USING STATISTICAL ANALYSIS AND EXPLANATORY POWER IN TWO APPROACHES TO EATING DISORDER PROBLEMS

Authors

  • Tahereh Mahmoudiyan Department of Psychology, Islamic Azad University, Behshahr Branch, Behshahr, Iran
  • Hassan Badkoobehi Department of Engineering and Computing, National University, San Diego, CA 92123, United States of America

DOI:

https://doi.org/10.20319/lijhls.2020.61.5572

Keywords:

Cognitive Behavioral Therapy, Bulimia Nervosa, Parental Bonding, Schema Therapy

Abstract

This study compares the effectiveness of schema therapy and cognitive behavioral therapy (CBT) on modifying early maladaptive schemas in patients with bulimia nervosa considering parental bonding and examining the relative roles of statistical analysis and explanatory power. The study follows an experimental methodology with pretest-posttest design and follow-up with control group. The population for the study includes all patients aged 16 to 23 years with eating disorders who had been referred to psychiatry, psychotherapy, and obesity clinical treatment centers in Tehran. Purposive sampling was used in this study. 39 patients were diagnosed to have Bulimia nervosa by performing psychological screening. Finally, the selected patients were matched in two experimental groups and one control group. Data were collected through two questionnaires and diagnostic interviews based on diagnostic criteria for eating disorders and psychiatric diagnosis. The two questionnaires used in the study included: (1) Parental Bonding Questionnaire (2) Young Schema Questionnaire. The main problems of the patients included having cuts, being rejected, autonomy, and impaired performance. However, they were less vulnerable in other areas including orientation and violating restrictions. The findings of this study can be helpful in the etiology of bulimia nervosa disorder based on the systematic approach and pave the way for further research in this area.

References

Ahi, G.H. (2006). Standardization of a short version of the Young Schema Questionnaire (Unpublished Master's Thesis). Allameh Tabatabaei University.

American Psychiatric Association. (2013). Diagnostic Manual for Psychiatric Disorders, Fifth Edition.

Boone, L., Braet, C., Vandereycken, W., & Claes, L. (2013). Are maladaptive schema domains and perfectionism related to body image concerns in eating disorder patients?. European Eating Disorders Review, 21(1), 45-51. https://doi.org/10.1002/erv.2175

Canetti, L., Kanyas, K., Lerer, B., Latzer, Y., & Bachar, E. (2008). Anorexia nervosa and parental bonding: the contribution of parent–grandparent relationships to eating disorder psychopathology. Journal of Clinical Psychology, 64(6), 703-716. https://doi.org/10.1002/jclp.20482

Cecero, J. J., & Young, J. E. (2001). Case of Silvia: A schema-focused approach. Journal of Psychotherapy Integration, 11(2), 217-229. https://doi.org/10.1023/A:1016657508247

Cella S; Lannaccone M; Cotrufo P. (2014). How perceived parental bonding affects self-concept and drive for thinness: A community- based study. Eating Behaviors 25. 110-115. https://doi.org/10.1016/j.eatbeh.2013.10.024

Colman, A. M. (2015). A dictionary of psychology. Oxford University Press, USA.

Cooper, M. J., & Young, E. (2016). Parental Bonding and Body Mass Index in a Female Community Sample: The Mediating Role of Eating Disorder Thoughts and Core Beliefs. Behavioural and cognitive psychotherapy, 44(01), 123-127. https://doi.org/10.1017/S1352465815000053

Cooper, P. J., Whelan, E., Woolgar, M., Morrell, J., & Murray, L. (2004). Association between childhood feeding problems and maternal eating disorder: role of the family environment. The British Journal of Psychiatry, 184(3), 210-215. https://doi.org/10.1192/bjp.184.3.210

Correll, C., Galling, B., Pawar, A., Krivko, A. . . . & Kane, J. M. (2018) Comparison of early intervention services vs. treatment as usual for early-phase psychosis: A systematic review, meta-analysis and meta-regression. JAMA Psychiatry, Vol. 75(6), 555-565. https://doi.org/10.1001/jamapsychiatry.2018.0623

Cuijpers, P., Noma, H., & Karyotaki, E. (2019). Effectiveness and acceptability of cognitive behavior therapy delivery formats in adults with depression: A network meta-analysis. JAMA Psychiatry, Vol. 76(7), 700-707. https://doi.org/10.1001/jamapsychiatry.2019.0268

Dalle Grave, R., Calugi, S., Sartirana, M., & Fairburn, C. G. (2015). Transdiagnostic cognitive behaviour therapy for adolescents with an eating disorder who are not underweight. Behaviour research and therapy, 73, 79-82. https://doi.org/10.1016/j.brat.2015.07.014

Dashtbozorgi, Z., Amiri, SH., Mazaheri A., & Talebi, H. (2013). The effect of intervention on attachment to overeating and obesity in Girls (Unpublished Ph.D dissertation). Isfahan University.

Enten, R. S., & Golan, M. (2009). Parenting styles and eating disorder pathology. Appetite, 52(3), 784-787. https://doi.org/10.1016/j.appet.2009.02.013

Fairburn, C. G., Cooper, Z., Shafran, R., & Wilson, G. T. (2008). Eating disorders: A transdiagnostic protocol.

Fairchild, H., & Cooper, M. (2010). A multidimensional measure of core beliefs relevant to eating disorders: Preliminary development and validation. Eating behaviors, 11(4), 239-246. https://doi.org/10.1016/j.eatbeh.2010.05.004

Farrell, J. M., & Shaw, I. A. (2018). Experiencing Schema Therapy from inside out: A self-practice/ self-reflection workbook for therapists. New York: Guilford Press.

Gunty, A. L., & Buri, J. R. (2008). Parental Practices and the Development of Maladaptive Schemas. Online Submission.

Haines, J., Rifas-Shiman, S. L., Horton, N. J., Kleinman, K., Bauer, K. W., Davison, K. K., ... & Gillman, M. W. (2016). Family functioning and quality of parent-adolescent relationship: cross-sectional associations with adolescent weight-related behaviors and weight status. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 1. https://doi.org/10.1186/s12966-016-0393-7

Jones, C. J., Leung, N., & Harris, G. (2006). Father‐daughter relationship and eating psychopathology: The mediating role of core beliefs. British Journal of Clinical Psychology, 45(3), 319-330. https://doi.org/10.1348/014466505X53489

Krug, I., King, R. M., Youssef, G. J., Sorabji, A., Wertheim, E. H., Le Grange, D., ... & Olsson, C. A. (2016). The effect of low parental warmth and low monitoring on disordered eating in mid-adolescence: Findings from the Australian Temperament Project. Appetite, 105, 232-241. https://doi.org/10.1016/j.appet.2016.05.015

Lattimore, P. J., Wagner, H. L., & Gowers, S. (2000). Conflict avoidance in anorexia nervosa: An observational study of mothers and daughters. European Eating Disorders Review, 8(5), 355-368. https://doi.org/10.1002/1099-0968(200010)8:5<355::AID-ERV368>3.0.CO;2-B

Leahi, R. L. (1394). Cognitive-behavioral techniques for depression and anxiety disorders.

Leung, N., Waller, G., & Thomas, G. (1999). Core beliefs in anorexic and bulimic women. The Journal of nervous and mental disease, 187(12), 736-741. https://doi.org/10.1097/00005053-199912000-00005

Lewis, J. A. (2005). Early maladaptive schemas and personality dysfunction in adolescence: An investigation of the moderating effects of coping styles. ETD Collection for Fordham University.

Locher, C., Koechlin, H., Zion, S. R., Werner, C., Pine, D. S., Kirsch, I., & Kessler, R. C, & Kossowsky, J. (2017). Efficacy and safety of selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and placebo for common psychiatric disorders among children and adolescents: A systematic review and meta-analysis. JAMA Psychiatry, 74(10), 1011-1020. https://doi.org/10.1001/jamapsychiatry.2017.2432

Lyke Jennifer; Masten Julie. (2013). Family functioning and risk factors for disordered eating. Eating Behaviors 14. 497-499. https://doi.org/10.1016/j.eatbeh.2013.08.009

Meyer C, Gillings K.(2004) Parental bonding and bulimic psychopathology: The mediating role of mistrust/abuse beliefs. Int J Eat Disord; 35(2):229-33. https://doi.org/10.1002/eat.10236

Muris, P. (2006). Maladaptive schemas in non‐clinical adolescents: Relations to perceived parental rearing behaviours, big five personality factors and psychopathological symptoms. Clinical Psychology & Psychotherapy, 13(6), 405-413. https://doi.org/10.1002/cpp.506

Murphy, R., Straebler, S., Cooper, Z., & Fairburn, C. G. (2010). Cognitive behavioral therapy for eating disorders. Psychiatric Clinics of North America, 33(3), 611-627. https://doi.org/10.1016/j.psc.2010.04.004

Nicholls, D., & Grindrod, C. (2013). Behavioural eating disorders. Paediatrics and Child Health, 23(1), 11-17. https://doi.org/10.1016/j.paed.2012.10.004

Oei, T. P., & Baranoff, J. (2007). Young Schema Questionnaire: Review of psychometric and measurement issues. Australian Journal of Psychology, 59(2), 78-86. https://doi.org/10.1080/00049530601148397

Parker, G. (1983). Parental overprotection: A risk factor in psychosocial development. Grune & Stratton.

Patrick, H., & Nicklas, T. A. (2005). A review of family and social determinants of children’s eating patterns and diet quality. Journal of the American College of Nutrition, 24(2), 83-92. https://doi.org/10.1080/07315724.2005.10719448

Pugh, M. (2015). A narrative review of schemas and schema therapy outcomes in the eating disorders. Clinical psychology review, 39, 30-41. https://doi.org/10.1016/j.cpr.2015.04.003

Sadock, B. J., & Sadock, V. A. (2008). Kaplan & Sadock's concise textbook of clinical psychiatry. Lippincott Williams & Wilkins.

Shayeghian, Z., Agilard Vafaei, M., & Rasoulzadeh Tabatabaei, S.K. (2011). Study of schemas and parental bonding in normal, obese, or adolescent girls with symptoms of bulimia Nervosa. Scientific Journal of Shahid Beheshti University of Medical Sciences, 16 (1), 30-38.

Stice, E., Presnell, K., & Spangler, D. (2002). Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation. Health Psychology, 21(2), 131. https://doi.org/10.1037/0278-6133.21.2.131

Striegel-Moore, R. H., & Bulik, C. M. (2007). Risk factors for eating disorders. American Psychologist, 62(3), 181. https://doi.org/10.1037/0003-066X.62.3.181

Strober, M., & Humphrey, L. L. (1987). Familial contributions to the etiology and course of anorexia nervosa and bulimia. Journal of Consulting and Clinical Psychology, 55(5), 654. https://doi.org/10.1037/0022-006X.55.5.654

Swanson, H., Power, K., Collin, P., Deas, S., Paterson, G., Grierson, D., ... & Taylor, L. (2010). The relationship between parental bonding, social problem solving and eating pathology in an anorexic inpatient sample. European Eating Disorders Review, 18(1), 22-32. https://doi.org/10.1002/erv.967

Tetley, A., Moghaddam, N. G., Dawson, D. L., & Rennoldson, M. (2014). Parental bonding and eating disorders: A systematic review. Eating behaviors, 15(1), 49-59. https://doi.org/10.1016/j.eatbeh.2013.10.008

Thimm, J. C. (2010). Mediation of early maladaptive schemas between perceptions of parental rearing style and personality disorder symptoms. Journal of behavior therapy and experimental psychiatry, 41(1), 52-59. https://doi.org/10.1016/j.jbtep.2009.10.001

Turner, H. M., Rose, K. S., & Cooper, M. J. (2005). Parental bonding and eating disorder symptoms in adolescents: The meditating role of core beliefs. Eating Behaviors, 6(2), 113-118. https://doi.org/10.1016/j.eatbeh.2004.08.010

Turner, H., Marshall, E., Stopa, L., & Waller, G. (2015). Cognitive-behavioural therapy for outpatients with eating disorders: Effectiveness for a transdiagnostic group in a routine clinical setting. Behaviour research and therapy, 68, 70-75. https://doi.org/10.1016/j.brat.2015.03.001

Unoka, Z., Tölgyes, T., Czobor, P., & Simon, L. (2010). Eating disorder behavior and early maladaptive schemas in subgroups of eating disorders. The Journal of nervous and mental disease, 198(6), 425-431. https://doi.org/10.1097/NMD.0b013e3181e07d3d

Voderholzer, U., Schwartz, C., Thiel, N., Kuelz, A. K., Hartmann, A., Scheidt, C. E., ... & Zeeck, A. (2013). A comparison of schemas, schema modes and childhood traumas in obsessive-compulsive disorder, chronic pain disorder and eating disorders. Psychopathology, 47(1), 24-31. https://doi.org/10.1159/000348484

Waller, G., Kennerley, H., & Ohanian, V. (2007). Schema-Focused Cognitive-Behavioral Therapy for Eating Disorders. Book Chapter Selected

Waller, G., Ohanian, V., Meyer, C., & Osman, S. (2002). Cognitive content among bulimic women: The role of core beliefs. International Journal of Eating Disorders, 28(2), 235-241. https://doi.org/10.1002/1098-108X(200009)28:2<235::AID-EAT15>3.0.CO;2-1

Wilson, G. T., Fairburn, C. C., Agras, W. S., Walsh, B. T., & Kraemer, H. (2002). Cognitive-behavioral therapy for bulimia nervosa: Time course and mechanisms of change. Journal of consulting and clinical psychology, 70(2), 267. https://doi.org/10.1037/0022-006X.70.2.267

Yang, C. (1999). Cognitive therapy for personal disorders: Schematic approach.

Young, J. E. (1994). Cognitive therapy for personality disorders: A schema-focused approach (rev. Professional Resource Press/Professional Resource Exchange.

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide.. Journal of psychosomatic research, 57, 113-116.

Young, J. E., Klosko, J., Weishaar, M. E. (2006). Schema therapy: A practitioner’s guide. New York: Guilford Press. https://doi.org/10.1007/s11630-006-0071-1

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Published

2020-06-17

How to Cite

Mahmoudiyan, T., & Badkoobehi, H. (2020). USING STATISTICAL ANALYSIS AND EXPLANATORY POWER IN TWO APPROACHES TO EATING DISORDER PROBLEMS. LIFE: International Journal of Health and Life-Sciences, 6(1), 55–72. https://doi.org/10.20319/lijhls.2020.61.5572