Date of Award:

5-2009

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

Psychology

Committee Chair(s)

Jamison Fargo

Committee

Jamison Fargo

Committee

David Stein

Committee

Melanie Domenech-Rodriguez

Committee

Mary Doty

Committee

Edward M. Heath

Abstract

The present study aimed to examine the relationship between maladaptive schemas and treatment outcomes of adolescent and adult women with an eating disorder receiving residential treatment. Existing data were obtained from 67 females aged 11 to 47 years (m =18.61) that had entered residential treatment for anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) at a Western United States residential eating disorder treatment facility. Pre- and posttreatment data were collected by the personnel at the facility on eating disorder symptomatology, mood, and core beliefs. Three hypotheses were tested: (a) that maladaptive schemas would be positively correlated with eating disorder symptom severity, (b) that females endorsing more maladaptive schemas at admission or those with stable maladaptive schemas across their course of treatment would have less favorable posttreatment outcomes at the time of their discharge from residential treatment than females with lower scores initially or improved scores over the course of their treatment and follow-up, and (c) that females endorsing more maladaptive schemas or with greater stability of their maladaptive schemas across treatment will spend more time in residential treatment. To address the above hypotheses a series of hierarchical linear regressions, linear mixed-effects models, and Cox proportional-hazards regressions were conducted. Results indicated that maladaptive schemas at the start of treatment were predominantly predictive of admit rather than discharge symptomatology. Different combinations of maladaptive schemas were found to have both positive and negative relationships to one's symtomatology across time. The most common maladaptive schemas found to be significantly associated with symptomatology were impaired limits, impaired autonomy and performance, and overvigilance and inhibition. Lastly, a relationship existed between both impaired limits and overvigilance and inhibition and a participant's length of stay in treatment. The results of this study suggest that maladaptive schemas provide some predictability of treatment outcomes and are important targets for psychological interventions aimed at recovery. Furthermore, the results of the study highlight the complexity associated with maladaptive schemas in females with eating disorders and the need for longitudinal research to examine common patterns and therapeutic targets based on diagnosis and status in treatment.

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