To date, few studies have examined the personality characteristics and clinical predictors of impulsive behaviors in eating disorders (ED). The aim of this work was to study the prevalence of a wide range of impulsive behaviors in a sample of 554 ED subjects and to examine the predictors of these behaviors. Subjects were diagnosed according to DSM-IV criteria as having anorexia nervosa restricting type (ANR; n = 183), anorexia nervosa binge eating/purging type (ANBP; n = 65), bulimia nervosa purging type (BNP; n = 244), and bulimia nervosa nonpurging type (BNNP; n = 62). Nine different types of impulsive behaviors were assessed in these groups. About 55% of the whole sample reported at least one type of impulsive behavior, 35% more than one, and about 13% more than three. According to findings, impulsive and multi-impulsive subjects are characterized by the presence of purging behavior and by specific temperamental features such as high levels of novelty seeking and low persistence. The prediction of impulsive behavior is further improved by considering the presence of a history of childhood abuse, maternal psychiatric morbidity, and some specific psychological symptoms such as maturity fears, perfectionism, depression, and obsessive-compulsive symptoms. The presence of impulsive behavior appears to be associated with overall higher levels of psychiatric symptomatology and eating psychopathology, thus indicating that they are an important feature to be considered in the assessment and treatment of ED.

Background: To date, the number of epidemiological studies on eating disorders (ED) in Italy and in other Mediterranean countries is still limited. This study evaluated the eating attitudes and the prevalence of eating disorders in a sample of 359 16-year-old Italian schoolgirls. Methods: The study followed a two-stage procedure consisting in a first screening stage followed by clinical interviews. A third stage consisting in a case register study and a 1-year follow-up confirmed the importance of evaluating subjects who chose not to participate in the survey. Results: Prevalence rates found in our sample are consistent with those of other prevalence studies conducted on adolescent girls: 0% for anorexia nervosa, 0.5% for bulimia nervosa and 3.7% for ED not otherwise specified. Also some important features associated with the presence of an ED appeared to be present in Italian female students, as in Anglo-Saxon populations: the tendency towards denial that led to an overrepresentation of ED among nonrespondents, and the ascertainment that just a small proportion of people seeks help for ED. The Italian sample reported higher scores on eating attitudes test compared to Anglo-Saxon samples. Conclusions: No evidence of different rates of ED was found in our Italian sample in comparison with non-Mediterranean samples. The importance of using a two-stage design and a third control stage in prevalence studies is emphasized by our findings.

Background: To explore the impact of a prevention program on the eating and body attitudes of a sample of adolescent schoolgirls. Methods: The program involved lessons and group discussions of general adolescent problems and eating disorders. A total of 254 16-year-old schoolgirls were evaluated, of whom 154 participated in the program and a further 154 subjects formed the control group. Variations in weight, Eating Attitudes Test and Eating Disorders Inventory at a 1-year follow-up were compared for the two groups. Results: Among high-risk subjects, no significant differences were found between the prevention and the control group. The preventive program appeared to reduce significantly body dissatisfaction and to decrease the risk of bulimic attitudes in low-risk subjects. Conclusions: Providing schoolgirls with the correct information about eating disorders did not encourage unhealthy attitudes to eating and weight regulation practices. However, for high-risk subjects more intensive and specific intervention may be required, for which further research is needed.

Body image disturbance is a multidimensional characteristic linked to psychological features, such as anticipatory anxiety, ineffectiveness and interoceptive awareness. These findings have scientific and treatment implications, and should be considered by clinicians in adopting successful treatment strategies.

In utero exposure to viral infection could be a risk factor for developing AN. We need further epidemiological and serological studies to confirm this hypothesis.