Seasonal mood patterns in eating disorders.

There has been an increasing body of research literature suggesting a seasonal pattern of mood fluctuations and eating behavior in bulimic patients. Fornari et al. [5] reported worsening of bulimic symptoms during winter. There is a logical connection between Seasonal Affective Disorder (SAD) and bulimia nervosa as both show increased appetite and carbohydrate craving and probably share a common neurobiologic abnormality such as serotonergic dysfunction. The aim of this study was to determine the prevalence of SAD in a sample of 259 consecutively evaluated outpatients admitted to an eating disorders clinic (254 women and 5 men). Eating disorder diagnosis was established on the basis of DSM-III-R criteria, and a modified version of the Seasonal Pattern Assessment Questionnaire was used to determine seasonality among patients. The sample was comprised of the following: 53.7% bulimics, 27.4% anorexics, 15.1% were classified as having an eating disorder not otherwise specified, and 3.9% had a diagnosis other than an eating disorder. The results indicated that 27.0% of the eating disorder patients met criteria for SAD. Of this group, 86 (71.4%) were bulimic, 35 (18.6%) were anorexic, and 20 (10.0%) were nonspecified. Details and additional findings are discussed.

Hypersensitivity to social interactions in bulimic syndromes: relationship to binge eating.

This study used a 6- to 22-day experience-sampling procedure to test for hypersensitivity to social interactions in bulimic individuals. Ratings on daily social interactions, self-concepts, moods, and eating behaviors from 55 actively bulimic, 18 formerly bulimic, and 31 noneating-disordered women were obtained. Hierarchical linear modeling analyses showed negative social interactions to be associated with significant increases in self-criticism (SC) and deteriorations in mood in all participants. However, bulimic participants (active or in remission) showed larger increases in SC following negative social interactions than did normal eaters (and thus seemed to be hypersensitive to interpersonal experiences). Additional analyses indicated that binge episodes tended to be preceded by poorer than average social experiences, self-concepts, and moods and followed by deteriorations in self-concept, mood, and social perception. The authors discuss possible perpetuating influences of interpersonal sensitivity in bulimic syndromes.

A controlled study of trait narcissism in anorexia and bulimia nervosa.

INTRODUCTION: Many theories attribute anorexia and bulimia nervosa to "pathological narcissism," but this conception has not been adequately evaluated. METHOD: We compared the scores of 90 eating disorder (ED) sufferers (23 anorexic restricters, 14 anorexic bingers, and 53 bulimics) with those of 36 psychiatric-control (PC) and 54 normal-control (NC) females on validated self-report scales measuring Narcissism, Affective Instability, Stimulus Seeking, Compulsivity, and Restricted Expression. RESULTS: Narcissism scores of ED patients (whether restricters or bingers/purgers) consistently exceeded those of the PC and NC cases, suggesting that Narcissism does indeed load more heavily in the EDs than in other psychiatric disturbances. Conversely, Affective Instability was characteristic of all clinical cases (i.e., of EDs and PCs), Restricted Expression and Compulsivity were characteristic of restricters, and Stimulus Seeking was characteristic of bingers/purgers. DISCUSSION: Results are consistent with the notion that different ED variants may reflect subtype-specific temperaments and/or adaptive styles acting-upon shared underlying narcissistic disturbances.

Axis II comorbidity and developmental adversity in bulimia nervosa.

Using data from 61 bulimic patients, we evaluated associations among axis II disturbances, psychopathological traits, eating symptoms, and adverse developmental experiences (e.g., childhood sexual and physical abuse). Findings showed likelihood of childhood abuse to increase markedly in function of comorbid personality pathology. In addition, comorbid borderline personality disorder was found to be a better predictor of object-relations disturbances, primitive defenses, and hostility than developmental adversity was. Although marked trait disturbances were strongly associated with borderline personality disorder (more than with severity of childhood adversity), the converse seemed true of severity of bulimic symptoms (i.e., comorbid personality disorder had no predictive effects, whereas developmental variables had inconsistent effects). Bulimic and general psychopathological symptoms, thus, seemed to have intriguingly independent determinants. We interpret these findings as showing that the observed association between developmental adversity and bulimic syndromes may, in large part, be attributable to comorbid personality pathology.