The relationship between two-dimensional self-esteem and problem solving style in an anorexic inpatient sample

Negative mood induction effects on problem-solving task in women with eating disorders: a multi-method examination

BACKGROUND

The effects of negative affect on problem-solving and its psychophysiological correlates are poorly understood in eating disorder populations.

METHODS

This study examined respiratory sinus arrhythmia (RSA) and skin conductance responses of women with Binge Eating Disorder (BED: n = 56), Anorexia Nervosa (AN: n = 12), Bulimia Nervosa (BN: n = 32), and 24 healthy controls (HCs) at baseline, and then during: a negative mood induction task, an adapted Means Ends Problem-Solving (MEPS) task, and recovery. The MEPS task included four interpersonal scenarios: (1) binge-eating as a solution to stress, (2) job loss, (3) rejection by friends, and (4) by a significant other.

RESULTS

We found that individuals with eating disorders reported less positive mood than HCs and individuals with BN and BED reported more negative mood and greater urges to binge than HCs. After a negative mood induction, women with BED provided significantly less effective problem-solving strategies compared to HCs and women with BN for the binge-eating MEPS scenario. Relative to baseline and the negative mood induction, all participants exhibited significantly higher skin conductance measures throughout the MEPS scenarios and recovery. BED showed significantly lower respiratory sinus arrhythmia (RSA) levels than individuals with BN and HCs throughout the protocol.

CONCLUSIONS

The multimethod findings suggest individuals with BED are likely to have disorder-specific problem-solving difficulties after a negative mood induction.

The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach

Background

Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between adaptive and maladaptive emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology.

Methodology

A total of 104 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted. We ran a Bayesian random effects network meta-analysis and the initial network was well-connected with each emotion regulation strategy being linked to at least one other strategy. We also conducted a network meta-regression to explore whether between-study differences in body mass index (BMI), age, and whether the sample consisted of solely female participants explained any possible network inconsistency.

Results

The network meta-analysis revealed that ruminations and non-acceptance of emotions were most closely associated with ED psychopathology. There was no significant network inconsistency but two comparisons approached significance and thus meta-regressions were conducted. The meta-regressions revealed a significant effect of BMI such that the associations between different emotion regulation strategies and ED symptomatology were weaker among those with low BMI.

Discussion

The present findings build on previous work and highlight the role of rumination and difficulties with accepting emotions as key emotion regulation difficulties in EDs. Additionally, the finding that the associations were weaker among ED patients with low BMI may point toward a complex relationship between ED behaviors and emotion regulation. Taken together, our findings call for interventions that target emotion regulation, specifically rumination and difficulties accepting emotions, in the treatment of EDs.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249996, PROSPERO, identifier: CRD42021249996.

The role of positive self-compassion, distress tolerance, and social problem-solving in the relationship between perfectionism and disordered eating among racially and ethnically diverse college students

Eating disorders (EDs) are associated with high levels of distress, functional impairment, and morbidity. Perfectionism has been consistently identified as an important factor in the etiology and maintenance of disordered eating, and as a promising target for treatment efforts. To address the detrimental effects of perfectionism on disordered eating, further research is needed to better understand what mechanisms may influence the relationship between these variables. In the present research, we examined three constructs related to self-regulation as potential mediators of the relationship between perfectionism and disordered eating: positive self-compassion, distress tolerance, and social problem-solving. We collected data from a sample of racially and ethnically diverse undergraduate students (N = 280) using an online questionnaire battery. Using structural equation modeling (SEM), we developed measurement and structural models to meet criteria for good fit and tested the hypothesized relationships. Distress tolerance emerged as a robust, statistically significant mediator of the relationship between perfectionism and disordered eating. Social problem-solving and self-compassion did not mediate this relationship. Distress tolerance may counterbalance the cognitive load associated with perfectionism; freeing up mental resources to focus on resisting urges for immediate relief through engagement in maladaptive disordered eating.

The relationship between attention and avoidance coping in anorexia nervosa: functional magnetic resonance imaging study

BACKGROUND

Numerous studies have demonstrated attentional control difficulties and high avoidance coping in patients with anorexia nervosa. Attention is a critical coping resource because it enables individuals to demonstrate self-control and complete goal-directed behaviours.

AIMS

We aimed to examine whether attentional control difficulty is related to high avoidance coping, and investigate the neural underpinnings of attentional control difficulties in individuals with anorexia nervosa.

METHOD

Twenty-three patients with anorexia nervosa and 17 healthy controls completed questionnaires that assessed attention and coping, and underwent functional magnetic resonance imaging while performing a go/no-go task.

RESULTS

Patients with anorexia nervosa showed weaker attentional control, higher omission error rates and higher avoidance coping compared with healthy controls. Attentional control difficulty was associated with higher avoidance coping in both groups. Functional magnetic resonance imaging analysis showed less deactivation in regions representing internal mental processing, such as the praecuneus, cuneus and left lingual gyrus, during the no-go condition. Moreover, weakened deactivation of the left lingual gyrus was associated with higher commission error rate in the anorexia nervosa group.

CONCLUSIONS

Our results suggest that patients with anorexia nervosa may have difficulty in maintaining attention to external ongoing events because of disturbance from internal self-related thought, and support the notion that attentional control difficulties underlie the frequent use of avoidance coping in anorexia nervosa.

Self-esteem, social support and coping strategies of left-behind children in rural China, and the intermediary role of subjective support:a cross-sectional survey

BACKGROUND

Negative coping strategies and behavioral problems are common among Chinese left-behind children, which are relate to a variety of negative consequences. At this stage of development, the relevant factors of coping strategies need to be further studied, in which social support and self-esteem are worthy of our attention. The aim of this study is to detect the current situation of self-esteem, social support, and coping styles of left-behind children (LBC) in rural China.

METHODS

322 children from 3 schools in China enrolled in this study, including 236 LBC and 86 non-left-behind children (NLBC) to assess self-esteem, social support and coping strategies.

RESULTS

The LBC group had lower self-esteem score and lower total social support (subjective support, objective support and support-seeking behavior) than the NLBC group. In terms of coping strategies, the LBC group was lower than the NLBC group in problem-solving and rationalization. The self-esteem score in LBC was significant positive associated with the subjective support score, objective support score, problem-solving and help-seeking score. In addition, self-esteem has significant mediating effect between subjective support and problem-solving, subjective support and help-seeking, respectively.

CONCLUSIONS

The finding indicate that Chinese LBC's self-esteem and social support need to be improved. Given the significant correlativity between self-esteem, subjective support and coping strategy, it is necessary to promote Chinese LBC's self-esteem and social support, especially subjective support.

Schadenfreude, malicious and benign envy are associated with low body mass index in restrictive-type anorexia nervosa

PURPOSE

According to the Cognitive-Interpersonal Maintenance Model of anorexia nervosa, social factors are involved in the maintenance and development of this disorder. Therefore, this study aimed to test whether patients with restrictive-type anorexia nervosa (AN-R) experience malicious envy (negative emotions associated with the wish that others lack their superior quality), benign envy (negative emotions associated with the desire to reach and obtain the others' superior quality) and Schadenfreude (pleasure at the misfortunes of others) with a higher intensity than healthy controls (HC).

METHODS

26 AN-R patients and 32 HC completed scenarios that aimed to induce envy and Schadenfreude and completed questionnaires measuring envy, self-esteem and social comparison.

RESULTS

AN-R patients reported more benign envy than HC. Interestingly, higher body mass index (BMI) was associated with less Schadenfreude, malicious and benign envy in AN-R only.

CONCLUSIONS

This study shows that AN-R patients present higher motivation to evolve when facing others' superior quality (i.e., benign envy). It also underlines the importance of considering social factors in the maintenance of AN-R and the role of BMI when examining emotions related to others' fortune.

LEVEL OF EVIDENCE

Level III, case-control analytic study.

Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa?

INTRODUCTION

Inefficient problem solving in the social domain may be one of the difficulties underlying the interpersonal challenges thought to maintain anorexia nervosa (AN). However, past studies have neglected to control for depression, anxiety, and intolerance of uncertainty (IU), which are known to contribute to social problem solving.

METHODS

This study aimed to investigate whether adults with AN would show differences in social problem solving on an experimental task (Means-End Problem Solving; MEPS) and report differences in their attitudes (positive, negative) toward social problem solving and their use of social problem-solving styles (rational, impulsive-careless, avoidant) on the Social Problem-Solving Inventory Revised (SPSRI) compared to a non-AN control group.

RESULTS

Seventy-four adult women took part (30 with AN and 44 non-AN controls), and data show that those with AN generated significantly less effective solutions on the MEPS (d = 1.96) reported overall poorer social problem solving on the SPSRI (d = 0.58), reporting more negative and less positive attitudes toward social problem solving, and less impulsive and more avoidant social problem-solving styles. However, those with AN did not differ from controls in being able to rationalize social problems. Once depression (Beck Depression Inventory: BDI), state anxiety (State-Trait Anxiety Inventory: STAI), and IU (Intolerance of Uncertainty Scale-12; IUS-12) were included as covariates, these differences were no longer significant, suggesting that comorbid depression, anxiety, and IU symptoms may contribute to social problem solving in AN.

CONCLUSIONS

There was no specific effect of depression. Treating anxiety and IU might help to improve social problem solving and enable people with AN to be able to better access social support to aid their recovery.

Emotion regulation across eating pathology: A meta-analysis

The goal of this meta-analysis was to examine the associations between specific emotion regulation abilities (emotional awareness, emotional clarity) and strategies (acceptance of emotions, reappraisal, problem-solving, rumination, avoidance of emotions, and suppression), and eating pathology. A total of 96 studies and 239 effect sizes were included in the analysis. Relations between global and specific emotion regulation abilities and strategies and eating disorders and eating-related symptoms were examined. Results indicated medium-to-large effect sizes for the associations between adaptive emotion regulation and eating disorder and eating-related symptoms, and medium-to-large effect sizes for the associations between maladaptive emotion regulation and eating disorders and eating-related symptoms. In terms of specific emotion regulation strategies, large magnitude of associations were identified for the relations between lack of emotional awareness, clarity, acceptance, reappraisal, problem-solving, and eating disorders. Rumination, avoidance of emotions, and suppression also showed large associations with anorexia nervosa and bulimia nervosa. Overall, emotion regulation did not differ across eating disorders, a finding supporting the transdiagnostic character of emotion regulation problems in eating pathology. These findings have important theoretical and practical implications for prevention and intervention programs.

Psychological Predictors of Unhealthy Eating Attitudes in Young Adults

The objective of this study was to determine the predictive role of psychological risk factors for restrained and compulsive eating in young women and men. We examined the relationship between resilience, impulsivity, emotional intelligence and self-esteem, and restrained and compulsive eating. It was assumed that resilience and impulsivity can directly explain unhealthy eating attitudes (restrained and compulsive: both emotional eating and external eating). The study group comprised 211 individuals (105 men and 106 women) aged 20-29, all of whom were living in southern Poland. Measures included the Resilience Measurement Scale (SPP-25), the Eysenck's Impulsivity Inventory (IVE), the Multidimensional Self-Esteem Inventory (MSEI), the Emotional Intelligence Questionnaire (INTE), and the Polish adaptation of the Dutch Eating Behavior Questionnaire (DEBQ). The statistical analysis showed significant and positive correlations between emotional eating and general self-esteem, impulsivity, and weaker (but still significant) correlations with physical attractiveness. External eating was positively and significantly correlated with impulsivity and self-esteem (including physical attractiveness). Restrained eating was also positively and significantly correlated with general self-esteem. Both types of compulsive eating attitudes (emotional and external eating) were significantly and negatively correlated with resilience. Women showed a significantly higher positive correlation between impulsivity and external eating compared to men. The level of intensity of other measures proved similar across the entire study group regardless of sex. Impulsivity had the strongest and most direct significant influence on both emotional eating and external eating, and a negative effect on emotional intelligence. Resilience proved to have a significant impact on all three examined types of eating attitude (a direct negative effect on emotional eating and external eating, and positive direct effect on restrained eating), self-esteem, and emotional intelligence. An important psychological intervening variable in generating unhealthy eating attitudes proved to be self-esteem among both men and women. Emotional intelligence, which remains correlated with resilience, proved independent, with no effect on unhealthy eating attitudes. These results suggest that preventive treatment and educational programs implemented particularly among adolescents and young adults may support development of their psychological resources.

The role of self-esteem in the treatment of patients with anorexia nervosa - A systematic review and meta-analysis

OBJECTIVE

We aimed to provide a comprehensive overview of the role of self-esteem in the treatment of patients with anorexia nervosa (AN). Specifically, our objectives were to investigate the differences in self-esteem between individuals with AN and healthy controls, or individuals with other eating disorders, and to examine self-esteem as an outcome, predictor, moderator, and mediator in AN treatment.

METHOD

The databases PsycINFO, PSYNDEXplus, Ovid MEDLINE®, and ProQuest were searched for studies published from 1990 to 2018. To estimate aggregated effect sizes, we performed random-effects meta-analyses.

RESULTS

A screening of 1,596 abstracts and 203 full-texts identified 68 relevant publications. Results suggest a significantly lower global self-esteem in individuals with AN than in healthy controls (d = -1.90, p < .001). In contrast, global self-esteem of AN and bulimia nervosa (BN) patients was found to be comparable (d = 0.05, p = .529). It might be specific to AN patients that negative self-evaluations may not affect scholastic and professional abilities. Significantly moderate self-esteem increases were observed in treated AN patients at the end of treatment (d = 0.56, p < .001), short-term (d = 0.50, p < .001), and long-term (d = 0.75, p < .001) follow-up. Self-esteem did not predict end of treatment remission-or weight-related outcome and treatment dropout. However, small to moderate predictive effects were detected on short-term (r = .15, p = .007) and long-term remission or weight (r = .33, p = .017). Finally, first indications point to self-esteem as a mediator in adult AN inpatient treatment.

DISCUSSION

The review provides insights relevant for theory, research, and practice. Implications concern the overall support for transdiagnostic approaches and the recommendation to consider low initial self-esteem for decisions on after-care.

Neural differences in self-perception during illness and after weight-recovery in anorexia nervosa

Anorexia nervosa (AN) is a severe mental illness characterized by problems with self-perception. Whole-brain neural activations in healthy women, women with AN and women in long-term weight recovery following AN were compared using two functional magnetic resonance imaging tasks probing different aspects of self-perception. The Social Identity-V2 task involved consideration about oneself and others using socially descriptive adjectives. Both the ill and weight-recovered women with AN engaged medial prefrontal cortex less than healthy women for self-relevant cognitions, a potential biological trait difference. Weight-recovered women also activated the inferior frontal gyri and dorsal anterior cingulate more for direct self-evaluations than for reflected self-evaluations, unlike both other groups, suggesting that recovery may include compensatory neural changes related to social perspectives. The Faces task compared viewing oneself to a stranger. Participants with AN showed elevated activity in the bilateral fusiform gyri for self-images, unlike the weight-recovered and healthy women, suggesting cognitive distortions about physical appearance are a state rather than trait problem in this disease. Because both ill and recovered women showed neural differences related to social self-perception, but only recovered women differed when considering social perspectives, these neurocognitive targets may be particularly important for treatment.

Aggregating factors of the change process in the treatment of anorexia nervosa

PURPOSE

We aimed to reduce the large body of factors which may be associated with the change process in treatments for Anorexia Nervosa (AN) into a clinically and scientifically useful number of higher-rank dimensions. In addition, we examined the associations between the identified factors and eating disorder psychopathology and body mass index (BMI) in exploratory analyses.

METHODS

Within a naturalistic multicenter study we administered the Change Process Questionnaire (CPQ-AN) to inpatients with AN upon admission. The factorial structure of the CPQ-AN was explored via factor analysis. Multiple regression analyses were performed to examine the associations with BMI and eating disorder symptomatology (EDI-2).

RESULTS

In total 233 female inpatients with AN (mean BMI=14.9 kg/m(2), SD=1.7) participated. The factor analysis yielded four latent factors: basic need satisfaction, AN-specific cognitions and behavior, emotional involvement and commitment to treatment, and alliance and treatment confidence. Furthermore, greater basic need satisfaction and less AN-specific cognitions and behavior predicted lower EDI-2 scores. Higher alliance and treatment confidence were associated with higher BMI as well as a lower EDI-2 score.

CONCLUSION

The associations between the newly derived dimensions and BMI and AN-psychopathology provide evidence to support the clinical relevance of the identified change process dimensions. Future investigations could provide further insights to deepen our understanding of the change process in AN.

Empathy and social functioning in anorexia nervosa before and after recovery

INTRODUCTION

People with anorexia nervosa (AN) are known to have difficulties with social and emotional functioning, as indicated by their symptom presentation and also performance on tests of emotion perception. This study explores the level of empathy in AN, in terms of resonant experience of emotion in other people using a self-report measure.

METHODS

Twenty-eight women with acute AN were compared to 25 women who have recovered from AN, and a further 54 healthy control (HC) participants. They were assessed using a questionnaire to measure reported levels of empathy, emotional recognition, social conformity, and antisocial behaviour.

RESULTS

The acute AN group reported lower levels of empathy than the recovered AN group and HC, but they also reported less antisocial behaviour. No differences were found in emotional recognition or social conformity.

CONCLUSIONS

These results suggest that emotional empathy is reduced during acute AN. Lower levels of antisocial behaviour may reflect a contrasting desire of people with AN to minimise presentation of antisocial behaviour in the acute state.

Neural Responses during Social and Self-Knowledge Tasks in Bulimia Nervosa

Self-evaluation closely dependent upon body shape and weight is one of the defining criteria for bulimia nervosa (BN). We studied 53 adult women, 17 with BN, 18 with a recent history of anorexia nervosa (AN), and 18 healthy comparison women, using three different fMRI tasks that required thinking about self-knowledge and social interactions: the Social Identity task, the Physical Identity task, and the Social Attribution task. Previously, we identified regions of interest (ROI) in the same tasks using whole-brain voxel-wise comparisons of the healthy comparison women and women with a recent history of AN. Here, we report on the neural activations in those ROIs in subjects with BN. In the Social Attribution task, we examined activity in the right temporoparietal junction (RTPJ), an area frequently associated with mentalization. In the Social Identity task, we examined activity in the precuneus (PreC) and dorsal anterior cingulate (dACC). In the Physical Identity task, we examined activity in a ventral region of the dACC. Interestingly, in all tested regions, the average activation in subjects with bulimia was more than the average activation levels seen in the subjects with a history of anorexia but less than that seen in healthy subjects. In three regions, the RTPJ, the PreC, and the dACC, group responses in the subjects with bulimia were significantly different from healthy subjects but not subjects with anorexia. The neural activations of people with BN performing fMRI tasks engaging social processing are more similar to people with AN than healthy people. This suggests biological measures of social processes may be helpful in characterizing individuals with eating disorders.

An experimental exploration of social problem solving and its associated processes in anorexia nervosa

People with Anorexia Nervosa (AN) have well-documented socio-emotional and neurocognitive impairments. As yet, little is known about their ability to solve problems in social situations, although a link with cognitive avoidance has been suggested. This study explored social problem-solving (SPS), using an experimental task. Secondly, the role of cognitive avoidance in SPS was investigated. Individuals with AN (n=31) and healthy controls (HC; n=39) completed the Social Problem Resolution Task which consists of problem scenarios involving awkward everyday social situations. Participants were asked to generate both the optimal solution and their personal solution. Solutions were rated in terms of how socially sensitive and practically effective they were. AN patients produced relatively poorer personal solutions compared to optimal solutions than HC participants and had higher scores on a measure of cognitive avoidance than the HC group. In AN patients, cognitive avoidance was partially associated with poor SPS. These findings suggest that whilst people with AN have no difficulty in generating socially sensitive and effective solutions to problems, but may have difficulty applying this knowledge to themselves.

Relationships between self-esteem, media influence and drive for thinness

The media is a powerful societal tool for expressing expectations about how men and women should look. As a result, over the past several years, women have shown an increase in body dissatisfaction (Cash, Morrow, Hrabosky, & Perry, 2004). The present study examined the relationships between drive for thinness, self-esteem, and media influence among men and women. Two hundred ninety-four college students completed the Texas Social Behavior Inventory (Helmreich & Stapp, 1974), Sociocultural Attitudes towards Appearance Scale-3 (Thompson, van den Berg, Roehrig, Guarda, & Hienberg, 2004), self-constructed questionnaire influence of media models, and the drive for Thinness Subscale (DT) from the Eating Disorder Inventory-3 (EDI-3; (Garner, 2004)). We expected to find an association between drive for thinness and media influence and between drive for thinness and self-esteem for both men and women. Finally, we expected that the use of media, social pressures and media internalization would be predictors of drive for thinness. We found a relationship between media influence and drive for thinness. There was also a relationship between self-esteem and drive for thinness. For both men and women, media models were the primary predictor for drive for thinness. However, for women the secondary predictor was social pressures; whereas for men the secondary predictor was internalization. Such findings show the importance of examining the impact of media sources on men and women in order to entangle gender differences.

Who am I? How do I look? Neural differences in self-identity in anorexia nervosa

Anorexia nervosa (AN) patients exhibit a disparity in their actual physical identity and their cognitive understanding of their physical identity. Functional magnetic resonance imaging (fMRI) tasks have contributed to understanding the neural circuitry involved in processing identity in healthy individuals. We hypothesized that women recovering from AN would show altered neural responses while thinking about their identity compared with healthy control women. We compared brain activation using fMRI in 18 women recovering from anorexia (RAN) and 18 healthy control women (CON) using two identity-appraisal tasks. These neuroimaging tasks were focused on separable components of identity: one consisted of adjectives related to social activities and the other consisted of physical descriptive phrases about one's appearance. Both tasks consisted of reading and responding to statements with three different perspectives: Self, Friend and Reflected. In the comparisons of the RAN and CON subjects, we observed differences in fMRI activation relating to self-knowledge ('I am', 'I look') and perspective-taking ('I believe', 'Friend believes') in the precuneus, two areas of the dorsal anterior cingulate, and the left middle frontal gyrus. These data suggest that further exploration of neural components related to identity may improve our understanding of the pathology of AN.

Impaired neural processing of social attribution in anorexia nervosa

Anorexia nervosa (AN) patients have been found to have problems in social cognition, including the process of thinking about other people's thoughts and feelings, often referred to as Theory of Mind (ToM). We examined neural correlates relating to thinking about social relationships in 17 women in recovery from anorexia (RAN) and 17 healthy women (CON) using a functional magnetic resonance imaging (fMRI) task. The task consisted of short videos of moving shapes that subjects viewed either in the context of performing a social decision related to how the shapes interacted: "People: All friends?" or in the context of performing a visuospatial task related to how the shapes moved after bumping into each other: "Bumper cars: Same weight?". The RAN participants showed reduced activation in the social cognition network, with the most robust differences in the right temporoparietal junction (RTPJ). There were no significant differences between the CON and RAN groups in regions more active during the visuospatial task. These neural correlates show differences in the processing of social knowledge in RAN subjects suggesting that biological impairments in social cognition may contribute to pathology in AN.

Effectiveness of self-esteem and social skills group therapy in adolescent eating disorder patients attending a day hospital treatment programme

OBJECTIVE

To evaluate self-esteem and social skills in adolescent eating disorder patients before and after specific group therapy as part of a Day Hospital Programme.

METHOD

One hundred and sixty adolescent eating disorder patients, classified as anorexia nervosa and related disorders (AN-rd) (N = 116) or bulimia nervosa and related disorders (BN-rd) (N = 44) received structured group therapy for developing self-esteem and social skills.

RESULTS

BN-rd patients had poorer perceptions of some self-esteem and social skills variables. After group therapy, both groups presented significant improvements in their perceptions of physical appearance, their self-concept related to weight and shape and to others, happiness and satisfaction, social withdrawal and leadership. BN-rd patients presented more changes on many of the variables.

DISCUSSION

Specific self-esteem and social skills group therapy in patients with eating disorders can be useful in improving certain core features.

Effectiveness for interpersonal problem-solving is reduced in women with binge eating disorder

OBJECTIVE

Therapeutic programs for binge eating disorder (BED) often include the mediation of problem-solving skills to deal with the desire to binge. In women with BED, problem-solving abilities have not been studied yet. Knowing that reasons for binge episodes are often linked to interpersonal topics, we expected women with BED to have poorer problem-solving abilities than healthy controls (HC).

METHODS

Twenty-five women with BED and 30 overweight HC were given a shortened version of the Means-Ends Problem-Solving Procedure (MEPS). Dependent variables were the number of relevant means, the effectiveness and the specificity of the generated solution.

RESULTS

Generated solutions in the group of women with BED were significantly less effective and less specific compared to HC. Moreover, reduced effectiveness of interpersonal problem-solving was related to increased binge frequency.

CONCLUSIONS

The results support the importance of teaching problem-solving ability in individuals with BED to promote behaviour change.