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

The experience of traumas are implicated in the development of eating disorders (e.g.
Vanderlinden and Vandereycken, 1997), it is likely that the bullying reported was not to
such a degree and therefore not relevant to increasing ones EDR. There was also no
significant mean difference between the academic performance groups in relation to
inflexibility, showing that better academic performance is not related to flexibility or
inflexibility.
Lastly, self-esteem was found to be significantly associated with EDR and was found to
be the strongest predictor of EDR. This finding is consistent with Fairburn and Shafran’s
(2003) transdiagnostic model in which it is proposed that in certain patients’ one or more
of four additional maintaining processes interact with the core eating disorder. These
include core low self-esteem as well as clinical perfectionism, mood intolerance and
interpersonal difficulties. Due to the importance of these maintaining processes they will
be considered in relation to ACT below.
Relevance of the findings to theoretical issues and the literature
The hypotheses that have been confirmed add evidence to the ACT premise that
inflexibility is associated with pathology.
If inflexibility is associated with pathology and acceptance (i.e. the reverse) associated
with less pathology, then facilitating acceptance by working on experiential avoidance
and cognitive fusion may be an important part to include in a transdiagnostic model of
eating pathology. This may be useful as a preventative strategy with individuals
engaging in disordered eating as well as in individual treatment for the clinical diagnostic
categories of AN, BN or EDNOS.
The transdiagnostic CBT approach presented by Fairburn et al, (2003) states the
importance of low core self-esteem in the maintenance of EDs.
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