Patients with Binge Eating Disorder and Obesity have qualitatively different interpersonal characteristics: Results from an Interpersonal Circumplex study

Abstract

Background: Patients with Binge Eating Disorder (BED) and obesity experience distressing relationships, which could trigger negative affect and over-eating. To date no studies compared the interpersonal profiles and prototypicality of both groups using the interpersonal circumplex. Method: A sample of 177 patients with BED (mean age: 41.0 ± 12.5 years; 11.3% males), 321 obese non-BED adults (mean age: 44.5 ± 13.4 years; 28% males), and 108 normal weight adults (mean age: 37.3 ± 9.6 years; 52.77% males) completed the Inventory of Interpersonal Problems (IIP-32), and scales of binge eating and psychological distress at one time-point. Results: Compared to normal weight and obese participants, those with BED reported higher levels of interpersonal problems on all circumplex dimensions, except for Vindictive, with small to medium effects. All groups had highly prototypical profiles. Both obese and normal weight adults had very similar interpersonal profiles characterized by predominant friendly-dominant themes. On the contrary, those with BED had predominant friendlysubmissive themes. Patients with BED reported significantly higher levels of psychological distress and binge eating severity, compared to the other two groups. Greater Domineering, Cold, Socially Inhibited and Non-Assertive scale scores, and lower Vindictive scale scores significantly predicted higher binge eating and psychological distress, regardless of group membership. Discussion: Findings lend support to an interpersonal model of binge eating and to the presence of qualitative differences between patients with obesity and BED. Finally, results suggest some strategies for the clinical management of BED focused on non-assertion and problems with experiences and expression of anger.

Persistence of friendly and submissive interpersonal styles among those with binge‐eating disorder: Comparisons with matched controls and outcomes after group therapy

“…Those with BED had prototypical profiles of submissiveness and exploitability, but the severity of these profiles was much higher than the matched control groups. In accordance with previous findings (Brugnera et al, ), these specific interpersonal problems clearly differentiated BED from obesity. However, no differences were observed between patients with BED and NW women, suggesting that the friendly–submissive interpersonal style by itself may not explain the core symptoms of BED.…”

“…These findings go beyond simply comparing overall interpersonal problems between these groups, as was done in previous research (Maxwell et al, ), and provide a more detailed and nuanced understanding of this difference. In addition, our results are partly consistent with past research, which demonstrated that women with BED were less assertive than women who were obese without a diagnosis of BED (Brugnera et al, ; Duchesne et al, ). Nonassertive individuals fear rejection and conflict (Duchesne et al, ), which may discourage them from social interaction.…”

“…Few studies have assessed the prototypical IPC profile of individuals with BED (Blomquist et al, ; Brugnera et al, ; Ung et al, ) or compared IPC profiles of those with BED with comparison groups (Brugnera et al, ; Eldredge, Locke, & Horowitz, ; Ung et al, ). If interpersonal problems are specific to the psychopathology that underlies BED, then those with BED should have interpersonal problem profiles that differentiate them from overweight (OW) and normal weight (NW) women without BED.…”

“…For this part of the study, we used an SSM‐based analysis of circumplex profiles from the IIP‐64. We hypothesized that participants with BED will have a highly prototypical profile of friendly–submissive relational problems (as suggested by Brugnera et al, ; Ung et al, ), which will be significantly different than the interpersonal profile of OW and NW controls (Brugnera et al, ). The SSM‐based analyses allowed us to statistically compare circumplex profiles relying on bootstrapped 95% confidence intervals (CIs), thus (a) providing greater power and more reliable findings in comparison with other linear statistical approaches and (b) allowing us to examine the presence of specific clusters of interpersonal problems in the three samples.…”

“…The hypothesis was that GPIP will significantly reduce the level or severity of interpersonal problems and of dominance and affiliation second‐order factors (i.e., IIP axes) among patients with BED up to 1 year posttreatment, in accordance with previous findings (Tasca, Balfour, Presniak, & Bissada, ). Individuals who binge eat tend to have highly prototypical interpersonal profiles (Brugnera et al, ; Ung et al, ), and the interpersonal theory of personality considers interpersonal patterns relatively stable traits (Sullivan, ). Hence, we also hypothesized that although the severity of prototypical interpersonal problems will decline, the profile prototypicality of participants with BED will remain consistent during and up to 1 year following a short‐term interpersonally based group treatment.…”