The cognitive-interpersonal model of disordered eating: A test of the mediating role of alexithymia

Eur Eat Disord Rev. 2020 May;28(3):296-308. doi: 10.1002/erv.2720. Epub 2020 Jan 28.

Abstract

Objective: The cognitive-interpersonal model proposes that high levels of attention to detail and cognitive rigidity confer risk for the development of eating disorders (EDs) and that socioemotional deficits, such as alexithymia, contribute to their maintenance. However, no studies have examined the direct and indirect relationships of these constructs. We investigated the mediating role of specific alexithymia traits (difficulties describing feelings, difficulties identifying feelings, and externally oriented thinking) on the relationship between attention to detail, cognitive rigidity, and ED symptoms while controlling for anxiety and depression symptoms.

Method: Four hundred and one nonclinical female participants (M = 20.57, SD = 4.99 years old) completed self-report measures assessing the variables of interest.

Results: Path analyses revealed that difficulties identifying feelings was the only significant mediator between attention to detail and cognitive rigidity to ED symptoms. However, these mediation effects became nonsignificant after controlling for anxiety and depression.

Conclusions: Difficulties identifying feelings may in part underlie the relationship between attention to detail and cognitive rigidity and ED symptoms, providing support for the cognitive-interpersonal model. However, these relationships are heavily influenced by anxiety and depression symptoms. Enhancing individual's ability to identify emotional states may help to decrease ED symptoms for individuals who report high levels of attention to detail and cognitive rigidity.

Keywords: alexithymia; attention to detail; cognitive rigidity; eating disorders.

MeSH terms

  • Adolescent
  • Adult
  • Affective Symptoms / psychology*
  • Attention
  • Cognition / physiology
  • Feeding and Eating Disorders / psychology*
  • Female
  • Humans
  • Interpersonal Relations
  • Middle Aged
  • Models, Psychological
  • Self Report
  • Young Adult