Guilt and hostility as coexisting characteristics of bulimia nervosa

Abstract

ulimia nervosa has recently emerged as a major mental health problem. Bulimics, usually women, suffer B episodes of uncontrollable eating following by purging and/or vomiting behaviours to rid themselves of the food.Previous work has examined the role of hostility in binge-purge behaviour, and clinical observation has noted the presence of strong guilt feelings. Most studies of hostility have used the Hostility and Direction of Hostility Questionnaire. Very little work has been done on the role of guilt in bulimia. Studies of both guilt and hostility in bulimia were absent. This study used the Buss-Durkee Inventory (1957) to compare a clinical sample of bulimic women (n = 17) with nonbulimic female students (n = 20) on guilt and overt and covert hostility. As predicted, bulimics scored significantly higher than students on guilt, one-tailed t(35) = 7.17, p c .05, and covert hostility, one-tailed (34) = 5.23, p c .05, but did not differ on overt hostility. A distinctive pattern of associations between measures of guilt, covert hostility, and eating behaviours was found for the bulimic women. These results suggested that women with high guilt and covert hostility might be more susceptible to bulimia than women who were less guilty or hostile. Longitudinal studies examining these variables throughout the teenage and young adulthood years would clarify the roles of guilt and covert hostility as possible etiological factors for bulimia.

Causes of Eating Disorders

“…AFFECTIVE INFLUENCES Although a temperamental characteristic such as negative emotionality is unlikely to lead to EDs in and of itself, stress and negative mood are commonly reported antecedents for EDs (e.g., Ball & Lee 2000, Leon et al 1997. For example, BN patients have elevated self-directed hostility scores, even controlling for other factors such as mood and family hostility level (Friedman et al 1997), and women with EDs score higher than controls in guilt, covert hostility (BN) (Allen et al 1998), and suppressed anger (AN) (Geller et al 2000). Furthermore, negative affect has been shown to mediate the relation between dieting and binge eating, although dieting and negative affect remain independent risk factors for binge eating (Stice et al 2000a).…”

Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature

“…For instance, high rates of co-occurring mood and anxiety disorders have been reported in both AN and BN (e.g., Hudson et al, 2007; Kaye et al, 2004; Lilenfeld, 2004). Findings from studies using dimensional measures also suggest that AN and BN are characterized by elevated negative emotionality (e.g., depressive symptoms, overall negative affect, specific negative affective states; Allen, Scannell, & Turner, 1998; Engel et al, 2005; Pollice, Kaye, Greeno, & Weltzin, 1997; Stice, Nemeroff, & Shaw, 1996; Waller et al, 2003). Finally, personality traits (e.g., neuroticism) and/or other psychiatric disorders associated with disturbances in emotional functioning (e.g., borderline personality disorder) are also common among individuals with AN and BN (Cassin & von Ranson, 2005).…”

Mediational Links for the Severity of Anorexia and Bulimia a Path Analysis Study

“…Comorbidity studies in the eating disorders area have also identi ed the important role of mood symptoms for the presence and progression of both AN and BN (Hudson et al, 2007;Kaye et al, 2004), mainly depression (Tseng & Hu, 2012;Fischer et al, 2008), but also negative emotional states (Engel et al, 2005;Waller et al, 2003;Allen et al, 1998;Stice et al, al., 1996). In particular, it has been documented that AN and BN patients show high levels of depression compared with control samples without ED symptoms (Pyle et al, 1981;Bora & Köse, 2016;Franko et al, 2018;Hudson et al, 1987;Johnson & Larson, 1982;Kaye et al, 1986;Keck et al, 1990;Laessle et al, 1987;.…”