Abstract
In the recent revision of the DSM-III, the diagnosis of “bulimia nervosa” includes the criterion of “persistent overconcern with body shape and weight,” which may be conceptualized as a form of body-image disturbance. The new diagnostic criteria for bulimia nervosa include only those who exhibit a binge-purge eating patern, excluding binge-eaters who, in the older DSM-III, receive a diagnosis of bulimia. This study was conducted to investigate body-image disturbances in bulimia nervosa and simple bulimia (i.e., binge-eating without purging). The experimental design included two control groups, obese and normal subjects, in order to determine whether the binge-eater had body-image disturbances different form those of normal and overweight samples. The study evaluated 596 subjects (417 normals, 109 bulimia nervosa subjects, 50 binge-eaters, and 30 obese subjects) in terms of perception of current body size and selection of ideal body size. Results indicated that the bulimia nervosa group selected a current body size larger than that selected by normals and an ideal body size smaller than that chosen by normals. However, bingeeaters did not differ from the obese control group on either current or ideal body size. These results are discussed in terms of the recent debate regarding the diagnosis of bulimia nervosa and sociocultural influences upon body-image disturbances.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Allebeck, P., Hallberg, D., & Espmark, S. (1976). Body image: An apparatus for measuring disturbances in estimation of size and shape.Journal of Psychosomatic Research, 20, 583–589.
American Psychiatric Association (1980).Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: APA.
American Psychiatric Association (1987).Diagnostic and statistical manual of Mental Disorders (3rd. ed., rev.). Washington, DC: APA.
Cash, T. F., & Brown, T. A. (1987). Body image in anorexia nervosa and bulimia nervosa: A review of the literature.Behavior Modification, 11, 487–521.
Casper, R. C., Halmi, K. A., Goldberg, S. C., Eckert, E. D., & Davis, J. M. (1978). Disturbances in body image estimation as related to other characteristics and outcomes in anorexia nervosa.British Journal of Psychiatry, 134, 60–66.
Fairburn, C. G., & Garner, D. M. (1986). The diagnosis of bulimia nervosa.International Journal of Eating Disorders, 5, 403–419.
Garner, D. M., Olmstead, M. A., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia.International Journal of Eating Disorders, 2, 15–34.
Hsu, L. K. (1982). Is there a disturbance in body image in anorexia nervosa?The Journal of Nervous and Mental Disease, 170, 305–307.
Huon, G. F. & Brown, L. B. (1986). Body images in anorexia nervosa and bulimia nervosa.International Journal of Eating Disorders, 5, 421–439.
Kolb, L. (1959). Disturbances of the body-image. In S. Arieti (Ed.),American handbook of psychiatry. New York: Basic Books.
Pierloot, R. A., & Houben, M. E. (1978). Estimation of body dimensions in anorexia nervosa.Psychological Medicine, 8, 317–324.
Prather, R. C., & Williamson, D. A. (1988). Psychopathology associated with bulimia, binge eating, and obesity.International Journal of Eating Disorders, 7, 177–184.
Ruff, G. A., & Barrios, B. A. (1986). Realistic assessment of body image.Behavioral Assessment, 8, 237–251.
Russell, G. F. (1979). Bulimia nervosa: An ominous variant of anorexia nervosa.Psychological Medicine, 9, 429–448.
Slade, P. S., & Russell, G. F. (1973). Awareness of body dimensions in anorexia nervosa: Cross-sectional and longitudinal studies.Psychological Medicine, 3, 188–199.
Smith, M. C., & Thelen, M. H. (1984). Development and validation of a test for bulimia.Journal of Consulting and Clinical Psychology, 52, 863–872.
Thompson, J. K., Berland, N. W., Linton, P. H., & Weinsier, R. L. (1986). Utilization of a self-adjusting light beam in the objective assessment of body image distortion in seven eating disorder groups.International Journal of Eating Disorders, 5, 113–120.
Traub, A. C., & Orbach, J. (1964). Psychophysical studies of body image. I. The adjustable body-distorting mirror.Archives of General Psychiatry, 11, 53–66.
Williamson, D. A., Davis, C. J., Goreczny, A. J., & Blouin, D. C. (1989). Body image disturbances in bulimia nervosa: Influences of actual body size.Journal of Abnormal Psychology.
Williamson, D. A., Kelley, M. L., Cavell, T. A., & Prather, R. C. (1988). Eating and eliminating disorders. In C. L. Frame & J. L. Maison (Eds.),Handbook of assessment in childhood psychopathology: Applied issues in differential diagnosis and treatment evaluation. New York: Plenum (in press).
Williamson, D. A., Kelley, Davis, C. J., Goreczny, A. J., Bennett, S. M., & Watkins, P. C. (1988). The Eating Questionnaire-Revised: A new symptom checklist for bulimia. In P. A. Keller & L. G. Ritt (Eds.),Innovations in Clinical Practice: A Source Book, Sarasota, FL: Professional Resource Exchange (in press).
Williamson, D. A., Kelley, M. L., Davis, C. J., Ruggiero, L., & Blouin, D. C. (1985). Psychopathology of eating disorders: A controlled comparison of bulimic, obese, and normal subjects.Journal of Consulting and Clinical Psychology, 53, 161–166.
Willmuth, B. A., Leitenberg, H., Rosen, J. C., Fondacaro, K. M., & Gross, J. (1985). Body size distortion in bulimia nervosa.International Journal of Eating Disorders, 4, 71–78.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Davis, C.J., Williamson, D.A., Goreczny, A.J. et al. Body-image disturbances and bulimia nervosa: An empirical analysis of recent revisions of the DSM-III. J Psychopathol Behav Assess 11, 61–69 (1989). https://doi.org/10.1007/BF00962699
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00962699