Dyscontrol in Women with Bulimia Nervosa: Lack of Inhibitory Control over Motor, Cognitive, and Emotional Responses in Women with Bulimia Nervosa

Abstract

Dyscontrol is an essential trait in women with bulimia nervosa (BN). Indeed, impulsivity seems to underlie the neuropsychological and psychophysiological functioning of women suffering from BN. The present chapter looks at the lack of inhibitory control in BN through a wide range of behavioral, cognitive, and emotional processes. Throughout the chapter, empirical evidence shows that BN individuals appear to succumb to food cravings and binge eating in order to escape negative emotional states. Also, parallel to eating, sexual activity is known to become uncontrollable due to the affective comfort that it provides. Thus, women with BN may attempt to gain emotional relief and control through a long-term cycle of extreme dieting, bingeing, purging and even becoming sexually promiscuous. However, as the neuropsychological literature suggests, these destructive impulses reflect a significant motor impulsivity and an impairment of decision-making abilities that increase, rather than decrease, the feelings of dyscontrol. Consequently, chronic lack of inhibitory control of physiological and emotional processes that characterize unsuccessful dieters seems to maintain the poor autonomic regulation indexed by defensive reactions and heart rate variability. Finally, the present work emphasizes the need of integrating behavioral, neuropsychological, and psychophysiological intervention techniques to improve the treatment of the dyscontrol in women with BN.