Posttraumatic stress disorder (PTSD) is 3-5 times more prevalent in individuals with bulimia nervosa (BN) than those without (Dansky et al., 1997). However, the relationship between PTSD and BN–in particular, how PTSD might affect or moderate bulimic symptoms–remains largely unexplored. In a recent study, Trisha Karr and colleagues followed 119 women (20 with PTSD and BN, and 99 with BN only) for a 2 week period to investigate whether participants with comorbid PTSD + BN differed from those with BN only on the:
They used the ecological momentary assessment (EMA) tool to track behaviours and emotional states close to when they occur. I’ve blogged about a study using EMA before (‘What’s The Point of Bingeing/Purging? And Why Can’t You Just Stop?’), but briefly,
Participants were prompted to recording their mood and behaviour(s) at 6 semirandom times each day, over a two-week period. The authors then looked at the …
Is anorexia nervosa a subtype of body dysmorphic disorder (BDD)? Well, probably not, but don’t click the close button just yet. In this post, I’ll explore the relationship between anorexia nervosa and BDD, and discuss how understanding this relationship might help us develop better treatments for both disorders.
Despite the fact that there are obvious similarities between the disorders, studies exploring the relationship between BDD and AN are few and far between. In a recent paper, published in the Clinical Psychology Review, Andrea Hartmann and colleagues summarized the current state of knowledge in the field. The review compared clinical, personality, demographic, and treatment outcome features of AN and BDD. I’ll summarize the key points of the paper in this post.
(I will be focusing on the relationship between AN and BDD, as opposed to EDs and BDD, because that’s the scope of the review article.)
First, what is body dysmorphic disorder?
Approximately 1/3 of individuals do NOT recognize that the beliefs about their appearance are due to a mental disorder and 2/3 believe that other people are laughing/staring …
When we think about eating disorders, we tend to think about eating disorder subtypes: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder. A lot of previous work has shown that individuals with AN and BN tend to be anxious, depressed, perfectionistic, and harm-avoidant. Patients with AN also tend to score low on novelty-seeking, impulsivity, and self-directedness, whereas patients with BN score high on novelty-seeking and impulsivity. More recently, however, some researchers began to wonder if there was another way to categorize patients–not according to symptoms, but according to personality traits?
They identified three clusters of personality subtypes that seemed to “cut across” eating disorder diagnoses, outlined below (taken from a previous post):
However, that research was done in ill patients, and so the question remained: Do these personality clusters persist after recovery? This is the question that Angela Wagner and colleagues asked in their study, published in 2006.
Specifically, they asked:
Given that eating disorders disproportionately affect women, it is not unreasonable to assume that men differ from women in clinical presentation, personality and psychological characteristics. My guess would be that they differ. My reasoning is this: males and females grow up facing different pressures and expectations. Given that, I’d think there would be (perhaps only slightly) different risk factors that predispose men and women to develop eating disorders. Thus, I’d think that different groups of men and women (i.e. with different personality characteristics, psychiatric comorbidities, and life experiences) would be susceptible to EDs. (Hopefully that makes sense.) To answer that question, Dr. D. Blake Woodside and colleagues compared men with eating disorders vs. women with eating disorders vs. men without eating disorders.
Why are females much more likely to suffer from eating disorders than males? It appears that (at least) two arguments have been put forth:
Previous studies suggest that, at least in a clinical setting, men and women with eating disorders don’t really differ in their “clinical presentation, psychological measurements, or response to treatment.” But, what about individuals with eating disorders from a large …
Eating disorders don’t discriminate, they just have a bias (more on this in the future). While the majority of eating disorder patients are females, males suffer from eating disorders as well. In fact, it is about, roughly, a 10:1 ratio.
Men tend to just keep quiet about it (and who can blame them, given the stigma women face, it only gets worse for the men.) But, on the inside, their experiences, thoughts, behaviours and recovery span the same spectrum. This is evident from an NYTimes feature (10 min video) called “Patient Voices“, where 2 brave men and several women share their stories of “what it is like to have an eating disorder”.
There’s relatively little research out there on men with eating disorders, in large part due to the low prevalence rates which makes it harder to get a large enough sample size. So, you have to get creative, as the authors of this study did: they reviewed the prevalence of eating disorders and comorbid psychiatric disorders using data from the Veterans Affairs medical centers of male patients in the fiscal …
Patients with eating disorders commonly exhibit comorbid psychiatric disorders, including anxiety, depression and OCD. The presence of comorbid disorders has been shown to exacerbate the severity and chronicity of the disorder, and unfavourably affect treatment outcome. Moreover, comorbid disorders may necessitate specialized treatment plans that take into account all the co-occuring disorders. Recovery from an eating disorder is hard enough, but when it is complicated by depression and severe anxiety, it can be a lot harder.
Nonetheless, commonly co-occuring psychiatric disorders may also provide researchers and clinicians clues about the etiology of eating disorders, the underlying neuronal processes as well as possible pharmacological interventions.
Researchers have been identifying disorders that commonly co-occur with eating disorders and studying the differences in co-morbidity between disorders. I picked one to write about today, it is a study by Blinder and colleagues that came out in 2007. It is by no means the best, but also not the worst, and of course it has several limitations, which I will mention. But it is a place to start.
This is a retrospective study, meaning that the authors went back through …