A Proposal for a Model of Maintenance Processes in Eating Disorders in Accordance With Metacognitive Interpersonal Therapy
Raffaele Popolo, Melania Marini, Giancarlo Dimaggio, Addolorata Cacciatore, Mafalda Golia, Gloria Fioravanti
Eating disorders (EDs) are severe disorders that are accompanied by a significant impairment of quality of life. Currently, the most widely used treatment model for EDs is the transdiagnostic model (Fairburn et al., 2003); this model considers EDs as a single diagnostic category in which the disorders are maintained by a primary mechanism, i.e. preoccupation with weight and body shape, and by secondary mechanisms, such as perfectionism, low nuclear self-esteem, interpersonal difficulties and intolerance of emotions. A review of the literature shows, however, that the results obtained with this treatment are good, but there is room for improvement and a reduction in dropouts. In this paper, in continuity with the transdiagnostic model, we assume that to better explain the maintenance of Eds, it is useful to add the role of metacognitive dysfunctions, and to conceptualise the secondary mechanisms in the light of the concept of maladaptive interpersonal schema according to metacognitive interpersonal therapy (MIT). From these observations, we will show, through clinical exemplification, how considering these factors may lead to a case formulation useful for treatment planning, in particular in the case of comorbidity with personality disorders.
Keywords
Eating disorders, Personality disorders, Metacognitive interpersonal therapy, Interpersonal schemas, Metacognition.
