Cognitive content and process in eating-disordered patients with obsessive–compulsive features

ObjectiveThis study examined the schema-level cognitive content and processes that might explain the presence of compulsive behaviours among patients with eating disorders.MethodEach of 62 eating-disordered women completed standardised measures of schema-level core beliefs and cognitive processes, and was interviewed for diagnosis and obsessive compulsive features.ResultsCompulsive behaviours were associated with four core beliefs — ‘mistrust/abuse’, ‘defectiveness/shame’, ‘dependence/incompetence’ and ‘subjugation’. Higher levels of avoidance of emotional arousal were also associated with compulsivity.DiscussionSchema-level beliefs and processes are associated with the presence of compulsivity. The key cognitions might impact via the activation of negative affect, meaning that the compulsive behaviours serve the function of emotion regulation. Such cognitions are likely to be a necessary target in CBT for those presenting with compulsive behaviours in the eating disorders.