A cross-sectional analysis of the cognitive model of bulimia nervosa

Objective: The present study aimed to directly test Cooper et al.'s cognitive model of the maintenance of bulimia nervosa. Method: The major predictions of the model were tested cross-sectionally using multiple regression analyses and structural equation modeling in a mixed sample comprising nonclinical female university students (n = 298) and clinical eating disorder patients (n = 44). Results: Consistent with model, negative self-beliefs was associated with negative emotion, negative emotion with positive and negative beliefs about eating, beliefs about eating with eating behavior, and binge eating with negative self-beliefs. However, contrary to hypotheses, results did not consistently support a direct link between compensatory behavior and negative self-beliefs. Furthermore, the role of permissive thoughts was found to be questionable. Of note, results suggested that components of the model may operate to maintain bulimic pathology in a slightly different way for purging and nonpurging behaviors. Discussion: While the results of this research provide some preliminary evidence for the validity of the cognitive model as an explanation of the persistence of bulimic symptoms, further work is required to develop the model. (Int J Eat Disord 2012; 45:776-786)