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The role of schema processes in the eating disorders



This study tested a new schema-based cognitive-behavioural model of eating disorders. The model is predicated on the assumption that important differences between bulimic and restrictive psychopathology exist at the level of schema processing. To test this model, 134 females with eating disorders and 345 non-eating disordered females were recruited. Factor analyses validated the measures used. Three factors emerged for primary avoidance of affect (strategies to avoid the activation of emotion), and two for secondary avoidance of affect (strategies to reduce the experience of emotion once it has been triggered). As predicted, primary and secondary avoidance of affect were found in anorexia, where anorexics of the binge/purge subtype displayed the highest levels. In contrast, secondary avoidance of affect was found to characterise bulimia nervosa, and this avoidance was confined to the behavioural/somatic domain. These findings cannot be explained by existing models of eating disorders, but offer some support for the proposed schema-based model. Treatment implications are discussed, and it is suggested that cognitive-behavioural treatments might be extended to address schema processes in order to help those who suffer from eating-disorders to change their behaviours

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