Cognitive dysfunction in eating disorders

Recent theories have implicated disturbed cognitions in the etiology and perpetuation of eating disorders. However, the specific nature of these disturbances has received only limited empirical attention. Therefore the present study assessed subjects with a range of eating pathology on three types of cognitive dysfunction: logical errors, cognitive slippage, and conceptual complexity. Affective features were also assessed for purposes of contrast and discriminant validity. The Cognitive Error Questionnaire (Lefebvre, 1981), Thought Disorder Index (Blatt & Ritzier, 1974), Friedman's Developmental Level (Goldfried, Stricker, & Weiner, 1971), Sentence Completion Test (Loevinger & Wessler, 1970), Dysphoria Questionnaire (Johnson & Larson, 1982), and Beck Depression Inventory (Beck, 1978) were administered to 19 restrictive anorexics, 14 bulimic anorexics, 17 normal-weight bulimics, 15 subclinical eating disorders, and 17 normal control subjects. All groups were matched for age, sex, race, education, and marital status. The eating disordered groups were matched for duration of illness and treatment history, and the anorexic groups were matched on percent of ideal body weight. Both anorexic groups manifested more logical errors than the control group; the normal-weight bulimic and subclinical groups were indistinguishable from the controls on this index. There were no significant differences among groups on cognitive slippage or conceptual complexity. In contrast, dysphoria and depression were prominent features of all four eating disordered groups. The significance and conjoint influence of cognitive and affective factors in eating pathology is discussed.