Aggressiveness, Anger and Eating Disorders: A Review

Abstract

Anger and aggressive behaviours, especially those self-directed, are frequent in subjects suffering from anorexia nervosa and bulimia nervosa. They increase the complexity of the clinical features, change the prognosis and cause a more difficult management of these disorders. In order to elucidate the complex relationships between eating disorders, anger and aggressiveness, the history of traumatic experiences, the prevalence of dissociative, obsessive, impulsive and compulsive symptoms, as well as the role of severe personality disorders in subjects suffering from anorexia nervosa, bulimia nervosa and self-injurious behaviours are considered. In the final section of this paper, a model exploring such a relationship in the light of the undefined sense of self is described.

Effect of Aggression Regulation on Eating Disorder Pathology: RCT of a Brief Body and Movement Oriented Intervention

“…Research findings indicate that anger is a significant underlying emotion contributing to disordered eating (Engel et al, 2007;Fox & Power, 2009;Harrison, Sullivan, Tchanturia, & Treasure, 2010;Ioannou & Fox, 2009;Quinton & Wagner, 2005). Patients with bulimia often feel anger and may impulsively direct it toward others or toward objects (Truglia et al, 2006). Patients suffering from anorexia nervosa can feel anger as a terrifying emotion that needs to be avoided (by concentration on food, body and weight), needs to be suppressed, for example by physical activity, and released by anorectic self-control or self-harm (Espeset, Gulliksen, Nordbø, Skårderud, & Holte, 2012).…”

“…It is suggested that treatment of non-suicidal self-injury in ED should focus on stabilizing affective states rather than on reducing affects like anger (Vansteelandt et al, 2013). Despite such findings, there is a lack of research on how to approach anger and aggression in the treatment of ED (Fassino, Daga, Piero, & Rovera, 2002;Krug et al, 2008;Miotto et al, 2003;Truglia et al, 2006).…”

“…Anger and aggressiveness are associated with several eating disorder (ED) subtypes, severity of ED symptoms and poorer treatment outcome (Krug et al, 2008). In ED, aggressiveness is mostly directed at the self in an attempt to control the body and regulate emotions, and as a means to confirm one's own fragile identity (Truglia et al, 2006). ED behaviours can be seen as self-destructive behaviours related to a great extent to inhibited anger expression (Truglia et al, 2006).…”

“…It is suggested that treatment of non-suicidal self-injury in ED should focus on stabilizing affective states rather than on reducing affects like anger (Vansteelandt et al, 2013). Despite such findings, there is a lack of research on how to approach anger and aggression in the treatment of ED (Fassino, Daga, Piero, & Rovera, 2002;Krug et al, 2008;Miotto et al, 2003;Truglia et al, 2006).A specific evidence-based intervention protocol targeted at aggression is missing. In this respect, psychomotor therapy (PMT) -a body and movement oriented therapy frequently used in mental health care in the Netherlands and Belgium (Probst, Knapen, Poot, & Vancampfort, 2010) -may prove useful.…”

“…In ED, aggressiveness is mostly directed at the self in an attempt to control the body and regulate emotions, and as a means to confirm one's own fragile identity (Truglia et al, 2006). ED behaviours can be seen as self-destructive behaviours related to a great extent to inhibited anger expression (Truglia et al, 2006).…”