Abstract
‘Thought–shape fusion’ (TSF) is a cognitive distortion specific in patients with eating disorders and occurs when the thought about eating a forbidden food increases a person’s estimate of her weight/shape, elicits a perception of moral wrongdoing and makes her feel fat. This study aimed to experimentally induce, study and compare TSF between patients with bulimia nervosa (BN) and patients with anorexia nervosa (AN). 31 patients diagnosed with a current eating disorder, of which 20 met DSM-IV-TR criteria for BN and 11 for AN, participated in a mixed-model experimental design with the aim of eliciting TSF and investigating the effects of corrective behaviors (checking and mental neutralizing). Verbal analogue scales constituted the main outcome measures. TSF was experimentally induced and expressed in a similar way in both clinical groups, apart from ‘feeling fat’ which was higher in BN patients. TSF induction triggered heightened levels of anxiety, guilt and urges to engage in corrective behaviors in both groups. Body dissatisfaction only increased in the BN patients. Mental neutralizing and to a lesser extent checking reduced most effects of the experimental procedure, but this effect was larger for BN patients. The nature of TSF seems to have similarities between BN and AN patients; however, the precise connection between TSF and different types of eating disorders remains to be explored in future clinical trials.
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Notes
The experimenter was female and is referred to throughout the procedure as “she”.
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Acknowledgments
The authors are grateful to Dr. Shafran for providing important materials to this study and for her valuable communications. They would like to express their sincere thanks to the patients who participated in this study.
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The authors declare that they have no conflict of interest.
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Kostopoulou, M., Varsou, E. & Stalikas, A. Thought–shape fusion in anorexia and bulimia nervosa: a comparative experimental study. Eat Weight Disord 18, 245–253 (2013). https://doi.org/10.1007/s40519-013-0040-0
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DOI: https://doi.org/10.1007/s40519-013-0040-0