Article

Impulse control disorders in women with eating disorders

Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
Psychiatry Research (Impact Factor: 2.68). 02/2008; 157(1-3):147-57. DOI: 10.1016/j.psychres.2007.02.011
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ABSTRACT We compared symptom patterns, severity of illness, and comorbidity in individuals with eating disorders with and without impulse control disorders (ICD), and documented the temporal pattern of illness onset. Lifetime ICD were present in 16.6% of 709 women with a history of eating disorders. The most common syndromes were compulsive buying disorder and kleptomania. ICD occurred more in individuals with binge eating subtypes, and were associated with significantly greater use of laxatives, diuretics, appetite suppressants and fasting, and with greater body image disturbance, higher harm avoidance, neuroticism, cognitive impulsivity, and lower self-directedness. In addition, individuals with ICD were more likely to have obsessive-compulsive disorder, any anxiety disorder, specific phobia, depression, cluster B personality disorder, avoidant personality disorder, and to use psychoactive substances. Among those with ICD, 62% reported the ICD predated the eating disorder and 45% reported the onset of both disorders within the same 3-year window. The presence of a lifetime ICD appears to be limited to eating disorders marked by binge eating and to be associated with worse eating-related psychopathology, more pathological personality traits, and more frequent comorbid Axis I and II conditions. Untreated ICD may complicate recovery from eating disorders.

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    • "In the present study, we also found purging, but not binge eating behavior, to be significantly associated with novelty seeking, a personality trait that has been associated previously with impulsive behavior in individuals with AN and BN (Favaro, et al., 2005). Several past studies reporting an association of binge eating with measures of impulsivity in AN did not explore the independent effects of purging in their analyses, although many individuals reporting binge eating in their samples also engaged in purging (Casper, et al., 1980; Fernandez-Aranda, et al., 2008; Garfinkel, et al., 1980). Thus, given our findings, purging may be the stronger predictor of impulsivity in AN. "
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    ABSTRACT: To further refine our understanding of impulsivity, obsessions, and compulsions in anorexia nervosa (AN) by isolating which behaviours--binge eating, purging, or both--are associated with these features. We conducted regression analyses with binge eating, purging, and the interaction of binge eating with purging as individual predictors of scores for impulsivity, obsessions, and compulsions in two samples of women with AN (n = 1373). Purging, but not binge eating, was associated with higher scores on impulsivity, obsessions, and compulsions. Purging was also associated with worst eating rituals and with worst eating preoccupations. Our results suggest that purging, compared with binge eating, may be a stronger correlate of impulsivity, obsessions, and compulsions in AN.
    European Eating Disorders Review 05/2012; 20(3):e129-36. DOI:10.1002/erv.2161 · 1.38 Impact Factor
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    • "In the present study, we investigated the relationship between CB and CIU, both considered as ICD not otherwise specified, in a sample of 60 patients with ED. The prevalence of both CB and CIU was about 10%, which is similar to the findings of previous studies that reported prevalence rates of 12% to 18% of CB in patients with ED (Fernandez‐Aranda et al., 2008) and between 0% to 20% of problematic internet use in samples of ED (Shapira et al., 2003). Both CB and CIU were significantly related to restrictive eating behaviours, as previously found by Claes et al. (2011) and Tao and Liu (2009). "
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    ABSTRACT: The aim of the present study was to investigate the association among compulsive buying (CB), compulsive internet use (CIU) and reactive/regulative temperament in a sample of 60 female patients with eating disorders. All patients were assessed by means of the Compulsive Buying Scale, the CIU scale, the Eating Disorder Inventory-2, the Behavioral Inhibition System/Behavioral Activation System scales, the Dimensional Assessment of Personality Pathology and the effortful control scale of the Adult Temperament Questionnaire. The results showed a positive association between CB and CIU, both categorized as impulse control disorders, not otherwise specified. Both CB and CIU showed significantly positive correlations with emotional lability, excitement seeking and lack of effortful control (more specifically lack of inhibitory and lack of activation control). The implication of these findings for the treatment of both disorders will be discussed.
    European Eating Disorders Review 03/2012; 20(2):126-31. DOI:10.1002/erv.1136 · 1.38 Impact Factor
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    • "Some dimension of impulsivity is involved in obesity development (Goudie et al., 2008; Nederkoorn et al., 2006); for example disinhibited eating as measured by the Three factor eating questionnaire is associated with obesity (Yeomans et al., 2008). Impulsivity is considered a common trait in those with eating disorders and even considered a risk factor for the development of BN (Wonderlich et al., 2004; Fernandez-Aranda et al., 2008). "
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    ABSTRACT: The eating disorders anorexia and bulimia nervosa have traditionally been regarded as entirely separate from obesity. Eating disorders have been regarded as Western culture-bound syndromes, arising in societies with excessive emphasis on weight, shape and appearance, and best treated by psychological therapies, in particular cognitive behavioural therapy or family-based interventions. In contrast, obesity has been considered a medical illness with metabolic and genetic origins, and thought to be best treated by mainstream medicine, involving dietary, drug or surgical treatment. We believe that this polarisation is fundamentally flawed, and research and treatment of both types of disorder would be better served by greater appreciation of the psychosocial components of obesity and the biological and genetic components of eating disorders. There are similarities in phenotype (such as excessive attempts at weight control, binge eating behaviours) and in risk factors (such as low self-esteem, external locus of control, childhood abuse and neglect, dieting, media exposure, body image dissatisfaction, weight-related teasing and shared susceptibility genes). One example of shared genetic risk is the brain-derived neurotrophic factor (BNDF) gene, in which the valine allele of the Val66Met amino acid polymorphism predisposes to obesity, whereas the methionine allele predisposes to eating disorders. Thus the evidence suggests that these disorders will have both shared and distinct susceptibility factors; some will predispose to both types of disorder, some will push in opposite directions, and some will separate them.
    Epidemiologia e psichiatria sociale 06/2009; 18(2):96-100. DOI:10.1017/S1121189X00000956 · 3.16 Impact Factor
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