Abstract
(1) Background: patients with Anorexia Nervosa (AN) are classified either as restrictive (ANr) or binge/purge (ANbp) according to the absence or presence of impulsive eating and compensatory behaviors. The aim of the present study was to assess the levels of impulsivity in both AN subtypes and to explore whether individual differences in impulsivity may be explained by differences in the presence of early maladaptive schemas. (2) Methods: the sample group included 122 patients with ANr, 112 patients with ANbp, and 131 healthy women (HW). All of these participants completed the UPPS-P scale for an assessment of impulsive behaviors and the Young Schema Questionnaire (YSQ-S3) for an assessment of early maladaptive schemas. (3) Results: the patients with ANbp displayed higher levels of impulsivity compared with the patients with ANr and HW. Patients with AN, especially the restrictive subtype, also reported higher levels of early maladaptive schemas than HW, and regression analyses revealed that specific maladaptive schemas partially explain the variability in impulsivity in both patients and HW. (4) Conclusions: it appears that maladaptive beliefs developed during childhood or adolescence may predict the development of impulsivity, a personality trait usually associated with maladaptive behaviors, and appears to be prevalent among ANbp patients. The clinical effects of this, as well as directions for future study, are also discussed in this paper.
Highlights
Anorexia Nervosa (AN) is a severe, life-threatening psychiatric disorder characterized by impaired body experience and perception
In line with the findings of other studies, our results corroborate the presence of a top-down control in ANr patients [53,54], thereby showing that low levels of impulsivity are linked to negative emotions as well as a lack of premeditation or perseveration, which are more characteristic of cognitive rumination
As for the specific differences between patients with AN and healthy women, we found that the negative urgency trait is predicted by disconnection and rejection domains, a group of schemas that are highly consistent with patients with AN and include factors such as feeling defective, unwanted, and/or invalid in significant aspects as well as the expectation of being rejected and isolated by others [11,36]
Summary
Anorexia Nervosa (AN) is a severe, life-threatening psychiatric disorder characterized by impaired body experience and perception. AN may be classified as restrictive (ANr) or binge eating/purging (ANbp) depending on the absence or presence of behaviors such as binge eating, purging, or other compensatory strategies such as excessive exercising or fasting [1] This subtype distinction has been associated with specific clinical features, such as comorbidity and psychopathological characteristics [4,5,6,7], impulsivity, neurocognitive profiles, and treatment approaches [8,9,10]. Some authors have suggested that various different latent variables, such as impulsivity or compulsivity, should be taken into consideration in order to better understand the classification [11] This aspect is possibly linked to the presence of overlapping psychopathological elements, as has already been shown in bulimia nervosa [21]. The recent literature has focused on differences in impulsivity traits between ED patients, showing the possible existence of a spectrum distribution from high self-control to high impulsivity traits [4,22]
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