The cognitive-interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors
Janet Treasure,Ulrike Schmidt +1 more
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TLDR
The Cognitive-Interpersonal Maintenance Model maintenance model for anorexia nervosa is supported by accumulating evidence and some of the traits are inherited vulnerabilities and are present in family members.Abstract:
To describe the evidence base relating to the Cognitive-Interpersonal Maintenance Model for anorexia nervosa (AN). A Cognitive-Interpersonal Maintenance Model maintenance model for anorexia nervosa was described in 2006. This model proposed that cognitive, socio-emotional and interpersonal elements acted together to both cause and maintain eating disorders. A review of the empirical literature relating to the key constructs of the model (cognitive, socio-emotional, interpersonal) risk and maintaining factors for anorexia nervosa was conducted. Set shifting and weak central coherence (associated with obsessive compulsive traits) have been widely studied. There is some evidence to suggest that a strong eye for detail and weak set shifting are inherited vulnerabilities to AN. Set shifting and global integration are impaired in the ill state and contribute to weak central coherence. In addition, there are wide-ranging impairments in socio-emotional processing including: an automatic bias in attention towards critical and domineering faces and away from compassionate faces; impaired signalling of, interpretation and regulation of emotions. Difficulties in social cognition may in part be a consequence of starvation but inherited vulnerabilities may also contribute to these traits. The shared familial traits may accentuate family members’ tendency to react to the frustrating and frightening symptoms of AN with high expressed emotion (criticism, hostility, overprotection), and inadvertently perpetuate the problem. The cognitive interpersonal model is supported by accumulating evidence. The model is complex in that cognitive and socio-emotional factors both predispose to the illness and are exaggerated in the ill state. Furthermore, some of the traits are inherited vulnerabilities and are present in family members. The clinical formulations from the model are described as are new possibilities for targeted treatment.read more
Citations
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Predictors of treatment outcome in individuals with eating disorders: A systematic review and meta-analysis: PREDICTORS OF TREATMENT OUTCOME IN INDIVIDUALS WITH EATING DISORDERS
Eva Vall,Tracey D. Wade +1 more
TL;DR: The most robust predictor of outcome at both end of treatment (EoT) and follow-up was the meditational mechanism of greater symptom change early during treatment, and drop-out was predicted by more binge/purge behaviors and lower motivation to recover.
Journal ArticleDOI
Predictors of treatment outcome in individuals with eating disorders: A systematic review and meta‐analysis
Eva Vall,Tracey D. Wade +1 more
TL;DR: The most robust predictor of outcome at both end of treatment (EoT) and follow-up was the meditational mechanism of greater symptom change early during treatment, and drop-out was predicted by more binge/purge behaviors and lower motivation to recover.
Journal ArticleDOI
A systematic review and meta-analysis of ‘Systems for Social Processes’ in eating disorders
H Pinar Caglar-Nazali,Freya Corfield,Valentina Cardi,Suman Ambwani,Jenni Leppanen,Olaolu Olabintan,Stephanie Deriziotis,Alexandra Hadjimichalis,Pasquale Scognamiglio,Ertimiss Eshkevari,Nadia Micali,Janet Treasure +11 more
TL;DR: The facets of social processing in ED according to the NIMH RDoC 'Systems for Social Processes' framework are reviewed, showing evidence that people with ED had attachment insecurity, and less evidence for problems with production and reception of non-facial communication, animacy and action.
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Has the time come for a staging model to map the course of eating disorders from high risk to severe enduring illness? An examination of the evidence.
TL;DR: Whether high‐risk markers and prodromal features presenting in childhood and adolescence can later transition to the full manifestation of the illness in early adulthood, and whether over time, the illness can be described as becoming severe and enduring, often resistant to treatment.
Journal ArticleDOI
Alexithymia in eating disorders: Systematic review and meta-analyses of studies using the Toronto Alexithymia Scale.
TL;DR: Across the spectrum of eating disorders, individuals report having difficulties recognising or describing their emotions, and research to develop and evaluate treatments and clinician-administered assessments of alexithymia is warranted.
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