This thesis explored possible underlying processes of bulimic behaviours by conducting a naturalistic examination into binge antecedents and consequences. Main hypotheses were derived from contemporary theories of binge-eating behaviour, which postulate that dietary restraint, negative affect, and dissociative phenomena (i.e., lapses in self-awareness) may precipitate and maintain bulimic symptoms. A secondary aspect of this study was to determine whether or not personality variations influence individuals' sensitivity to processes that may precipitate binge eating or that may shape binge consequences. A sample of 39 women with bulimia-spectrum eating disorders provided "on line" self-reports on eating episodes, urge to binge, behavioural and cognitive dietary restraint, negative and positive affect, and dissociation, with samplings obtained in response to random prompts, and before and after every eating episode. Across participants, recording with the daily diaries spanned 7- to 29-day intervals and resulted in a total of 3,204 recordings. Multilevel modelling analyses indicated that increases in behavioural dietary restraint preceded stronger urges to binge. Affect was also poor prior to actual binge episodes and seemed to worsen after bingeing. In addition, dissociation was likely to be present prior to and after bingeing. These results suggest that processes linked to dietary restraint, affect, and dissociation potentiate, trigger, and/or maintain bulimic behaviours. In contrast, the results did not consistently support the role of personality traits as moderators of binge antecedents or consequences. The present findings suggest that binge eating is a multiply determined behaviour that is linked to diverse cognitive, behavioural, and affective processes. Recommendations for future research and clinical implications are discussed.

No description available.

The present study was designed in an effort to address two general questions: (1) the primacy of social dysfunction in bulimia nervosa, and its potential as a risk factor in disease onset; and (2) the proximal antecedents of the binge eating episode in bulimic patients. Given the substantial clinical and empirical evidence of social impairment in this psychiatric group, as well as findings documenting the treatment effectiveness of Interpersonal Psychotherapy (a therapeutic program designed to exclusively address social disturbances) with bulimic patients, it has been speculated that difficulty with interpersonal relationships may be a predisposing factor in the development of bulimia. The present study sought to determine whether social problems could present as potential markers for later disturbances of eating in weight-preoccupied women. A comparison of bulimic patients with a group of restrained eaters and a group of unrestrained eaters on such features as social adjustment across domains of functioning, specific deficits in interpersonal transactions, and qualitative aspects of everyday social experiences was undertaken to determine whether deficits in the social sphere parallel the continuum of eating pathology. In support of previous research and consistent with predictions, bulimic subjects were found to display greater social maladjustment and interpersonal deficits, and to report more negative social interaction experiences than control subjects. Few dimensions of social dysfunction were found to differentiate restrained eaters from unrestrained eaters, thereby suggesting that bulimia nervosa and restrained eating are not continuous with regard to social problems. / Studies examining the proximal antecedents of binge eating episodes have suggested that negative affect reliably precedes binge eating, and as such, has been considered a precipitant to bulimic episodes. However, no previous empirical work has addressed the precursors of this negative mood state. The present study postulated an "interpersonal stress" model of the binge/purge episode which incorporates disturbances in social relatedness and negative interpersonal interaction as precipitants of the negative affect that characterizes the pre-binge state. The model was evaluated in a naturalistic investigation of social interaction experiences and eating behavior in a sample of clinical eating disorder patients. The interpersonal distress/negative affect/binging linkages postulated in the present study were supported, thus highlighting the significance of negative social interaction experiences in the elicitation of binge eating. The clinical implications of the present findings are substantial as they underscore the effectiveness of eating disorder treatment programs which consider interpersonal disturbances in their therapeutic interventions.

No description available.

This study used a qualitative/phenomenological research methodology to examine the perspective of five bulimic subjects about their lives in order to understand the bulimic individual's point of view and develop a clearer picture of the world of the bulimic. This approach involved three interviews for each of the five subjects totalling 22 1/2 hours. The three interviews dealt with the subjects' past and present experiences and their ideas about the future. The qualitative/phenomenological methodology created an in-depth view of each subject's relationship to the beginning of her bulimia and its subsequent development. During the period when the interviews were being transcribed, patterns and concepts emerged and were examined. Nine categories were developed from this data reflecting some of the characteristics of a bulimic's personality. Six research questions were formulated and then answered by evaluating them in the light of the nine categories as well as data and descriptions from the interviews. No one single category was found to be uniquely dominant, but rather the categories tended to appear in a cluster-like fashion depending on the individual personality of the bulimic. The data of this study revealed a distinction between the personality and the behavior of the bulimic. A form with a Likert-like response was developed by the researcher and given out to 11 raters in order to evaluate the presence or non-presence of the categories in selected passages. On the basis of the findings of this study, with its limited subject pool, certain recommendations are presented for the reader that might perhaps be of some use in understanding bulimia.

This study hypothesized body weight and eating patterns to be important discriminators of psychological characteristics among eating disordered groups. A total of 146 bulimic and non-bulimic women from underweight (anorexic), normal weight, and overweight (obese) categories were examined. Based upon the theoretical and research literature reviewed, this study hypothesized locus of control, personal potency, self-esteem, and psychopathology to be central psychological characteristics in anorexia nervosa, bulimia, and obesity. These variables were measured by Rotter's Internal-External Locus of Control Scale, the Semantic Differential Potency Scale, Rosenberg's Self-Esteem Scale, and the Minnesota Multiphasic Personality Inventory, respectively. The relative importance of these variables in the disorders was also addressed. Results showed women in the eating disordered groups examined to demonstrate the following psychological characteristics: (1) Non-bulimic anorexics--an external locus of control, low self-esteem, and hysteria; (2) Bulimic anorexics--the greatest external locus of control, the lowest self-esteem, psychopathic deviance, hysteria, thought disorder, depression, a preoccupation with somatic concerns, and hypofemininity; (3) Normal weight bulimics--an external locus of control, low self-esteem, psychopathic deviance, hysteria, thought disorder, and depression; (4) Non-bulimic obese--low self-esteem; and (5) Bulimic obese--low self-esteem, an external locus of control, thought disorder and depression. The primary conclusion drawn from this study is that bulimia is a better predictor of the psychological characteristics than body weight. Bulimia, across all weight categories, was associated with an external locus of control, low self-esteem, psychopathic deviance, hysteria, thought disorder, and depression. That there was little variability in personality characteristics associated with bulimia across weight categories emphasized the stability of the symptom constellation associated with this disorder. This study supported the view of the normal weight bulimic as psychologically similar to the bulimic anorexic. This study also supported the stance that simple obesity does not represent a unitary psychological disorder.

The emerging consensus among investigators seems to be that bulimia is a multidetermined disorder with a number of contributing factors, including biological components, sociocultural factor, personality, and family characteristics (Garfinkel & Garner, 1982). An etiological model was examined in this study integrating two important theoretical perspectives in the bulimia literature: the stress-coping perspective (Cattanach & Rodin, 1988) and the family systems perspective (Minuchin et al., 1978). Five latent variables: Family Characteristics, Coping Resources, Psychological Disturbance, Environmental Stressors, and Bulimia were represented by twelve measured variables. Structural Equation Modeling analysis allowed for the simultaneous examination of the hypothesized interrelationships between model variables. Findings confirmed a direct impact of psychological disturbances on bulimic symptoms. Hypothesized indirect relationships of family characteristics, coping resources and environmental stressors to bulimia were confirmed. Treatment implications as well as directions for future research were discussed.

This study explored three areas believed to play a central role in the pathogenesis and presenting clinical picture of the eating disorders, anorexia nervosa and bulimia. Measures of personal effectiveness, family dynamics, and traditional sex-role beliefs were assessed in groups of restricted anorexics, bulimic anorexics, normal weight bulimics and controls. Control subjects manifested the highest degree of psychological adjustment, resourcefulness, and self-direction, while restricting anorexics obtained the lowest score on this measure. Bulimics experienced the highest degree of personal effectiveness of the patient groups, with bulimic anorexics falling in-between restricting anorexics and bulimics. Control subjects also reported that they felt more independent, accepted and tolerated in their family than any of the eating disorder groups. Bulimic subjects scored closest to controls on this measure, with bulimic anorexics experiencing the least degree of acceptance, tolerance and independence of all groups. Finally, control subjects defined themselves in a more traditionally masculine role than did any of the eating disorder groups. Restricting anorexics were most likely to describe themselves as passive, submissive, constricted and sensitive; bulimic subjects were more likely to endorse such self-descriptive adjectives as assertive, uninhibited, self-confident and competitive. Bulimic anorexics perceived themselves to be less traditionally feminine than did restricting anorexics, but more than bulimics or controls. The results of this study support the theory that ego deficits contribute to the development of eating disorders.

The eating disorders, encompassing both bulimia and anorexia nervosa, have become a matter of increasing concern for mental health professionals. The presence of bulimic symptoms within the syndrome of anorexia nervosa has been associated with greater individual and family psychopathology as well as with poorer prognosis when compared to restricter type anorectics. This study hypothesizes that when compared with a normal control group, non-anorectic bulimics would show higher levels of individual psychopathology and family dysfunction, and more disordered eating attitudes and behaviors. This study further hypothesizes that an anorectic group would exhibit a similar pattern on these variables due to the presence of bulimic symptoms in many anorectics. These hypotheses were confirmed and support was generated for the proposition that bulimia even in normal weight persons is associated with significant pathology comparable to that documented in the bulimic subtype of anorexia nervosa.

Research efforts in the area of eating disorders have been numerous and varied. However, few studies have investigated the existence of specific predisposing factors that could render a young female adolescent more susceptible to developing an eating disorder. The present study was attempted in an effort to fill this knowledge gap. One hundred and fifty nine, 12 to 14 year old female students not known as having an eating disorder, were surveyed at a public school in Roanoke County, Virginia. The participants were asked to complete four different instruments which were: The Piers-Harris Children's Self-Concept Scale, the Children's Assertiveness Inventory, the Nutrition Questionnaire designed by the researchers and the Eating Disorder Inventory or EDl. Correlational statistics were used to identify any significant relationships between the first three instruments and the ED!. Significant relationships were identified, suggesting the existence of specific factors related to tendencies toward eating disorders as assessed by the EDI. Among these factors were: poor self-concept and body image, obesity and weight problems, active interest or involvement in dieting as well as certain familial behaviors. The results of this research effort will hopefully be used in designing educational programs for the prevention of eating disorders, as well as for enhancing the detection of these disorders. Further research needs will also be suggested. / Master of Science