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BACKGROUND AND AIMS: In the present study, we investigated differences in obsessive-compulsive (OC) symptoms in patients with an eating disorder (ED) with or without recent/lifetime impulsive non-suicidal self-injury (NSSI). We included 429 female inpatients with an ED, of whom 31.9% engaged in recent impulsive NSSI and 56.4% in lifetime impulsive NSSI. MATERIALS: They filled out the Eating Disorder Evaluation Scale, the Self-Injury Questionnaire-Treatment Related and the Padua Inventory-Revised (OC symptoms). METHODS AND RESULTS: Patients with anorexia nervosa, binge-eating/purging type (AN-BP) and bulimia nervosa (BN) engaged more frequently in recent/lifetime impulsive NSSI compared to patients with anorexia nervosa, restrictive-type (AN-R). Two MANCOVAs with OC symptoms as dependent variables, and ED subtypes and recent/lifetime impulsive NSSI as independent variables controlling for age and body mass index showed the main effects of ED subtypes and recent/lifetime impulsive NSSI. Patients with AN-BP reported significantly more impulses (i.e., being afraid of losing control over motor behaviours) compared to patients with AN-R and BN. ED patients with impulsive recent/lifetime NSSI scored significantly higher on all OC scales compared to patients without NSSI. DISCUSSION AND CONCLUSION: In sum, the presence of recent/lifetime impulsive NSSI in patients with an ED seems to be related to more severe OC symptoms. Hence, this comorbidity needs to be addressed in psychotherapy, such as in transdiagnostic cognitive behavioural therapy for EDs. ispartof: EUROPEAN EATING DISORDERS REVIEW vol:29 issue:4 pages:663-669 ispartof: location:England status: published

Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients, the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity.

This study reports on a pilot study of a family group intervention with or without patient participation adjunctive to a specialized inpatient treatment for eating disorders (EDs). Participants were 112 female adolescent ED inpatients and one or both of their parents. The parents were invited to participate in an adjunctive multi-family group with patient (MFT) or in a similar multi-parent group without patient participation (MPT). Questionnaires assessing ED symptoms, family functioning and caregiving experiences were administered before and after intervention. Post-intervention results obtained from both patient and parent(s) indicated that improvement in ED symptoms and parental burden occurred after both types of interventions. Family functioning improved differently according to the informant: fathers reported an improvement of general family functioning, patients reported an improvement of problem solving and mothers reported a decrease in problem solving across both formats. This study emphasized the importance of including a multi-informant approach in family interventions. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Eating disorder (ED) patients show alarmingly high prevalence rates of Non-Suicidal Self-Injury (NSSI). Adolescents seem to be particularly at risk, as EDs and NSSI both have their onset in mid-adolescence. It has been suggested that personality could be a transdiagnostic mechanism underlying both EDs and NSSI. However, little attention has been given to adolescent clinical samples compared to adult and/or community samples. Therefore, the current study investigated the role of personality in a sample of 189 female inpatients with an ED (M = 15.93, SD = 0.98). Our results confirmed the high prevalence of NSSI in EDs, specifically in patients with bingeing/purging behaviours (ED-BP). Temperamental differences were found between ED-BP and the restrictive ED subtype (ED-R). Namely, ED-BP patients showed more harm avoidance and less self-directedness compared to ED-R. Temperamental differences were found in NSSI as well, regardless of ED subtype: ED patients who had engaged in NSSI during their lifetime reported less self-directedness and more harm avoidance. Interestingly, only ED patients who recently engaged in NSSI showed less novelty seeking. These temperamental profiles should be recognised as key mechanisms in the treatment of adolescent ED patients with and without NSSI. ispartof: Journal Of Clinical Medicine vol:9 issue:4 pages:1-14 ispartof: location:Switzerland status: Published online

INTRODUCTION: Epidemiologic information on sociodemographic and clinical characteristics in eating disorders in Western European countries are scarce. PURPOSE: In this study, we report demographic and clinical characteristics of eating disorder (ED) patients undergoing treatment in five specialized ED centers in Flanders (Belgium). METHOD: Data from 642 ED patients were collected by means of a structured questionnaire. RESULTS: Data show that 93.8% of patients are female, with an average age of 22.6 years. The largest subgroup in our sample suffers from anorexia nervosa, namely 52.8%. Bulimia nervosa (BN), binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS) account for 17.7%, 10.7% and 18.8% of the sample, respectively. Mean age of onset was 17 years. Mean duration of illness was 5.6 years, but 20.2% of patients had their illness for over 8 years. Anorexia nervosa patients of the restricting type (AN-R) have the shortest duration of illness. BED patients stood out because they were older on average, more often in a relationship and more often in ambulatory treatment. 70% of patients over 20 years old completed higher education, but one-third of this group was unemployed and/or disabled. Remarkably, ED patients grow more up in intact families compared to the general population. CONCLUSIONS: Epidemiology of ED patients in treatment in Flanders (Belgium) seems to resemble worldwide findings. The long duration of illness, the common evolution towards chronicity and the early work impairment underline the severe personal and societal impact of ED and call to the need for early detection and treatment of these patients. LEVEL OF EVIDENCE: Level V: cross-sectional descriptive study. ispartof: EATING AND WEIGHT DISORDERS-STUDIES ON ANOREXIA BULIMIA AND OBESITY vol:26 issue:2 pages:475-481 ispartof: location:Germany status: published

This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non-suicidal self-injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self-Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self-control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

This study investigated the caregiving experiences of mothers and fathers of restrictive and binge-eating/purging eating disordered (ED) inpatients with and without non-suicidal self-injury (NSSI). Sixty-five mothers and 65 fathers completed the Experience of Caregiving Inventory. All inpatients completed the Self-Injury Questionnaire-Treatment Related to assess NSSI and the Eating Disorder Evaluation Scale to assess eating disorder symptoms. Mothers reported significant more negative and more positive caregiving experiences compared with fathers. Mothers (but not fathers) of restrictive ED patients reported more positive caregiving experiences compared with mothers of binge-eating/purging patients. The presence of NSSI in ED patients was associated with more negative caregiving experiences of both parents. Mothers and fathers of ED inpatients differ in caregiving experiences, and both binge-eating behaviours and NSSI negatively affect their caregiving experience. Therefore, supportive interventions for parents of ED patients are necessary, especially of those patients who engage in NSSI.

This study aimed to investigate family functioning of restrictive and binge-eating/purging eating disordered adolescents with or without non-suicidal self-injury (NSSI), as perceived by the patients and their parents (mothers and fathers). In total, 123 patients (between 14 and 24 years), 98 mothers and 79 fathers completed the Family Assessment Device. Patients completed the Self-Injury Questionnaire-Treatment Related and the Symptom Checklist 90-Revised. No main effects were found of restrictive versus binge-eating/purging behaviour nor of presence/absence of NSSI. For the parents, a significant interaction between binge-eating/purging behaviour and NSSI emerged: Mothers and fathers reported worse family functioning in the binge-eating/purging group in presence of NSSI, whereas mothers reported worse family functioning in the restrictive group without NSSI. Parental perception of family functioning is affected by the combined presence of binge-eating/purging behaviour and NSSI. This finding should be taken into account when treating families living with eating disorders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. Language: en

Non-suicidal self-injury (NSSI) and borderline personality disorder (BPD) features are common in patients with eating disorders (ED), yet little is known regarding the clinical presentation of ED patients who present with NSSI with and without BPD. The current study compared self-injurious, female ED inpatients with (n = 98; NSSI+BPD) and without BPD (n = 45; NSSI-only) on different self-reported clinical features. Results suggest that ED patients with NSSI+BPD differ from those with NSSI-only with regard to frequency of suicidal ideation, alcohol, drug or medication abuse, internalizing/externalizing psychopathology, interpersonal problems, and coping strategies, with the NSSI+BPD group demonstrating more impairment in each of these domains. Despite these differences in clinical presentation, however, groups did not differ in NSSI features. In sum, while self-injurious ED patients may present with similar NSSI behavior regardless of BPD diagnosis, those with NSS+BPD represent a group with much higher clinical complexity and greater treatment needs. ispartof: PSYCHOLOGICA BELGICA vol:58 issue:1 pages:243-255 ispartof: location:England status: published

This study reports on a pilot study of a family group intervention with or without patient participation adjunctive to a specialized inpatient treatment for eating disorders (EDs). Participants were 112 female adolescent ED inpatients and one or both of their parents. The parents were invited to participate in an adjunctive multi-family group with patient (MFT) or in a similar multi-parent group without patient participation (MPT). Questionnaires assessing ED symptoms, family functioning and caregiving experiences were administered before and after intervention. Post-intervention results obtained from both patient and parent(s) indicated that improvement in ED symptoms and parental burden occurred after both types of interventions. Family functioning improved differently according to the informant: fathers reported an improvement of general family functioning, patients reported an improvement of problem solving and mothers reported a decrease in problem solving across both formats. This study emphasized the importance of including a multi-informant approach in family interventions. Copyright (c) 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

In the present study, we investigated the association between non-suicidal self-injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self-report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI.

The study explores the reflections of older adults on the process preceding their suicide attempt. Data were gathered using in-depth interviews with eight older inpatients who had attempted suicide. Grounded theory methodology was used for data analysis. They described their life and the self as disrupted after experiencing a loss, loneliness, loss of control, and unwillingness to continue living the current life. The findings suggest that the concurrence of these constructs precedes a suicide attempt in later life.

© 2017 Guilford Publications, Inc. The current study examines whether autonomy-supportive and controlling parenting are related to the presence/absence of binge-eating/purging behavior and/ or non-suicidal self-injury in adolescents with an eating disorder (ED). Fifty-three ED patients completed validated questionnaires assessing perceived maternal and paternal autonomy-supportive and psychologically controlling parenting. A total of 53 mothers and 37 fathers also completed these questionnaires. All patients completed the Self-Injury Questionnaire-Treatment Related to assess non-suicidal self-injury (NSSI). Results showed that patients with binge-eating purging behaviors experienced more maternal psychological control compared to restrictive patients independently of the presence of NSSI. Paternal psychological control or autonomy support did not differ as a function of ED subtype and presence/ absence of NSSI. These results suggest that especially mothers of patients engaging in binge-eating/purging behaviors could benefit from family interventions that support parents in diminishing the use of psychological control. ispartof: Journal of Social and Clinical Psychology vol:36 issue:2 pages:126-141 status: published

Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age-matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non-suicidal self-injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John WileySons, Ltd and Eating Disorders Association.

This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non-suicidal self-injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self-Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self-control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John WileySons, Ltd and Eating Disorders Association.

This study investigated the caregiving experiences of mothers and fathers of restrictive and binge-eating/purging eating disordered (ED) inpatients with and without non-suicidal self-injury (NSSI). Sixty-five mothers and 65 fathers completed the Experience of Caregiving Inventory. All inpatients completed the Self-Injury Questionnaire-Treatment Related to assess NSSI and the Eating Disorder Evaluation Scale to assess eating disorder symptoms. Mothers reported significant more negative and more positive caregiving experiences compared with fathers. Mothers (but not fathers) of restrictive ED patients reported more positive caregiving experiences compared with mothers of binge-eating/purging patients. The presence of NSSI in ED patients was associated with more negative caregiving experiences of both parents. Mothers and fathers of ED inpatients differ in caregiving experiences, and both binge-eating behaviours and NSSI negatively affect their caregiving experience. Therefore, supportive interventions for parents of ED patients are necessary, especially of those patients who engage in NSSI.

This study aimed to investigate family functioning of restrictive and binge-eating/purging eating disordered adolescents with or without non-suicidal self-injury (NSSI), as perceived by the patients and their parents (mothers and fathers). In total, 123 patients (between 14 and 24 years), 98 mothers and 79 fathers completed the Family Assessment Device. Patients completed the Self-Injury Questionnaire-Treatment Related and the Symptom Checklist 90-Revised. No main effects were found of restrictive versus binge-eating/purging behaviour nor of presence/absence of NSSI. For the parents, a significant interaction between binge-eating/purging behaviour and NSSI emerged: Mothers and fathers reported worse family functioning in the binge-eating/purging group in presence of NSSI, whereas mothers reported worse family functioning in the restrictive group without NSSI. Parental perception of family functioning is affected by the combined presence of binge-eating/purging behaviour and NSSI. This finding should be taken into account when treating families living with eating disorders.

Despite recent modifications to the DSM-V diagnostic criteria for Eating Disorders (ED; American Psychiatric Association, 2013), sources of variability in the clinical presentation of ED patients remain poorly understood. Consistent with previous research that has used underlying personality dimensions to identify distinct subgroups of ED patients, the present study examined (1) whether we could identify clinically meaningful subgroups of patients based on temperamental factors including Behavioral Inhibition (BIS), Behavioral Activation (BAS) and Effortful Control (EC), and (2) whether the identified subgroups would also differ with respect to ED, Axis-I and Axis-II psychopathology. One hundred and forty five ED inpatients participated in this study. Results of a k-means analysis identified three distinct groups of patients: an Overcontrolled/Inhibited group (n=53), an Undercontrolled/Dysregulated group (n=58) and a Resilient group (n=34). Further, group comparisons revealed that patients in the Undercontrolled/Dysregulated group demonstrated more severe symptoms of bulimia, hostility and Cluster B Personality Disorders compared to the other groups, while patients in the Resilient group demonstrated the least severe psychopathology. These findings have important implications for understanding how individual differences in personality may impact patterns of ED symptoms and co-occurring psychopathology in patients with ED.

Introduction Studies on patients' experience of involuntary admission focused on the patients' retrospective view of the appropriateness of the admission, the perceived coercion during hospitalization and the experienced impact on their relationships and on prospects for future employment. The experiences and opinions of patients and their relatives on the judicial procedure of involuntary admission itself were never investigated in depth. Objectives and aims (1) We aim to systematically gather and analyse the perceptions and views of patients subjected to involuntary admission. Starting from their experiences and perceptions, we will explore their views on the concept and the judicial procedure of involuntary admission in all his aspects. (2) We aim to investigate the experiences and views of patients' relatives and of (3) other stakeholders (psychiatric and judicial) in the same manner in order to constitute a comprehensive experiential knowledge base. Methods Using semi-structured interviews, a qualitative research approach will be systematically complemented with aggregated views from patient organisations, ombudservices and patients' relatives organisations. To avoid bias, an independent clinician interviews patients and relatives at least one month after termination of involuntary admission. Interviews will be analysed by means of hierarchical cluster analyses. Results The themes, concerns, opinions and perceptions of patients, relatives and stakeholders will be presented mainly from a hierarchical perspective distinguishing experiential importance and weight. Conclusion Systematical qualitative research on patient' and patients' relatives' views on compulsory admission is an important complement to patient participation initiatives in order to inform clinical and judicial practice and possible reforms.

Introduction Compulsory admission is controversial and highly relevant to society. Nevertheless, epidemiological European data are scarce and of limited reliability and comparability. In several countries including Belgium and the Netherlands, the incidence of compulsory admissions seems to increase despite legislative amendments aiming to reduce coercion. Objectives and aims By pooling and analysing available epidemiological data, we estimated the incidence and evolution of compulsory admission in Belgium and the Netherlands within the 7-year timeframe of most recent available data. Methods We ran a systematic literature review including relevant epidemiological data, either published or from grey literature (e.g. unpublished governmental, regional or health care reports and databases). All data were (re)calculated into incidence rates per 100,000 inhabitants per year. Statistical testing (e.g. trend analyses) was performed when applicable. Results Incidence of compulsory admission increased with 38% (Belgium, 1999–2006) and 39% (2002–2009, Netherlands), respectively (all p Conclusions Our data suggest a significant increase of the incidence of compulsory admissions in both Belgium and the Netherlands. Uniformity and standardization in registration of compulsory admission throughout Europe is needed to enhance the comparability and quality of the data. Substantial differences in legal frameworks and the structure and organisation of healthcare further limit international comparability

Introduction Epidemiological data regarding compulsory admission are mainly limited to unpublished reports and databases, often gathered unsystematically with great heterogeneity in both definitions and data recording methods. The scarcity of scientifically validated and published data is in sharp contrast with the societal relevance of coercion. Therefore the Flemish Community implemented since 2007 a uniform data collection and recording method inspired by the Dutch registration, resulting in a database of incident cases of compulsory admission. Objectives and aims (a) to investigate the epidemiology of compulsory admission in Flanders in terms of sociodemographic and psychiatric characteristics, past use of services, and temporal trends; (b) to compare Flemish epidemiological profiles with Belgian population-representative data (N = 7,821; 1997–1998) and data gathered from a Belgian university teaching hospital (N = 1,501; 2000–2010). Methods Data were systematically collected and quality controlled by a government agency, supervised by a scientific committee. All incident cases of compulsory admission were included prospectively (2007–2009, N = 10,607, response rate=100%). Descriptive statistics, advanced uni- and multivariate regression models and time-trend models were applied. Results Epidemiological profiles of prevalence and incidence data comprising data from all three sources will be presented. Data will be disaggregated by sociodemographic profiles (e.g. gender/age comparisons), psychiatric disorders, severity estimates, correlates of compulsory admissions, and temporal trends in these disaggregation variables. Conclusions This is the first study investigating the epidemiology of compulsory admissions in Belgium using large and longitudinal databases. Our findings will be placed into an international context relating to implications for further epidemiological research, legislative issues, and methodological improvements.

Introduction Low socio-economic status (SES) is associated with mental disorders and involuntary admission, but the extent to which those associations change over time is unknown. Objectives and aims We aim to investigate (1) to what extent SES is a predictor of initiation of involuntary admission, (2) multivariate predictive associations between mental disorders and involuntary admission, and (3) evolutions of (1) and (2) between 2000 and 2010. Using both bivariate and multivariate models, we will present time trends in the associations between SES and involuntary admission, using mental disorders and service use as covariates. Methods Data stem from a large epidemiological study on psychiatric emergencies in the University Hospital of Leuven, Belgium. All patients presenting to the psychiatric emergency room were systematically monitored in terms of sociodemographic factors, presenting problems, mental disorders, and service use variables. The subset of all consecutive patients who were involuntary admitted from the emergency room between 2000 and 2010 (N = 1,053) was analysed. Results We found an increased rate of involuntary admitted patients between 2000 and 2010 (p = .0140). The number of employed patients decreased significantly (from 29.6% to 15.8%). This was also the case, although to a lesser extent, for those who were living together (from 46.9% to 40.0%). More fine-grained results, SES estimates and associations with mental disorders will be presented. Conclusions Our data suggest a significant increase of the number of involuntary admissions, together with differences in SES patterns. Implications on both the clinical and the policy level will be discussed.

Introduction The increase of the number of compulsory admissions in several European countries contradicts the growing attention for patient rights, autonomy and the evolution towards community care and deinstitutionalisation. The increase is not substantiated scientifically either: there is little scientific evidence for the effectiveness of coercive measures in reducing risk nor for the accuracy of risk assessment (false positives). Aims, objectives and methods Using ethical analysis, our objective is to examine the reasons for this increase and its negative consequences. Results The increase reflects a societal shift with growing readiness to sacrifice the values ‘freedom’ and ‘autonomy’ for (perceived) safety and security. Both physical safety of patient and others and juducial safety of the psychiatrist (avoidancing litigation) collude. On the other hand, the scientific attention for the deleterious consequences of compulsory admissions is growing. Perceived coercion is an important risk factor for PTSD symptoms after psychiatric admission. Coercive measures may also be counterproductive, undermining trust and cooperation and inducing regressive behaviour, care avoidance, resistance and a struggle for power and control. Furthermore, an increased association of mental health care with coercion in the public perception might induce fear, aversion and avoidance in those who need help, thus impairing early intervention and raising the threshold for voluntarily seeking help. It also reduces the openness of patients to freely talk about symptoms, feelings and thoughts thus undermining assessment and therapy. Conclusions Long term negative consequences of coercion might outweigh short term safety benefits, justifying greater reticence initiating compulsory admissions.

Personality features are considered to be important factors in the pathogenesis of both eating disorder (ED) and substance use disorder (SUD). This study investigates similarities and differences between these early maladaptive schemas (EMSs) (a) between female patients with ED (N = 179) or SUD (N = 169) and (b) between ED subtypes of the restrictive (N = 52), bulimic type (N = 127), or SUD. In total, 348 female patients (Mage = 29.95; SDage = 8.40) completed the Young Schema Questionnaire. Multivariate analyses of covariance with EMS scales as dependent variables and (a) ED versus SUD and (b) ED subtypes versus SUD as independent variables and age and psychopathology as control variables revealed that ED patients scored significantly higher on Unrelenting Standards, Defectiveness, Social Undesirability, and Failure than did SUD patients. Additionally, when comparing ED subtypes and SUD, bulimic and SUD patients scored significantly higher on Insufficient Self-Control than did restrictive patients. These results confirm the role of EMSs in ED (subtypes) and SUD. ispartof: EUROPEAN EATING DISORDERS REVIEW vol:26 issue:5 pages:422-430 ispartof: location:England status: published