Cognitive processes in women with eating disorders

• Main Author: Quinton, Stephanie Jane
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-1998
• Subjects: Clinical psychology; Cognitive psychology
• ISBN: 0355587726; 9780355587722

An information-processing bias has been noted in both eating-disordered and non-eating- disordered women for information considered salient to eating psychopathology (e.g., food, weight, shape). Recently non-eating 'threat' information has been addressed (e.g., general threat, ego threat). Using a novel information-processing task, it has been suggested that in non-clinical women, relatively bulimic eating attitudes are associated with both an initial attentional bias and a slowing in the processing of general 'threat' compared to neutral information. This has been taken to reflect the cognitive pattern underlying 'escape' models of bulimia. The current thesis aimed to investigate further the suggestion that bulimia is an 'escape from self-awareness' in situations perceived as threatening or unacceptable through a lowering of awareness or 'cognitive narrowing'. Using an information-processing task capable of demonstrating a slowing in processing, 'threat' information irrelated to eating per se was addressed. This involved both general 'threat' and five specific types of 'threat' (autonomy, sociotropy, physical discomfort, ego threat from others and ego threat from self), in both clinical and non-clinical women. These 'threats' were considered relevant as control, social isolation, perfectionism and self-criticism have been implicated in the eating disorders. If 'escape' models of bulimia are correct, it was expected that relatively bulimic eating attitudes would be associated with a slowing in the processing of 'threat' compared to neutral information. In the first (replication) study in non-clinical women, results were not entirely as predicted. No clear pattern in the processing of general 'threat' information occurred according to the level of bulimic attitudes (low- and high-bulimia), and both bulimic and restrictive attitudes were associated with a slowing in the processing of 'threat'. A similar pattern of results occurred in the second study involving non-clinical women (low- and high-bulimia) and the five specific types of 'threat'. In the third and clinical study with the five specific types of 'threat', results suggested a complex pattern. However, the eating- disordered women as a group (comprising both anorexic- and bulimic-type disorders) were slower when processing certain 'threats', as well as manifesting a distinct response style. The 'escape' hypothesis of bulimia was tested further by considering the 'bulimic' women (bulimia nervosa and binge-eating disorder) only, providing more unequivocal support for bulimia as an 'escape' from 'threat'. However, the current task was primarily designed to demonstrate a slowing in processing, and failed to support the prediction of an attentional bias to 'threat' and bulimia in each of the three studies. Therefore, the fourth and final study in non-clinical women employed an information-processing task specifically addressing attentional bias. The prediction that those women with relatively bulimic attitudes (high- bulimia) would have an attentional bias to 'threat' information was supported. Taken together these four studies provided indirect and limited support for 'escape' models of bulimia as demonstrated by an attentional bias and slowing in the processing of 'threat' information. However, the relationship between 'threat' processing and eating psychopathology requires clarification. Further investigations incorporating multi-causal models of eating psychopathology are needed to address the 'escape' hypothesis of bulimia, as well as the five specific types of 'threat' information in both restrictive and bulimic eating disorders.