The role of bulimic behaviors in affect regulation: Different functions for different patient subgroups?

Abstract

One hundred and eighty consecutive patients seeking treatment for eating disorders rated adjectives describing their affective states before binge eating and after purging. Patients were divided into borderline (n = 40) and nonborderline (n = 35) groups and were compared on the above dimensions. Both patient subgroups reported reductions in anxiety and fragmentation after the binge‐purge episode. The borderline subgroup, however, experienced significantly greater reductions in anxiety and a decreased level of depression, while the nonborderline subgroup reported a slight increase in their level of depression. The clinical and research implications of these findings are discussed.

Incarcerated women: Impact of childhood sexual abuse and family functioning on dissociation and psychological distress

“…Although logical deduction may lead to an assumption that a highly dissociative individual would minimally experience or be aware of anxiety and distress, it also seems reasonable to assume that the discontinuity of consciousness, produced by dissociative periods, would add to anxiety experienced before the dissociative episode. Even with such an expected relationship, minimal, if any research, has addressed whether psychological distress and dysfunctional family dynamics are related to higher levels of dissociation and if such a combination is manifested in the most pathological CSA symptom presentations (Heatherton & Baumaster, 1991;Pian.ta Egeland & Adam, 1996;Steinberg, Tobin & Johnson, 1990;Waites, 1993).…”

Incarcerated women: Impact of childhood sexual abuse and family functioning on dissociation and psychological distress

“…Although logical deduction may lead to an assumption that a highly dissociative individual would minimally experience or be aware of anxiety and distress, it also seems reasonable to assume that the discontinuity of consciousness, produced by dissociative periods, would add to anxiety experienced before the dissociative episode. Even with such an expected relationship, minimal, if any research, has addressed whether psychological distress and dysfunctional family dynamics are related to higher levels of dissociation and if such a combination is manifested in the most pathological CSA symptom presentations (Heatherton & Baumaster, 1991;Pian.ta Egeland & Adam, 1996;Steinberg, Tobin & Johnson, 1990;Waites, 1993).…”

Pathways mediating sexual abuse and eating disturbance in children

“…These findings suggest that eating disturbances in victims of childhood sexual abuse may follow a developmental pathway characterized by pervasive impulsivity and drug-using behavior, but not the more typical route that emphasizes self-esteem deficits, body image concerns, and perfectionistic dieting behavior (Agras, 1991;Fairburn, 1981). The idea that there may be at least two pathways into disordered eating has previously been discussed by several authors (Steinberg, Tobin, & Johnson, 1990;Vitousek & Manke, 1994).…”

Binge eating as escape from self-awareness.

“…Some evidence fits the view that binges are associated with such downward shifts in affect (Steinberg, Tobin, & Johnson, 1990). For example, Johnson et al (1984) compared the binge state with an altered state of consciousness and with a dissociative experience, insofar as it causes one's perception of events and one's memory to be somewhat "blurred" (p. 251).…”

Incarcerated women: Impact of childhood sexual abuse and family functioning on dissociation and psychological distress

“…Although logical deduction may lead to an assumption that a highly dissociative individual would minimally experience or be aware of anxiety and distress, it also seems reasonable to assume that the discontinuity of consciousness, produced by dissociative periods, would add to anxiety experienced before the dissociative episode. Even with such an expected relationship, minimal, if any research, has addressed whether psychological distress and dysfunctional family dynamics are related to higher levels of dissociation and if such a combination is manifested in the most pathological CSA symptom presentations (Heatherton & Baumaster, 1991;Pian.ta Egeland & Adam, 1996;Steinberg, Tobin & Johnson, 1990;Waites, 1993).…”

Pathways mediating sexual abuse and eating disturbance in children

“…These findings suggest that eating disturbances in victims of childhood sexual abuse may follow a developmental pathway characterized by pervasive impulsivity and drug-using behavior, but not the more typical route that emphasizes self-esteem deficits, body image concerns, and perfectionistic dieting behavior (Agras, 1991;Fairburn, 1981). The idea that there may be at least two pathways into disordered eating has previously been discussed by several authors (Steinberg, Tobin, & Johnson, 1990;Vitousek & Manke, 1994).…”

Binge eating as escape from self-awareness.

“…Some evidence fits the view that binges are associated with such downward shifts in affect (Steinberg, Tobin, & Johnson, 1990). For example, Johnson et al (1984) compared the binge state with an altered state of consciousness and with a dissociative experience, insofar as it causes one's perception of events and one's memory to be somewhat "blurred" (p. 251).…”

Incarcerated women: Impact of childhood sexual abuse and family functioning on dissociation and psychological distress

“…Although logical deduction may lead to an assumption that a highly dissociative individual would minimally experience or be aware of anxiety and distress, it also seems reasonable to assume that the discontinuity of consciousness, produced by dissociative periods, would add to anxiety experienced before the dissociative episode. Even with such an expected relationship, minimal, if any research, has addressed whether psychological distress and dysfunctional family dynamics are related to higher levels of dissociation and if such a combination is manifested in the most pathological CSA symptom presentations (Heatherton & Baumaster, 1991;Pian.ta Egeland & Adam, 1996;Steinberg, Tobin & Johnson, 1990;Waites, 1993).…”

Pathways mediating sexual abuse and eating disturbance in children

“…These findings suggest that eating disturbances in victims of childhood sexual abuse may follow a developmental pathway characterized by pervasive impulsivity and drug-using behavior, but not the more typical route that emphasizes self-esteem deficits, body image concerns, and perfectionistic dieting behavior (Agras, 1991;Fairburn, 1981). The idea that there may be at least two pathways into disordered eating has previously been discussed by several authors (Steinberg, Tobin, & Johnson, 1990;Vitousek & Manke, 1994).…”

Binge eating as escape from self-awareness.

“…Some evidence fits the view that binges are associated with such downward shifts in affect (Steinberg, Tobin, & Johnson, 1990). For example, Johnson et al (1984) compared the binge state with an altered state of consciousness and with a dissociative experience, insofar as it causes one's perception of events and one's memory to be somewhat "blurred" (p. 251).…”