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The study explored lifetime prevalence of non-suicidal self-injury (NSSI) in female and male individuals with eating disorders (ED) and compared ED symptoms, general psychopathology and personality traits across individuals with and without a history of NSSI. The incremental discriminative capacity of gender on the manifestation of lifetime NSSI was also studied. A total sample of 1649 consecutively admitted ED patients (1515 women and 134 men) participated in the current study [339 ED + NSSI (ED with NSSI) and 1310 ED − NSSI (ED without NSSI)]. Specific self-report measures were included and other clinical and psychopathological indices. The observed lifetime prevalence of NSSI was 20.6% (20.9% in women and 17.2% in men). NSSI was not associated with ED type or gender. However, ED + NSSI patients exhibited more impulsive behaviour, substance-abuse disorders and additional impulse-control disorders, were younger and had more previous treatments. Age was shown to affect the presentation of NSSI. Additionally, ED + NSSI patients exhibited more severe ED and general psychopathological symptoms and had more dysfunctional personality traits when compared with ED − NSSI. ED + NSSI was found to be positively associated with harm avoidance and self-transcendence but negatively with reward dependence, self-directedness and cooperativeness. Thus, the variables with stronger capacity to identify the presence of ED + NSSI were younger age, harm avoidance, self-directedness and self-transcendence. A lack of association between sex and ED subtype with the presence of NSSI was observed. [ABSTRACT FROM AUTHOR]

Objective: We sought to estimate prevalences of childhood emotional abuse (CEA) in bulimic and normal-eater control groups, and to replicate previous findings linking CEA to severity of eating symptoms in BN. We also examined potential mediators of the link between CEA and disordered eating. Method: Women diagnosed with a bulimic disorder ( n = 176) and normal-eater women ( n = 139) were assessed for childhood traumata, eating-disorder (ED) symptoms and psychopathological characteristics (ineffectiveness, perfectionism, depression, and affective instability) thought to be potential mediators of interest. Results: CEA was more prevalent in the bulimic than in the nonbulimic group, and predicted severity of some eating-symptom indices. Ineffectiveness and affective instability both mediated relationships between CEA and selected ED symptoms. Discussion: We found CEA to predict eating pathology through mediating effects of ineffectiveness and affective instability. CEA might influence severity of ED symptoms by impacting an individual's self-esteem and capacity for affect regulation. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012) [ABSTRACT FROM AUTHOR]

Objective: In participants with eating disorders (EDs), prior physical or sexual abuse has been associated with increased likelihood of impulsivity and affective instability. However, previous studies among participants with eating disorders have not systematically explored relationships between empirically derived, personality-trait-based classes, on the one hand, and likelihood of exposure to either childhood sexual or physical abuse, on the other. Method: We assessed multiple psychopathological traits, eating symptoms, and history of abuse in 185 women with an ED and 93 with no ED. Results: A latent class analysis, conducted using psychopathological-trait measures, yielded latent classes of participants with eating disorders fitting the descriptors “dissocial/impulsive,” “inhibited/compulsive,” and “low psychopathology.” ED was generally associated with increased risk of childhood sexual abuse, but the dissocial/impulsive characteristic corresponded with a unique likelihood of physical abuse and especially high rates of sexual abuse. Discussion: Observed associations between different forms of childhood abuse and trait-defined ED variants help inform models on the development of eating disorders and of psychopathological traits that often accompany them. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [ABSTRACT FROM AUTHOR]

Objective: We conducted a naturalistic study to examine negative affect and dissociative experiences as antecedents to binge episodes. Method: Using handheld computers, 33 women with bulimic syndromes provided ongoing self-reports on eating behaviors, affects, and dissociative experiences over 7- to 29-day intervals. Results: Multilevel modeling analyses indicated that negative affect and dissociation were elevated prior to binge episodes. In addition, antecedent effects of dissociation on bingeing were independent of those attributable to negative affect. Conclusion: Our results are consistent with models of binge eating that assign a causal role to negative mood and altered self-awareness. As such, our findings imply that binge eating is a multiply determined behavior linked to diverse cognitive and affective processes. © 2007 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background A short (s) allele in the promoter region of the 5-hydroxytryptamine (5-HT) transporter gene (5HTTLPR) has been associated with low transcription of the 5-HT transporter protein, and with clinical manifestations including impulsivity, affective disorder, and bulimia nervosa. Methods We studied implications of the 5HTTLPR s allele for eating symptoms, psychopathologic traits, and platelet [3H-] paroxetine binding in 59 women with bulimia spectrum syndromes. Results Compared with those without it, carriers of the s allele of 5HTTLPR showed significantly more affective instability, behavioral impulsivity, interpersonal insecurity, comorbid borderline personality disorder (BPD), and lower density (Bmax) of paroxetine-binding sites. Conclusions Our results suggest that proneness to impulsivity, affective dysregulation, and reduced central 5-HT reuptake may (in part) be codetermined by the 5HTTLPR polymorphism. However, given inconsistent 5HTTLPR expression in different populations, we speculate that we may be observing a phenotype (i.e., eating disorder)-dependent manifestation. © 2004 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

This study extends an earlier investigation on the link between familial traits and eating disorders (EDs), and examines the extent to which selected eating attitudes and psychopathological traits are (a) familial in nature and (b) specific to anorexia- and bulimia-spectrum disorders. A principal components analysis (PCA), used to reduce variables and to characterize main sources of variation, yielded three interpretable factors: eating concerns and symptoms (grouping all eating-related dimensions), dramatic-erratic traits (grouping affective instability, narcissism, and conceptually related dimensions), and obsessive-compulsive traits (grouping compulsivity and restricted expression). Correlations among subjects' factor scores (derived from the PCA) showed two types of transgenerational effects: correspondences between daughters' and parents' psychopathological traits, and between daughters' and mothers' eating concerns. Despite these, relatives of ED probands were not discriminable on any factor score from relatives of controls. These results imply that transgenerational effects exist on eating attitudes and psychopathological traits, but do not uniquely identify families in which clinical ED syndromes occur. [ABSTRACT FROM AUTHOR]

Findings ,indicate that bulimics with Borderline Personality Disorder (BPD) may represent a distinct subgroup, with extreme psychopathology and unique treatment needs. However, since mood disturbances can produce "borderline" manifestations, findings from available borderline/nonborderline comparisons in bulimic samples could confound features associated with personality disorder (PD) with those associated with mood disturbance. We compared psychiatric and personality features in 91 bulimics, divided (using DSM-III-R criteria) into those with BPD, Other PDs, or No PD, in direct comparisons, cases meeting "border- line" criteria seemed broadly more disturbed than did cases with other Axis-II comorbidity patterns. However, when variance attributable to depression was accounted lot, greater psychopathology in "borderlines" became restricted to focal dimensions, predictably characterizing a "hostile-impulsive" phenotype. While "borderlines" displayed higher prevalences of certain Axis-I syndromes than did "nonborderlines", results did not indicate distinct patterns of comorbidity, on Axis I, across groups. Overall, finding suggested that comorbidity on Axis-Il may predict different degrees of disturbance, rather than fundamental differences as to areas in which disturbance will occur. [ABSTRACT FROM AUTHOR]

This study compared psychological and family features of adolescents with varying degrees of eating and mood symptoms. Questionnaires (administered to 715 high school girls) assessed maladaptive eating, mood disturbances, body-image concerns, traits of perfectionism, impulsivity, self-criticism, and reported family incohesion. Canonical correlation analysis and comparisons among groups displaying different combinations of eating and mood symptoms suggested the following: that concurrent mood and eating symptoms were linked to an aberrant psychological profile, characterized by body concerns, multiple psychological issues, and family incohesion. Circumscribed eating disturbances were associated with body concerns, but an otherwise intact profile. Mood disturbances were associated with an again more-disturbed psychological and family profile, but in which body concerns were unremarkable. Shared psychological and family features appeared to represent a possible basis for concurrence of mood and eating symptoms evident in our nonclinical population, and were discussed in the light of a ‘two-component’ model of the eating disorders proposed by Garner, Olmsted, Polivy & Garfinkel (1984). [ABSTRACT FROM AUTHOR]

Presence of DSM-III-R personality disorders was examined in 67 women with eating disorders (anorexic restricters, anorexic bingers, and bulimics with or without a prior history of anorexia nervosa) and in 25 noneating-disordered women. Additional measures of family functioning were available in 55 of the eating disorders (EDs) and 24 controls. Personality and family disturbances (as measured by the Personality Diagnostic Questionnaire-Revised and the Family Assessment Device) were prevalent among the EDs, but ‘restricter/binger’ differences were not indicated on either measure. Hence results did not support a ‘restricter/binger dichotomy’ concept. They also questioned the degree to which personality problems in ED patients may be consequences of eating disturbances, since severity of personality disorder, while related to reported family dysfunction, was unrelated to severity of eating symptoms. [ABSTRACT FROM AUTHOR]

Three alternative causal hypotheses have been proposed concerning the relationship between mood and eating disturbances: (1) mood disturbances in eating disorders are consequences of eating abnormalities; (2) eating abnormalities are consequences of underlying mood disturbances; (3) mood and eating disturbances are not causally related but are both effects of some other set of common causes or ‘third variables.’ The present study used a cross-lagged panel design to examine these competing causal hypotheses concerning mood and eating symptoms in a nonclinical population. High-school girls, 543, ranging in age from 13 to 17, were tested twice (across a 6-month interval) for depressive symptoms and eating abnormalities. Autocorrelations indicated that mood and eating disturbances were quite stable over the 6-month period (.71 for mood and .72 for eating). Synchronous correlations revealed a moderate but stable association between mood and eating disturbances (.41 for Time 1 and .42 for Time 2). Comparison of cross-lagged correlations from mood to eating pathology (.34) and from eating to mood disturbances (.35), however, indicated no predominant causal sequence between these two variables. Implications of these findings were discussed. [ABSTRACT FROM AUTHOR]

To evaluate various psychological constructs used in formulations of anorexia and bulimia nervosa, we compared 76 eating-disordered, 20 psychiatric, and 24 normal women on measures of irrational cognitions, object-relations disturbances, and defense style. The eating-disordered group exhibited more disturbance on all measures than normals and many pathological elevations relative to psychiatric controls. Despite these differences, common qualitative features were identified in all patient groups, suggesting that formulations based on the factors examined alone, while useful in providing an understanding of patients' issues, will be inadequate to account for eating-disorder development. [ABSTRACT FROM AUTHOR]

Fifty-eight women with anorexia or bulimia nervosa were compared with 24 normal women on measures of defense style and parental bonding. Results indicated that all eating-disorder subtypes exhibit more primitive defenses and fewer mature ones than controls. Eating-disorder patients uniformly recalled /ess paternal em pa- thy than controls. Thus, difficulties involving object representations of fathers may be a theme common to eating disorders. No major differences were identified among eating-disorder subtypes, suggesting that these disorders share substantial psychodynamic features. Patterns of parental bonding were associated with defense styles in a manner consistent with theories that link defense style development to early object relationships. [ABSTRACT FROM AUTHOR]

Aim The objective of the study was to analyse shared commonalities and differences between bulimia nervosa (BN) and certain impulse-related disorders, namely compulsive buying (CB) and gambling disorder (GD), with respect to general psychopathology and personality traits. Methods A total of 188 female patients [50 BN without comorbid CB (BN−CB), 49 BN with comorbid CB (BN+CB), 53 GD and 36 CB] and 50 comparison non-psychiatric women participated in the current study. All patients were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth revised edition, the Temperament and Character Inventory-Revised, and other clinical indices. Results A positive-growing trend was observed in psychopathology and personality traits across the four clinical groups. Comorbid BN with CB was associated with highest eating psychopathology and social anxiety. On Novelty Seeking, the CB, GD and BN+CB were similar to each other, whereas BN−CB presented a distinct profile. Moreover, the BN+CB group displayed more dysfunctional personality traits and higher general psychopathology. The clinical groups demonstrated overall higher levels of psychopathology compared with the control group. Conclusions The results of this study demonstrate that disorders with impulsive traits (CB, GD, BN+CB and BN−CB) follow a linear trend in general psychopathology and specific personality traits, but differ along specific personality and psychopathological dimensions. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]