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Imagery is a relatively novel area of interest in eating disorders (EDs). Clinical experience and some research work indicate that rescripting of early memories may be a useful way to modify core beliefs in EDs. Relevant constructs, as applied in the current paper, are defined and described, including core beliefs, imagery rescripting, and early memories. Existing empirical research on the outcome of imagery rescripting of early memories is outlined, including in EDs. Relevant ED research on images and early memories in EDs is presented. A case is made for applying imagery rescripting to early memories in EDs. The origins and development of a clinical protocol are described. The aim of the protocol is to identify and rescript or modify early memories associated with the core beliefs characteristic of EDs. This process has also been applied in other disorders. Clinical examples illustrate the application of the protocol in EDs, including extracts of dialogue from a clinical case. The paper covers indications for use of the protocol, practical and ethical considerations, its suitability in individual cases, and some final practical tips. These include examples of useful questions to ask patients that facilitate successful rescripting of memories, and thus core belief modification. The paper concludes with some thoughts on future work. (Contains 4 tables.)

Background: It is likely that disrupted early parent-child relationships, eating disorder related cognitions and negative self-beliefs are relevant to some women who are overweight/obese. Aims: This study tested the hypotheses that disrupted parent-child relationships would be linked to higher body mass index (BMI) and that this relationship would then be mediated by cognition. Method: A group of women were recruited from the community and completed measures of eating disorder (ED) thoughts, negative self-beliefs, and parental bonding. Individual body mass indices (BMIs) were calculated. Results: One hundred and eighteen women completed the study. There was a relationship between parental bonding and higher BMI. As hypothesized, the relationship between parental bonding (as measured by maternal care, and paternal overprotection) and BMI appeared to be mediated by a range of ED thoughts, and some negative self-beliefs. Conclusion: The cognitions measured here, both ED related cognitions and negative self-beliefs, may be a useful target when considering psychological treatment for women who are overweight or obese. [ABSTRACT FROM AUTHOR]

Positive core beliefs, compared with negative self or negative core beliefs, are relatively neglected in the eating disorder (ED) research literature, despite their significance in treatment. Using a sample of younger women and relevant to those who typically experience EDs, this study outlines a new measure of positive core beliefs and examines its psychometric properties. On the basis of factor analysis, two subscales were developed: positive social self beliefs and positive individual self beliefs. The measure had good internal consistency and good construct validity. Positive individual self beliefs predicted low levels of ED symptoms when confounds were controlled. Positive social self beliefs predicted low levels of depressive symptoms, when confounds were controlled. Positive core beliefs would benefit from further study in subclinical and clinical ED groups of younger women. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Abstract: Imagery is a relatively novel area of interest in eating disorders (EDs). Clinical experience and some research work indicate that rescripting of early memories may be a useful way to modify core beliefs in EDs. Relevant constructs, as applied in the current paper, are defined and described, including core beliefs, imagery rescripting, and early memories. Existing empirical research on the outcome of imagery rescripting of early memories is outlined, including in EDs. Relevant ED research on images and early memories in EDs is presented. A case is made for applying imagery rescripting to early memories in EDs. The origins and development of a clinical protocol are described. The aim of the protocol is to identify and rescript or modify early memories associated with the core beliefs characteristic of EDs. This process has also been applied in other disorders. Clinical examples illustrate the application of the protocol in EDs, including extracts of dialogue from a clinical case. The paper covers indications for use of the protocol, practical and ethical considerations, its suitability in individual cases, and some final practical tips. These include examples of useful questions to ask patients that facilitate successful rescripting of memories, and thus core belief modification. The paper concludes with some thoughts on future work. [Copyright &y& Elsevier]

A study using a cross-sectional survey design examined whether eating disorder (ED) related symptoms are associated with understanding one's own and others' minds. A non-clinical sample of 145 women completed self-report questionnaires and recorded their emotional, cognitive and behavioural responses to descriptions of scenarios (vignettes). Responses to scenarios were made from the perspective of self, an attachment figure and a same sex acquaintance. Data were analysed using multiple regression statistics with ED related symptoms as the dependent variable. High levels of ED related symptoms were associated with 'concretised' understanding of own emotions (i.e. a greater number of food related responses), but sophisticated understanding of same sex acquaintance's emotions. They were associated with fewer positive thoughts for self, fewer negative emotions about their own behaviour, and more food responses for same sex acquaintance's behaviour. Similarities and differences were observed in the different perspectives. Limitations are discussed. Implications for further research related to this topic and relevant to EDs are briefly summarised. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

This study aimed to identify differences in the personal themes in negative self or core beliefs that might be characteristic of high levels of eating disorder symptoms when compared to high levels of depressive symptoms in those with an eating disorder and/or depression. Differences between putative diagnostic subgroups were also examined. One hundred and ninety-three participants completed self-report measures of negative self-beliefs, eating, and depressive symptoms. Putative diagnostic subgroups were also identified, including an eating disorder group that also had high levels of depressive symptomatology and in most cases a diagnosis of depression. Six themes descriptive of the self corresponding to 6 robust factors were identified and provisionally labeled isolated, repelled by self, self-dislike, lacking in warmth, childlike, and highly organized. Multiple regression analyses indicated that, in the whole sample, eating disorder symptoms were uniquely predicted by subscales reflective of repelled by self and lacking in warmth, though depressive symptoms were uniquely predicted by subscales measuring isolation and self-dislike. Between-group analyses indicated that high scores on isolation, self-dislike, and lacking in warmth were typical of both eating-disordered and depressed-only diagnostic groups when compared to the control group, though only the eating-disordered group (also high in depressive symptoms and "diagnosis" of depression) also had high scores on repelled by self. The findings indicate that eating disorder and depressive symptoms are associated with some potentially important differences in self-beliefs. Putative diagnostic subgroups may also differ in these beliefs. The findings further indicate that psychometrically sound themes exist in the core or negative self-beliefs associated with eating disorder and depressive symptoms. Implications of the findings for cognitive therapy with eating disorders and depression are briefly considered, and the limitations and implications of the diagnostic subgroups identified here are discussed. [ABSTRACT FROM AUTHOR]

Objective To explore metacognition in women with anorexia nervosa (AN), dieting and non-dieting women. Method A cross-sectional study between groups design compared women with AN (n = 15), normal dieters (n = 17) and non-dieters (n = 18). A semi-structured interview was used to explore presence and content of explicit metacognitions and use of metacognitive control strategies. Results Explicit metacognitions and metacognitive control strategies were present in all three groups of women. There were group differences in amount and function of metacognitive activity and trends in the qualitative data suggested participants with AN believed that their thoughts were abnormal and uncontrollable. They used six metacognitive strategies more than control groups and were less successful at using thought re-appraisal and attending to body and others. Half of participants with AN reported using these strategies to deliberately make themselves feel worse. Discussion It is suggested that metacognitive activity may play a role in the maintenance of AN, particularly in reinforcing negative self-evaluations. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective To provide a preliminary, systematic exploration of some features associated with the experience of ‘feeling fat’. Method Women with anorexia nervosa (N = 16), women who were dieting (N = 15) and non-dieting women (N = 17) took part in a semi-structured interview. Results Feeling fat was common in all three groups of women. It was associated with distress, negative emotions, internal and external body sensations, images in a range of modalities, negative self beliefs and a first memory of feeling fat. Differences specifically characteristic of those with anorexia nervosa were identified, including feeling fatter, greater associated distress, more negative emotions, greater ‘emotional’ belief in cognitions, a richer experience, an earlier first memory, greater strength of negative self beliefs and a link to restricting behaviour. Some qualitative data are reported. Conclusions The experience of feeling fat can be ‘unpacked’ in a way that may be useful in cognitive therapy for those with anorexia nervosa. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Abstract: The current study aimed to investigate the psychometric properties of the Eating Disorder Belief Questionnaire in older adolescent females. Three hundred and sixty-seven girls aged 17 or 18 who were in secondary school education completed the Eating Disorder Belief Questionnaire, the Beck Depression Inventory and the Eating Attitudes Test. They also provided information on height and weight. The Eating Disorder Belief Questionnaire had an almost identical factor structure to that previously found in adult women, although the factors were not quite as discrete as those in the original validation study. Internal consistency for each factor was high and construct validity (including convergent and criterion related validity) was very good. The almost identical factor structure, and other good psychometric properties, found for the Eating Disorder Belief Questionnaire in the current study suggests that it is an appropriate measure for use in clinical settings and in research studies involving 17–18 year old girls. This includes older adolescents with eating disorders. The possibility that adolescents show a developmental tendency for less separation between the constructs assessed, when compared with adults, is of particular interest, and requires further exploration. [Copyright &y& Elsevier]

Abstract: The specific content of core beliefs and schema in adolescent girls high and low in eating disorder symptoms was investigated using the Eating Disorder Belief Questionnaire (EDBQ)-negative self-beliefs sub-scale and Young Schema Questionnaire (YSQ). Girls with high Eating Attitude Test (EAT) scores had higher scores on both measures (using total and sub-scale scores) than girls with low EAT scores. However, all scores were related to eating disorder as well as depressive symptoms. Analysis of individual items on the EDBQ and YSQ found that scores on all EDBQ, but not all YSQ items, differed between the two groups, with higher scores in the high EAT group. However, a number of individual items (on both measures) in the high EAT group, as well as in the low EAT group, were related specifically to eating disorder symptoms and not also to depressive symptoms. [Copyright &y& Elsevier]

This paper describes a new cognitive model of bulimia nervosa. It provides a detailed account of the development of the disorder and explains, in detail and encompassing cognition, behaviour, emotion, and physiology, how binge eating is maintained. Relevant maintaining factors include positive beliefs about eating, negative beliefs about weight and shape, permissive thoughts, and thoughts of no control. Relevant developmental factors include negative early experiences, negative self-beliefs, schema compensation processes, and different types of underlying assumption. Recent empirical findings on which the new model is based, and which support the model, are described. Existing observations and findings are also presented, and their consistency with the new model is confirmed. Novel features of the model are highlighted, and phenomena unexplained by existing cognitive models of bulimia nervosa, including treatment failure and relatively poor outcome following treatment with cognitive therapy, are assessed in the light of the new model. The relationship to recent findings on the role of dieting in bulimia nervosa and to developments in the understanding or normal eating is considered. Implications for basic and treatment-related research are then discussed. Finally, the clinical implications of the new model, including the use of schema-focused techniques, are briefly discussed. [ABSTRACT FROM AUTHOR]

Demographic and clinical correlates of interference with color-naming words related to eating, weight, and shape were investigated in 75 patients with bulimia nervosa. Interference with color-naming was related to two measures, overall level of psychiatric symptoms and frequency of purging. Multiple regression analysis showed that frequency of purging, and not level of general psychiatric symptoms, was the best predictor of interference. Thus, as would be predicted by cognitive theories, interference appears to be most closely related to features specific to bulimia nervosa rather than to measures of general psychopathology. [ABSTRACT FROM AUTHOR]

The Stroop color-naming paradigm was used to investigate information processing in bulimia nervosa. Patients with bulimia nervosa were compared with age-matched female controls as well as with a sample of men. It was found that the patients were slower than female controls were in color-naming words related to eating, shape, and weight, whereas there were no differences between the male and female controls. The findings suggest that bulimia nervosa is associated with the selective processing of information related to eating, shape, and weight and that this phenomenon may be restricted to those with an eating disorder of clinical severity. [ABSTRACT FROM AUTHOR]

A semi-structured interview was used to investigate negative self beliefs in female patients with eating disorders and women without an eating disorder history. Information about possible developmental influences on these beliefs was also collected. Beliefs linking eating behavior with weight and shape and beliefs about the self were identified, but only by the patients. Self-beliefs were invariably negative and unconditional. Beliefs about eating, weight and shape were usually in the form of conditional assumptions. Most patients identified specific origins for their negative self-beliefs: usually trauma or abuse in childhood. All patients believed that dieting was a way of counteracting the negative implications associated with their self-beliefs. Bingeing seemed to provide an initial distraction in some cases from negative automatic thoughts, images, negative self-beliefs and negative emotional states. However, after bingeing, these intensified. Implications for cognitive theories of eating disorders and for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study investigated whether attachment history predicts unique variance in body mass index in young women. Method: A cross-sectional design was employed. One hundred and forty five women completed self report measures of attachment history and psychological symptoms. Results: The findings indicated that negative parental discipline predicted significant variance in body mass index when common variance associated with demographic and psychological symptom measures was taken into account. Conclusions: It is concluded that attachment history may contribute to overweight and obesity and may be an important factor to consider in the prevention and treatment of overweight in women. [Copyright &y& Elsevier]

Abstract: This study aimed to investigate the mediating role of early maladaptive schemas in the relationship between parental bonding and eating disorder symptoms in a group of female adolescents. Three hundred and sixty-seven female adolescents completed the Parental Bonding instrument [PBI; Brit. J. Med. Psychol. 52 (1979) 1–10], the Young Schema Questionnaire short version [YSQ; Young, J. E. (1998). The Young Schema Questionnaire: Short form. Available at http://home.sprynet.com/sprynet/schema/ysqs1.htm], and the Eating Attitudes Test [EAT; Psychol. Med. 9 (1979) 273–279]. Two underlying schemas, defectiveness/shame and dependence/incompetence, were perfect mediators in the relationship between parental bonding and eating disorder symptoms. Schemas relating to both shame and dependency may be important in determining the effect that parental bonding has on eating disorder symptoms in a sample of female adolescent schoolgirls. [Copyright &y& Elsevier]