Bulimia and borderline personality disorder

Abstract

Female patients with bulimia or atypical eating disorder (n = 31) were compared on dimensions of psychiatric symptomatology (SCL‐90) and measures of eating problems (Eating Disorder inventory, Diagnostic Survey for Eating Disorders) with 10 similar patients who were also diagnosed as having borderline personality disorder. In addition to greater symptom severity and higher levels of distress (p < .05), the borderline subgroup scored higher on SCL‐90 scales for interpersonal sensitivity, phobic anxiety, paranoid ideation, and depression (p < .05), with no differences on the scales for bulimia and body‐related concerns. The borderline subgroup of eating disorder patients did not differ on any SCL‐90 scales from another comparison group of borderline patients without eating disorder (n = 32). The differential self‐perceptions of the borderline subgroup may have implications for the formation of a therapeutic relationship.

Personality and family disturbances in eating-disorder patients: Comparison of “restricters” and “bingers” to normal controls

“…Otherwise, patients with more severe eating symptoms should have displayed greater personality disturbances. Our findings here resemble those of other studies that fail to link severities of personality disturbances to severities of eating symptoms (e.g., Cooper et al, 1988).…”

Construct validity of the three-factor eating questionnaire: Flexible and rigid control subscales

“…Our use of an almost exclusively borderline sample raises the question of the generalizability of these results to other samples. Although borderline patients are likely to be more disturbed than eating disorder subjects without a BPD diagnosis on a number of dimensions including general psychiatric symptoms, they have been shown to be similar in weight distribution, dieting patterns, binge eating, and a variety of scales from eating disorder instruments (Cooper et al, 1988;Johnson, Tobin, & Enright, 1989;Steiger, Liquornik, Chapman, & Hussain, 1991). Thus, the conclusions based on the associations with body weight and measures of history of anorexia or bulimia can probably be extended to eating disorder patients as a whole.…”

Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa

“…The majority of studies, however, suggest a high prevalence of BPD among bulimia nervosa patients and even in the Pope et al (1987) study there was a 25% prevalence of BPD if the usual DIB criteria were used. In addition, the prevalence rates of any Axis I1 diagnosis range from 46-66% of bulimia nervosa patients (Cooper et al, 1988;Gartner et al, 1989;Gwirtsman et al, 1983;Johnson et al, 1989;Levin & Hyler, 1986;Sansone et al, 1989;Schmidt & Telch, 1989;Wonderlich et al, 1990;Yager et al, 1989;Yates, Sieleni, & Bowers, 1989;Zanarini et al, 1990). Table 1 shows the prevalence rates of BPD and other Axis I1 diagnoses in the published studies to date.…”

“…The two latter studies reflect clinical observations suggesting that among patients with bulimia nervosa, those with concomitant personality disorder diagnoses are the most challenging cases with the least favorable outcomes (Johnson, Tobin, & Enright, 1989). BPD appears to coexist in a large number of bulimic patients with prevalence rates ranging from 25% to 48% across the majority of studies (Cooper et al, 1988;Gartner, Marcus, Halmi, & Loranger, 1989;Gwirtsman, Roy-Byrne, Yager, & Gerner, 1983;Johnson et al, 1989;Levin & Hyler, 1986;Sansone, Seuferer, Fine, & Bovenzi, 1989;Schmidt & Telch, 1989;Wonderlich, Swift, Slotnick, & Goodman, 1990;Yager, Landsverk, Edetstein, & Hyler, 1989;Zanarini et al, 1990). The only dissenting study was by Pope, Frankenburg, Hudson, Jonas, & Yergelun-Todd (1987) in which only 1.9% of bulimia nervosa patients met criteria for BPD according to modified strict criteria on the Diagnostic Interview for Borderlines (DIB).…”