Colloquium: An evaluation of the cognitive-behavioural theory of bulimia nervosa

Cognitive-behavioural therapy is the treatment of choice for bulimia nervosa, yet only 30 to 50% of patients experience remission of binge eating and purging following treatment. Understanding the processes that maintain this disorder may prove a useful step forward in developing more effective treatments. Therefore, the primary aim of this research was to evaluate the cognitive-behavioural theory of the maintenance of bulimia nervosa. This aim was achieved in two stages. First, the original (Fairburn, Cooper, & Cooper, 1986) and the enhanced (Fairburn, Cooper, & Shafran, 2003) cognitive-behavioural models were compared in a treatment-seeking sample of patients with bulimia nervosa to determine if the enhanced model provided a better account of the occurrence of eating disorder symptoms. Second, temporal and directional hypotheses informed by the original cognitive-behavioural model were tested using repeated measures data and latent difference score modelling in a clinical sample. Results provided mixed support for the cognitive-behavioural theory of the maintenance of bulimia nervosa.