Beliefs and expectations regarding etiology, treatment and outcome in bulimia nervosa

To examine pretreatment client beliefs and expectations about the causes of bulimia nervosa (BN), and helpfulness of treatment. The association between outcome expectations, pretreatment characteristics, and treatment outcome was also tested.

76 BN clients completed a questionnaire assessing beliefs and expectations before participating in a randomized treatment trial.

Clients attributed their BN to problems of dysphoria, low self-esteem, perfectionism, and weight preoccupation. They also anticipated a wide array of therapeutic modalities to be helpful, and expected to make changes within 7 weeks of treatment. Surprisingly, outcome expectations were not related to treatment response. Clients who were identified as treatment optimists were more likely to be older, have a longer duration of illness, and greater pretreatment depression and BN symptomatology.

These results are discussed in the context of the transtheoretical model, suggesting that veteran BN clients who experience greater complications are less ambivalent and more hopeful about change.