The Relationship Between Temperament and Impulsive Behaviors in Eating Disordered Subjects

Abstract

To date, few studies have examined the personality characteristics and clinical predictors of impulsive behaviors in eating disorders (ED). The aim of this work was to study the prevalence of a wide range of impulsive behaviors in a sample of 554 ED subjects and to examine the predictors of these behaviors. Subjects were diagnosed according to DSM-IV criteria as having anorexia nervosa restricting type (ANR; n = 183), anorexia nervosa binge eating/purging type (ANBP; n = 65), bulimia nervosa purging type (BNP; n = 244), and bulimia nervosa nonpurging type (BNNP; n = 62). Nine different types of impulsive behaviors were assessed in these groups. About 55% of the whole sample reported at least one type of impulsive behavior, 35% more than one, and about 13% more than three. According to findings, impulsive and multi-impulsive subjects are characterized by the presence of purging behavior and by specific temperamental features such as high levels of novelty seeking and low persistence. The prediction of impulsive behavior is further improved by considering the presence of a history of childhood abuse, maternal psychiatric morbidity, and some specific psychological symptoms such as maturity fears, perfectionism, depression, and obsessive-compulsive symptoms. The presence of impulsive behavior appears to be associated with overall higher levels of psychiatric symptomatology and eating psychopathology, thus indicating that they are an important feature to be considered in the assessment and treatment of ED.

Personality pathology in purging disorder and bulimia nervosa

“…4,22 Purging in BN may reflect an impulsive need to rid oneself of food following a binge episode or may be associated with impulsivity through a third underlying variable-frequency of OBEs. Although SBEs had no significant personality correlates in BN, both anxious/rigid personality measures (Cluster C and STAI-Trait) and impulsivity (BIS-11) were correlated with OBE frequency, suggesting that the combination of anxious and impulsive personality traits may underlie OBEs in BN just as these same features may underlie SBEs in PD.…”

Self Injurious Behavior in Adolescent Girls with Eating Disorders

“…But the "true" origins of EDs are not understood as yet. In contrast Favaro et al (2005) stated that impulsive or multi-impulsive behaviour in EDs does not necessarily relate to PD because impulsive behaviours usually diminish or disappear with remission of the ED.…”

“…Impulsive behaviours are involved in all four diagnostic subgroups of EDs (AN-R: restricting AN, AN-BP: binge eating/purging AN, BN-P: purging BN, BN-NP: non purging BN) (Favaro et al, 2005). Binge eating, however, significantly predicts the presence and number of impulsive behaviours.…”

“…Impulsive behaviours are a trans diagnostic characteristic of EDs (Favaro et al, 2005) -they are very common, and the co-existence of even more than one type of impulsive behaviours is not uncommon. Various studies have implicated impulsivity as a maintaining factor of bulimic symptoms (Sullivan et al, 1998;Fahy & Eisler, 1993;Engel et al, 2005).…”

Emotional Eating Scale for Children and Adolescents: Psychometric Characteristics in a Spanish Sample

“…The Binge Eating Diagnosis (BED), as defined in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (APA, 2000), includes recurrent episodes of binge eating during which subjective sense of loss of control (LOC) episodes occur that are often reported as triggered by dysphoric moods, such as depression and anxiety. Furthermore, impulsive behaviors appear to be a transdiagnostic characteristic in Eating Disorder (ED) patients, not being uncommon among other ED clinical subtypes (Favaro et al, 2005). Although the relationships among disordered eating, impulsivity and difficulties in emotional regulation have been extensively studied in adults, it is still unclear whether binge eating in children is associated with deficits in emotion regulation, and which 3 emotion regulation strategies are problematic.…”