Psychosocial factors in the onset of eating disorders: responses to life-events and difficulties.

A number of studies have proposed a role for stress in the onset of eating disorders. Initially the focus was on the life-events and difficulties themselves. However, the aim of this study was to examine the coping and support elicited in response to the crises that precipitate onset of eating disorders. Thirty-two women who had developed an eating disorder within four years of presentation were administered semi-structured interviews asking about events and difficulties in the year before onset, as well as how they coped and the support they received. Twenty women with no history of eating disorders acted as a comparison group. Results show that the onset of anorexic symptoms is associated with cognitive avoidance in response to a crisis while the onset of bulimic symptoms is associated with cognitive rumination. In addition, women who developed an eating disorder were more likely to be helpless in response to the crisis than women who did not develop an eating disorder. It is concluded that coping interventions may be useful in terms of primary and relapse prevention.