Linguistic characteristics of patients with bulimic symptomatology in an online post-treatment program: an exploratory study

BACKGROUND: No former investigation has been performed related to the linguistic characteristics of patients with eating disorders using online synchronous communication mediums like chats. OBJECTIVE: The purpose of this study was to investigate the linguistic predictors of improvement in eating disorder-related attitudes, behaviours and emotional distress of patients with eating disorders. METHODS: Thirty-nine women, who had received treatment for bulimia nervosa or related eating disorders not otherwise specified, utilized the moderated therapeutic group chats of an Internet-based program for 4 months. The main themes of 134 session transcripts were created using a general inductive approach. The frequency of dictionary words in the text corpus was processed by the NooJ linguistic software. Eating Disorder Examination Questionnaire and Depression Anxiety Stress Scale were administered at the beginning and at the end of 4 months. No valid questionnaire data could be obtained from 11 participants, so the statistical analyses were performed in a sample of 28 subjects. RESULTS: According to the results of multiple linear regression analyses, higher ratio of words related to “family of origin” was associated with improvements in eating disorder-related attitudes, emotional distress, and reduction in the frequency of binge eating episodes (β = 0.73, p < 0.001; β = 0.67, p = 0.002; β = 0.53, p = 0.039, respectively). DISCUSSION: The expression of “family of origin” words following treatment termination was a linguistic predictor of improvement during group chat communication of patients with bulimic symptomatology. The results show the importance of family issues in enhancing the treatment outcome and provide preliminary evidence to address this topic during online chat moderation.