Are eating disorders "all about control?" The elusive psychopathology of nonfat phobic presentations

Autor(en): Murray, Helen B.
Coniglio, Kathryn
Hartmann, Andrea S. 
Becker, Anne E.
Eddy, Kamryn T.
Thomas, Jennifer Joanne
Affiliationen: Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, 02114. Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton Hall 119, Philadelphia, Pennsylvania, 19104. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, 02114. Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115. Osnabrück University, Knollstr. 15, Osnabrück, 49076, Germany. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, 02114. Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115. Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, Massachusetts, 02115. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, 02114. Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, 02114. Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, Massachusetts, 02115.
Stichwörter: Body Weight/physiology; Feeding and Eating Disorders/psychology; Humans; Adolescent; Female; Thinness/psychology; Psychopathology/methods; Body Dysmorphic Disorders/psychology
Erscheinungsdatum: 2017
Enthalten in: International Journal of Eating Disorders
Band: 50
Ausgabe: 11
Startseite: 1306
Seitenende: 1312
Zusammenfassung: 
OBJECTIVE There are a subset of individuals with eating disorders (EDs) who do not overevaluate body shape/weight (i.e., nonfat phobic ED; NFP-ED). According to the transdiagnostic cognitive-behavioral conceptualization of EDs, a need for control, in general, is hypothesized as the core psychopathology of NFP-EDs, with shape- and weight-related motivations for ED behavior merely superimposed in FP-ED presentations. This study tested the need for control as motivation for restriction in NFP-ED, using items aimed at assessing control from the Eating Disorder Examination (EDE) Restraint scale. METHOD Females ages 13-27 years consecutively admitted to residential treatment completed the EDE, Eating Disorder Inventory-3 Drive for Thinness subscale (EDI-DFT), and other self-report measures of psychopathology. We included patients with DSM-5 EDs, but excluded patients with avoidant/restrictive food intake disorder. Twenty participants had NFP-ED (≤14 on EDI-DFT) and 124 had fatphobic ED (FP-ED; >14 on EDI-DFT). RESULTS NFP-ED scored significantly lower than FP-ED on EDE Restraint scale shape/weight [χ2 (1) = 10.73-35.62, p's < .01] and on control items [χ2 (1) = 10.72-20.62, p's < .01], in addition to scoring lower on measures of general psychopathology and impairment. DISCUSSION Findings suggest those with NFP-ED report lower psychopathology overall and the new EDE Restraint scale control items do not capture additional motivation for restriction beyond that captured in the original Restraint scale shape/weight items. Future research should examine whether this latter finding is due to a minimizing response style in NFP-ED, an incomplete capture of desire for control by the EDE assessment method, or indeed reflects that need for control does not motivate restriction in NFP-EDs.
ISSN: 0276-3478
DOI: 10.1002/eat.22779

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