Cognitions and their origins in women with anorexia nervosa, normal dieters and female controls

The objective of the study was to develop a semi-structured interview with which to investigate cognitions and their origins in female patients with anorexia nervosa, normal female dieters and female non-dieting controls and to explore group differences in cognitions and, where appropriate, the role of early experience in their development. Following piloting, all participants completed the semi-structured interview and five self-report questionnaires to assess reliability and validity of the interview. When discussing eating-related concerns clinical participants reported more eating-related thoughts than non-clinical participants. These differences were also evident, although to a slightly lesser extent, when discussing concerns about weight and shape. Clinical participants reported more assumptions relating to eating, and weight and shape as a means to acceptance by self and others, and to control over-eating than non-clinical participants. A similar pattern of group difference was reported in degree of belief and associated distress. Clinical participants identified more negative self-beliefs than non-clinical participants. A similar pattern of group difference was reported in degree of rational and emotional belief, and associated distress. All clinical participants identified an association between negative early experiences and negative self-beliefs, and all reported a link between negative self-beliefs and dieting. There are clear differences in cognitive characteristics between women with anorexia nervosa, normal dieters and non-dieting female controls. The meaning attached to dieting may also distinguish dieters from those with a clinical eating disorder. © 2002 John Wiley & Sons, Ltd.