The role of interpersonal personality traits and reassurance seeking in eating disorder symptoms and depressive symptoms among women with bulimia nervosa

Abstract

Introduction The role of interpersonal factors has been proposed in various models of eating disorder (ED) psychopathology and treatment. We examined the independent and interactive contributions of two interpersonal-focused personality traits (i.e., social avoidance and insecure attachment) and reassurance seeking in relation to global ED psychopathology and depressive symptoms among women with bulimia nervosa (BN). Method Participants were 204 adult women with full or subclinical BN who completed a battery of self-report questionnaires. Hierarchical multiple OLS regressions including main effects and interaction terms were used to analyze the data. Results Main effects were found for social avoidance and insecure attachment in association with global ED psychopathology and depressive symptoms. In addition, two-way interactions between social avoidance and reassurance seeking were observed for both global ED psychopathology and depressive symptoms. In general, reassurance seeking strengthened the association between social avoidance and global ED psychopathology and depressive symptoms. Conclusion These results demonstrate the importance of reassurance seeking in psychopathology among women with BN who display personality features characterized by social avoidance.

The Pre-Existing Depressive Disorders, Substance Use Disorders Predicted the Suicidal Death of the Patients with Eating Disorders – A Preliminary Result of National Health Insurance Research Databases in a Chinese Population

“…Our results implicated that it is critical for the identification and intervention of the pre-existing psychiatric comorbidities among the patients with ED since there was addictive effect regarding the numbers of psychiatric comorbidities. On the other hand, we did not find the impact of comorbidities of anxiety disorders, personality disorders, schizophrenia in the suicidal death among the patient with ED although the impulsivity, and interpersonal deficits might explain the pathology of obsessive-compulsive disorder [32,33], personality disorders [34][35][36], schizophrenia [37,38] and eating disorders.…”

Negative interpretation bias in females with bulimia nervosa

“…In common with other psychiatric populations, such as those with depression, negative social experiences are common and maintaining factors in illness (Arcelus et al, 2013; Bohon & Stice, 2012; Bronstein et al, 2022; Cardi et al, 2013, 2017; Haynos et al, 2020; Hirsch et al, 2016; Huppert & Foa, 2004; Kerr‐Gaffney et al, 2018; Lavender et al, 2016; Mason et al, 2016; Pennesi & Wade, 2016; Rapee & Heimberg, 1997; Selby et al, 2010; Smith et al, 2018; Steiger et al, 1999; Treasure & Schmidt, 2013; Turton et al, 2018). Adverse social experiences, such as social rejection, are associated with cognitive biases toward negative social stimuli and an increased risk of developing an ED (Bernstein et al, 2010; Cardi et al, 2013; Menzel et al, 2010; Pickett et al, 2004; Puhl et al, 2017).…”

Associations of borderline personality disorder traits with stressful events and emotional reactivity in women with bulimia nervosa.

“…The current findings are also relevant to consider in the context of previous theoretical and empirical research. For instance, the roles of interpersonal factors and negative affect in relation to bulimic symptoms have been highlighted in theoretical models (e.g., the interpersonal model of binge eating; Ansell, Grilo, & White, 2012; Wilfley, MacKenzie, Welch, Ayres, & Weissman, 2000) and empirical research (e.g., Lunn, Poulsen, & Daniel, 2012; Mason et al, 2016). Of particular note, EMA findings indicate that changes in negative affect mediate the relationship between interpersonal stressful events and BN behaviors (Goldschmidt et al, 2014).…”

“…First, trait affective lability, or the tendency to experience emotions that quickly fluctuate both in intensity and valence (Livesley et al, 1992), has been found to significantly predict global eating disorder symptoms even when controlling for depression (Anestis et al, 2010). Second, higher scores on insecure attachment, which is conceptualized as fear of abandonment and rejection by others (Livesley et al, 1992), was associated with greater global eating disorder psychopathology and greater depressive symptoms in a BN sample (Mason et al, 2016). Third, eating disorder patients score higher on trait identity problems (e.g., the tendency to experience anhedonia, labile self-concept, and marked pessimism; Livesley et al, 1992) than controls and higher scores on this trait in BN are associated with suicide attempts (Pisetsky et al, 2015).…”