Two studies conducted to develop and cross validate a causal model of bulimia are reported. It was hypothesized that a stress process, comprised of three components, the sources of stress, the mediators of stress, and the manifestations of stress would provide the basis of a causal model of bulimia, using linear structural relations analysis (LISREL). In Study 1, 144 female introductory psychology students were assessed for bulimia as well as 10 other variables representative of the stress process. The proposed model was comprised of two sources of stress: Environmental stressors (life events and daily hassles), and Depression (depression and risk for depression). The model indicated that coping skills are an important mediator of stress, and that having a high frequency of environmental stressors and/or the presence of depression or risk for depression, may lead an individual to resort to ineffective coping mechanisms, which, in turn, results in the expression of bulimic behavior. The model was cross‐validated in Study 2, in which 150 female introductory psychology students were assessed on the same variables. Treatment implications are discussed.

The present study assessed use of food as a coping mechanism and cognitive distortions regarding food and weight in relation to extent of bulimic symptomatology. Subjects were 19 women who fulfilled an operationalized defination of the DSM‐III diagnostic criteria for bulimia (bulimics), 35 women who fulfilled an operationalized definition of an absence of bulimic symptomology (symptom‐free), and 41 women who fulfilled some but not all bulimic criteria (bulimic‐like). The symptom‐free, bulimic‐like, and bulimic groups each differed from one another in a linear fashion from low to high on measures of use of food as a coping mechanism, five of eight types of cognitive distortions regarding food and weight (dichotomous thinking, worry, exaggeration, superstitious thinking, and personalization), drive for thinness, and lack of interoceptive awareness. The bulimic and bulimic‐like groups evidenced greater perfectionism, defeatism, regret, and body dissatisfaction than the symptom‐free group. Variation in the extent of use of food and cognitive distortions accounted for 70% of explained variance in the severity of DSM‐III bulimic symptomatology. These results suggest that behavioral, affective, and cognitive indices of bulimia fall along parallel continua of symptomatic severity. The results also support the relevance of preventative and therapeutic programs with multidimensional foci.

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