علائم بلومیک در مردان و زنان در مقطع کارشناسی: سهم تمرکز حواس و سرکوب افکار

Experiential avoidance, the refusal to accept contact with unpleasant private experiences, is believed to play a role in the onset and maintenance of eating disorders. Preliminary evidence suggests that mindfulness- and acceptance-based interventions that reduce avoidance may be effective in treating disordered eating behaviors. The purpose of the current investigation was to examine whether one form of experiential avoidance (thought suppression) and the theoretically opposing construct of dispositional mindfulness are associated with bulimic symptoms. Undergraduate men (n = 219) and women (n = 187) completed questionnaires assessing mindful attention and awareness, chronic thought suppression, and bulimic symptoms. A series of hierarchical regression analyses revealed that thought suppression and mindfulness accounted for unique variance in bulimic symptoms among men and women after accounting for BMI. Results are discussed in terms of the role of dispositional mindfulness and thought suppression in disordered eating.

A substantial body of research has provided evidence for an association between negative affect and eating disorders (see Stice, 2002 for a review) and negative affect has been conceptualized as a risk factor for disordered eating among males and females (Ricciardelli and McCabe, 2004 and Stice, 2001). The recognition of negative affect as a risk factor for eating disorders has promoted the development of affect regulation models that conceptualize disordered eating behaviors as maladaptive strategies to reduce or avoid unpleasant emotional states (Heatherton and Baumeister, 1991, Polivy and Herman, 1993, Stice et al., 1996 and Wiser and Telch, 1999). Consistent with these models, recent studies have provided evidence that emotion regulation difficulties contribute to disordered eating behaviors. For instance, Whiteside and colleagues (2007) found that undergraduate men and women who reported binge eating reported experiencing greater difficulties in emotion regulation than their non-binge eating peers. Specifically, binge eaters reported less emotional clarity and access to fewer adaptive affect regulation strategies than non-binge eaters. Similarly, Lavender and Anderson (in press) found that limited access to adaptive regulation strategies and nonacceptance of emotional experiences were difficulties that contributed to disordered eating in undergraduate men. Research therefore supports the conceptualization of behaviors such as binge eating, purging, and excessive exercise as efforts to avoid unpleasant affective states, particularly among individuals who have a limited repertoire of adaptive emotion regulation skills. 1.1. Thought suppression A tendency to engage in maladaptive avoidance behaviors in response to distressing or unwanted thoughts and emotions may reflect a broader pattern of experiential avoidance, defined as the refusal to accept contact with unpleasant emotional, physical, and cognitive experiences (Chawla and Ostafin, 2007 and Hayes et al., 1996). One form of experiential avoidance is thought suppression, which has been shown to be associated with a variety of affective disorders (Purdon, 1999). Efforts to suppress unpleasant cognitions frequently can be maladaptive and ultimately ineffective due to a paradoxical increase or rebound in the unwanted thoughts that often occur when suppression attempts fail (O'Connell et al., 2005, Soetens et al., 2006 and Wegner et al., 1987). In an effort to further clarify the role of avoidance in disordered eating, studies have examined the effects of suppressing eating- and weight-related thoughts among individuals high and low in dietary restraint and disinhibition. The results of these studies have been mixed, with some suggesting that restrained eaters and disinhibited eaters are able to successfully suppress eating- and weight-related cognitions (Harnden et al., 1997 and Oliver and Huon, 2001) and others supporting the idea that suppression efforts result in a rebound effect among restrained eaters and individuals high in both restraint and disinhibition (O'Connell et al., 2005 and Soetens et al., 2006). Research also suggests that individuals high in dietary restraint and disinhibition exhibit a greater tendency to engage in generalized thought suppression than unrestrained eaters and individuals who are high in dietary restraint, but low in disinhibition (Soetens, Braet, & Moens, 2008). In sum, preliminary evidence suggests that rejection and avoidance of aversive affective states and cognitions may be associated with disordered eating behaviors. Although the mechanisms underlying this association require further elaboration, some individuals may be more likely to engage in disordered eating behaviors in response to the increased distress that results from failed suppression attempts. 1.2. Mindfulness Consistent with the recognition that certain forms of experimental avoidance such as thought suppression may contribute to disordered eating, several therapies recently applied to the treatment of eating disorders include components designed to reduce experiential avoidance and increase awareness and acceptance, including Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) and Dialectical Behavior Therapy (DBT; Linehan, 1993a and Linehan, 1993b). Although the role of acceptance in DBT and ACT is conceptualized somewhat differently, the therapies include similar strategies to promote awareness and acceptance. For instance, these interventions utilize mindfulness skills training as a method of promoting acceptance and awareness of private experiences in the present moment (i.e., thoughts, emotions, memories). Numerous case reports and treatment studies have provided preliminary evidence for the efficacy of these newer therapies in treating binge eating disorder, bulimia nervosa, and anorexia nervosa (see Baer, Fischer, & Huss, 2005 for a review). Although the exact mechanisms underlying the positive effects of mindfulness practice on disordered eating symptoms require further elaboration, Baer et al. (2005) have proposed several possibilities that are consistent with both cognitive–behavioral and affect regulation models of eating disorders. For example, the authors suggest that adopting a mindful outlook may promote the understanding that distressing cognitions (e.g., irrational thoughts about the consequences of breaking a dietary rule) are only temporary and do not require a particular behavioral response (e.g., purging). Researchers also have suggested that mindfulness functions via exposure and thus reduces the likelihood that an individual will engage in impulsive and maladaptive behaviors in response to aversive private experiences (Baer et al., 2005 and Lynch et al., 2006). 1.3. Current study Although newer mindfulness- and acceptance-based therapies have shown promise in treating individuals with eating disorders, little research has been conducted on the relationship between disordered eating behaviors and dispositional mindfulness, a trait characterized by attention to and acceptance of one's experiences. Given preliminary research suggesting that increasing mindfulness is associated with reductions in eating disorder symptoms, individuals who exhibit higher levels of dispositional mindfulness may be less likely to engage in disordered eating behaviors. Furthermore, although several studies have assessed the ability of individuals high and low in dietary restraint and disinhibition to suppress food-and weight-related thoughts, few studies have assessed the contribution of generalized thought suppression to the broad array of eating disorder symptoms. The purpose of the present investigation was to determine the extent to which chronic thought suppression and mindful attention and awareness contribute to bulimic symptoms in undergraduate men and women. These constructs are in theoretical opposition because mindfulness is characterized by acceptance and awareness of private experiences, whereas thought suppression is characterized by nonacceptance and efforts to reduce unwanted cognitions. It was hypothesized that both of these variables would account for unique variance in bulimic symptoms. Specifically, it was hypothesized that higher levels of dispositional mindfulness would be associated with less bulimic symptomatology, while higher levels of thought suppression would be associated with greater bulimic symptomatology.

Table 1 presents the means and standard deviations of each variable included in the primary analyses for men and women. These scores are consistent with those obtained in previous studies with male and female undergraduates (Hayaki, in press, MacKillop and Anderson, 2007, Mitchell and Mazzeo, 2005 and Wegner and Zanakos, 1994). Independent samples t-tests revealed a significant gender difference in bulimic symptoms [t(336.02) = 5.18, p < .001], but no gender differences were found for BMI, thought suppression, or mindfulness.