An investigation of the relationship between fear of negative evaluation and bulimic psychopathology

doi:10.1016/j.eatbeh.2010.05.003

Eating Behaviors

Volume 11, Issue 4, December 2010, Pages 231-238

https://doi.org/10.1016/j.eatbeh.2010.05.003 Get rights and content

Abstract

The current study examined fear of negative evaluation (FNE), the core fear associated with social anxiety, in the context of the dual pathway model of the etiology of bulimia nervosa. Our primary aim was to improve the understanding of the development of bulimic psychopathology. We investigated the relationships between FNE, the risk factors of the dual pathway model and bulimic symptoms using path analysis in a sample of female undergraduates (N = 210). The inclusion of FNE increased the predictive ability of the model to account for 49% of the variance in bulimic symptoms compared to previous findings in which the model accounted for 33% of the variance. Additionally, FNE was related to several risk factors of the dual pathway model including the pressure to be thin, thin-ideal internalization and negative affect, as well as contributing directly to bulimic symptoms. These findings suggest that FNE may increase the risk for developing established risk factors of the model, as well as bulimic symptoms, and that targeting FNE in prevention programs may be useful in circumventing this serious disorder.

Section snippets

The link between fear of negative evaluation, established risk factors of the dual pathway model and bulimic symptoms

Fear of negative evaluation is defined as apprehension and distress about others' negative evaluations, avoidance of evaluative situations, and an expectation of negative evaluation by others (Watson & Friend, 1969). Individuals with high FNE fear the loss of social approval and have a strong desire to preserve or attain positive appraisals by others. Thus, FNE may help explain why some individuals are more susceptible to perceived pressures to be thin from parents, peers, and the media. Given

Study hypotheses

Collectively, extant work suggests that FNE is related to several established risk factors of the dual pathway model. However, it is important to note that previous research has not yet examined the effects of FNE on the risk factors of BN in the context of the full dual pathway model. The aim of the present study was to investigate an extension of the dual pathway model by examining the relationships between FNE, the risk factors of the dual pathway model and bulimic behaviors using path

Participants

Study participants (N = 210) were women recruited from undergraduate level psychology classes at a large Southwestern University. This population was selected for the present research based on epidemiological evidence suggesting that the peak age of onset for BN is 19 years old (Hudson et al., 2007) and the high incidence rate of BN in college women (Heatherton et al., 1995). The college experience is also a source of increased interpersonal distress (Ross, Neibling, & Heckert, 1999), especially

Results

Correlations for all of the variables of interest are presented in Table 2. These correlations are similar to those in other studies examining the dual pathway model (e.g., Duemm et al., 2003, Stice, 2001). In order to test whether the model including FNE accounted for more variance in bulimic symptoms compared to the original dual pathway model (Hypothesis 5), we first fitted the original dual pathway model, as proposed by Stice and Agras (1998), to the data. Consistent with previous findings,

Discussion

Recent research suggests an overlap between social anxiety and bulimic psychopathology; however, no studies to date have examined the specific relationship between FNE, the core fear associated with social anxiety, and the development of BN. The aim of the current study was to investigate the relationship between FNE and the established risk factors of the dual pathway model. The findings from the present study provide us with several important pieces of information. First, it is important to

Role of funding sources

There were no sources of funding for this manuscript.

Conflict of interest

All authors declare that they have no conflicts of interest.

Contributors

All authors contributed to the study design and Dr. Utschig wrote the protocol. Dr. Utschig and Ms. Madeley conducted all experimental sessions with participants. Dr. Utschig conducted statistical analyses and wrote the first draft of the manuscript; all authors contributed to and have approved the final manuscript.

Acknowledgments

The authors thank K. Paige Harden, Ph.D. (University of Texas, Austin, TX) for her statistical advice on the this project.

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Citation Excerpt :
Fear of negative evaluation (FNE) refers to the fear of being appraised negatively in social contexts and is a core cognitive dimension of social anxiety (Weeks et al., 2005). Regarding eating psychopathology, over and above known risk factors (e.g., body dissatisfaction, pressure to be thin, thin-idealization, dietary restraint, and negative affect), trait FNE predicted symptoms of bulimia nervosa (Utschig et al., 2010). Further, a vulnerability model identified trait FNE as a risk factor for disordered eating, predicting disordered eating composite scores above other social anxiety constructs (Levinson & Rodebaugh, 2012).
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Research examining the interpersonal correlates of body talk has primarily focused on the negative consequences of perceiving fat talk on women’s own body talk and eating behaviours; however, little is known about the correlates and effects of positive body talk. This study examined the associations between perceived family and peer negative and positive body talk and adolescent girls’ body talk and eating disorder attitudes, and the mediating role of adolescents’ fear of negative evaluation and self-compassion in these relationships. Influences of family members and peers were compared to examine the uniformity of these interpersonal processes. Adolescent girls (N = 331, M age = 15.7, SD = 1.0) completed a survey. Path analysis models suggested that in the peer and family models, perceived negative body talk was associated with more self-related negative talk through fear of negative evaluation and lower self-compassion, whereas perceived positive body talk was associated with more self-related positive talk through self-compassion. Additionally, adolescents’ fear of negative evaluation and self-related negative talk were mediators between perceived negative body talk and eating disorder attitudes. Results suggest that negative and positive body talk are cultivated interpersonally by increasing evaluative concerns and decreasing self-compassion.
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Citation Excerpt :
Results supported the model in both samples. Consistent with previous research, fear of negative evaluation was positively associated with thin ideal internalization (Gilbert and Meyer, 2003, 2005; DeBoer et al., 2013; Levinson and Rodebaugh, 2013; Utschig et al., 2010) and negative affect (Utschig et al., 2010). However, the significance of the latter effect was tempered with the inclusion of self-compassion in the model.
The dual pathway model, a theoretical model of eating disorder development, suggests that thin ideal internalization leads to body dissatisfaction which leads to disordered eating via the dual pathways of negative affect and dietary restraint. While the dual pathway model has been a valuable guide for eating disorder prevention, greater knowledge of characteristics that predict thin ideal internalization is needed.
The present study replicated and extended the dual pathway model by considering the addition of fear of negative evaluation, suggestibility, rumination, and self-compassion in a sample of community women and female university students.
Results showed that fear of negative evaluation and suggestibility predicted thin ideal internalization whereas rumination and self-compassion (inversely) predicted body dissatisfaction. Negative affect was predicted by fear of negative evaluation, rumination, and self-compassion (inversely).
The extended model fit the data well in both samples. Analogue and longitudinal study of these constructs is warranted in future research.

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An investigation of the relationship between fear of negative evaluation and bulimic psychopathology

Abstract

Section snippets

The link between fear of negative evaluation, established risk factors of the dual pathway model and bulimic symptoms

Study hypotheses

Participants

Results

Discussion

Role of funding sources

Conflict of interest

Contributors

Acknowledgments

Eating Behaviors

Journal of Anxiety Disorders

Behavior Therapy

European Psychiatry

Eating Behaviors

Biological Psychiatry

Journal of the American Academy of Child & Adolescent Psychiatry

Behaviour Research and Therapy

Eating Behaviors

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Behavior Therapy

Behaviour Research and Therapy

Journal of Affective Disorders

A new look at the statistical model identification

IEEE Transactions on Automatic Control

Diagnostic and statistical manual of mental disorders

Cognitions, attitudes and personality dimensions in depression

British Journal of Cognitive Psychotherapy

Comparative fit indexes in structural models

Psychological Bulletin

The happy American body: A survey report

Psychology Today

Self-focused attention and social anxiety: The effects of experimentally heightened self-awareness on fear, blushing, cognitions, and social skills

Cognitive Therapy & Research

Sociocultural factors and the development of disordered eating: A longitudinal analysis of competing hypotheses

Journal of Counseling Psychology

Eating disorders and antecedent anxiety disorders: A controlled study

Acta Psychiatry Scandanavia

A cognitive model of social phobia

The addition of sociotropy to the dual pathway model of bulimia

Canadian Journal of Behavioural Science

Studies of the epidemiology of bulimia nervosa

American Journal of Psychiatry

Eating disorder inventory-2: Professional manual

Fear of negative evaluation and the development of eating pathology: A longitudinal study among nonclinical women

International Journal of Eating Disorders