Threat processing in women with bulimia

Cognitive–behavioral treatments are the most commonly used approaches for bulimia nervosa. However, these treatments tend to produce only moderate remission rates. Therefore, it is useful to consider how experimental cognitive approaches can help to revise current cognitive–behavioral models of bulimia. Information processing models highlight the role of attentional biases and schema avoidance in the etiology and maintenance of pathology. This review considers how these processes relate to bulimia. In particular, a growing body of evidence suggests that bulimic behaviors may function to “block” aversive self-awareness. Blocking behaviors also feature strongly in other impulsive disorders. This review considers the relationship between bulimia and impulsivity, and discusses whether the functions of the two behaviors are the same. The clinical implications and future research needs that arise from this literature are discussed.