Bulimic Symptomatology Research Articles

Physical, psychological, and societal correlates of bulimic symptomatology among African American college women.

Physical, psychological, and societal correlates of bulimic symptomatology among African American college women.

Social physique anxiety and disordered eating: what’s the connection?

Social physique anxiety (SPA) is highly correlated with other body image measures that have been considered to be important in understanding eating disorders. However, SPA has not been directly studied with respect to eating disorders. Thus, the purpose of this investigation was to examine the link between SPA and measures of eating disorder symptomatology to determine if SPA should be considered as an additional risk factor in the prediction of eating disturbances. One hundred and sixty female undergraduates completed questionnaires measuring body mass index (BMI), social physique anxiety (SPAS), anorexic symptoms (EAT), bulimic symptoms (BULIT-R), depression (CES-D), self-esteem (SES) and obligatory exercise (OEQ). Regression analyses revealed that SPA and depression were the psychological correlates that predicted bulimic symptomatology and that SPA, depression, and obligatory exercise predicted anorexic symptomatology; all variables were positively related to eating disorder symptoms. Overall, the results indicate that social physique anxiety appears to be a useful construct for understanding eating disorder symptoms in female undergraduates.

Eating disorders, body satisfaction and unwanted sexual experience: U.K., Australian and U.S. data

The extent to which eating disorders may be associated with sexual abuse or unwanted sexual experience has been assessed by a number of studies and findings have been conflicting. The present study describes three clinical samples of eating disorder patients from the U.K., Australia and the U.S.A. who completed a sexual events questionnaire. Within the U.K. sample, comparisons were also made across diagnostic categories to test the hypothesis that unwanted sexual experience might be associated with bulimic symptomatology. U.K. comparisons showed little difference in reporting between diagnostic groups. The comparisons across the three countries showed high levels of consistency of responses on most items, although there were differences between the samples on rates of reporting of sexual contact with a biologically close male relative. While the U.K. group showed some association between body dissatisfaction and unwanted sexual experience, this was not the case for the Australian sample. © 1997 John Wiley & Sons, Ltd and Eating Disorders Association.

The role of general family environment and sexual and physical abuse in the origins of eating disorders

This paper reviews the role of childhood family functioning and of sexual and physical abuse in eating disorders. Bearing in mind the huge methodological differences across studies the following tentative conclusions can be reached: there is evidence of more family pathology in eating disorder families than in normal control families. Those with bulimic disorders seem to have poorer family functioning than restrictors. Different eating disorder subgroups show less or comparable levels of family pathology compared to psychiatric or other medical controls depending on the comparison group. In bulimia nervosa high levels of family disturbance seem to be associated with greater severity and chronicity of bulimic symptomatology. There is some suggestion that family functioning may have more of an effect on Axis II than on Axis I disorders. Rates of sexual abuse appear to be higher in bulimia nervosa than in normal controls. Depending on which psychiatric control groups are chosen, eating disorder patients may have similar, higher or lower rates of contact sexual abuse. The majority of studies fails to find differences between eating disorder subtypes in terms of rates of sexual abuse. The evidence on whether there is any link between abuse characteristics and the severity of eating disorder is inconclusive. On balance, childhood sexual abuse does not seem to be a specific risk factor for eating disorders. Physical abuse is more common in bulimic than in restricting disorders and usually occurs in the context of a disturbed family environment. The clinical implications of these findings are discussed. Future research in the area of family factors or childhood trauma in eating disorders needs to get away from mere ‘head counts’ and needs to focus more strongly on the mediators between abuse and neglect and the development of eating disorders and also on the relative importance of family factors compared with other aetiological factors. © 1997 John Wiley & Sons, Ltd and Eating Disorders Association.

Attitudes toward bulimic behaviors in two generations: The role of knowledge, body mass, gender, and bulimic symptomatology

The perceived commonality and acceptability of symptoms of bulimia, as well as associated variables including gender, generation, knowledge of bulimia, body mass index, and bulimic symptomatology, were assessed. These views were explored in a sample of college students ( N = 155 male; N = 173 female) and their parents ( N = 194 mothers; N = 163 fathers). Females perceived bulimic symptoms to be more common than males, and students perceived them to be more common than their parents. Students perceived bulimic symptoms to be more acceptable than their parents. Females had higher levels of bulimic symptomatology, particularly daughters. Stepwise simultaneous regression analyses revealed that one's own level of bulimic symptomatology was the primary predictor of one's attitudes toward the commonality and acceptability of bulimic symptoms. Bulimic symptomatology was primarily predicted from perceptions of the acceptability of bulimic symptoms and body mass index. Results suggest that college-age students may be at greater risk for the development of bulimia nervosa because of their greater tolerance of these symptoms: alternatively, people endorsing higher levels of bulimic symptomatology may adjust their attitudes, perceiving bulimic symptoms to be more tolerable, in order to alleviate the dissonance between their attitudes and behaviors.

Eating behavior following stress in women with and without bulimic symptoms.

This study examined the effects of an interpersonal stressor on subsequent calorie intake in females with (N = 20) and without (N = 20) significant bulimic symptomatology. Subjects participated in two laboratory sessions that differed according to experimental condition (stress versus no stress), completed self-report measures of mood and anxiety before and after the experimental task, and were provided with an array of snack foods after each session. Counter to the hypothesis, women with bulimic symptoms did not differentially increase their intake when exposed to stress. However, results for the intake of each macronutrient indicated that both bulimic and control women increased their consumption of carbohydrates following the stressor. Thus, stress was related to increased carbohydrate consumption by all subjects but did not differentially affect the consumption of women with bulimic symptoms. It may be that women with bulimic symptoms are not differentially vulnerable to eating in response to stress or that current laboratory paradigms are unable to detect differences in eating following a stressor.

Self-directed hostility and family functioning in normal-weight bulimics and overweight binge eaters

The aim of this study was to examine whether overweight binge eaters demonstrate similar perceptions of family interactions and views of the self as do normal-weight bulimics. We compared 37 obese binge eaters and 37 normal-weight bulimics to 38 normal-weight nonbulimic controls, and 10 overweight nonbulimic controls on the Bulimia Test (BULIT), Profile of Mood States (POMS), Structural Analysis of Social Behavior (SASB) Short Form, which includes measure of hostility of family interactions and self-directed hostility; the Family Interaction Survey (FIS), and a measure of history of physical and sexual abuse and familial psychopathology. Both normal-weight bulimics and overweight binge eaters differed from nonbulimic controls across all measures of symptomatology, family functioning, history of abuse, familial psychopathology, and self-directed hostility. Normal-weight bulimics demonstrated significantly higher BULIT scores and self-directed hostility than did overweight binge eaters. Post hoc analysis showed that among binge eaters and bulimics, self-directed hostility accounted for a significant percentage of the variance of BULIT scores when controlling for the effects of age, BMI, family hostility, and mood. The possible role of self-directed hostility in the maintenance of bulimic symptomatology is discussed.

Relation of dietary restraint to bulimic symptomatology: The effects of the criterion confounding of the Restraint Scale

Studies indicate that various measures of dietary restraint show inconsistent relations to bulimic symptomatology. The present study tested the assertion that this is because the scales differ in the extent to which they reflect the success or failure of dietary efforts. This study also tested the competing hypothesis that criterion confounding of the Restraint Scale produced the inconsistent findings. Data from 117 undergraduates indicated that both the Restraint Scale and the Dutch Restrained Eating Scale were correlated with bulimic pathology, but that the magnitude to the relations were higher for the former. These results supported the dietary success-failure hypothesis, however, this difference disappeared when the two disinhibited eating items from the Restraint Scale were deleted. Thus, the inconsistent findings in prior research appear to be due to the criterion confounding of the Restraint Scale. Implications for the measurement of restraint are discussed.

Acculturation, Body Image, Self-Esteem, And Eating-Disorder Symptomatology In Adolescent Mexican American Women

In this article the relationship among acculturation, body image, self-esteem, and eating disorder symptomatology in 120 Mexican American adolescent women was investigated. Surprisingly, acculturation levels were not related to anorexic or bulimic symptomatology, self-esteem, body dissatisfaction or thinness of ideal and attractive figures. Lower levels of self-esteem predicted higher levels of anorexic and bulimic symptomatology. Body mass was positively related to bulimic scores. In contrast to Lester and Petrie (1995), body dissatisfaction was significantly related to eating-disorder symptomatology. The high levels of disordered eating attitudes and behaviors found in this study suggest that rather than exclusively being an Anglo, middle-to upper-class phenomenon, eating-disordered behavior also exists within lower socioeconomic status Mexican American adolescent women.

Test of the Dual Pathway Model of Bulimia Nervosa: Evidence for Dietary Restraint and Affect Regulation Mechanisms

Although sociocultural pressures are thought to contribute to bulimia nervosa, little research has examined the mechanisms by which these factors might actually produce eating pathology. The present study tested an integrative model of bulimia that centers around dietary restraint and affect regulation pathways. It also incorporates perceived sociocultural pressure, body-mass, ideal-body internalization, and body dissatisfaction. Using data from 257 female undergraduates, structural equation modeling revealed that the model accounted for 71% of the variance in bulimic symptomatology. The relation between perceived sociocultural pressure and bulimic symptoms was mediated by ideal-body internalization, body dissatisfaction, dietary restraint, and negative affect. The results support the dual pathway model of bulimia and suggest variables that might be targeted in prevention efforts.

Familial and individual perspectivetaking processes in adolescent females with bulimic symptomatology

Abstract In light of data linking level of individuated relating in families to both perspective-taking ability and bulimic symptomatology in adolescence, the present study compared perspective-taking processes in adolescent females displaying signs of bulimia and their mothers (N = 17) to control mother-daughter dyads (N = 41). The bulimic adolescents and their mothers were less able to predict the responses of the other on personality instruments than were the controls. On a selfreport measure of perspective-taking tendencies, however, the bulimic and control adolescents did not differ. The theoretical and clinical significance of the findings is discussed.

Bulimic Symptomatology in High School Girls

This study tests the explanatory power of an integrated sociocultural and personality model in predicting bulimic symptomatology. Family, peer, and personality factors were assessed at three levels of analysis. The first level of the model measured the general functioning of the family system and friendship network. The second level assessed the extent to which the family system and friendship network were concerned with issues of weight and dieting, as well as the rate of eating disorders among members in these groups. The third level investigated the relationship of certain personality variables to bulimic symptoms. Based on self-report data from approximately 400 high school girls, correlates of bulimic symptomatology at each of the three levels of analysis were identified. An integrated model, in which the three levels of analysis were considered in unison, demonstrated that risk factors at each level of analysis cumulatively contribute to an increase in bulimic symptoms.

Dissociation and bulimia: Research and theory

AbstractA number of studies are now reporting on dissociation and its links to eating psychopathology. Dissociation is a defence mechanism that is characterized by poor integration of thought processes, and is most likely to be activated when an individual is faced with an overwhelming traumatic experience. Despite the recent research on the possible links between trauma, dissociation and bulimia, the precise nature of this relationship is not yet fully understood. Therefore, it is the aim of this paper to examine the mechanisms of dissociation and to suggest how a reliance on this defence mechanism may influence the development of eating symptomatology. Based on the findings of research in this area, a hypothetical model is proposed of the relationship between trauma, dissociation and bulimic symptomatology. This model is an attempt to understand the development of bulimic psychopathology (and other tensionreducing behaviours) in individuals who report a history of trauma that is relevant to their current diagnosis. The clinical implications of this model are discussed and suggestions are made for further research.

Assessing dissociative symptoms in eating disordered patients: Construct validation of two self-report measures

Dissociative symptomatology has been reported among patients with eating disorders, necessitating the availability of valid assessment instruments. In the current investigation, we examined the construct-related validity of two self-report instruments for assessing dissociative symptoms: the Dissociative Experiences Scale and the Trauma Symptom Checklist-40. The instruments were administered, along with instruments measuring depressive, anorexic, and bulimic symptomatology, to a sample of 125 eating disordered subjects. The dissociation measures demonstrated good convergent and discriminant validity, with a convergent validity coefficient (r = .73) that was approximately equal to that for the instruments measuring each of the three other psychological constructs. A principal components analysis further supported the construct-related validity of the dissociation scales. Severity of dissociative symptoms was generally unrelated to anorexic or bulimic symptomatology, but was significantly associated with depression. The results supported the construct validity of the dissociation instruments and the general status of dissociation as a valid and well-defined psychological phenomenon.

Identification of “binge-prone” women: An experimentally and psychometrically validated cluster analysis in a college population

This study investigated the escape model of binge eating through a cluster analysis using standardized measures. A sample of 126 undergraduate women underwent a manipulation of their level of cognition and were asked to “taste-test” several flavors of ice cream. Questionnaire data from these women were entered into a cluster analysis. Two groups emerged: women in the “binge-prone” group were significantly more depressed, had lower self-esteem, had more chaotic and extreme eating patterns, and were more self-conscious than those in the control group. In validation work, binge-prone women were shown to report elevated levels of bulimic symptomatology and, when in the presence of a food they enjoyed, to respond to increases in level of cognition by eating more. These results were consistent with some, but not all, of the components of the escape model.

Reported sexual abuse and eating psychopathology: a review of the evidence for a causal link.

It has been claimed that there is no specific link between a reported history of sexual abuse and the eating disorders. In particular, studies and reviews investigating the relationship between reported sexual abuse and the eating disorders have concluded that the prevalence rate of abuse among eating-disordered women is similar to the rates found in other psychiatric groups and in the general population. However, it is argued in this review that such a conclusion is based on an inappropriate level of analysis of the phenomena of sexual abuse and diagnosable eating disorders. When these two relatively blunt constructs are considered in finer detail, there appears to be a complex link between the nature of sexual abuse and specific bulimic symptomatology. This relationship is discussed with particular reference to important mediating factors (including dissociation, self-denigration, borderline personality disorder, and disclosure experiences), the functions of the bulimic behaviors, and the particular cognitive schemata that the victims of abuse may develop. The clinical implications of this relationship are considered, and suggestions are made for further research.

Dimensions of Perfectionism, Life Stress, and Depressed and Anxious Symptoms: Prospective Support for Diathesis-Stress but not Specific Vulnerability among Male Undergraduates

We investigated important issues relevant to a specific vulnerability, diathesis-stress approach to the relations between perfectionism, life stress, and depressed and anxious symptoms. To address limitations of past work, we used a prospective methodology, and addressed the moderating role of gender and symptom specificity. One hundred seventy-four undergraduates completed questionnaires on self-oriented and socially prescribed perfectionism, achievement-related and interpersonal life stress, and depressed and anxious symptoms, at two points in time separated by three weeks. Among males but not females, a diathesis-stress, but not specific vulnerability perspective was supported. Specifically, males high in socially prescribed perfectionism experienced increases in depressed symptoms under high but not low life stress, whether the stress was interpersonal or achievement-related in nature. Males high in self-oriented perfectionism were prone to depression increases under high but not low levels of interpersonal, but not achievement-related stress. A general negative events composite interacted with both socially prescribed and self-oriented perfectionism to predict depression increases. There was modest support for our hypothesis that interactions involving socially prescribed perfectionism would predict increases in both depressed and anxious symptoms, whereas those involving self-oriented perfectionism would predict increases in depressed symptoms only.

Personality and physical correlates of bulimic symptomatology among Mexican American female college students.

Although eating disorders have been the focus of much research, the inclusion of minority populations in such investigations has been minimal. Thus, the purpose of this study was to examine personality and physical correlates of bulimic symptomatology in a sample of Mexican American female college students. Hierarchical regression analysis revealed that body mass and endorsement of U.S. societal values concerning attractiveness were related positively to bulimic symptomatology, accounting for a combined 38% of the variance. Age, body satisfaction, and acculturation level, however, were unrelated to bulimic symptoms. Implications for counseling interventions as well as directions for future research are discussed

Personality and physical correlates of bulimic symptomatology among Mexican American female college students.

Personality and physical correlates of bulimic symptomatology among Mexican American female college students.

Bulimic symptoms and body-image characteristics among university women.

A nonclinical sample of 102 women students were given the BULIT-R to measure bulimic symptomatology and the Multidimensional Body-Self Relations Questionnaire, a multidimensional measure of body-image parameters. Statistically significant relationships between Appearance Evaluation, Appearance Orientation, and Illness Orientation subscales of the two inventories were identified. These findings indicate that women university students reporting higher scores on bulimic symptoms are more likely to report a general unhappiness with their physical appearance.