Personality Profiles in Eating Disorders: Rethinking the Distinction Between Axis I and Axis II

Abstract

Axis I symptoms are a useful component, but only one component, in the accurate diagnosis of eating disorders. Classifying patients with eating disorders by eating symptoms alone groups together patients with anorexic symptoms who are high functioning and self-critical with those who are highly disturbed, constricted, and avoidant, and groups together patients with bulimic symptoms who are high functioning and self-critical with those who are highly disturbed, impulsive, and emotionally dysregulated. These distinctions may be relevant to etiology, prognosis, and treatment.

Exploring the boundary between temperament and generalized anxiety disorder: A receiver operating characteristic analysis

“…These data also raise the important question of whether or not individuals with GAD and high harm avoidance are different from individuals with GAD and moderate harm avoidance in other meaningful ways such as illness phenomenology, underlying neurobiology, or treatment response. Research in other areas such as eating disorders has demonstrated that subtyping individuals based on personality may reveal more important differences than even their specific DSM disorder (Westen & Harnden-Fischer, 2001). Behavioral and molecular genetics studies could indicate, for example, the presence of different genes in the subpopulation of individuals with high HA and no anxiety disorders.…”

Methylation of the glucocorticoid receptor gene promoter in bulimic women: Associations with borderline personality disorder, suicidality, and exposure to childhood abuse

“…Bulimia nervosa (BN) often co-aggregates with problems of impulse control, affect regulation, and anxiousness, but there are striking individual differences as to comorbid characteristics 1,2 : About 30% of those affected are frankly ''dysregulated'' (emotionally labile and impulsive), a third ''overregulated'' (emotionally constricted and inhibited), and another third quite free of apparent psychopathology. Available evidence links such phenomenological variations to different constitutional risks, environmental exposures, and treatment needs.…”

“…Available evidence links such phenomenological variations to different constitutional risks, environmental exposures, and treatment needs. 1,2 Gene-Environment Interactions in BN Most contemporary etiological theories attribute BN to the activation, by environmental pressures, of hereditary susceptibilities. 2,3 In keeping with this view, our group has documented several geneenvironment interactions (involving selected neuroregulatory genes and childhood-abuse exposures) that appear to be relevant to risk for BN or its common comorbid symtpoms.…”

Psychotherapy Outcome Research: Issues and Questions

“…Contrary to the assertions of many EBT advocates, there exists a substantial literature that demonstrates the effectiveness of idiographic psychotherapies (Driessen et al, 2015, Leichsenring, 2005Leichsenring & Leibing, 2003;Leichsenring & Rabung, 2008;Leichsenring, Rabungm, & Leibing, 2004;Leichsenring & Scheauenburg, 2014;Leichsenring, Leweke, Klein, & Steinaart, 2015;Shedler, 2010;Wampold, 2007;Westen & Harnden-Fischer, 2001). This literature is too large to be reviewed in this article however, contrary to statements that idiographic approaches to psychotherapy are "ineffective" and "unscientific," psychotherapy effectiveness research indicates the opposite (Clarkin, Levy, Lenzenweger, & Kernberg, 2007;Leichsenring & Leibing, 2003;Leichsenring & Rabung, 2008;Leichsenring et al, 2004;Levy & Ablon, 2008;Lewis, Dennerstein, & Gibbs, 2008;Seligman, 1996;Shedler, 2010;Wampold, 2007).…”