Psychological Medicine



Personality traits among currently eating disordered, recovered and never ill first-degree female relatives of bulimic and control women


L. R. R. LILENFELD a1, D. STEIN a1, C. M. BULIK a1, M. STROBER a1, K. PLOTNICOV a1, C. POLLICE a1, R. RAO a1, K. R. MERIKANGAS a1, L. NAGY a1 and W. H. KAYE a1c1
a1 Department of Psychology, Georgia State University, Atlanta, GA, Virginia Institute for Psychiatric and Behavioral Sciences, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, Neuropsychiatric Institute and Hospital, School of Medicine, University of California at Los Angeles, CA, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA, Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA; and Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Israel

Abstract

Background. A combined family study and recovered study design was utilized to examine several hypothesized relationships between personality and bulimia nervosa (BN).

Methods. We studied 47 women with a lifetime history of DSM-III-R BN (31 currently ill and 16 recovered), 44 matched control women (CW) with no history of an eating disorder (ED), and their first-degree female relatives (N = 89 and N = 100, respectively), some of whom had current or previous EDs.

Results. BN probands' relatives with no ED history had significantly elevated levels of perfectionism, ineffectiveness, and interpersonal distrust compared to CW probands' relatives with no ED history. In contrast, diminished interoceptive awareness, heightened stress reactivity and perfectionistic doubting of actions were found among the previously eating disordered relatives of bulimic probands compared to their never ill relatives. Finally, a sense of alienation and emotional responsivity to the environment were elevated among currently ill compared to recovered bulimic probands.

Conclusions. The fact that perfectionism, ineffectiveness and interpersonal distrust are transmitted independently of an ED in relatives suggests that they may be of potential aetiological relevance for BN. In contrast, diminished interoceptive awareness, heightened stress reactivity and perfectionistic doubting of actions are more likely consequent to, or exacerbated by, previously having experienced the illness. Finally, a sense of alienation and emotional responsivity to the environment are more likely to be associated with currently having BN.


Correspondence:
c1 Address for correspondence: Dr Walter H. Kaye, Western Psychiatric Institute and Clinic, 3811 O'Hara Street E-724, Pittsburgh, PA 15213, USA.


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