Childhood social arena and cognitive sets in eating disorders

Objective: While there is much evidence to suggest that women with eating disorders experience difficulties in the social domain, little has been done to establish whether such difficulties play a causal role or the extent to which these involve cognitive factors. The purpose of this report is to determine whether difficulties in certain aspects of the childhood social arena are reported as existing prior to developing an eating disorder. Method: A sample of 43 women with a history of eating disorders and 20 women with no such history were interviewed retrospectively about their feelings and experiences of loneliness, shyness and inferiority in childhood and adolescence. Results: Women with a history of anorexia nervosa of the binge/purge subtype reported higher levels of loneliness, shyness and feelings of inferiority in adolescence than did women with no history of an eating disorder, and women with a history of bulimia nervosa reported higher levels of shyness. However, this was not true for earlier childhood where such feelings did not differ significantly between groups. This difference could not be accounted for by current depressive disorder, recovery from the eating disorder or level of victimization in adolescence. Conclusion: There are a number of differences in the aetiology of subtypes of eating disorder. The present results suggest that cognitive styles pertaining to the social arena in adolescence, and prior to the onset of any eating disorders, may play a causal role in the development of anorexia nervosa of the binge/purge subtype, but not anorexia nervosa of the restricting subtype.