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Over-evaluation of thoughts about food: Differences across eating-disorder subtypes and a preliminary examination of treatment effects

Authors

  • Jennifer S. Coelho PhD,

    Corresponding author
    1. Eating Disorders Program, Douglas University Institute in Mental Health, Verdun, Quebec
    2. Department of Psychiatry, McGill University, Montreal, Quebec
    • Correspondence to: J. S. Coelho, Provincial Specialized Eating Disorders Program, BC Children's Hospital, P3-4500 Oak St., Box 178, Vancouver BC, Canada V6H 3N1. E-mail: Jennifer.coelho@cw.bc.ca

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  • Samantha Wilson BA,

    1. Eating Disorders Program, Douglas University Institute in Mental Health, Verdun, Quebec
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  • Amanda Winslade,

    1. Eating Disorders Program, Douglas University Institute in Mental Health, Verdun, Quebec
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  • Lea Thaler PhD,

    1. Eating Disorders Program, Douglas University Institute in Mental Health, Verdun, Quebec
    2. Department of Psychiatry, McGill University, Montreal, Quebec
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  • Mimi Israel MD,

    1. Eating Disorders Program, Douglas University Institute in Mental Health, Verdun, Quebec
    2. Department of Psychiatry, McGill University, Montreal, Quebec
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  • Howard Steiger PhD

    1. Eating Disorders Program, Douglas University Institute in Mental Health, Verdun, Quebec
    2. Department of Psychiatry, McGill University, Montreal, Quebec
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ABSTRACT

Objective

Over-evaluation of food, shape and weight is a multi-faceted component of cognitive-behavioral models of eating disorders. One specific aspect of over-evaluation of food is a cognitive distortion known as thought-shape fusion (TSF). TSF is purported to be specific to eating pathology; however, research has not yet elucidated whether individuals across the subtypes of eating disorders are differentially susceptible to this phenomenon. Furthermore, it remains unclear whether susceptibility to TSF decreases over the course of treatment.

Method

TSF, eating pathology, and generalized psychopathology were assessed in 76 individuals with eating disorders. Changes in TSF from pre- to post-treatment were assessed in a subset of participants (n = 24).

Results

Individuals with the binge/purge subtype of anorexia nervosa were more susceptible to TSF than were individuals with bulimia nervosa or the restrictive subtype of anorexia nervosa. Increased TSF corresponded with higher levels of eating pathology, depression, and impulsivity. In addition, there were decreases in TSF over the course of treatment.

Discussion

The observed differences in TSF susceptibility across eating disorder subtypes suggests that subtypes may be differentially prone to over-evaluation of thoughts about food, which represents a facet of one of the core maintenance mechanisms in cognitive-behavioral models of eating disorders. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:302–309)

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