Anorexia nervosa: valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice.
Anorexia nervosa (AN) is highly valued by people with the disorder. It is also a highly visible disorder, evoking intense emotional responses from others, particularly those closest to the person. A maintenance model of restricting anorexia nervosa, combining intra- and interpersonal factors is proposed. Four main maintaining factors (perfectionism/cognitive rigidity, experiential avoidance, pro-anorectic beliefs, response of close others) are suggested and the evidence supporting these is examined. These factors need to be integrated with what is known about starvation-related maintenance factors. This model departs from other models of AN in that it does not emphasize the role of weight and shape-related factors in the maintenance of AN; that is, it is culture-free. Implications for clinical practice and research are discussed.
Schmidt
Ulrike
U
Section of Eating Disorders, Institute of Psychiatry, De Crespigny Park, PO Box 59, London SE5 8AF, UK. u.schmidt@iop.kcl.ac.uk
Treasure
Janet
J
D000856:Anorexia Nervosa / Q000523:psychology*; D001828:Body Image; D001835:Body Weight; D003469:Culture; D003674:Defense Mechanisms; D006801:Humans; D007398:Interpersonal Relations; D008960:Models, Psychological; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D012056:Reinforcement, Social; D012307:Risk Factors; D012649:Self Concept; D012945:Social Values