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Until recently, it was widely accepted that eating-disordered symptoms are caused and maintained by patterns of maladaptive thinking (negative automatic thoughts and dysfunctional assumptions) regarding body size, shape, and weight. However, current research and clinical investigations suggest that broader patterns of maladaptive thinking exist in cognitive organization of eating psychopathology and that cognitive therapy for eating disorders might benefit from in-depth consideration of the individual's cognitive content. For these reasons, research into the impact of core beliefs in eating disorders has increased in recent years. This article provides a review and critique of the existing findings. The main methodological problems of examining core beliefs in eating disorders are discussed, and the conceptual issues that arise in this area are also reviewed. Finally, suggestions for the directions of future research are also made.
Keywords: unhealthy cognitions; core beliefs; anorexia; bulimia
The importance of core beliefs as cognitive organizing constructs has been discussed by Beck (1967, 1976; Beck et al., 1990) for over 30 years. Recently, increased attention has been given to the more detailed description and categorization of core beliefs described by Young (1990, 1999). These beliefs are hypothesized to be highly important in the development and maintenance of psychiatric problems such as personality disorders, depression, anxiety disorders, and affective disorders. Cognitive distortions have been described as being the "core psychopathology" of both anorexia and bulimia nervosa (e.g., Fairburn, 1997), and a growing body of research has investigated the associations between unhealthy cognitions and eating psychopathology. The aim of the current review is to examine this literature and will concentrate in particular on Young's (1990) core beliefs.
Despite recent interest in eating disorders in males, there exists a significant gender bias in epidemiological investigation of eating problems, and the extant literature examining core beliefs in eating disorders has only used female populations. Therefore, the present review will only discuss early maladaptive core beliefs in women with eating disorders. Overall, work with eating-disordered women has shown that these individuals tend to have high levels of unhealthy beliefs that may contribute not only to the development but also to the maintenance of the disorders.
UNHEALTHY COGNITIONS AND EATING DISORDERS
It has been argued that both anorexia and bulimia nervosa are essentially cognitive disorders in which the...