Vanzhula IA, Kinkel-Ram SS, Levinson CA. Perfectionism and Difficulty Controlling Thoughts Bridge Eating Disorder and Obsessive-Compulsive Disorder Symptoms: A Network Analysis.
J Affect Disord 2021;
283:302-309. [PMID:
33578342 DOI:
10.1016/j.jad.2021.01.083]
[Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/10/2021] [Accepted: 01/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND
Eating disorders (ED) and obsessive-compulsive disorder (OCD) are highly comorbid, but little is known about how this comorbidity is maintained. Prior research suggests that obsessive thoughts and perfectionism may be shared maintenance factors for EDs and OCD.
METHODS
The current study used network analysis to (1) identify bridge pathways in an ED-OCD comorbidity network and (2) test if perfectionism symptoms bridge between ED-OCD symptoms in a combined network model including ED, OCD, and Perfectionism symptoms. Participants (N = 1,619) were a mixed sample of undergraduate students and individuals diagnosed with EDs.
RESULTS
Difficulty controlling thoughts was the symptom with the highest bridge centrality in both models, connecting with ED-related worry and doubts. In the ED-OCD-Perfectionism comorbidity network, doubts about simple everyday things and repeating things over and over bridged between ED and OCD symptoms. Additionally, specific and distinct pathways were identified between OCD and two types of ED pathology: restricting (checking compulsions and rigidity around food) and binge eating (hoarding and binge eating symptoms).
LIMITATIONS
Due to the cross-sectional nature of the data, no directional inferences can be made. Due to a higher OCD symptom prevalence rate than reported in previous studies, our undergraduate sample may not be representative of other college populations.
CONCLUSIONS
The presence of intrusive cognitions and maladaptive perfectionism may contribute to the maintenance of co-occurring ED and OCD symptoms. These findings begin to delineate specific pathways among OCD and ED symptoms, which can be used in the development of interventions to disrupt connections among these disorders.
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