Subclinical bulimia vs. depression in an interpersonal context (original) (raw)
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Comprehensive Psychiatry, 2012
Background: The aim of the study was to investigate whether patients with bulimia nervosa (BN) could be subdivided into clinically meaningful groups reflecting the complex patterns of eating disorder symptoms and personality characteristics that face the clinician. Methods: Seventy patients diagnosed with BN using the Eating Disorder Examination were assessed with measures of negative affect, attachment patterns, and interpersonal problems. An exploratory hierarchical cluster analysis was performed. Results: The study found two main subtypes differing primarily in terms of symptom severity and level of negative affect, but these subtypes were further subdivided into four clinically relevant subtypes: A dietary restraint/negative affect/high symptomatic group, an emotionally overcontrolled group, a low dietary restraint/emotionally underregulated group, and a high functioning/securely attached group. Conclusions: The study indicates that cluster-analytic studies, including a broad range of instruments measuring eating disorder symptoms as well as negative affect, relational patterns, and other personality characteristics, may contribute to an integration of previously suggested models of subtypes in BN.
Interpersonal sensitivity predicts bulimic symptomatology cross-sectionally and longitudinally
Eating Behaviors, 2009
Individuals who experience interpersonal sensitivity (IPS) may be at an increased risk for developing eating disorder symptomatology. The purpose of the present study was to assess the predictive capacity of IPS and related constructs in the development of bulimic symptomatology both cross-sectionally and longitudinally while controlling for depressive symptoms. Participants were 119 female undergraduate psychology students attending a private mid-size Midwestern university. Data were collected at both the beginning and end of the academic semester. Participants completed the Center for Epidemiological Study-Depression Scale, Brief Fear of Negative Evaluation Scale, Interpersonal Sensitivity Measure, and the Bulimia Test-Revised. The Fragile Inner Self subscale of the IPSM was found to significantly account for additional variability in BULIT-R scores after controlling for depression both cross-sectionally and longitudinally (8% and 2%, respectively). IPS is a suitable candidate for inclusion in the dual pathway model of bulimic symptomatology.
Sociotropy and bulimic symptoms in clinical and nonclinical samples
International Journal of Eating Disorders, 2003
Objective: The purpose of this study is to examine the relation between sociotropy and bulimic symptoms. Studies of interpersonal functioning among individuals with bulimia nervosa consistently reveal issues of social dependency, need for approval, and fear of rejection. These themes are conceptually related to sociotropy, a cognitive-personality factor that has been implicated in the development and maintenance of depression. Individuals high in sociotropy are keenly invested in attaining others' approval and avoiding social rejection. Methods: The relationship between sociotropy and bulimic symptoms was examined in two samples of women: undergraduate women and community women seeking treatment at a private eating disorder facility. Results: In both samples, sociotropy was significantly associated with bulimic symptoms beyond the shared relation with depressed mood. Discussion: Findings are discussed in terms of the maintenance and treatment of bulimia nervosa.
Relational-Interdependent self-construal as a function of bulimic symptomatology
Journal of Clinical Psychology, 2006
The present study compares differences in the levels of relationalinterdependent self-construal among asymptomatic, symptomatic, and bulimic participants in a natural groups' design. Asymptomatic (n ϭ 169), symptomatic (n ϭ 73), and bulimic (n ϭ 21) participants completed the Questionnaire for Eating Disorder Diagnoses (Q-EDD; L.B. Mintz, M.S. Halloran, A. Mulholland, & A.S. Paxton, 1997) and the Relational-Interdependent Self-Construal Scale (RISC; S.E. Cross, P.L. Bacon, & M.L. Morris, 2000)
1 Interpersonal Problems in People with Bulimia Nervosa and the Role of Interpersonal Psychotherapy
2017
The term ‘interpersonal’ encompasses not only the patterns of interaction between the individual and significant others, but also the process by which these interactions are internalised and form part of the self-image (Sullivan, 1953). Interpersonal functioning is considered crucial to good mental health. According to Klinger (1977), when people are asked what makes their lives meaningful, most will mention their close relationships with others. Being involved in secure and fulfilling relationships is perceived by most individuals as critical to wellbeing and happiness (Berscheid & Peplau, 1983). Maladaptive interpersonal functioning is considered central to several psychiatric disorders, such as depression (e.g. Petty, et al, 2004), anxiety (e.g. Montgomery et al, 1991), schizophrenia (e.g. Sullivan & Allen, 1999) and autistic spectrum disorders (e.g. Travis & Sigman, 1998). Interpersonal skill deficits may cause vulnerability to developing mental health problems and may also play...
Interpersonal problems in eating disorders
International Journal of Eating Disorders, 2009
Objective:Eating disorders are often chronic in nature and lead to a number of problems among which interpersonal issues are suggested to be central. Although research has shown that individuals with disturbed patterns of eating consistently report problems in social interactions, this study is unique in assessing a range of interpersonal problems among patients with all types of eating disorders before and after intensive hospital-based treatment.Eating disorders are often chronic in nature and lead to a number of problems among which interpersonal issues are suggested to be central. Although research has shown that individuals with disturbed patterns of eating consistently report problems in social interactions, this study is unique in assessing a range of interpersonal problems among patients with all types of eating disorders before and after intensive hospital-based treatment.Method:A total of 208 patients receiving a primary diagnosis of restrictive anorexia nervosa, bulimia nervosa, or anorexia nervosa of the binge/purging-subtype were included in the study. Eating pathology, symptom severity, and interpersonal patterns were examined before and after treatment.A total of 208 patients receiving a primary diagnosis of restrictive anorexia nervosa, bulimia nervosa, or anorexia nervosa of the binge/purging-subtype were included in the study. Eating pathology, symptom severity, and interpersonal patterns were examined before and after treatment.Results:Patients with eating disorders exhibited a generally nonassertive, submissive interpersonal style, with anorexic patients of the binge/purging-subtype reporting more difficulties with social inhibition and nonaffiliation. These patterns were found to change over the course of treatment with interpersonal problems at intake predictive of greater binge severity at discharge. Furthermore, issues of dominance and social avoidance predicted outcome for specific subgroups of patients.Patients with eating disorders exhibited a generally nonassertive, submissive interpersonal style, with anorexic patients of the binge/purging-subtype reporting more difficulties with social inhibition and nonaffiliation. These patterns were found to change over the course of treatment with interpersonal problems at intake predictive of greater binge severity at discharge. Furthermore, issues of dominance and social avoidance predicted outcome for specific subgroups of patients.Discussion:Results underscore the importance of interpersonal problems in eating disorders and suggest that interpersonal patterns remain a focus of treatment and future research. © 2009 by Wiley Periodicals, Inc. (Int J Eat Disord 2010;)Results underscore the importance of interpersonal problems in eating disorders and suggest that interpersonal patterns remain a focus of treatment and future research. © 2009 by Wiley Periodicals, Inc. (Int J Eat Disord 2010;)
Journal of Eating Disorders
Background: Interpersonal psychotherapy (IPT) can be effective for both Bulimia Nervosa (BN) and co-occurring depression. While changes in symptoms of Eating disorder (ED) and depression have been found to correlate, it is unclear how they interact during treatment and in which order the symptoms decrease. Methods: Thirty-one patients with BN and depressive symptoms received IPT using the manual IPT-BNm in a naturalistic design. The outcome was measured with the Eating Disorder Examination Questionnaire (EDE-Q) and the Montgomery Åsberg Depression Rating Scale (MADRS-S). Symptom improvement at each session was measured with Repeated Evaluation of Eating Disorder Symptoms (REDS) and the Patient Health Questionnaire-9 (PHQ-9). Results: Significant improvements with large effect sizes were found on both ED symptoms and depression. The rates of change were linear for both BN and depression. A strong correlation between reduction of depressive symptoms and ED symptoms was found. Depressive symptom reduction at one session predicted improvement of ED symptoms at the next session. Conclusions: IPT-BNm had an effect on both BN and co-occurring depressive symptoms. The analyses indicated that reduction in depressive symptoms preceded reduction in bulimic symptoms.
Depression in bulimia at 2- to 5- year followup
Psychiatry Research, 1985
Previous research has indicated a strong association between bulimia and affective disorder at the time of initial clinical assessment. To investigate this relationship from a long-term perspective, 30 normal weight female bulimics were evaluated 2 to 5 years posthospital admission with psychometric measures and clinical interviews. Contrary to previous reports, the depression scores of the bulimics were surprisingly low, even though 26 of the 30 continued to fulfill DSM-III criteria for bulimia. Higher depression scores were associated with more intense bulimic symptomatology and attitudes, and greater psychiatric disturbance at followup. Although these data demonstrate a relationship between bulimic symptomatology and depression at long-term followup, they do not support recent assertions that bulimia is a variant of an underlying affective disorder.
1985
Based on psychodynamic and object relations theories, 17 variables were proposed to be salient for those suffering from bulimia. In the present study four groups were compared: (a) bulimics with a prior history of anorectic-like behavior (FAB); (b) bulimics without a prior history of anorectic-like behavior (NAB); (c) a nonobese, nonbulimic group who evidenced excessive concerns about their weight (CAW); and (d) a normal control group (Control). Differences were predicted between both the bulimic and control groups as well as between both bulimic groups (FAB and NAB). Seventy-five women between the ages of 18 and 35 completed the Minnesota Multiphasic Personality Inventory, the Eating Disorders Inventory, and Levenson's Locus of Control Scale. Results of a multivariate analysis of covariance procedure revealed differences across the groups on 12 variables. Post hoc testing indicated that both bulimic groups differed from the control groups confirming the first hypothesis. Furthe...