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Thought–shape fusion in anorexia and bulimia nervosa: a comparative experimental study

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

‘Thought–shape fusion’ (TSF) is a cognitive distortion specific in patients with eating disorders and occurs when the thought about eating a forbidden food increases a person’s estimate of her weight/shape, elicits a perception of moral wrongdoing and makes her feel fat. This study aimed to experimentally induce, study and compare TSF between patients with bulimia nervosa (BN) and patients with anorexia nervosa (AN). 31 patients diagnosed with a current eating disorder, of which 20 met DSM-IV-TR criteria for BN and 11 for AN, participated in a mixed-model experimental design with the aim of eliciting TSF and investigating the effects of corrective behaviors (checking and mental neutralizing). Verbal analogue scales constituted the main outcome measures. TSF was experimentally induced and expressed in a similar way in both clinical groups, apart from ‘feeling fat’ which was higher in BN patients. TSF induction triggered heightened levels of anxiety, guilt and urges to engage in corrective behaviors in both groups. Body dissatisfaction only increased in the BN patients. Mental neutralizing and to a lesser extent checking reduced most effects of the experimental procedure, but this effect was larger for BN patients. The nature of TSF seems to have similarities between BN and AN patients; however, the precise connection between TSF and different types of eating disorders remains to be explored in future clinical trials.

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Notes

  1. The experimenter was female and is referred to throughout the procedure as “she”.

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Acknowledgments

The authors are grateful to Dr. Shafran for providing important materials to this study and for her valuable communications. They would like to express their sincere thanks to the patients who participated in this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, Panteion University, 136 Syngrou Avenue, 176 71, Athens, Greece

    Myrsini Kostopoulou & Anastassios Stalikas

  2. Department of Psychiatry, Eating Disorder Outpatient Clinic, Eginition Hospital, University of Athens, 72-74 Vasilissis Sofias Avenue, 115 28, Athens, Greece

    Eleftheria Varsou

  3. 11 Kyprou Street, Kifissia, 145 62, Athens, Greece

    Myrsini Kostopoulou

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  1. Myrsini Kostopoulou
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  2. Eleftheria Varsou
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  3. Anastassios Stalikas
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Correspondence to Myrsini Kostopoulou.

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Kostopoulou, M., Varsou, E. & Stalikas, A. Thought–shape fusion in anorexia and bulimia nervosa: a comparative experimental study. Eat Weight Disord 18, 245–253 (2013). https://doi.org/10.1007/s40519-013-0040-0

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  • DOI: https://doi.org/10.1007/s40519-013-0040-0

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