An experimental exploration of social problem solving and its associated processes in anorexia nervosa
Abstract
People with Anorexia Nervosa (AN) have well-documented socio-emotional and neurocognitive impairments. As yet, little is known about their ability to solve problems in social situations, although a link with cognitive avoidance has been suggested. This study explored social problem-solving (SPS), using an experimental task. Secondly, the role of cognitive avoidance in SPS was investigated. Individuals with AN (n=31) and healthy controls (HC; n=39) completed the Social Problem Resolution Task which consists of problem scenarios involving awkward everyday social situations. Participants were asked to generate both the optimal solution and their personal solution. Solutions were rated in terms of how socially sensitive and practically effective they were. AN patients produced relatively poorer personal solutions compared to optimal solutions than HC participants and had higher scores on a measure of cognitive avoidance than the HC group. In AN patients, cognitive avoidance was partially associated with poor SPS. These findings suggest that whilst people with AN have no difficulty in generating socially sensitive and effective solutions to problems, but may have difficulty applying this knowledge to themselves.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Previous experimental and self-report studies on social problem solving in anorexia nervosa did not consider or control for the impact of anxiety or depression.
“both the experimental study (Sternheim et al., 2012) and the three self‐report studies (Paterson et al., 2007; Patterson et al., 2010; Swanson et al., 2010) did not consider the role of, or, control for the impact of anxiety/depression on social problem solving”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Sternheim et al., 2012
In people with anorexia nervosa, when asked what they themselves would do in awkward social situations, they generated fewer optimal solutions than non-anorexia nervosa controls, although they generated optimal solutions for a hypothetical character as effectively as controls.
“While people with AN were able to generate optimal solutions for the hypothetical character that were as effective as those generated by a non‐AN control group, when asked what they themselves would do in that situation, they generated fewer optimal solutions.”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Sternheim et al., 2012
The high levels of avoidant social problem-solving style reported by participants in this study are typical of other avoidant styles of coping and avoidant behavior in AN, such as safety behaviors and cognitive avoidance strategies.
“In addition, the high levels of avoidant social problem‐solving style reported by the participants in this study are typical of the other avoidant styles of coping and avoidant behavior in AN, such as safety behaviors and cognitive avoidance strategies (Pallister & Waller, 2008; Sternheim et al., 2012).”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Sternheim et al., 2012
These results corroborate previous research demonstrating maladaptive social problem-solving styles and attitudes in AN.
“These results corroborate previous research (Paterson et al., 2007; Patterson et al., 2010; Sternheim et al., 2012; Swanson et al., 2010) demonstrating maladaptive social problem‐solving styles and attitudes in AN.”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Sternheim et al., 2012
Sternheim et al. (2012) found that those with AN generated solutions comparable in effectiveness to healthy control participants when it regarded a hypothetical character, but generated much poorer solutions when it regarded themselves.
“Similarly, Sternheim et al. (2012) found that while those with AN generated solutions comparable in effectiveness to HC participants when it regarded a hypothetical character, yet generated much poorer solutions when it regarded themselves.”
From Do anxiety, depression, and intolerance of uncertainty contribute to social problem solving in adult women with anorexia nervosa? (2020) · cites this paper as Sternheim et al. (2012)
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,406 · see citing works
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,385 · see citing works
Lovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523 · see citing works
The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.040 · Cited by 4,973 · see citing works
Diagnostic and Statistical Manual of Mental Disorders ( DSM ‐ IV ‐ TR )
Segal, D. L. (2010) · Wiley eBooks · doi:10.1002/9780470479216.corpsy0271 · Cited by 4,683 · see citing works
Binge Eating: Nature, Assessment and Treatment
Hanson, K., & Pasulka, P. S. (1994) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/014860719401800419 · Cited by 1,166 · see citing works
Mond, J., Hay, P., Rodgers, B., Owen, C., & Beumont, P. J. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00161-x · Cited by 1,124 · see citing works
Incidence, prevalence and mortality of anorexia nervosa and other eating disorders
Hoek, H. W. (2006) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000228759.95237.78 · Cited by 891 · see citing works
Schmidt, U. H., & Treasure, J. L. (2006) · British Journal of Clinical Psychology · doi:10.1348/014466505x53902 · Cited by 882 · see citing works
Self-citationA systematic review and meta-analysis of set-shifting ability in eating disorders
Roberts, M., Tchanturia, K., Stahl, D. R., Southgate, L., & Treasure, J. L. (2007) · Psychological Medicine · doi:10.1017/s0033291707009877 · Cited by 502 · see citing works
Update on course and outcome in eating disorders
Keel, P. K., & Brown, T. A. (2010) · International Journal of Eating Disorders · doi:10.1002/eat.20810 · Cited by 462 · see citing works
Steinhausen, H. (2008) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2008.07.013 · Cited by 461 · see citing works
Social Problem Solving in Adults
D'Zurilla, T. J. (1982) · Elsevier eBooks · doi:10.1016/b978-0-12-010601-1.50010-3 · Cited by 416 · see citing works
(2012) · SpringerReference · doi:10.1007/springerreference_184175 · Cited by 288 · see citing works
The socio-emotional processing stream in Anorexia Nervosa
Oldershaw, A., Hambrook, D. G., Stahl, D. R., Tchanturia, K., Treasure, J. L., & Schmidt, U. H. (2010) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.11.001 · Cited by 286 · see citing works
Self-citationRieger, E., Van Buren, D. J., Bishop, M., Tanofsky-Kraff, M., Welch, R., & Wilfley, D. E. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.02.001 · Cited by 279 · see citing works
The psychometric tradition: Developing the wechsler adult intelligence scale
Wechsler, D. (1981) · Contemporary Educational Psychology · doi:10.1016/0361-476x(81)90035-7 · Cited by 274 · see citing works
Central coherence in eating disorders: a systematic review
López, C., Tchanturia, K., Stahl, D. R., & Treasure, J. L. (2008) · Psychological Medicine · doi:10.1017/s0033291708003486 · Cited by 230 · see citing works
Emotional Theory of Mind and Emotional Awareness in Recovered Anorexia Nervosa Patients
Oldershaw, A., Hambrook, D. G., Tchanturia, K., Treasure, J. L., & Schmidt, U. H. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181c6c7ca · Cited by 197 · see citing works
Self-citationThe Cognitive Avoidance Questionnaire: Validation of the English translation
Sexton, K. A., & Dugas, M. J. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.04.005 · Cited by 183 · see citing works
The relations between social problem solving and coping
D’Zurilla, T. J., & Chang, E. C. (1995) · Cognitive Therapy and Research · doi:10.1007/bf02230513 · Cited by 171 · see citing works
Is anorexia nervosa a version of autism spectrum disorders?
Oldershaw, A., Treasure, J. L., Hambrook, D. G., Tchanturia, K., & Schmidt, U. H. (2011) · European Eating Disorders Review · doi:10.1002/erv.1069 · Cited by 170 · see citing works
Self-citationBerg, K. C., Peterson, C. B., Frazier, P. A., & Crow, S. J. (2011) · Psychological Assessment · doi:10.1037/a0023246 · Cited by 159 · see citing works
Ways of Coping in Women with Eating Disorders
Troop, N. A., Holbrey, A., TROWLER, R., & Treasure, J. L. (1994) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199410000-00001 · Cited by 130 · see citing works
Hambrook, D. G., Oldershaw, A., Rimes, K. A., Schmidt, U. H., Tchanturia, K., Treasure, J. L., Richards, S., & Chalder, T. (2010) · British Journal of Clinical Psychology · doi:10.1348/014466510x519215 · Cited by 126 · see citing works
Self-citationSocial comparison and submissive behaviour in eating disorder patients
Troop, N. A., Allan, S., Treasure, J. L., & Katzman, M. A. (2003) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608303322362479 · Cited by 126 · see citing works
Real-Life-Type Problem-Solving in Asperger's Syndrome
Channon, S., Charman, T., Heap, J., Crawford, S., & Rios, P. (2001) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1012212824307 · Cited by 121 · see citing works
Self-citationPsychosocial factors in the onset of eating disorders: Responses to life‐events and difficulties
Troop, N. A., & Treasure, J. L. (1997) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1997.tb01913.x · Cited by 94 · see citing works
Sternheim, L., Konstantellou, A., Startup, H., & Schmidt, U. (2011) · European Eating Disorders Review · doi:10.1002/erv.1029 · Cited by 91 · cited 3× · see citing works
“This is despite the importance people with AN commonly place on judgements of close others (Sternheim et al., 2011).”
BackgroundInfluentialSelf-citationChannon, S., & Crawford, S. (1999) · Neuropsychologia · doi:10.1016/s0028-3932(98)00138-9 · Cited by 87 · see citing works
Self-citationMentalising and social problem-solving after brain injury
Channon, S., & Crawford, S. (2010) · Neuropsychological Rehabilitation · doi:10.1080/09602011003794583 · Cited by 82 · see citing works
Self-citationPoor social comparison and the tendency to submissive behavior in anorexia nervosa
Connan, F., Troop, N., Landau, S., Campbell, I. C., & Treasure, J. L. (2007) · International Journal of Eating Disorders · doi:10.1002/eat.20427 · Cited by 73 · see citing works
Frontal lobe dysfunction and everyday problem-solving: social and non-social contributions.
Channon, S. (2004) · Acta Psychologica · doi:10.1016/j.actpsy.2003.12.008 · Cited by 70 · see citing works
Self-citationCoping in Dieting and Eating Disorders
Ghaderi, A., & Scott, B. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200005000-00004 · Cited by 68 · see citing works
Crawford, S., & Channon, S. (2002) · Aging & Mental Health · doi:10.1080/13607860120101130 · Cited by 62 · see citing works
Self-citationGosselin, P., Langlois, F., Freeston, M. H., Ladouceur, R., Dugas, M. J., & Pelletier, O. (2002) · Journal de Thérapie Comportementale et Cognitive · Cited by 53 · see citing works
Swanson, H., Power, K., Collin, P., Deas, S., Paterson, G., Grierson, D., Yellowlees, A., Park, K., & Taylor, L. (2010) · European Eating Disorders Review · doi:10.1002/erv.967 · Cited by 48 · see citing works
Specificity and Social Problem-Solving: Relation to Depressive and Anxious Symptomology
Haugh, J. A. (2006) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2006.25.4.392 · Cited by 41 · see citing works
Paterson, G., Power, K., Yellowlees, A., Park, K., & Taylor, L. (2007) · European Eating Disorders Review · doi:10.1002/erv.708 · Cited by 38 · see citing works
Coping Strategies and Recovery in Patients with a Severe Eating Disorder
Bloks, H., van Furth, E. F., Callewaert, I., & Hoek, H. W. (2004) · Eating Disorders · doi:10.1080/10640260490445131 · Cited by 34 · see citing works
A mediational model of self‐esteem and social problem‐solving in anorexia nervosa
Paterson, G., Power, K., Collin, P., Greirson, D., Yellowlees, A., & Park, K. (2010) · European Eating Disorders Review · doi:10.1002/erv.1021 · Cited by 19 · see citing works
Assessment of eating disorders: interview or self-report questionnaire
Fairburn, C. G., & Beglin, S. J. (1994) · International Journal of Eating Disorders · doi:10.1002/1098-108x(199412)16:4
Flagged first, then by citations
Cited by
Sorted by citations
Treasure, J., & Schmidt, U. (2013) · Journal of Eating Disorders · doi:10.1186/2050-2974-1-13 · Cited by 646 · see citing works
Self-citationSchmidt, U., Wade, T. D., & Treasure, J. (2014) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.28.1.48 · Cited by 159 · see citing works
Self-citationWorry and Rumination in Anorexia Nervosa
Startup, H. M., Lavender, A., Oldershaw, A., Stott, R. B., Tchanturia, K., Treasure, J. L., & Schmidt, U. H. (2012) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000847 · Cited by 106 · see citing works
Self-citationCardi, V., Tchanturia, K., & Treasure, J. (2018) · Current Neuropharmacology · doi:10.2174/1570159x16666180118100028 · Cited by 98 · see citing works
An Exploration of Social Functioning in Young People with Eating Disorders: A Qualitative Study
Patel, K., Tchanturia, K., & Harrison, A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0159910 · Cited by 83 · see citing works
Leptin: A hormone linking activation of neuroendocrine axes with neuropathology
Stieg, M. R., Sievers, C., Farr, O. M., Stalla, G. K., & Mantzoros, C. S. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.09.004 · Cited by 75 · see citing works
Understanding catastrophic worry in eating disorders: Process and content characteristics
Sternheim, L. C., Startup, H. M., Saeidi, S., Morgan, J. F., Hugo, P., Russell, A., & Schmidt, U. H. (2012) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2012.05.006 · Cited by 65 · see citing works
Self-citationOldershaw, A., Lavender, T., & Schmidt, U. H. (2018) · European Eating Disorders Review · doi:10.1002/erv.2602 · Cited by 43 · see citing works
Self-citationEmotional development in eating disorders: A qualitative metasynthesis
Henderson, Z. B., Fox, J. R. E., Trayner, P., & Wittkowski, A. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2365 · Cited by 39 · see citing works
Sternheim, L. C., Startup, H. M., & Schmidt, U. H. (2014) · Advances in Eating Disorders · doi:10.1080/21662630.2014.948469 · Cited by 32 · see citing works
Self-citationSternheim, L., Danner, U., van Elburg, A., & Harrison, A. (2020) · Brain and Behavior · doi:10.1002/brb3.1588 · Cited by 24 · see citing works
“These results corroborate previous research (Paterson et al., 2007; Patterson et al., 2010; Sternheim et al., 2012; Swanson et al., 2010) demonstrating maladaptive social problem-solving styles and attitudes in AN.”
BackgroundResultInfluentialSelf-citationFranta, C., Philipp, J., Waldherr, K., Truttmann, S., Merl, E., Schöfbeck, G., Koubek, D., Laczkovics, C., Imgart, H., Zanko, A., et al. (2018) · European Eating Disorders Review · doi:10.1002/erv.2600 · Cited by 24 · see citing works
Autistic Traits Mediate Reductions in Social Attention in Adults with Anorexia Nervosa
Kerr‐Gaffney, J., Mason, L., Jones, E. J. H., Hayward, H., Harrison, A., Murphy, D., & Tchanturia, K. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04686-y · Cited by 23 · see citing works
Funke, J. (2013) · The Journal of Problem Solving · doi:10.7771/1932-6246.1156 · Cited by 15 · see citing works
Social perception in people with eating disorders
Renwick, B., DeJong, H., Kenyon, M., Samarawickrema, N., Loomes, R., Watson, C., Ghelani, S., & Schmidt, U. H. (2013) · European Psychiatry · doi:10.1016/j.eurpsy.2013.03.004 · Cited by 15 · see citing works
Self-citationIn the here and now: Future thinking and social problem-solving in depression
Noreen, S., & Dritschel, B. (2022) · PLoS ONE · doi:10.1371/journal.pone.0270661 · Cited by 13 · see citing works
Feng, E., & Jiang, L. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.9389 · Cited by 11 · see citing works
Timko, C. A., Schnabel, J., & Orloff, N. C. (2024) · International Journal of Eating Disorders · doi:10.1002/eat.24164 · Cited by 9 · see citing works
French, E. N., Eneva, K. T., Arlt, J. M., Yiu, A., & Chen, E. Y. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00591-0 · Cited by 5 · see citing works
Is Alexithymia the Link Between Anorexia and Autism Spectrum Disorders?
Miniati, M., Marazziti, D., & Palagini, L. (2022) · PubMed Central · doi:10.36131/cnfioritieditore20220302 · Cited by 5 · see citing works
Coping with Stress in People with Eating Disorders
Wiatrowska, A. K. (2017) · Annales Universitatis Mariae Curie-Skłodowska sectio J – Paedagogia-Psychologia · doi:10.17951/j.2017.30.1.161 · Cited by 4 · see citing works
The Locus of Control and Coping with Stress in Women with Anorexia Nervosa – Preliminary Research
Wiatrowska, A. K. (2018) · Annales Universitatis Mariae Curie-Skłodowska sectio J – Paedagogia-Psychologia · doi:10.17951/j.2017.30.3.149 · Cited by 4 · see citing works
[Effect of leptin on long-term spatial memory of rats with white matter damage in developing brain].
Feng, E., & Jiang, L. (2017) · PubMed Central · doi:10.7499/j.issn.1008-8830.2017.12.009 · Cited by 3 · see citing works
Noreen, S., & Dritschel, B. (2023) · PLoS ONE · doi:10.1371/journal.pone.0289676 · Cited by 1 · see citing works
Kilci, A. K., Yalçıner, S., & Bekir, S. (2025) · Research Square · doi:10.21203/rs.3.rs-5868921/v1 · Cited by 1 · see citing works
Strategie radzenia sobie z lękiem u osób z zaburzeniami odżywiania.
Katarzyna, M.-R. (2014) · Biblioteka Uniwersytetu Medycznego w Poznaniu
French, E. N., Eneva, K. T., Arlt, J. M., Yiu, A., & Chen, E. Y. (2022) · Figshare · doi:10.6084/m9.figshare.19808996
Kilci, A. K., Bekir, S., Yalçıner, S., & ÖZDAYI, N. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1797082
- Authors
- Sternheim, L., Startup, H., Pretorius, N., Johnson-Sabine, E., Schmidt, U., & Channon, S.
- Affiliations
- King's College London (GB)
- University College London (GB)
- Corresponding author
- Sternheim, Lot
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 200
- Issue
- 2-3
- Pages
- 524-529
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2091194549
- Cited by
- 29
- References
- 43
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 4 · 2020: 2 · 2019: 1 · 2018: 5 · 2017: 3 · 2016: 1 · 2014: 4 · 2013: 3 · 2012: 2
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute of Health Research (NIHR) (RP-PG-0606-1043)
- Local Scholar in the Marie Curie Research Training Network INTACT (MRTN-CT-2006-035988)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Health Professions › Speech and Hearing › Problem Solving Skills Development
- Keywords
- anorexia nervosa, social problem solving, cognitive avoidance, social sensitivity, neurocognitive impairment
- MeSH terms
- Adolescent, Adult, Anorexia Nervosa, Anxiety, Cognition, Depression, Emotions, Female, Humans, Interpersonal Relations, Neuropsychological Tests, Problem Solving, Surveys and Questionnaires, Social Behavior, Social Perception, Body Mass Index
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
