Stratégies d’ajustement et mécanismes de défense dans les troubles du comportement alimentaire. Résultats d’une étude exploratoire à méthodologie quantitative et qualitative intégrée

Abstract: Throughout the history of psychopathology, anorexia and bulimia nervosa were considered sometimes as two separated nosologic entities, sometimes as belonging to the same continuum. From the point of view of adaptation to reality, those conducts can be interpreted as more or less dysfunctional coping strategies. From the point of view of structural psychopathology, the preeminence of defense mechanisms linked to borderline functioning must not be neglected. To make a contribution to these theoretical discussions, we undertook an intensive study with small groups, combining psychometric scales, the MDBF [Steyer et al. Der Mehrdimensionale Befindlichkeitsfragebogen. Göttingen: Hofgrefe; 1997] and the SVF120 [Janke et al. Sressverarbeitungsfragebogen mit SVF 120 und SVF 78. Göttingen: Hofgrefe; 1997] with a projective test, that is, the test of Rotter [J Consult Psychol (1947) 44–48], interpreted in the phenomenological and structural perspective. Two clinical subgroups, composed of n =21 bulimics and n =12 anorexics, were compared with a control group of n =32 persons. With the help of non-parametric inferential and multidimensional statistical procedures, we made between-groups comparisons, within-groups structural analyses and within-groups explorations of the meaning of differences between conscious and unconscious expression of affect. Our data underline the proximity of the two clinical subgroups in relationship with the tendency to use dysfunctional coping strategies, but they stress also the relational ambivalence of anorectics in comparison with the relational dependency of bulimics. The results are discussed at the light of the above quoted theoretical questions, at the light of the pertinence of methodology and from the point of view of appropriate treating measures. [Copyright &y& Elsevier]