Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-27T02:12:09.364Z Has data issue: false hasContentIssue false
  • English
  • Français

Return of the Suppressed: Mental Control and Bulimia Nervosa

Published online by Cambridge University Press:  06 October 2014

Tony Ward ,
Cynthia M. Bulik  and
Lucy Johnston
Tony Ward*
Affiliation:
University of Canterbury
Cynthia M. Bulik
Affiliation:
University of Canterbury
Lucy Johnston
Affiliation:
University of Canterbury
*
Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, New Zealand. E-mail: t.ward@psyc.canterbury.ac.nz
Get access

Abstract

The clinical literature has long acknowledged the paradoxical findings that deliberate attempts to suppress particular thoughts actually increase their occurrence. The unwanted, intrusive thoughts that are a major feature of obsessive disorders, depression, sleep disorders, and a range of other disturbances are of particular clinical concern. The exploration of psychological factors associated with cognitive control is, therefore, clinically relevant. The present paper considers the role of mental control and thought suppression in bulimia nervosa in explaining the occurrence of unwanted thoughts and feelings, specifically in relation to weight, shape, and food. Our fundamental argument is that suppression of thoughts of food, weight, and body shape can lead to the increased frequency of these thoughts. The increase in unwanted thoughts is likely to result in a loss of control over eating, and lead to the escalation and perpetuation of bulimia. Dietary restriction is likely to be associated with successful suppression, and binge-eating with failed suppression. Indeed, the initial success of suppression paradoxically causes its inevitable failure. We conclude that the suppression of thoughts of food and weight or shape in bulimia nervosa is maladaptive and counterproductive. In addition, the therapeutic implications of thought suppression are considered.

Type
Research Article
Information
Behaviour Change , Volume 13 , Issue 2 , June 1996 , pp. 79 - 90
Copyright
Copyright © The Author(s) 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association. (1994). Diagnostic and Statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
Ames-Frankel, J., Devlin, M.J., Walsh, B.T., Strasser, T.J., Sadik, C., Oldham, J.M., & Roose, S.P. (1992). Personality disorder diagnoses in patients with bulimia nervosa: Clinical correlates and changes with treatment. Journal of Clinical Psychiatry, 53, 90–96.Google ScholarPubMed
Ben-Tovim, D., & Walker, M. (1991). Further evidence for the Stroop test as a quantitative measure of psychopathology in eating disorders. International Journal of Eating Disorders, 10, 609–613.Google Scholar
Ben-Tovim, D., Walker, M, Fok, D., & Yap, E. (1989). An adaptation of the Stroop Test for measuring shape and food concerns in eating disorders: A quantitative measure of psychopathology? International Journal of Eating Disorders, 8, 681–687.Google Scholar
Brisman, J., & Siegel, M. (1984). Bulimia and alcoholism: Two sides of the same coin? Journal of Substance Abuse Treatment, 1, 113–118.Google Scholar
Bulik, C. (1987). Drug and alcohol abuse by bulimic women and their families. American Journal of Psychiatry, 144, 1604–1606.Google Scholar
Bulik, C. (in press). Anxiety and eating disorders: A review of their relationship. New Zealand Journal of Psychology.Google Scholar
Butow, P., Beumont, P., & Touyz, S.J. (1993). Cognitive processes in dieting disorders. International Journal of Eating Disorders, 14, 319–329.Google Scholar
Carter, F.A., & Bulik, C.M. (1994). Exposure treatments for bulimia nervosa: Procedure, efficacy, and mechanisms. Advances in Behaviour Therapy and Research, 16, 77–129.CrossRefGoogle Scholar
Carter, F.A., Bulik, C.M., Lawson, R.H., Sullivan, P.F., & Wilson, J.S. (1995). Effect of mood and food cues on information processing in women with bulimia and controls. Submitted for publication.Google Scholar
Clark, D.M., Ball, S., & Pape, D. (1991). An experimental investigation of thought suppression. Behavior Research and Therapy, 29, 253–257.Google Scholar
Cooper, M.J., Anastasiades, P., & Fairburn, C.G. (1992). Selective processing of eating-, shape-, and weight-related words in persons with bulimia nervosa. Journal of Abnormal Psychology, 101, 352–355.Google Scholar
Cooper, M.J., & Fairburn, C.G. (1992). Thoughts about eating, weight, and shape in anorexia nervosa and bulimia nervosa. Behaviour Research and Therapy, 50, 501–511.Google Scholar
Corrigan, S.A., Johnson, W.G., Alford, G.S., Bergeron, K.C., & Lemmon, C.R. (1990). Prevalence of bulimia among patients in a chemical dependency program. Addictive Behaviors, 15, 581–585.Google Scholar
Davis, R., Freeman, R.J., & Gamer, D.M. (1988). A naturalistic investigation of the eating behavior in bulimia nervosa. Journal of Consulting and Clinical Psychology, 56, 273–279.Google Scholar
Duval, S., & Wicklund, R.A. (1972). A theory of subjective self awareness. San Diego, CA: Academic Press.Google Scholar
Erdelyi, M.H., & Goldberg, B. (1978). Let's not sweep repression under the rug: Toward a cognitive psychology of repression. In Kihlslrom, J.F. & Evans, F.J. (Eds.), Functional disorders of memory (pp. 355–402). Hillsdale, NJ: Erlbaum.Google Scholar
Fiske, S.T., & Taylor, S.E. (1991). Social cognition (2nd ed.). New York: McGraw-Hill.Google Scholar
Franklin, J.C., Schiele, B.C., Brozek, J., & Keys, A. (1948). Observations on human behavior in experimental semistarvation and rehabilitation. Journal of Clinical Psychology, 4, 28–45.Google Scholar
Gilbert, D.T. (1991). How mental systems believe. American Psychologist, 46, 107–119.Google Scholar
Glassman, J., Rich, C., Darko, D., & Clarkin, A. (1990). Some correlates of treatment response to a multicomponent psychotherapy program in outpatients with eating disorders. Annals of Clinical Psychiatry, 2, 33–38.Google Scholar
Goldbloom, D., Naranjo, C., Bremner, K., & Hicks, L. (1992). Eating disorders and alcohol abuse in women. British Journal of Addiction, 87, 913–920.CrossRefGoogle ScholarPubMed
Gross, J.J., & Leverson, R.W. (1993). Emotional suppression: Physiology, self-report and expressive behaviour. Journal of Personality and Social Psychology, 64, 970–986.Google Scholar
Hadigan, C.M., LaChaussee, J.L., Walsh, B.T., & Kissileff, U.R. (1992). 24-hour dietary recall in patients with bulimia nervosa. International Journal of Eating Disorders, 12, 107–111.Google Scholar
Hamilton, D.L. (1979). A cognitive-attributional analysis of stereotyping. In Berkowitz, L. (Ed ), Advances in experimental social psychology (Vol. 12, pp. 53–84). New York: Academic Press.Google Scholar
Hamilton, D.L., & Sherman, J.W. (1994). Stereotypes. In Wyer, R.S. Jr. & Srull, T.K. (Eds.), Handbook of social cognition (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Hamilton, D.L., & Trolier, T.K. (1986). Stereotypes and stereotyping: An overview of the cognitive approach. In Dovidio, J.F. & Gaertner, S.L. (Eds.), Prejudice, discrimination and racism (pp. 127–163). Orlando, FL: Academic Press.Google Scholar
Heatherton, T.F., & Baumeister, R.F. (1991). Binge eating as an escape from self-awareness. Psychological Bulletin, 110, 86–108.Google Scholar
Herman, C.P., & Polivy, J. (1988). Restraint and excess in dieters and bulimics. In Pirke, K.M., Vandereycken, W., & Ploog, D.. (Eds.), The psychobiology of bulimia nervosa (pp. 33–41). Berlin: Springer.Google Scholar
Herman, C.P., & Polivy, J. (1993). Mental control of eating: Excitatory and inhibitory food thoughts. In Wegner, D.M. & Pennebaker, J.W. (Eds.), Handbook of mental control (pp. 491–505). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Herzog, D.B., Keller, M.B., Lavori, P.W., Kenny, G.M., & Sacks, N.R. (1992). The prevalence of personality disorders in 210 women with eating disorders. Journal of Clinical Psychiatry, 53, 147–152.Google Scholar
Hinz, L.D., & Williamson, D.A. (1987). Bulimia and depression: a review of the affective variant hypothesis. Psychological Bulletin, 102, 150–158.Google Scholar
Hsu, L.K.G. (1990). Eating disorders. New York: Guilford.Google Scholar
Hudson, J.I., Pope, H.G., Yurgelun-Todd, D., Jonas, J.M., & Frankenburg, F.R. (1987). A controlled study of lifetime prevalence of affective and other psychiatric disorders in bulimic outpatients. American Journal of Psychiatry, 144, 1283–1287.Google Scholar
Jacoby, L.L. (1983). Remembering the data: Analyzing interactive processes in reading. Journal of Verbal Learning and Verbal Behaviour, 22, 485–508.Google Scholar
Johnson, C., & Connors, M.E. (1987). The etiology and treatment of bulimia nervosa. New York: Basic Books.Google Scholar
Johnson, C., & Larson, R. (1982). Bulimia: An analysis of moods and behavior. Psychosomatic Medicine, 44, 341–351.Google Scholar
Johnson, W.G., Schlundt, D.G., Barclay, D.R., Carr-Nangle, R.E., & Engler, L.B. (1995). A naturalistic functional analysis of binge eating. Behavior Therapy, 26, 101–118.Google Scholar
Kelly, A.E., & Kahn, J.H. (1994). Effects of suppression of personal intrusive thoughts. Journal of Personality and Social Psychology, 66, 998–1006.Google Scholar
Lingswiler, V.M., Crowther, J.H., & Stephens, M.A.P. (1989). Affective and cognitive antecedents to eating episodes in bulimia and binge eating. International Journal of Eating Disorders, 8, 533–539.Google Scholar
Logan, G.D. (1979). On the use of concurrent memory load to measure attention and automaticity. Journal of Experimental Psychology: Human Perception and Performance, 5, 189–207.Google Scholar
Lowe, M.R. (1993). The effects of dieting on eating behavior: A three factor model. Psychological Bulletin, 114, 100–121.Google Scholar
Macrae, C.N., Bodenhausen, G.V., Milne, A.B., & Jetten, J. (1994). Out of mind but back in sight: Stereotypes on the rebound. Journal of Personality and Social Psychology, 67, 808–817.Google Scholar
Mizes, J.S. (1985). Bulimia: A review of its symptomatology and treatment. Advances in Behaviour Research and Therapy, 7, 91–142.Google Scholar
Newman, J.P., Wolff, W.T., & Hearst, E. (1980). The feature-positive effect in adult human subjects. Journal of Experimental Psychology: Human Learning and Memory, 6, 630–650.Google Scholar
Powell, J., Gray, J., Bradley, B., Kasvikis, Y., Strang, J., & Barratt, L. (1990). The effects of exposure to drug-related cues in detoxified opiate addicts: A theoretical review and some new data. Addictive Behaviors, 15, 339–354.Google Scholar
Rachman, S., & de Silva, P. (1978). Abnormal and normal obsessions. Behavior Research and Therapy, 16, 233–248.Google Scholar
Rachman, S., & Hodgson, R. (1980). Obsessions and compulsions. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Ruderman, A.J. (1986). Dietary restraint: A theoretical and empirical review. Psychological Bulletin, 99, 247–262.Google Scholar
Salkovskis, P.M. (1985). Obsessional-compulsive problems: A cognitive behavioural analysis. Behavior Research and Therapy, 23, 571–583.Google Scholar
Salkovskis, P.M. (1989). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behavior Research and Therapy, 27, 677–682.CrossRefGoogle ScholarPubMed
Salkovskis, P.M., & Campbell, P. (1994). Thought suppression induces intrusion in naturally occurring negative intrusive thoughts. Behavior Research and Therapy, 32, 1–8.CrossRefGoogle ScholarPubMed
Salkovskis, P.M., & Harrison, J. (1984). Abnormal and normal obsessions: A replication. Behavior Research and Therapy, 22, 549–552.Google Scholar
Sansone, R., & Fine, M. (1992). Borderline personality as a predictor of outcome in women with eating disorders. Journal of Personality Disorders, 6, 176–186.Google Scholar
Saunders, W.A., & Allsop, S. (1987). Relapse: A psychological perspective. British Journal of Addiction, 82, 417–429.CrossRefGoogle ScholarPubMed
Sloman, S.A., Hayman, C.A.G., Ohta, N., Law, J., & Tulving, E. (1988). Forgetting in primed fragment completion. Journal of Experimental Psychology: Learning, Memory and Cognition, 14, 223–239.Google Scholar
Smith, E.R., Stewart, T.L., & Buttram, R.T. (1992). Inferring a trait from a behaviour has long-term, highly specific effects. Journal of Personality and Social Psychology, 62, 753–759.Google Scholar
Srull, T.K., & Wyer, R.S. Jr. (1979). The role of category accessibility in the interpretation of information about persons: Some determinants and implications. Journal of Personality and Social Psychology, 37, 1660–1672.Google Scholar
Steele, C.M., & Josephs, R.A. (1990). Alcohol myopia: Its prized and dangerous effects. American Psychologist, 45, 921–933.Google Scholar
Stroop, J. (1935). Studies of interference in serial verbal reactions. Experimental Psychology, 18, 643–661.Google Scholar
Sutherland, G., Newman, B., & Rachman, S. (1982). Experimental investigations of the relations between mood and intrusive unwanted cognitions. British Journal of Medical Psychology, 55, 127–138.Google Scholar
Tulving, E., Schacter, D.L., & Strack, H.A. (1982). Priming effects in word-fragment completion are independent of recognition memory. Journal of Experimental Psychology: Learning, memory and Cognition, 8, 336–342.Google Scholar
Vitousek, K.B., & Hollon, S.D. (1990). The investigation of schematic content and processing in eating disorders. Cognitive Therapy and Research, 14, 191–214.Google Scholar
Ward, T., Hudson, S.M., & Bulik, CM. (1993). The abstinence violation effect in bulimia nervosa. Addictive Behaviors, 18, 671–680.Google Scholar
Wegner, D.M. (1994). Ironic processes of mental control. Psychological Review, 101, 34–52.Google Scholar
Wegner, D.M., & Erber, R. (1993). Social foundations of mental control. In Wegner, D.M. & Pennebaker, J.W. (Eds.), Handbook of mental control (pp. 36–56). Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Wegner, D.M., Erber, R., & Bowman, R.E. (1993). On trying not to be sexist. Unpublished manuscript.Google Scholar
Wegner, D.M., Schneider, D.J., Carter, S. III, & White, L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53, 5–13.Google Scholar
Wegner, D.M., Shortt, J.W., Blake, A.W., & Page, M.S. (1990). The suppression of exciting thoughts. Journal of Personality and Social Psychology, 58, 409–418.Google Scholar
Wenzlaff, R., Wegner, D.M., & Roper, D. (1988). Depression and mental control: The resurgence of unwanted negative thoughts. Journal of Personality and Social Psychology, 55, 882–892.Google Scholar
Zotter, D.L., & Crowther, J.H. (1991). The role of cognitions in bulimia nervosa. Cognitive Therapy and Research, 15, 413–426.Google Scholar