Decisional balance in anorexia nervosa: capitalizing on ambivalence



Previous research has shown that unlike two-factor solutions found in other populations, the Decisional Balance (DB) scale for anorexia nervosa consists of three factors: Benefits (Pros), Burdens (Cons), and Functional Avoidance.


The purpose of this study was to examine the psychometric properties of the DB scale for anorexia nervosa and to investigate relationships between DB scores and pre-action stages of change.


Eighty women with anorexia nervosa were recruited from consecutive referrals to an eating disorder clinic. Participants completed the DB scale, as well as measures to assess validity.


The DB scale demonstrated good convergent and discriminant validity. Furthermore, relative to individuals in precontemplation, individuals in contemplation reported more disadvantages of anorexia nervosa (i.e. higher Burdens) and more insight regarding how anorexia nervosa provides a means to avoid (i.e. higher Functional Avoidance). Benefits of anorexia nervosa did not change between pre-action stages.


The clinical implications for enhancing readiness to change are addressed. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.