Eating psychopathology and personality in eating disorders

Fassino, Secondo; Abbate-Daga, Giovanni; Amianto, Federico; Facchini, F.; Rovera, Giovanni

doi:10.1017/s1121189x00003109

Cited by 11 publications

(8 citation statements)

References 38 publications

(59 reference statements)

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“…Moreover, it was not possible to overcome the recall biases consequent to different degrees of awareness and the unavoidable subjectivity of judgement about the parental relationship. Nevertheless present findings are consistent with literature evidences on personality (Fassino et al, 2002) and psychopathology patterns (Bulik et al, 2000;Fassino et al, 2003a) of BN women and add some knowledge in the field of parenting influences on bulimia nervosa.…”

Section: Discussionsupporting

confidence: 92%

“…Bulimic women assessed with the Temperament and Character Inventory (TCI; Cloninger et al, 1993) are characterised by a specific personality pattern (Fassino et al, 2002), which is extensively related to their eating psychopathology (Fassino et al, 2003a;Picot & Lilenfeld, 2003). Thus, it is possible that personality traits mediate between parental bonding and eating psychopathology in bulimic women.…”

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confidence: 99%

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Parental bonding and eating psychopathology in bulimia nervosa: personality traits as possible mediators

Fassino

Amianto

Rocca

et al. 2010

Epidemiol Psichiatr Soc

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SUMMARYAims– The relationship between eating disorders, attachment, personality traits and eating psychopathology remains unexplored. This study tested the mediating role of temperament and character between parental bonding and psy-chopathology in bulimic women.Methods– 154 bulimic subjects and 154 healthy controls were compared using Parental Bonding Instrument (PBI), Temperament and Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), and Beck Depression Inventory (BDI). Multiple regression analysis tested the mediation of personality traits between parenting and eating psy-chopathology.Results– Bulimic subjects displayed low maternal and paternal care and low self-directedness, and high novelty seeking and eating psychopathology. Maternal care was negatively related to social insecurity, inadequacy and impulsiveness. Paternal care predicted novelty seeking, self-directedness, interoceptive awareness, impulsiveness, and asceticism. The mediation effect of self-directedness between paternal care and psychopathology was significant, not the one of novelty seeking. Conclusions – Parental care is lower in bulimic than in control women even when controlled for possible confounding variables. Some eating psychopathology traits are related to maternal and paternal care, but not the bulimia subscale. Paternal care is also related to temperament and character traits which are related to eating psychopathology. Self-directedness mediates with different degrees between parenting and eating psychopathology. Clinical implications are discussed.Declaration of Interest:The first author received financing from Compagnia di San Paolo Foundation for the research on eating disorders (3989 IT/FA 2005.1797). The National Eating Disorder Association (NEDA) awarded a Charron Family Grant to the second author to sustain research about the families of subjects affected by eating disorders. The third author received a grant from “Regione Piemonte” for research on Eating Disorders for the years 2008 and 2009. The authors have not received any other financing for the present research, including pharmaceutical company support or any honoraria for consultancies for interventions during the last two years. The authors are not involved in any conflict of interest in connection to the submitted article.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

Parental bonding and eating psychopathology in bulimia nervosa: personality traits as possible mediators

Fassino

Amianto

Rocca

et al. 2010

Epidemiol Psichiatr Soc

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“…Several factors have been called into question as enhancing treatment resistance: 1) low self-esteem and 2) mood intolerance [65]; 3) perfectionism [65,78]; 4) body experiences [17,125]; 5) general psychopathology [39,56,64]; 6) personality [66-68,72,73,76,79]; 7) interpersonal relationships [65,75]; 8) cognitive inflexibility and 9) avoidance of experience and emotions [29,131,132]; 10) care givers’ expressed emotion [14,62,71,75]; 11) poor problem solving abilities [69];12) scarce social support [64,74]; and 13) reduced relational abilities [39,69,133] (for a review on widely used treatment models see: Hay and colleagues [134]). Evidence on a relationship between dropout, treatment response and both character and temperament [14,67,135] encourages to focus on considering in detail patients’ personality.…”

Section: Discussionmentioning

confidence: 99%

“…This psychotherapeutic model was only sporadically tested in literature [68,135] and - although it may look outdated - it could be proposed again in the light of the studies on psychotherapy currently available.…”

Section: Discussionmentioning

confidence: 99%

Resistance to treatment and change in anorexia nervosa: a clinical overview

et al. 2013

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BackgroundCurrent literature on Eating Disorders (EDs) is devoid of evidence-based findings providing support to effective treatments, mostly for anorexia nervosa (AN). This lack of successful guidelines may play a role in making these disorders even more resistant. In fact, many individuals do not respond to the available treatments and develop an enduring and disabling illness. With this overview we aimed to highlight and discuss treatment resistance in AN – with an in-depth investigation of resistance-related psychological factors.A literature search was conducted on PubMed and PsychINFO; English-language articles published between 1990 and 2013 investigating the phenomenon of resistance to treatment in AN have been considered.DiscussionThe selected papers have been then grouped into four main thematic areas: denial of illness; motivation to change; maintaining factors and treatment outcome; and therapeutic relationship. Eating symptomatology was found to only partially explain resistance to treatment. The role of duration of illness has been questioned whilst some maintaining factors seemed promising in providing a useful framework for this phenomenon. Emotive and relational aspects have been investigated on their role in resistance as well as therapists’ countertransference.SummaryRemarkably there has been little research done on resistance to treatment in the ED field, in spite of its clinical relevance. Motivation, insight and subjective meaning of the illness can be useful tools to manage the resistance phenomenon when coupled with a wider approach. The latter enables the therapists to be aware of their role in the therapeutic alliance through countertransference aspects and to consider the EDs as disorders of the development of both personality and self, entailing severe impairments as regards identity and relationships.

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“…In contrast, an electrophysiological study of persons with anorexia nervosa reported lower error rates than in controls on a flanker task and reduced error-related negativity, suggesting deficient error detection. 29 Differences across patients with anorexia nervosa and BN in their ability to detect errors, however, may reflect their respective personality characteristics of perfectionism and impulsiveness that distinguish patients with restricting-type from those with binge-type eating disorders 52. Moreover, less activation of the dorsal ACC and prefrontal and parietal cortices accompanied more errors in patients (Figure 5B), indicating that deficient activation in these regions during correct responses (Figure 2C) was associated with less interference (Figure 3B) and the commission of more errors in patients (Figure 5B).…”

Section: Commentmentioning

confidence: 99%

Deficient Activity in the Neural Systems That Mediate Self-regulatory Control in Bulimia Nervosa

Marsh¹,

Steinglass²,

Gerber³

et al. 2009

Arch Gen Psychiatry

168

197

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Context Disturbances in neural systems that mediate voluntary self-regulatory processes may contribute to bulimia nervosa (BN) by releasing feeding behaviors from regulatory control. Objective To study the functional activity in neural circuits that subserve self-regulatory control in women with BN. Design We compared functional magnetic resonance imaging blood oxygenation level–dependent responses in patients with BN with healthy controls during performance of the Simon Spatial Incompatibility task. Setting University research institute. Participants Forty women: 20 patients with BN and 20 healthy control participants. Main Outcome Measure We used general linear modeling of Simon Spatial Incompatibility task–related activations to compare groups on their patterns of brain activation associated with the successful or unsuccessful engagement of self-regulatory control. Results Patients with BN responded more impulsively and made more errors on the task than did healthy controls; patients with the most severe symptoms made the most errors. During correct responding on incongruent trials, patients failed to activate frontostriatal circuits to the same degree as healthy controls in the left inferolateral prefrontal cortex (Brodmann area [BA] 45), bilateral inferior frontal gyrus (BA 44), lenticular and caudate nuclei, and anterior cingulate cortex (BA 24/32). Patients activated the dorsal anterior cingulate cortex (BA 32) more when making errors than when responding correctly. In contrast, healthy participants activated the anterior cingulate cortex more during correct than incorrect responses, and they activated the striatum more when responding incorrectly, likely reflecting an automatic response tendency that, in the absence of concomitant anterior cingulate cortex activity, produced incorrect responses. Conclusions Self-regulatory processes are impaired in women with BN, likely because of their failure to engage frontostriatal circuits appropriately. These findings enhance our understanding of the pathogenesis of BN by pointing to functional abnormalities within a neural system that subserves self-regulatory control, which may contribute to binge eating and other impulsive behaviors in women with BN.

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Eating psychopathology and personality in eating disorders

Cited by 11 publications

References 38 publications

Parental bonding and eating psychopathology in bulimia nervosa: personality traits as possible mediators

Parental bonding and eating psychopathology in bulimia nervosa: personality traits as possible mediators

Resistance to treatment and change in anorexia nervosa: a clinical overview

Deficient Activity in the Neural Systems That Mediate Self-regulatory Control in Bulimia Nervosa

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