title: Early maladaptive schemas and body mass index in subgroups of eating disorders: a differential association.
abstract: OBJECTIVE
  The objectives were (1) to examine whether 3 eating disorder subgroups, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) classification system, exhibit a specific profile in terms of early maladaptive schema (EMS) factors, and (2) to investigate the relationship between body mass index (BMI) and EMS factors in each of the individual eating disorder subgroups.
  
  
  METHODS
  The presence of EMS was measured by the Young Schema Questionnaire Long Form among patients affected by restrictive anorexia nervosa, binge/purging-type anorexia nervosa, and bulimia nervosa. Principal component factor analysis was used to investigate the factor structure of the EMS across eating disorder subgroups. General linear model analysis was applied to examine the differences of the subgroups in terms of their EMS factors. Differential association between BMI and schema factors was tested by analysis of covariance.
  
  
  RESULTS
  Four EMS factors were extracted, which accounted for approximately 72% of the variance. The 3 eating disorder subgroups differed in terms of their EMS factor profiles. The analysis of covariance resulted in a significant negative relationship between BMI and EMS factor 2 in the bulimia nervosa group (P < .0099), indicating that higher severity on defectiveness, failure, dependence, enmeshments, subjugation, approval-seeking (EMS factor 2) was associated with lower values on BMI.
  
  
  CONCLUSIONS
  The findings of this study indicate that EMSs based on Young's conceptualization of EMS, as measured by the Young Schema Questionnaire, differ significantly among eating disorder subgroups defined by the phenomenological approach used by the DSM-IV diagnoses. These results are consistent with the notion that dysfunctional cognitions may play an important role in the development and maintenance of the symptoms that underlie the DSM-IV classification of the eating disorder subtypes.
authors.affiliation: Department of Psychiatry and Psychotherapy, Faculty of General Medicine Semmelweis University, 1083 Budapest, Hungary. unoka@psych.sote.hu
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Unoka
authors.forename: Tamás
authors.initials: T
authors.lastname: Tölgyes
authors.forename: Pál
authors.initials: P
authors.lastname: Czobor
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D001828:Body Image; D015992:Body Mass Index; D002032:Bulimia / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D052018:Bulimia Nervosa / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006760:Hospitalization; D006801:Humans; D007389:Internal-External Control; D010555:Personality Inventory; D011599:Psychopathology; D012649:Self Concept; D012919:Social Behavior; D011795:Surveys and Questionnaires