DClinPsy Portfolio Volume 1 of 3 - University of Hertfordshire ...

Neumark-Sztainer, Levine, Paxton Smolak, Piran and Wertheim (2007) suggest that to
address factors that might underlie not only eating problems, but also other problems by
taking a broader approach, with the potential to positively affect a variety of behavioural
and mental health problems, is very appealing. They suggest that programs that increase
skills for coping with stress and negative affect, improve self-esteem, and reduce
depression may reduce the potential of risk factors for eating disorders, because low selfesteem
(Jacobi, Hayward, de Zwaan, Kraemer, & Agras, 2004) and negative affect (Stice,
2002) have repeatedly been found to increase the risk of body image and eating
problems.
Fairburn, Cooper and Shafran (2003) also promote the potential utility of a
transdiagnostic approach; indeed they extended the Cognitive Behavioural Theory (CBT)
of BN to embrace all forms of eating disorder by developing a single unitary
‘transdiagnostic’ theory and putting forward new enhanced cognitive behavioural
treatment (CBT-E) derived from the transdiagnostic theory that is suitable for patients
with any form of eating disorder. They claim that transdiagnostic conceptualisation and
treatment is relevant when major clinical features are found to be shared by two or more
diagnostic disorders and are maintained by common pathological processes; there may
also be movement of patients between the diagnostic categories. Moreover, they suggest
that to establish the operation of transdiagnostic pathological processes there would need
to be direct clinical and research evidence that the processes maintaining the diagnostic
states do indeed overlap, for example, by identifying common distinctive obstacles to
change or by developing common distinctive methods of achieving change. Fairburn and
colleagues are currently undertaking treatment evaluation; effectiveness findings have
therefore not yet been published.
There are many specific and shared risk factors that have been identified across eating
disorders and obesity. These factors could perhaps be targeted preventatively using a
transdiagnostic model. Some of the major identified risk factors will briefly be
summarised below before focusing on body image which is considered a very strong
predictor of eating disorders symptomatology and is of primary interest in this study.
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