The relationship between social problem-solving and self-esteem in Anorexia Nervosa

Abstract

INTRODUCTION Cognitive-behavioural theories of anorexia nervosa suggest that anorexia develops out of feelings of ineffectiveness and loss of identity which lead the individual to develop ineffective coping strategies and experience low self-esteem. The current study aimed to investigate social-problem solving and self-esteem in anorexia, using multidimensional measures, with the hypotheses that specific elements of these constructs would be specific to eating pathology and that self-esteem would mediate the relationship between social problem solving and eating pathologyMETHODS The study examined multidimensional measures of social problem-solving and self-esteem in 55 female inpatients with a diagnosis of anorexia nervosa and 50 non-clinical matched controls. Participants completed four standardised self-report measures of general symptoms, eating disorders, social problem-solving and self-esteem at one time point only.RESULTS Results yielded significant differences between groups on all measures. Within groups analysis revealed positive problem orientation, negative problem orientation and avoidance coping and both self-worth and self-competence components of self-esteem were significantly related to anorexic pathologies involving feelings of concern over eating, weight and shape, but less related to eating restraint. Path analysis indicated that self-esteem mediated the relationship between social problem-solving and eating pathology.DISCUSSION The results provide further evidence for the importance of problem orientation and avoidance coping in anorexia and the importance of the worth and competency components of self-esteem. The results also suggested that social problem-solving and self-esteem were significant in development and maintenance of concerns regarding eating weight and shape, but less so to eating restraint. Finally, the results provided support for the mediating role of self-esteem in the relationship between social problem-solving and anorexia, however the issue of causality remains unresolved.