Compassion-Focused Therapy for Bulimia Nervosa in Women: Effects on Rumination and Early Maladaptive Schemas

Objective: Bulimia nervosa is frequently associated with elevated rumination and early maladaptive schemas. The aim of this study was to investigate the effectiveness of compassion-focused therapy (CFT) in reducing rumination and early maladaptive schemas among women with bulimia nervosa. Materials and Methods: This quasi-experimental study utilized a pretest-posttest control group design. Fifty women with a confirmed DSM-5 diagnosis of bulimia nervosa were recruited via convenience sampling from the Ahvaz Eating Disorders Association and randomly assigned to either an experimental group (n= 25) receiving compassion-focused therapy (8 sessions, 90 minutes each) or a no-intervention control group (n= 25). Rumination was assessed using the Rumination Response Scale (RRS), and early maladaptive schemas were measured with the 75-item Early Maladaptive Schema Questionnaire-Short Form. Data were analyzed using analysis of covariance (ANCOVA) in SPSS-25. Results: After controlling for pretest scores, women who received CFT showed significantly greater reductions in both rumination (P< 0.001) and early maladaptive schemas (P< 0.001) compared to the control group. Large effect sizes were observed for both outcomes (η²> 0.70). Conclusion: CFT is an effective intervention for reducing rumination and early maladaptive schemas in women with bulimia nervosa. These findings support the clinical utility of CFT in targeting core cognitive- emotional maintenance factors in this population and suggest that it may be a valuable treatment option for bulimia nervosa