Cognitive content in bulimic disorders: core beliefs and eating attitudes

Recent clinical and research reports have demonstrated that cognitive work with bulimia nervosa might benefit from addressing core beliefs (unconditional negative representations of the self), rather than simply focusing on the impact of beliefs and assumptions regarding food, shape, and weight. However, while links have been established between core beliefs and bulimic psychopathology, it remains to be established how these beliefs have their specific impact on different aspects of eating disturbance. This study investigates the links between core beliefs and "ego-dysfunction" characteristics (e.g., perfectionism, self-esteem), since those characteristics are potential mediators of that link. In a group of 75 bulimics, core beliefs were related to both eating psychopathology and ego-dysfunction characteristics. It is proposed that many of the ego-dysfunction characteristics might serve as mediators of the already-established link between core beliefs and eating pathology, although testing this model fully would require larger-scale prospective research. Clinical work with bulimics is likely to be more effective if it addresses a range of cognitive structures, as well as behaviours.