Dysfunctional metacognition and drive for thinness in typical and atypical anorexia nervosaReport as inadecuate




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Journal of Eating Disorders

, 3:24

First Online: 04 July 2015Received: 21 January 2015Accepted: 28 May 2015DOI: 10.1186-s40337-015-0060-4

Cite this article as: Davenport, E., Rushford, N., Soon, S. et al. J Eat Disord 2015 3: 24. doi:10.1186-s40337-015-0060-4

Abstract

BackgroundAnorexia nervosa is complex and difficult to treat. In cognitive therapies the focus has been on cognitive content rather than process. Process-oriented therapies may modify the higher level cognitive processes of metacognition, reported as dysfunctional in adult anorexia nervosa. Their association with clinical features of anorexia nervosa, however, is unclear. With reclassification of anorexia nervosa by DSM-5 into typical and atypical groups, comparability of metacognition and drive for thinness across groups and relationships within groups is also unclear. Main objectives were to determine whether metacognitive factors differ across typical and atypical anorexia nervosa and a non-clinical community sample, and to explore a process model by determining whether drive for thinness is concurrently predicted by metacognitive factors.

MethodsWomen receiving treatment for anorexia nervosa n = 119 and non-clinical community participants n = 100, aged between 18 and 46 years, completed the Eating Disorders Inventory 3 Edition and Metacognitions Questionnaire Brief Version. Body Mass Index BMI of 18.5 kg-m differentiated between typical n = 75 and atypical n = 44 anorexia nervosa. Multivariate analyses of variance and regression analyses were conducted.

ResultsMetacognitive profiles were similar in both typical and atypical anorexia nervosa and confirmed as more dysfunctional than in the non-clinical group. Drive for thinness was concurrently predicted in the typical patients by the metacognitive factors, positive beliefs about worry, and need to control thoughts; in the atypical patients by negative beliefs about worry and, inversely, by cognitive self-consciousness, and in the non-clinical group by cognitive self-consciousness.

ConclusionsDespite having a healthier weight, the atypical group was as severely affected by dysfunctional metacognitions and drive for thinness as the typical group. Because metacognition concurrently predicted drive for thinness in both groups, a role for process-oriented therapy in adults is suggested. Implications are discussed.

KeywordsAnorexia nervosa Atypical anorexia nervosa Metacognition Drive for thinness AbbreviationsANAnorexia nervosa

AN-tTypical anorexia nervosa

AN-atAtypical anorexia nervosa

BMIBody mass index

CASCognitive attentional syndrome

CNCCommunity-based non-clinical participants

DFTDrive for thinness subscale of the Eating Disorders Inventory-3

DSM-5Diagnostic and Statistical Manual of Mental disorders, Fifth edition

EDI-3Eating Disorders Inventory-3

MANOVAMultivariate analyses of variance

MCQMetacognitions questionnaire

MCQ-30Metacognitions questionnaire—brief version

S-REFSelf-regulatory executive function

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Author: Emily Davenport - Nola Rushford - Siew Soon - Cressida McDermott

Source: https://link.springer.com/







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