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Worry and Rumination in Anorexia Nervosa

Published online by Cambridge University Press:  29 October 2012

Helen Startup*
King's College London, Institute of Psychiatry, UK
Anna Lavender
King's College London, Institute of Psychiatry, UK
Anna Oldershaw
King's College London, Institute of Psychiatry, UK
Richard Stott
King's College London, Institute of Psychiatry, UK
Kate Tchanturia
King's College London, Institute of Psychiatry, UK
Janet Treasure
King's College London, Institute of Psychiatry, UK
Ulrike Schmidt
King's College London, Institute of Psychiatry, UK
Reprint requests to Helen Startup, King's College London, Institute of Psychiatry, Division of Psychological Medicine, Section of Eating Disorders (P059), De Crespigny Park, London SE5 8AF, UK. E-mail:


Background: Difficulties with comprehending and managing emotions are core features of the pathology of anorexia nervosa (AN). Advancements in understanding aetiology and treatment have been made within other clinical domains by targeting worry and rumination. However, worry and rumination have been given minimal consideration in AN. Aims: This study is the largest to date of worry and rumination in AN. Method: Sixty-two outpatients with a diagnosis of AN took part. Measures of worry, rumination, core AN pathology and neuropsychological correlates were administered. Results: Findings suggest that worry and rumination are elevated in AN patients compared with both healthy controls and anxiety disorder comparison groups. Regression analyses indicated that worry and rumination were significant predictors of eating disorder symptomatology, over and above the effects of anxiety and depression. Worry and rumination were not associated with neuropsychological measures of set-shifting and focus on detail. Conclusions: The data suggest that worry and rumination are major concerns for this group and warrant further study.

Research Article
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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