Using Network Theory for Psychoeducation in Eating Disorders

Marieke Meier,Katrin Jansen,Berta J Summers,Ulrike Buhlmann,Nicholas R Farrell,Melissa J Dreier

doi:10.1007/s10608-021-10204-w

Abstract

BackgroundNegative illness representations such as self-blame impede treatment-seeking behavior and therapy motivation in individuals with eating disorders (EDs). However, only one study so far has investigated how different explanatory models influence these beliefs in EDs. We aimed to expand these findings by introducing an explanatory model based on network theory (NT).MethodsWe presented three explanatory models to a diverse web-recruited sample (n = 290, 141 females, 149 males) with clinically elevated ED symptomatology. Participants either watched a video with a biological-genetic (BG), cognitive-behavioral (CB) or an NT explanatory model and were asked about illness representations before and after watching the video.ResultsThe BG group showed significantly greater reductions in self-blame but a significant decrease in personal control and less optimistic expectation regarding timeline compared to the CB and NT groups. There were no group differences regarding the perception of the clinician, comprehensibility of the explanatory model and credibility of a CBT intervention.ConclusionsGiven the increasing popularity of biological-genetic explanatory models of EDs, it is important to note the disadvantages we found to be associated with these models. Our findings indicate that explanatory models emphasizing cognitive-behavioral (CB) principles and/or network theoretical (NT) underpinnings of EDs may serve to promote optimism and greater perceptions of personal agency in affected populations.This trial's registration number is 316.

Highlights

Eating disorders (EDs) represent one of the most severe and complex mental illnesses that occur with a lifetime prevalence of 0.3% to 4.1% in men and 0.9% to 8.6% in women (Deloitte Access Economics 2020; Hudson et al 2007)
While we do not suggest that network theory (NT) and cognitive-behavioral therapy (CBT) models are completely different, we propose that NT offers another framework and another language that is worth exploring in the context of educating affected individuals about their condition
Outcome measures were analyzed in terms of whether they differed between conditions

Summary

Introduction

Eating disorders (EDs) represent one of the most severe and complex mental illnesses that occur with a lifetime prevalence of 0.3% to 4.1% in men and 0.9% to 8.6% in women (Deloitte Access Economics 2020; Hudson et al 2007). According to the common sense model (CSM) of illness (Leventhal et al 1980, 1992), individuals develop emotional and cognitive representations of health threats which influence the way they manage symptoms (e.g., avoidance or approach coping) and the way individuals engage in help-seeking behavior or in therapy. Studies around mental illness show that negative illness representations can impede help–seeking Negative illness representations such as self-blame impede treatment-seeking behavior and therapy motivation in individuals with eating disorders (EDs). Our findings indicate that explanatory models emphasizing cognitive-behavioral (CB) principles and/or network theoretical (NT) underpinnings of EDs may serve to promote optimism and greater perceptions of personal agency in affected populations.

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