Adverse relationship processes: the attempts of women with bulimia nervosa symptoms to fit the perceived ideal of intimate partners

Eur Eat Disord Rev. 2008 Jan;16(1):59-66. doi: 10.1002/erv.797.


Objective: This study drew together research on anxious attachment, self-silencing, self-consciousness during sexual activity and bulimic symptoms.

Method: A mixed community/university sample of 225 women aged 18-63 (M = 30.24, SD = 10.44) and involved in an intimate relationship completed questionnaires.

Results: Adverse relationship processes were significantly associated and each was also associated with bulimic symptoms. Self-consciousness during sexual activity was the best predictor of bulimic symptoms, followed by anxious attachment. Self-silencing was redundant when the other relationship processes were included in the regression. General psychopathology mediated the association between self-silencing and bulimic symptoms, and partially mediated associations between bulimic symptoms and both anxious attachment and self-consciousness during sexual activity.

Discussion: Women with bulimic symptoms attempt to change themselves by engaging in adverse processes in intimate relationships to meet the perceived expectations of their partners. Targeting these relationship processes in therapy might further add to the success of relationship-oriented treatments (e.g. interpersonal therapy).

MeSH terms

  • Adolescent
  • Adult
  • Body Image
  • Bulimia Nervosa / psychology*
  • Female
  • Humans
  • Interpersonal Relations*
  • Middle Aged
  • Multivariate Analysis
  • Object Attachment
  • Regression Analysis
  • Self Concept
  • Sexual Behavior*
  • Spouses / psychology*