ADULT
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Eating Disorder Research: Klarman Eating Disorder Center
Abstracts to be presented as posters at the Annual Association of Behavior and Cognitive Therapies in Philadelphia, PA, November 2007
Core Beliefs and Psychopathology Among Patients in Residential Treatment for Eating Disorders
Sarah St. Germain, B.S., Sherrie S. Delinsky, Ph.D., William H. Fagley, M.Ed., Katherine Ellison, B.A., Anne E. Becker, M.D., PhD., and Philip Levendusky, Ph.D., McLean Hospital, Massachusetts General Hospital
Background: Little is known about the relation of core beliefs (schemas) to psychopathology and treatment outcome in patients receiving residential treatment for eating disorders. Better understanding of core beliefs may lead to more effective cognitive interventions with these patients. Objectives: To examine: (1) core beliefs and their correlates among female residential patients with eating disorders; (2) whether specific profiles differ across diagnostic subtypes; and (3) change in core beliefs over the course of treatment. Method: Residential patients ages 16-23 (n = 54) with Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Eating Disorder Not Otherwise Specified (EDNOS) were assessed at intake, 2 weeks, 4 weeks, and at discharge. Assessments included a structural clinical interview (SCID), Young Schema Questionnaire (YSQ), Eating Disorder Examination-Questionnaire (EDE-Q), Beck Depression Inventory (BDI-2), and the Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ). Mean length of stay in residential treatment was 7 weeks. Results: YSQ subscale scores were comparable to other patient samples with BN and significantly higher than non-psychiatric comparison women. In the full sample, total YSQ score was significantly positively correlated with all four subscales of the EDE-Q (Weight Concern: r = .5, p = .001, Shape Concern: r = .5, p = .001, Eating Concern: r = .4, p = .024, and Restraint: r = .4, p = .008). Dysfunctional core beliefs were most strongly associated with Weight Concern and Shape Concern. Defectiveness, Abandonment, Practical Incompetence, and Emotional Inhibition subscales were positively correlated with both these EDE-Q subscales at the p >.01 level. The Emotional Inhibition subscale score was also significantly positively correlated with BDI score (r = .4, p=.012), and both the Emotional Inhibition subscale (r = -.3, p = .042) and the Insufficient Self Control subscale (r = -.4, p=.018) were negatively correlated with self-reported quality of life. The presence of a co-morbid mood disorder was significantly positively correlated with both the Failure to Achieve (r = .3, p=.040) and Social Isolation (r = .4, p=.003) subscales. Of the 18 subscales, only two showed differences across diagnostic categories. Patients with AN were significantly higher on Emotional Inhibition than BN (p=.018) and EDNOS (p=.003). Additionally, patients with BN were significantly higher on Insufficient Self-Control than AN (p=.007) and EDNOS (p=.019). Consistent with previous research, YSQ scores did not change significantly from intake to discharge, with the exception of the Insufficient Self Control subscale (t (13)=3.5, p=.004). Discussion: These data suggest high levels of dysfunctional core beliefs, comparable to other patient samples. Certain core belief profiles appear to be related to elevated eating disorder psychopathology, especially weight and shape concerns, as well as depression and worse quality of life. Diagnostic differences and change in core belief profiles will be discussed in terms of their relation to eating psychopathology, with emphasis on theoretical and clinical implications.
McLean Hospital Research
| 02/01/2007 | First National Survey on Eating Disorders Finds Binge Eating More Common Than Other Eating Disorders |
| 03/06/2006 | Binge Eating Disorder May Have Genetic Ties, McLean Study Finds |