The dual pathway model differentiates bulimics, subclinical bulimics, and controls: Testing the continuity hypothesis

Although research suggests that the dual pathway model of bulimia predicts bulimic symptoms, it has not been applied to diagnostic levels of this disorder. This study first tested whether bulimics differed from controls on the variables composing this etiologic model. Second, because there is some debate as to whether the predictors of subclinical and clinical levels of eating pathology differ, this study also tested whether the variables composing the dual pathway model were able to differentiate subclinical bulimics from both controls and bulimics. Female bulimics, subclinical bulimics, and controls were compared on body mass, ideal-body internalization, body dissatisfaction, dietary restraint, perceived pressure to be thin, and negative affect. Bulimics reported elevated scores on all but one of the variables composing the dual pathway model, and subclinical bulimics differed from both controls and bulimics on most constructs. A discriminant function analysis indicated that the three groups lay along a single continuum. Results suggest that the dual pathway model applies to diagnostic levels of bulimia and support the continuity perspective of eating pathology.