Skip to main content
Log in

Subtyping women with bulimia nervosa along dietary and negative affect dimensions: A replication in a treatment-seeking sample

  • Brief Report
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Recent cluster-analysis studies of women with bulimia nervosa (BN) have suggested two subtypes, a pure dietary subtype and a mixed dietary-negative affect. We aimed to replicate the subtyping findings in a clinical study group of 48 adult women with BN. Cluster analyses revealed a dietary-negative affect subtype (56% of cases) and a pure dietary subtype (44% of cases). The dietary-negative affect subtype was characterized by significantly greater eating-related attitudinal psychopathology and associated psychological disturbance. Our findings suggest that severe restraint is a central feature of BN and that affective disturbance, which occurs in roughly half of cases, is associated with greater eating-related attitudinal psychopathology and psychological symptomatology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fairburn C.G., Welch S.L., Doll H.A., Davies B.A., O’Connor M.E.: Risk factors for bulimia nervosa: A community-based, case-control study. Arch. Gen. Psychiatry, 54, 509–551, 1997.

    Article  CAS  PubMed  Google Scholar 

  2. Lowe M.R.: The effects of dieting on eating behavior: A three-factor model. Psychol. Bull., 114, 100–121, 1993.

    Article  CAS  PubMed  Google Scholar 

  3. Heatherton T.F., Baumeister R.F.: Binge eating as an escape from self-awareness. Psychol. Bull., 110, 86–108, 1991.

    Article  CAS  PubMed  Google Scholar 

  4. Leon G.R., Fulkerson J.A., Perry C.L., Early-Zald M.B.: Prospective analysis of personality and behavioral vulnerabilities and gender differences in the later development of disordered eating. J. Abnorm. Psychol., 104, 140–149, 1995.

    Article  CAS  PubMed  Google Scholar 

  5. Stice E.: A review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clin. Psychol. Rev., 14, 633–661, 1994.

    Article  Google Scholar 

  6. Stice E., Agras W.S.: Subtyping bulimic women along dietary restraint and negative affect dimensions. J. Consult. Clin. Psychol., 67, 460–469, 1999.

    Article  CAS  PubMed  Google Scholar 

  7. American Psychiatric Association.: Diagnostic and statistical manual of mental disorders, ed. 4. Washington, DC, APA, 1994.

    Google Scholar 

  8. Fairburn C.G., Beglin S.J.: Assessment of eating disorders: Interview or self-report questionnaire? Int. J. Eat. Disord., 16, 363–370, 1994.

    CAS  PubMed  Google Scholar 

  9. Yanovski S.Z.: Binge eating disorder: Current knowledge and future directions. Obes. Res., 1, 306–324, 1993.

    Article  CAS  PubMed  Google Scholar 

  10. Fairburn C.G., Cooper Z.: The Eating Disorder Examination, ed. 12. In: Fairburn C.G., Wilson G.T.(Eds.), Binge eating: nature, assessment, and treatment. New York, Guilford Press, 1993, pp. 317–360.

    Google Scholar 

  11. Loeb K.L., Pike K.M., Walsh B.T., Wilson G.T.: Assessment of diagnostic features of bulimia nervosa: Interview versus self-report format. Int. J. Eat. Disord., 16, 75–81, 1994.

    Article  CAS  PubMed  Google Scholar 

  12. Nangle D.W., Johnson W.R., Carr-Nangle R.E., Engler L.E.: Binge eating disorder and the proposed DSM-IV criteria: Psychometric analysis of the questionnaire of eating and weight patterns. Int. J. Eat. Disord., 16, 147–157, 1994.

    Article  CAS  PubMed  Google Scholar 

  13. Stunkard A.J., Messick S.: The Three Factor Eating Questionnaire to measure dietary restraint, disinhibition, and hunger. J. Psychosom. Res., 29, 71–83, 1985.

    Article  CAS  PubMed  Google Scholar 

  14. Allison D.B., Kalinsky L.B., Gorman B.S.: A comparison of the psychometric properties of three measures of dietary restraint. Psychol. Assess., 4, 391–398, 1992.

    Article  Google Scholar 

  15. Beck A.T., Steer R.A.: Manual for revised Beck Depression Inventory. New York, Psychological Corporation, 1987.

    Google Scholar 

  16. Beck AT., Steer R.M., Garbin M.: Psychometric properties of the Beck Depression Inventory: 25 years of evaluation. Clin. Psychol. Rev., 8, 77–100, 1988.

    Article  Google Scholar 

  17. Watson D., Clark L.A.: Negative affectivity: The disposition to experience aversive emotional states. Psychol. Bull., 96, 465–490, 1984.

    Article  CAS  PubMed  Google Scholar 

  18. Rosenberg M.: Conceiving the self. New York, Basic Books, 1979.

    Google Scholar 

  19. Cooper P.J., Taylor M.J., Cooper Z., Fairburn C.G.: The development and validation of the Body Shape Questionnaire. Int. J. Eat. Disord., 6, 485–494, 1987.

    Article  Google Scholar 

  20. Cooper P.J., Fairburn C.G.: Confusion over the core psychopathology of bulimia nervosa. Int. J. Eat. Disord., 13, 385–389, 1993.

    Article  CAS  PubMed  Google Scholar 

  21. Plutchik R., van Praag H.M.: The measurement of suicidality, aggressivity, and impulsivity. Prog. Neuropsychopharmacol. Biol. Psychiatry, 13, 23–24, 1989.

    Google Scholar 

  22. Apter A., Plutchik R., van Praag H.M.: Anxiety, impulsivity, and depressed mood in relation to suicidal and violent behavior. Acta Psychiatr. Scand., 87, 1–5, 1993.

    Article  CAS  PubMed  Google Scholar 

  23. Brewerton T.D., Hand L.D., Bishop E.R.: The tridimensional personality questionnaire in eating disorder patients. Int. J. Eat. Disord., 14, 213–218, 1993.

    Article  CAS  PubMed  Google Scholar 

  24. McDermott P.A.: MEG: Megacluster analytic strategy for multi-stage hierarchical grouping with relocations and replications. Educ. Psychol. Measurements, 58, 677–686, 1998.

    Article  Google Scholar 

  25. Epstein S.: The stability of behavior: I. On predicting most of the people much of the time. J. Pers. Soc. Psychol., 37, 1097–1126, 1979.

    Article  Google Scholar 

  26. Grilo C.M., Shiffman S., Carter-Campbell J.: Binge eating antecedents in normal-weight non-purging females: is there consistency? Int. J. Eat. Disord., 16, 239–249, 1994.

    Article  CAS  PubMed  Google Scholar 

  27. Wilson G.T.: The clinical utility of randomized controlled trials. Int. J. Eat. Disord., 24, 13–29, 1998.

    Article  CAS  PubMed  Google Scholar 

  28. Fairburn C.G., Welch S.L., Norman P.A., O’Connor M.E., Doll H.A.: Bias and bulimia nervosa: How typical are clinic cases? Am. J. Psychiatry, 153, 386–391, 1996.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grilo, C.M., Masheb, R.M. & Berman, R.M. Subtyping women with bulimia nervosa along dietary and negative affect dimensions: A replication in a treatment-seeking sample. Eat Weight Disord 6, 53–58 (2001). https://doi.org/10.1007/BF03339753

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03339753

Keywords

Navigation