Investigating the role of implicit self-esteem in Bulimia Nervosa

Current cognitive models of Bulimia Nervosa (BN) emphasise the importance of global negative self-evaluations in the development and maintenance of the disorder. However, there are inconsistencies in the research findings that have examined the relationship between levels of self-esteem and BN. Although investigations are being made into, and tools designed to measure implicit self-esteem, to date in the eating disorder literature self-esteem has only been measured using self-report questionnaires and thus may only allow access to explicit self-esteem. The literature review examines the relevance of self-esteem within cognitive behavioural theories of BN and reviews the literature that has attempted to investigate relationships between levels of self-esteem and BN. Research investigating implicit self-esteem is then reviewed and the value of extending this research into the area of eating disorders considered. The empirical research then primarily investigates whether there are differences in implicit biases of self-between individuals with eating disorders compared to healthy controls, using the Implicit Associations Test (IAT: Greenwald, McGhee & Schwartz, 1998; Greenwald and Farnham, 2000). Differences between the groups in explicit self-esteem are also investigated. The results show a significant difference between the groups on both the explicit and implicit measures of self-esteem, but show that individuals with eating disorders actually have higher levels of implicit self-esteem. The results are discussed in relation to other research that has found that a positive implicit self-esteem bias exists in clinical populations and that considers the discrepancies between implicit and explicit measures.