Impulse control disorders in women with eating disorders

Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
Psychiatry Research (Impact Factor: 2.47). 02/2008; 157(1-3):147-57. DOI: 10.1016/j.psychres.2007.02.011
Source: PubMed


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.

Download full-text


Available from: Walter H Kaye
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · May 2012 · European Eating Disorders Review
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Mar 2012 · European Eating Disorders Review
  • Source
    • "This is consistent with the previous study showing that anxiety was positively correlated with risk-avoidant decision-making [34]. However, anxiety and impulsivity are co-morbid of such mental diseases as bipolar disorder [35], eating disorder [36], and alcoholism [37]. There might be differences between clinical and non-clinical samples. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In gambling situations, we found a paradoxical reinforcing effect of high-risk decision-making after repeated big monetary losses. The computerized version of the Iowa Gambling Task (Bechara et al., 2000), which contained six big loss cards in deck B', was conducted on normal healthy college students. The results indicated that the total number of selections from deck A' and deck B' decreased across trials. However, there was no decrease in selections from deck B'. Detailed analysis of the card selections revealed that some people persisted in selecting from the "risky" deck B' as the number of big losses increased. This tendency was prominent in self-rated deliberative people. However, they were implicitly impulsive, as revealed by the matching familiar figure test. These results suggest that the gap between explicit deliberation and implicit impulsivity drew them into pathological gambling.
    Full-text · Article · Feb 2010 · PLoS ONE
Show more