Understanding catastrophic worry in eating disorders: process and content characteristics.
OBJECTIVE
The majority of people with eating disorders (ED) experience high levels of comorbid anxiety and depression, yet the maintenance processes of these in ED remain largely unknown. Worry, a defining cognitive feature and important maintenance factor of anxiety, has not been well-studied amongst people with ED. This is the first study to explore both the process and content characteristics of catastrophic worry in ED.


METHODS
Twenty-nine patients with anorexia nervosa (AN), 15 patients with bulimia nervosa (BN) and 37 healthy controls (HC) completed measures assessing anxiety, depression, worry and eating disorder pathology. Catastrophic worry was assessed using the Catastrophizing Interview and catastrophic worry content was explored using qualitative Thematic Analysis.


RESULTS
Compared to HCs, ED groups had higher levels of anxiety, depression and worry and they generated a greater number of catastrophic worry steps. Worry was further found associated with depressive symptomatology in those with ED. Worry content for the ED groups included ED themes, but also themes reflecting broader inter and intrapersonal concerns.


CONCLUSIONS
The degree to which worry is driven by depressive versus anxious symptomatology remains unclear. The current study does not include an anxious or depressed control group, and results should be considered in the light of relatively small samples sizes.


CONCLUSIONS
Findings indicate that interventions that target worry processes may be a useful adjunct to treatment for those ED patients with clinical worry levels.
King's College London, Institute of Psychiatry, Division of Psychological Medicine and Psychiatry, Section of Eating Disorders, P059, De Crespigny Park, London SE5 8AF, UK. lot.sternheim@kcl.ac.uk
Lot
L
Sternheim
Helen
H
Startup
Saeideh
S
Saeidi
John
J
Morgan
Phillipa
P
Hugo
Alice
A
Russell
Ulrike
U
Schmidt
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000523:psychology*; D001007:Anxiety / Q000150:complications / Q000523:psychology*; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology*; D058443:Catastrophization / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged