The results described in this thesis support the strong empirical evidence for the effectiveness of CBT-Ef for patients with an eating disorder and a BMI>17.5. When compared to TAU, we found... Show moreThe results described in this thesis support the strong empirical evidence for the effectiveness of CBT-Ef for patients with an eating disorder and a BMI>17.5. When compared to TAU, we found comparable effects on eating disorder psychopathology, however CBT-Ef is superior in enhancing self-esteem with significantly fewer sessions and within a shorter time. We found no support for the hypothesis that more severe self-esteem problems, higher levels of perfectionism, or more interpersonal problems would obstruct long-term improvement and would therefore need extra attention in an extended protocol. A broader use of CBT-Ef in clinical practice could result in more efficient and accessible treatment for patients with an eating disorder. In another study we found COMET to be effective in enhancing self-esteem in patients with an eating disorder. Since we did not find the predictive value of low self-esteem in CBT-E treatment outcome, we suggest to integrate COMET in an eating disorder treatment only when low self-esteem is pronounced and interferes with making progress. Show less
Worry and rumination are cognitive processes that have been proposed to constitute a driving force across many psychological disorders, emotional disorders in particular. The two concepts are often... Show moreWorry and rumination are cognitive processes that have been proposed to constitute a driving force across many psychological disorders, emotional disorders in particular. The two concepts are often referred to by the overarching term repetitive negative thinking (RNT), however whether they are indeed representations of the same process is debated. The main aim of the present thesis is to contribute to the ongoing worry-rumination debate by investigating whether worry and rumination are indeed transdiagnostic processes and whether they represent a shared underlying process. In accordance with this aim several studies were designed covering two lines of research; i) epidemiological studies comparing worry and rumination in their relationship with each other and with emotional disorders; ii) experimental studies examining worry at a more functional/process level. Overall the studies presented in this thesis yield support for both accounts: worry and rumination are highly related, are present across emotional disorders and show both similarities and differences at process level. Especially at a general, abstract, level similarities between worry and rumination seem to predominate. However, at a more concrete and specific level both similarities and differences are observed. Such differences can be relevant for research as well as therapeutic interventions. Depending on the questions in a certain research or clinical context emphasis on a more general-abstract or concrete-specific perspective on worry and rumination seems warranted. Show less
