Neurobiological and Clinical Variables Associated with Alcohol Abuse in Bulimia Nervosa

Abstract

The study was aimed at analysing the reciprocal relationships of several clinical and neurobiological items in order to predict alcohol misuse in patients with bulimia nervosa (BN). Seventy BN patients and 70 healthy controls were assessed for depression, impulsivity, borderline personality traits and self-defeating behaviours using specific scales; serum cortisol and 24-hour urinary excretion of serotonin and 5-hydroxiindolacetic acid were also assessed. The study confirmed the implications of these clinical factors for alcohol misuse in BN patients, but the results suggested that depressive symptoms and hypercortisolism could lie behind these relationships.

Personality psychopathology differentiates risky behaviors among women with bulimia nervosa

“…Of particular importance, we did not find significant unique associations between any risky behavior and trait emotion dysregulation. Although prior research has linked emotion dysregulation to multiple risky behaviors, 1,5,7,12,[15][16][17][18][19][20] it may be that each separate behavior is related to emotion dysregulation, but not independently of the other associations. In other words, emotion dysregulation does not appear to differentiate risky behaviors, but is likely similarly associated with all types of risky behaviors.…”

“…Individuals with bulimia nervosa (BN), which is characterized by recurrent binge eating and purging behaviors, frequently report engaging in other maladaptive behaviors characterized as risky and impulsive, such as self‐harm, substance misuse, high‐risk sex, compulsive buying, and reckless driving . Depending on the specific risky behavior and assessment methodology used, researchers report that 16–44% of women with BN concurrently engage in some other form of risky behavior . Engaging in risky behaviors is associated with significant health problems, greater overall psychopathology, and poorer course of illness than engagement in bulimic behaviors alone .…”

“…For example, higher levels of neuroticism were found in individuals with BN who also abused alcohol compared to individuals who engaged in only BN behaviors, only substance use, or neither . Other dimensions of personality dysfunction have been implicated as important in the course of BN and engagement in risky behaviors, including dissocial behavior and social avoidance . However, most studies have focused on emotion dysregulation‐related personality traits, which have been found to be associated with risky behaviors in BN, including self‐harm, substance use, and reckless behaviors (e.g., behaviors which fall more broadly under impulse control disorders).…”

“…[1][2][3][4] Depending on the specific risky behavior and assessment methodology used, researchers report that 16-44% of women with BN concurrently engage in some other form of risky behavior. [5][6][7] Engaging in risky behaviors is associated with significant health problems, [8][9][10] greater overall psychopathology, and poorer course of illness than engagement in bulimic behaviors alone. 6 However, there is a paucity of research examining factors associated with engaging in specific risky behaviors that occur independently or co-occur among individuals with BN.…”

Impulsivity and test meal intake among women with bulimia nervosa

“…Despite this significant overlap, few studies examine shared mechanisms for the etiology and maintenance of BN and alcohol use disorders (AUDs). One characteristic feature of patients with BN (Vaz-Leal et al, 2015; Waxman, 2009) or AUDs (Jentsch et al, 2014) is impulsivity, which is hypothesized to increase risk for the development of both conditions. Impulsivity, or the inability to suppress a dominant or unwanted action, is not one construct, but rather encompasses a range of behavioral dyscontrol such as response inhibition, delay of gratification, and delay discounting (Stein, Hollander, & Liebowitz, 1993).…”