Ego functioning in eating disorders: Description and relation to diagnostic classification

Norring, Claes; Sohlberg, Staffan; Rosmark, Börje; Humble, Kristina; Holmgren, Sven; Nordqvist, Christina

doi:10.1002/1098-108x(198911)8:6<607::aid-eat2260080602>3.0.co;2-1

Cited by 27 publications

(23 citation statements)

References 28 publications

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“…There is evidence that these disorders can also occur in a relatively structured psyche then re ecting a neurotic internal con ict (Thiel & Schüßler, 1995). An investigation of the level of personality organization in eating disordered subjects according to Kernberg revealed that about 30% have a high (neurotic) level of structure, which is in concordance with the above cited studies (Norring, Sohlberg, Rosmark, Humble, Holmgren & Nordquist, 1989;Thiel & Schü ßler 1995). As each aetiological model of eating disorders developed so far, the self-psychological approach helps us to understand (only) a part of the aetiology and a number of patients, in particular those with high levels of self-regulatory disturbance (Goodsitt, 1997;Treasure, 1998).…”

supporting

confidence: 85%

Characteristics of self‐regulation in adolescent patients with anorexia nervosa

Karwautz

Völkl-Kernstock

Nobis

et al. 2001

British Journal of Medical Psychology

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The purpose of the study was to investigate the different modes of self-regulation in adolescent anorexia nervosa (AN). A self-system questionnaire, the Narcissism Inventory, was given to 61 adolescent females with AN and 61 controls. Patients with AN reported higher overall disturbances in self-regulation than controls. In particular, a highly unstable self-system, a tendency to use idealization as modus of regulation, and high narcissistic gain from their illness was found in the patient group; however, the patients did not report a 'classic narcissistic self'. Furthermore, we were able to differentiate between two clusters of patients, one with high (n = 34) and one with low (n = 27) disturbance in self-regulation; the latter reported a shorter duration of illness and lower oral control but did not differ on any other clinical variables. Stronger relationships were found between the dimension 'endangered self' and the overall scores of the Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI) as well as two subscales of the EAT and five of the EDI. Our study in anorexic adolescents demonstrated that the self-system is experienced as highly unstable, that idealization is used as mode of regulation, and that the dimension of the 'classic narcissistic self' is less important in this patient group. It is important to evaluate the system of self-regulation for planning treatment in the individual patient according to their needs.

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supporting

confidence: 85%

Characteristics of self‐regulation in adolescent patients with anorexia nervosa

Karwautz

Völkl-Kernstock

Nobis

et al. 2001

British Journal of Medical Psychology

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“…It suggests some restricteribinger differences (e.g., restricters being more obsessional), but not a dichotomy. Given such conflicting findings, and reports that fail to support the "dichotomy" concept altogether (Norring et al, 1989), factors that might make the "restricted binger dichotomy" an "elusive" phenomenon must be considered.…”

Section: Scu Ss Ionmentioning

confidence: 99%

“…For example, a second study based on DSM-III-R criteria reports comparable distributions of diagnoses from "dramatic-erratic" and "anxious-fearful" PD clusters, among patients divided into restricter and binger groups (Gartner et al, 1989). Another, using cluster analysis techniques on multiple measures of ego functioning, identifies "higher neurotic," "lower neurotic," "borderline," and "borderline-psychotic" organizations in restricters and bingers alike (Norring et al, 1989). Our own studies on personality and defensive organization also fail to reveal clear-cut restricteribinger differences (Steiger, Van der Feen, Goldstein, & Leichner, 1989;Steiger, Goldstein, Mongrain, & Van der Feen, 1990).…”

Section: Introductionmentioning

confidence: 99%

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

Steiger

Liquornik

Chapman

et al. 1991

Int. J. Eat. Disord.

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Presence of DSM‐III‐R personality disorders was examined in 67 women with eating disorders (anorexic restricters, anorexic bingers, and bulimics with or without a prior history of anorexia nervosa) and in 25 noneating—disordered women. Additional measures of family functioning were available in 55 of the eating disorders (EDs) and 24 controls. Personality and family disturbances (as measured by the Personality Diagnostic Questionnaire‐Revised and the Family Assessment Device) were prevalent among the EDs, but “restricter/binger” differences were not indicated on either measure. Hence results did not support a “restricter/binger dichotomy” concept. They also questioned the degree to which personality problems in ED patients may be consequences of eating disturbances, since severity of personality disorder, while related to reported family dysfunction, was unrelated to severity of eating symptoms.

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“…Interrater reliability as judged from the audiotaped interviews was highly satisfactory (average r = .77; cf. Norring et al, 1989). Overall mental health, using the Global Assessment Scale (GAS) (Endicott, Spitzer, Fleiss, & Cohen, 1976), was rated from this interview also.…”

Section: Procedures and Evaluation At Presentationmentioning

confidence: 99%

“…All patients had a clinically significant preoccupation with weightbody shape (cf. Norring et al, 1989). Insistence on the presence of this preoccupation ensures that the ED NOS diagnosis is given only to patients whose disturbance is of obvious clinical proportions.…”

Section: Patientsmentioning

confidence: 99%

Ego functioning in eating disorders: Prediction of outcome after one and two years

Norring

Sohlberg

1991

Int. J. Eat. Disord.

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This study prospectively investigated the prognostic significance over 1 and 2 years of objectively assessed ego functioning in a group of 37 eating disordered patients. Previously, ego functioning was found to vary substantially within the group, and to be unrelated to symptomatic aspects (Norring et al., 1989). Differences in ego pathology proved to be a strong predictor of status in terms of overall mental health, work adjustment, and self‐rated emotional problems, and was superior to other variables (e.g., binge eating, duration) in this respect. More specifically, deficits in the regulation of self‐esteem were suggested to be particularly important for prognosis. Status in terms of eating disorder symptomatology was predicted strongly the first year, but not the second. Post hoc analyses suggested that during the second year those with more severe ego disturbances caught up on the advantage held by the others. It is concluded that differences in ego pathology are of importance for prognosis with respect to overall psychological and social functioning in eating disorders, and may be so for the eating disturbance itself.

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Ego functioning in eating disorders: Description and relation to diagnostic classification

Cited by 27 publications

References 28 publications

Characteristics of self‐regulation in adolescent patients with anorexia nervosa

Characteristics of self‐regulation in adolescent patients with anorexia nervosa

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

Ego functioning in eating disorders: Prediction of outcome after one and two years

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