Social emotional functioning and cognitive styles in eating disorders

Br J Clin Psychol. 2012 Sep;51(3):261-79. doi: 10.1111/j.2044-8260.2011.02026.x. Epub 2011 Nov 25.


Objectives: Contemporary models of eating disorders (EDs) argue that both cognitive style (weak coherence and poor set shifting) and social emotional difficulties are involved in the maintenance of EDs. This study aimed to explore the factor structure of cognitive and social emotional functioning and to investigate whether a particular cognitive or social emotional profile was associated with a more severe and chronic form of illness.

Design: A cross-sectional design was used to investigate cognitive and social emotional functioning in people with EDs compared to healthy controls (HCs) and those recovered from an ED.

Methods: Two hundred twenty-five participants were assessed (100 with an ED, 35 recovered from an ED, and 90 HCs) using a battery of set shifting, coherence, and social emotional measures.

Results: There were no significant correlations between the cognitive or social emotional variables. A principal components analysis (PCA) identified three components: a fragmented perseverative cognitive style, for which the ED group scored highly, a global flexible cognitive style, for which HCs scored highly, and a social emotional difficulties profile, for which those with EDs scored highly. Individuals in recovery from an ED did not differ from the acute group, suggesting this cognitive and social emotional profile may be a trait associated with EDs. ED participants scoring highest for the fragmented perseverative cognitive style and social emotional difficulties had a more severe and chronic form of illness.

Conclusions: The findings provide empirical support for Schmidt and Treasure's (2006) maintenance model of EDs and suggest both cognition and emotional functioning should be considered in treatment.

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa / psychology*
  • Bulimia Nervosa / psychology*
  • Case-Control Studies
  • Cognition*
  • Cross-Sectional Studies
  • Emotions*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Middle Aged
  • Neuropsychological Tests
  • Personality*
  • Risk Factors
  • Severity of Illness Index
  • Social Adjustment*