Personality Pathology Among Individuals With a Lifetime History of Anorexia Nervosa

Abstract

Anorexia nervosa (AN) appears to be associated with certain personality features. The degree to which personality pathology persists after the acute phase of illness is unclear. This study aimed to investigate personality pathology in a large sample (n = 153) of women with histories of AN using the Dimensional Assessment of Personality Pathology (DAPP) and to evaluate the persistence of pathological personality features by comparing women with acute (n = 83) and remitted AN (n = 55). Women with AN demonstrated high levels of emotional dysregulation, social inhibition and compulsivity relative to age-matched healthy women (n = 124). Identity problems, intimacy problems and schizotypal features were highlighted as important. The same 14 pathological personality dimensions were significantly elevated in both ill and remitted participants, though remitted individuals' scores were reduced on 4 of the subscales. These results indicate that pathological personality features in AN are persistent traits, although some features may become exaggerated in the acute phase.

The Concept of Body Image Disturbance in Anorexia Nervosa: An Empirical Inquiry Utilizing Patients' Subjective Experiences

“…Personality factors such as high levels of negative emotionality, obsessionality, neuroticism, harm avoidance, perfectionism and low self-esteem are also viewed as important aetiological factors (Bulik, Sullivan, Fear, & Pickering, 2000;Bulik et al, 2003;Halmi et al, 2003;Holliday, Uher, Landau, Collier, & Treasure, 2006). In a population-based cohort of Swedish twins, Bulik and colleagues found that neuroticism emerged as the only prospective predictor of AN (Bulik et al, 2006).…”

Anorexia nervosa and autism spectrum disorders: Guided investigation of social cognitive endophenotypes.

“…Someone with this diagnosis is frequently constrained, conforming, obsessional, rigid, and perfectionistic" (p. S69). To demonstrate, we present a vignette of an individual with AN ( Figure 2) drawn from an historical account from 1866 (cited in Brumberg, 1988) to highlight features extensively documented in AN both premorbidly and following weight restoration: cognitive and behavioral rigidity (Anderluh et al, 2003;, perfectionism (Bastiani, Rao, Weltzin, & Kaye, 1995;Bulik et al, 2003;Halmi et al, 2000;Woodside et al, 2002), social withdrawal (Diaz-Marsa, Carrasco, & Saiz, 2000; I. C. Gillberg et al, 1995;Godart et al, 2004;Holliday, Uher, Landau, Collier, & Treasure, 2006;Karwautz, Troop, Rabe-Hesketh, Collier, & Treasure, 2003;Kaye et al, 2004), constriction (Geller, Cockell, Hewitt, Goldner, & Flett, 2000), and harm avoidance (Diaz-Marsa et al, 2000;Klump et al, 2000Klump et al, , 2004. In fact, the reliable presentation of this behavioral and personality cluster has been demonstrated to add to the incremental validity of diagnostic accuracy (Westen & Harnden-Fischer, 2001).…”

“…First, studies of personality features in AN have noted elevated levels of interpersonal constriction and social withdrawal that persist with recovery (C. Gillberg & Rastam, 1992;Nilsson et al, 1999). For example, Holliday et al (2006) studied the chronicity of personality features in both currently ill and recovered individuals with AN. Individuals with AN in the ill state demonstrated extreme social isolation relative to healthy control participants, with effect sizes greater than 1.5.…”

The Relationship between Multidimensional Narcissism, Explicit and Implicit Self-Esteem in Eating Disorders

“…Furthermore, narcissism persists over time, even when ED patients are in full remission (Holliday, Landau, & Treasure, 2006). Therefore, the study of ED patients might enlighten our understanding of narcissism.…”