Academic journal article Journal of Eating Disorders

Do Dysfunctional Coping Modes Mediate the Relationship between Perceived Parenting Style and Disordered Eating Behaviours?

Academic journal article Journal of Eating Disorders

Do Dysfunctional Coping Modes Mediate the Relationship between Perceived Parenting Style and Disordered Eating Behaviours?

Article excerpt

Author(s): Jessica M. Brown[sup.1], Stephanie Selth[sup.2], Alexander Stretton[sup.3] and Susan Simpson[sup.2]

Plain english summary

In this study, we investigated whether perceived childhood parenting experiences and coping mechanisms played a role in the development of eating disorder symptoms in a group of 174 participants who indicated that they had difficulties with eating and/or body image. The maladaptive coping mechanisms of perfectionism, avoidance, and compliance partially explained the relationship between perceived negative parenting experiences and restriction/purging/overexercising. Schema Therapy may therefore be an appropriate treatment that can address developmental factors associated with parenting, alongside here-and-now maintaining factors, including core beliefs and coping style.


Eating disorders are considered one of the most difficult psychopathologies to treat, due to high levels of complexity, ego-syntonicity, chronicity, and heterogeneity [1, 48]. Comorbidity with other mental health disorders is high, including anxiety, mood and substance misuse disorders [5, 11, 34] and personality disorders [8]. Although Cognitive Behavioural Therapy (CBT) is the treatment of choice for eating disorders (EDs), a significant number of sufferers do not respond [2]. Anorexia Nervosa in particular remains exceptionally difficult to treat, with Enhanced CBT outcome trials reporting low remission and high attrition rates [9, 10, 18, 19]. Given the limited efficacy of maintenance models such as CBT in the treatment of EDs, especially for those with higher comorbidity and severity, deeper level factors are now a focus of the ED literature [22], and there is a need for new and innovative therapeutic models to improve our conceptualization and treatment of the eating disorders [13, 55].

Schema Therapy encapsulates developmental, maintenance, and deeper level themes and was developed to conceptualise complex psychopathology with high comorbidity, including personality disorders [57]. Early maladaptive schemas (EMS) are defined as unconditional, implicit, and irrefutable cognitive beliefs that result from unmet core needs and repeated negative experiences with significant others during childhood and adolescence [57]. EMS act as frameworks for understanding interpersonal relationships and life experiences [28]. Schema modes are defined as the states or parts of the personality and coping mechanisms that manifest moment-to-moment. Further, there is preliminary, though limited, empirical support for the application of the schema model to ED populations [29, 40, 41]. Specifically, research has linked EMS and schema processes to ED pathology, and ED populations have been found to score higher on EMS [22, 25, 52] and schema modes [45, 49] than non-clinical populations. Preliminary studies suggest that the Compliant Surrenderer, and two avoidant coping modes, Detached Self-Soother and Detached Protector, appear to be higher in the ED population than in non-clinical populations [45] and other clinical groups [49].

Preliminary studies have also reported a link between negative parenting experiences - particularly emotional abuse and invalidation - and ED pathology [17, 24, 25, 47, 53]. Further, emerging evidence suggests EMS and schema coping processes may explain the link between adverse childhood experiences and the onset of ED pathology [15, 36, 47]. Turner et al. [47] found high maternal over-protection and low paternal care were significantly related to the 'Defectiveness' and 'Dependence' schemas. In turn, Defectiveness and Dependence mediated the relationship between parental bonding and ED symptoms. Similarly, Deas et al. [15] found participants with AN had significantly more EMS - particularly perfectionistic schemas - and perceived their parents as less caring and more controlling than healthy controls. Sheffield et al. [36] also found the variables of social control (an over-compensation process) and behavioural-somatic avoidance (an avoidance process) to partially mediate correlations between particular negative parenting experiences and ED pathology. …

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