Dual Pathway Model of Bulimia Nervosa: Longitudinal Support for Dietary Restraint and Affect-Regulation Mechanisms

Abstract

Although numerous risk factors for bulimia nervosa have been identified, no multivariate models of bulimia have been empirically investigated with longitudinal data. The current study provided a confirmatory test of the dual pathway model of bulimia nervosa using prospective data from a community sample of adolescents (N = 218). Latent variable modeling indicated that negative affect and dietary restraint predicted future bulimic symptomatology. Further, these two factors mediated the effects of initial perceived pressure for a thin body, body mass, ideal body internalization, and body dissatisfaction on subsequent bulimic pathology. These findings provide additional support for the dual pathway model of bulimia, suggest variables that might be targeted in prevention and treatment efforts, and point to several directions for future research.