Bulimia nervosa in Austria and the United States: A controlled cross-cultural study

Abstract

We sought to compare the features of bulimic subjects in two countries (Austria and the United States). To assess how bulimia nervosa presents in different cultural settings, we interviewed 33 women recruited from the University of Innsbruck, Austria, who met DSM-III-R criteria for bulimia nervosa and 33 bulimic women recruited from two universities in Massachusetts. Preliminary results on these bulimic groups have previously been reported. The present study adds a control group of 33 Austrian women and 33 Boston women who were recruited and interviewed by identical methods. Bulimic women in both countries proved significantly distinguishable from controls on eating behavior, attitudes toward body shape and weight, lifetime prevalence of major mood disorder, and a few variables regarding childhood experiences. In addition, we found several marked differences between Austria and the United States which appeared independent of the diagnosis of bulimia nervosa. The most prominent of these were satisfaction with body image and levels of substance abuse. Bulimia nervosa appears to exhibit stereotypic "core" features which are independent of culture, but it has other features which may influenced by underlying cultural differences.