Interpersonal functioning and eating-related psychopathology

Maladaptive interpersonal functioning is considered typical of eating disorders. The present thesis aimed to add to existing knowledge of interpersonal functioning in the eating disorders in terms of both symptomatology and treatment. In Study 1, relationships were found between eating disorder attitudes and several types of poor interpersonal functioning. These associations were present when controlling for depression and anxiety. Study 2 found that generalised interpersonal problems were more likely to be reported by women with bulimic disorders than comparison women, apart from problems with being too open, which were more likely to be reported by comparison women. In Study 3, individuals with self identified eating disorders were found to have poorer problem solving skills in specific interpersonal situations than healthy controls, generating less means to solve the problem, with these means being significantly less effective and less specific than those generated by healthy controls. In Study 4, the experience of an invalidating childhood environment was explored as a potential predictor of adult interpersonal problems in the eating disorders. Viewing the expression of emotions as a sign of weakness was a mediator of the relationship between having a more invalidating mother and adult eating concern in a nonclinical population. In Study 5, the interpersonal experiences of patients with bulimic disorders are explored using qualitative methodology. They report a range of problems characterised by social avoidance, social anxiety, non-assertiveness, and a difficulty with being genuine in relationships. In Study 6, patients reported their experiences of interpersonal psychotherapy for bulimic disorders. In general, they experienced the therapy as positive and beneficial. They express that it helped them address a range of interpersonal problems, and reduced but did not cure their eating disordered behaviours. Patients liked that therapy focused on both interpersonal relationships and eating. In Study 7, interpersonal psychotherapists discussed their perceptions of the modified therapy. They identified several factors as being related to outcome, such as the existence or willingness to build a support network, motivation to change, a clear interpersonal problem identified in the patient, level of depression, duration of the eating disorder and keeping therapy focused on the interpersonal. Results of these studies suggest that those with higher levels of eating disorder related attitudes and behaviours often have significant problems with interpersonal functioning. This thesis supports the use of interpersonal psychotherapy as a viable treatment approach to the eating disorders. It also supports the use of the modified version of the therapy, which addresses eating as well as interpersonal functioning