Maladaptive schemas in adolescent females with anorexia nervosa and implications for treatment
Abstract
Recent research has highlighted the presence of Young's Early Maladaptive Schemas (EMSs) in individuals with an eating disorder (ED). This study assessed the EMSs reported by adolescent females with Anorexia Nervosa (AN) compared with a community group. Thirty-six adolescent females diagnosed with AN or subthreshold AN and 111 female secondary school students completed a questionnaire that included the Young Schema Questionnaire, the Behavior Assessment System for Children Self-report of Personality, and the Eating Disorder Screen for Primary Care. Two independent AN subtypes and two community subtypes were derived from responses to the questionnaire, and significant differences between the four comparison groups were found. High Pathology AN participants reported the highest level of psychological maladjustment. Social Isolation and Emotional Inhibition appeared to be most characteristic of adolescent AN in this sample. The results suggest that EMSs may require attention in the treatment of AN in adolescent females, and that different AN subtypes may require individualized treatment approaches.
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People with AN may have cognitive/temperamental schemas that have a significant role in how they communicate feelings, such as how they perceive and respond to a prognosis like 'terminal' AN.
“Those of us with AN may have cognitive/temperamental schemas that have a significant role in how we communicate our feelings [20, 21], such as how we perceive and respond to a prognosis (i.e. 'terminal' AN).”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [20]
A 'terminal' diagnosis may trigger maladaptive schemas related to abandonment/rejection, dependence/incompetence, and self-sacrifice/burdensomeness, and influence engagement with future treatment if feelings change.
“We may be highly sensitive to social experiences that relate to perceived abandonment/rejection, dependence/incompetence, and self-sacrifice/burdensomeness, and a 'terminal' diagnosis may trigger these maladaptive schemas and influence the way we engage with others regarding re-engaging with future treatment if our feelings change (i.e., threat-related responses such as surrender) [20, 21].”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [20]
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- Authors
- Damiano, S. R., Reece, J., Reid, S., Atkins, L., & Patton, G.
- Affiliations
- Royal Children's Hospital (AU)
- RMIT University (AU)
- Corresponding author
- Damiano, Stephanie R.
- Venue
- Eating Behaviors
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 16
- Pages
- 64-71
- ISSN
- 1471-0153 (ISSN-L)
- OpenAlex
- W2047745592
- Cited by
- 34
- References
- 50
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 8 · 2022: 3 · 2020: 4 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 6 · 2015: 2
- FWCI
- 4.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Eating Behaviors (publishedVersion)
- PubMed (publishedVersion)
- RMIT Research Repository (RMIT University Library) (submittedVersion)
- Figshare (submittedVersion)
- Funders
- Australian Postgraduate Award
- Butterfly Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anorexia nervosa, early maladaptive schemas, adolescent girls, eating disorders, schema therapy, anorexia nervosa subtypes, social isolation, emotional inhibition, psychological maladjustment, therapeutic implications
- MeSH terms
- Adaptation, Psychological, Adolescent, Anorexia Nervosa, Emotions, Female, Humans, Inhibition, Psychological, Personality, Surveys and Questionnaires, Social Isolation
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