Content, origins, and consequences of dysfunctional beliefs in anorexia nervosa and bulimia nervosa

A semi-structured interview was used to investigate negative self beliefs in female patients with eating disorders and women without an eating disorder history. Information about possible developmental influences on these beliefs was also collected. Beliefs linking eating behavior with weight and shape and beliefs about the self were identified, but only by the patients. Self-beliefs were invariably negative and unconditional. Beliefs about eating, weight and shape were usually in the form of conditional assumptions. Most patients identified specific origins for their negative self-beliefs: usually trauma or abuse in childhood. All patients believed that dieting was a way of counteracting the negative implications associated with their self-beliefs. Bingeing seemed to provide an initial distraction in some cases from negative automatic thoughts, images, negative self-beliefs and negative emotional states. However, after bingeing, these intensified. Implications for cognitive theories of eating disorders and for clinical practice are discussed.