology.