Anorexia nervosa: Valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice
Ulrike Schmidt,
Janet Treasure,
Corresponding Author
Ulrike Schmidt
Institute of Psychiatry, London, UK
Correspondence should be addressed to Dr Ulrike Schmidt, Section of Eating Disorders, Institute of Psychiatry, De Crespigny Park, PO Box 59, London SE5 8AF, UK (e-mail: [email protected]).Search for more papers by this authorJanet Treasure
Department of Psychiatry, Guy's Campus, London, UK
Search for more papers by this authorUlrike Schmidt,
Janet Treasure,
Corresponding Author
Ulrike Schmidt
Institute of Psychiatry, London, UK
Correspondence should be addressed to Dr Ulrike Schmidt, Section of Eating Disorders, Institute of Psychiatry, De Crespigny Park, PO Box 59, London SE5 8AF, UK (e-mail: [email protected]).Search for more papers by this authorJanet Treasure
Department of Psychiatry, Guy's Campus, London, UK
Search for more papers by this authorAbstract
Anorexia nervosa (AN) is highly valued by people with the disorder. It is also a highly visible disorder, evoking intense emotional responses from others, particularly those closest to the person. A maintenance model of restricting anorexia nervosa, combining intra- and interpersonal factors is proposed. Four main maintaining factors (perfectionism/cognitive rigidity, experiential avoidance, pro-anorectic beliefs, response of close others) are suggested and the evidence supporting these is examined. These factors need to be integrated with what is known about starvation-related maintenance factors. This model departs from other models of AN in that it does not emphasize the role of weight and shape-related factors in the maintenance of AN; that is, it is culture-free. Implications for clinical practice and research are discussed.
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