Elsevier

Eating Behaviors

Volume 8, Issue 3, August 2007, Pages 398-406
Eating Behaviors

Negative self-image and outcome in eating disorders: Results at 3-year follow-up

https://doi.org/10.1016/j.eatbeh.2006.12.002Get rights and content

Abstract

Introduction

Negative self-image has been hypothesised to be of aetiological significance in eating disorders; however, its relationship to outcome remains unclear. The present study examined the relationship between self-image and follow-up status in a heterogeneous sample of eating disorder patients (N = 246).

Methods

Patients were assessed at intake and after 36 months. Self-image was measured using SASB, and a general outcome measure was calculated comprising eating disorder symptoms, occupational status, interpersonal relationships and general psychopathology.

Results

SASB self-hate was the most important variable for predicting poor outcome, followed by occupational status, interpersonal relationships, eating disorder symptoms, SASB self-emancipation and general psychiatric symptoms. Together these variables predicted 23% of the variance in outcome.

Discussion

High levels of self-hate may increase the risk of poor outcome in eating disorders by adversely affecting interpersonal relationships and making it difficult for patients to engage in treatment.

Section snippets

Participants

The present research was conducted within the framework of the Co-ordinated Evaluation and Research at Specialized Units for Eating Disorders in Sweden (CO-RED) project. This longitudinal naturalistic study has followed patients treated at 14 specialist treatment centres for eating disorders across Sweden. Participating centres offer a wide variety of treatment forms such as inpatient, day-patient, and outpatient forms of treatment, individual psychotherapy, family and group therapy,

Comparisons with cases having missing data

Since inclusion in the present study required complete data on all variables, initial comparisons were made between cases with and without complete data on age, BMI, diagnosis and other variables used in the study at intake and follow-up. Patients without complete data at follow-up reported higher scores on one variable at intake, namely key clinical symptoms (p = .04). However, the magnitude of this difference (Cohen's d = .12) was negligible. Cohen (1988) defines effect sizes < .20 as indicating

Discussion

The present study aimed to explore the association between initial self-image as assessed by SASB and outcome after 3 years in a heterogeneous sample of eating disorder patients. It utilised an overall measure of outcome based on both self-report and interview measures, covering eating disorder symptoms, general psychopathology, interpersonal relationships and occupational status. Results suggest that aspects of initial negative self-image, in particular self-hate, may increase the risk of poor

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