title: A mediational model of self-esteem and social problem-solving in anorexia nervosa.
abstract: OBJECTIVE
  Poor problem-solving and low self-esteem are frequently cited as significant factors in the development and maintenance of anorexia nervosa. The current study examines the multi-dimensional elements of these measures and postulates a model whereby self-esteem mediates the relationship between social problems-solving and anorexic pathology and considers the implications of this pathway.
  
  
  METHODS
  Fifty-five inpatients with a diagnosis of anorexia nervosa and 50 non-clinical controls completed three standardised multi-dimensional questionnaires pertaining to social problem-solving, self-esteem and eating pathology.
  
  
  RESULTS
  Significant differences were yielded between clinical and non-clinical samples on all measures. Within the clinical group, elements of social problem-solving most significant to anorexic pathology were positive problem orientation, negative problem orientation and avoidance. Components of self-esteem most significant to anorexic pathology were eating, weight and shape concern but not eating restraint. The mediational model was upheld with social problem-solving impacting on anorexic pathology through the existence of low self-esteem.
  
  
  CONCLUSIONS
  Problem orientation, that is, the cognitive processes of social problem-solving appear to be more significant than problem-solving methods in individuals with anorexia nervosa. Negative perceptions of eating, weight and shape appear to impact on low self-esteem but level of restriction does not. Finally, results indicate that self-esteem is a significant factor in the development and execution of positive or negative social problem-solving in individuals with anorexia nervosa by mediating the relationship between those two variables.
authors.affiliation: NHS Tayside Eating Disorders Service, Tayside, Scotland, UK. gillian.paterson@nhs.net.
authors.forename: Gillian
authors.initials: G
authors.lastname: Paterson
authors.forename: Kevin
authors.initials: K
authors.lastname: Power
authors.forename: Paula
authors.initials: P
authors.lastname: Collin
authors.forename: David
authors.initials: D
authors.lastname: Greirson
authors.forename: Alex
authors.initials: A
authors.lastname: Yellowlees
authors.forename: Katy
authors.initials: K
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011340:Problem Solving; D012649:Self Concept; D012919:Social Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult