Comparison of bulimic and non-bulimic anorexia nervosa patients during treatment

Eckert, Elke D.; Halmi, Katherine A.; Marchi, Peggy; Cohen, Jacob

doi:10.1017/s0033291700000696

Cited by 18 publications

(5 citation statements)

References 15 publications

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“…Our findings for BDI scores are similar to the range of values published by others for underweight anorexics (Casper, Hedeker, & McClough, 1992;Wambolt, Kaslow, Swift, & Ritholz, 1987;Eckert, Halmi, Marchi, & Cohen, 1987), short-term recovered anorexics (Wambolt et al, 1987;Eckert et al, 1987) and recovered anorexics (Casper et al, 1992). For the Hamilton Depression inventory, the scores in our study were similar to the range of values published by others for underweight anorexics Rosen, Murkofsky, Steckler, & Skolnick, 1989;Wambolt et al, 1987;Eckert et al, 1987) and short-term recovered anorexics (Wambolt et al, 1987;Ecker et al, 1987). To our knowledge, this instrument has not previously been administered to recovered anorexics.…”

Section: Depressionsupporting

confidence: 91%

Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa

Pollice

Kaye

Greeno

et al. 1997

Int. J. Eat. Disord.

251

157

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Objective Depression, anxiety, and obsessionality frequently are present in underweight, malnourished patients with anorexia nervosa. It is less certain if these symptoms persist after recovery. Thus, we assessed these symptoms in anorexic women at three states of illness (underweight, short‐term weight restored, and long‐term weight restored) in comparison to a group of healthy women. Method: We used standardized self‐ and trained rater instruments to assess depression (Hamilton Depression Rating Scale and Beck Depression Inventory), anxiety (Spielberger State‐Trait Anxiety Inventory and Hamilton Anxiety Rating Scale), and obsessions and compulsions (Yale‐Brown Obsessive Compulsive Scale). Results: A similar pattern was found for all symptoms. That is, scores for depression, anxiety, and obsessionality were most elevated in the underweight state. These symptoms improved with weight restoration. However, milder but significantly elevated symptoms persisted in long‐term weight‐restored anorexic women compared to healthy control women. Discussion: These data suggest that malnutrition intensifies the severity of depression, anxiety, and obsessionality in anorexia nervosa. However, the fact that mild to moderate symptoms persisted after long‐term weight restoration raises the possibility that such behaviors are related to the pathogenesis of this illness. © 1997 by John Wiley & Sons, Inc. Int J Eat Disord 21: 367–376, 1997.

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Section: Depressionsupporting

confidence: 91%

Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa

Pollice

Kaye

Greeno

et al. 1997

Int. J. Eat. Disord.

251

157

View full text Add to dashboard Cite

show abstract

“…Relevant to the latter point, Eckert et al (1987) found that several apparent personality differences between restrictors and bulimics disappeared after a month of inpatient weight restoration. They speculated that some that have been reported in the literature might be due to symptoms of acute illness, or simply to a tendency for bulimics to complain more about such symptoms.…”

Section: More Complex Modelsmentioning

confidence: 84%

Impulse Regulation in Anorexia Nervosa and Bulimia Nervosa: Some Formulations

Sohlberg

1991

Behavioural Neurology

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Empirical observations imply that impulsivity is specifically associated with poor prognosis in eating disorders. The present paper cites studies suggesting that this factor is predominantly associated with the bulimic pattern of eating disturbance, while "restriction" may be associated rather with hypercontrol of behaviour. Further evidence is cited suggesting that the relationship between hyper-and hypocontrol is actually very intimate, both on a behavioural and biochemical level. Rather than bulimics being generally impulsive and "restrictors" generally hypercontrolled, future studies may reveal impulse regulation difficulties of both kinds in both groups. Single-minded preoccupation with dieting may be an ill-equipped individual's effort to simplify life in periods of change and environmental challenge that demand capacity for flexible impulse regulation. IntroductionContrary to impressions of both professionals and the lay public, recent evidence suggests that the incidence of anorexia nervosa may not be greater today than during previous decades (Lucas et Nielsen, 1990). Still, this disorder and related patterns of weight-shape preoccupation, body image disturbance and severely disordered eating (bulimia nervosa and atypical or subclinical variants) continue to present significant health problems. Thus, beyond the risks directly associated with starvation, binge eating and purging, there are often significant and long-lasting psychological and social sequelae.Some 90-95% of patients are women and there is a fair amount of consensus that the disorders begin with dieting, often starting in the context of separation (e.g. going to boarding school, au pair work in another country, loss of a love relationship). For some, dieting escalates into frankly anorexic food refusal and emaciation. For others dieting is interrupted by periods of binge eating in which huge amounts of food are consumed in a short time, only to be purged immediately afterwards. When the afflicted individual eventually seeks help, her condition is a mixture of basic psychopathology and the effects of acute malnutrition (e.g. Woell et at., 1989). No firm conclusions have been drawn concerning why some dieters go on to have clinical eating disorders. In the present paper I will discuss how investigation of impulse regulation could shed some light on this issue.

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“…One is the need for analyses that combine search for distinctive traits with evaluation of per-as measures of personality. Eckert et al (53) found that several apparent personality differences between restrictors and bulimics disappeared after a month of inpatient weight restoration. They speculated that some that have been reported in the literature might be due to symptoms of acute illness, or simply to a tendency for bulimics to complain more about such symptoms.…”

Section: Unsolved Methodological Issuesmentioning

confidence: 99%

Personality in Anorexia nervosa: An update and a theoretical integration

Sohlberg

Strober

1994

Acta Psychiatr Scand

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No single cause is likely to be of supreme importance in the etiology of Anorexia nervosa, but personality factors continue to attract researchers' attention. This paper is a review of evidence on the subject, covering psychometric, interview, and projective investigations. Significant methodological problems exist in the literature, but do not suffice to explain findings of obsessive and inhibited features intermixed with impulsivity, and a high prevalence of defined personality disorders. Adding to previous work by Cloninger and Strober we suggest that vulnerable individuals are temperamentally incapable of coping with the challenges of adolescence by anything other than repetitive, reward seeking behavior. In a social environment that greatly emphasizes thinness as a criterion for self‐worth and success, the outcome may be Anorexia nervosa.

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Comparison of bulimic and non-bulimic anorexia nervosa patients during treatment

Cited by 18 publications

References 15 publications

Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa

Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa

Impulse Regulation in Anorexia Nervosa and Bulimia Nervosa: Some Formulations

Personality in Anorexia nervosa: An update and a theoretical integration

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