Eating in anorexia nervosa and bulimia : an application of the tri-partite model of anxiety

Although many factors have been Implicated in the etiology and maintenance of anorexia nervosa and bulimia, anxiety, particularly in the context of eating, may be critical. Applying the tri-partite model of anxiety, this study was designed to assess anxiety before, during, and after eating in eating disorder and normal control subjects. The experimental eating procedure was preceded by a neutral task. Four groups of ten female subjects each participated: normal-weight females, restricting-anorexics, bulimic-anorexics, and bulimics. Anxiety was assessed by self-report (ratings of pleasure, arousal, and anxiety), psychophysiological (heart rate and skin conductance) and behavioural (food consumption) measures. Controls reported themselves to be non-anxious throughout the study arid ate almost all of the small test meal. Somewhat surprisingly, physiological arousal (especially heart rate) was high during eating. During the neutral task, heart rate declined slightly in all groups. The eating disorder groups indicated a high level of anxiety throughout the study which showed a trend to increase further during eating. In addition, anorexics and bulimics described dysfunctional beliefs regarding the effects of eating on body shape and weight. Similar to controls, physiological arousal was high during eating. Overall, heart rate proved to be a more useful measure of arousal than skin conductance because many anorexics were hyporesponsive. Restricting-anorexics ate the least amount, bulimic-anorexics ate slightly more, and bulimics ate similar amounts to controls. Thus, food consumption was probably associated with weight status. Several conclusions were drawn. Women with eating disorders have a high level of general anxiety probably because of a conflict between biological pressures to eat and fears of weight gain. The high physiological arousal during eating appears to reinforce perceptions of anxiety. The eating disorder groups showed different degrees of concordance among measures of anxiety. Borrowing from the research on phobias, therapeutic procedures such as cognitive therapy, progressive relaxation, and exposure treatments can address the different components of anxiety anorexics and bulimics experience during eating.Arts, Faculty ofPsychology, Department ofGraduat