Psychosocial components of the stress process in bulimia

Increasingly, investigators have sought to relate stress to the etiology and maintenance of bulimia. The current research literature on stress in general now views stress as a process that includes not only stimulus and response but mediators such as appraisal, control, coping, and social support that may predispose one to experience stress or to be more reactive to potential stressors. We suggest that viewing the stress process comprehensively may have heuristic value in the study of bulimia. Such an approach provides a clearly articulated, testable model and facilitates organization of a currently confusing literature. We review current research on stress and bulimia in this context and try to identify what knowledge exists, where the gaps are, and what kinds of questions must be asked in future research.