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Self-injurious behavior in anorexia nervosa.

A Favaro1, P Santonastaso

  • 1Department of Neurological and Psychiatric Sciences, University of Padua, Padova, Italy.

The Journal of Nervous and Mental Disease
|September 6, 2000
PubMed
Summary

This study distinguishes between impulsive and compulsive self-injurious behaviors in anorexia nervosa patients. These dimensions, along with purging behaviors, predict treatment dropout and are linked to specific clinical features.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Eating Disorders Research

Background:

  • Self-injurious behavior (SIB) in anorexia nervosa (AN) is increasingly recognized.
  • Previous research suggests potential distinctions in SIB, such as impulsive versus compulsive types.

Purpose of the Study:

  • To analyze the dimensionality of self-injurious behavior in anorexia nervosa.
  • To investigate the relationship between different dimensions of SIB and clinical features in AN.
  • To identify predictors of treatment dropout in AN patients with SIB.

Main Methods:

  • Principal component analysis (PCA) was employed to explore the structure of SIB.
  • Data were collected from 236 AN patients using semistructured interviews and self-report questionnaires (EDI, HSCL).

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  • DSM-IV criteria were used for AN diagnosis.

    • Main Results:

    • PCA confirmed distinct dimensions of impulsive and compulsive SIB, existing on a continuum within AN subgroups.
    • A third dimension emerged, encompassing self-induced vomiting and laxative/diuretic abuse.
    • Impulsive SIB was predicted by childhood sexual abuse and anxiety; compulsive SIB by obsessionality and age.
    • Co-occurring impulsive and compulsive SIB strongly predicted treatment dropout.

    Conclusions:

    • Self-injurious behavior in anorexia nervosa is multidimensional, with distinct impulsive and compulsive components.
    • Specific clinical factors are associated with each dimension of SIB.
    • SIB dimensions are critical factors influencing treatment outcomes, particularly dropout rates in AN.
    • Future AN research should incorporate the assessment of SIB dimensions.