Am. Bardone et al., The confluence of perfectionism, body dissatisfaction, and low self-esteempredicts bulimic symptoms: Clinical implications, BEHAV THER, 31(2), 2000, pp. 265-280
We present a brief overview of empirically supported risk factors of bulimi
c behavior. We then propose an empirically supported, interactive, three-fa
ctor model of bulimic symptom occurrence from which we derive clinical impl
ications for assessment, treatment, and prevention. Our research finds that
perfectionism, body dissatisfaction, and self-esteem interact to predict b
ulimic symptoms. In particular, women who consider themselves overweight an
d who have elevated levels of perfectionism and lower levels of self-esteem
show the greatest risk for bulimic symptoms. Thus, our model identifies th
ree theoretically related targets for intervention: perfectionism, body dis
satisfaction, and low self-esteem. Assessment of these factors is recommend
ed. The extent to which cognitive-behavioral therapy for bulimia and interp
ersonal therapy for bulimia address these factors is reviewed and evaluated
, and theory-based recommendations are made for prevention efforts.