Schema-level Cognitions in Patients with Binge Eating Disorder: a Case Control Study

Objective: This study examined the schema-level cognitions (core beliefs) of patients with binge eating disorder to determine whether these patients differ from those with bulimia nervosa. A case control method (matching groups for age and body mass index [BMI]) was used, to avoid the confounding factors that are found in most studies of this sort.

Method: All clinical women were recruited from a specialist eating disorder clinic. The index group consisted of 25 women with DSM-IV diagnoses of binge eating disorder, who were compared with a clinical group of 25 women with bulimia nervosa and a group of 25 women with no eating disorder. Groups were closely matched for age and BMI. Each participant completed a well-validated measure of core beliefs.

Results: Although the binge eating disorder group had a range of more negative core beliefs than nonclinical women, the differences between the clinical groups were much smaller. The binge eating disorder group had more negative core beliefs than the bulimia nervosa group in many areas. However, the bulimia nervosa group was distinguished by having the highest level of abandonment beliefs, and this difference may account for the difference in the presence of purging behaviors.

Conclusions: Levels of abandonment beliefs seem to be crucial in understanding the behavioral differences between these clinical groups--particularly the absence of purging behaviors. However, the relevance of these beliefs to treatment outcome and to other aspects of psychopathology remains to be established.