Anger as comorbid factor for interpersonal problems and emotional dysregulation in patients with eating disorders

This work was undertaken to analyze general levels of anger in patients with eating disorders (ED) compared to a normative group, diagnosis-dependent differences in expressing anger, and the relation between anger dimensions and specific items of the Eating Disorder Inventory, third revision (EDI-3) (emotional dysregulation, interpersonal deficit, low self-esteem, and asceticism) and body mass index (BMI).

The study participants were 58 women with a diagnosis of ED hospitalized at the Reina Sofia General University Hospital in Murcia. The women had a mean age of 25.68 (SD=7.00) years. The distribution of ED diagnoses was 27.58% anorexia nervosa with food restriction (AN-R), 15.51% anorexia nervosa with purging (AN-P), 41.37% bulimia nervosa (BN), and 15.51% eating disorder not otherwise specified (EDNOS). ED was evaluated using the EDI-3 and anger was assessed with the State-Trait Anxiety Inventory-2 (STAXI-2).

The general anger levels of the patients with ED were higher than those of the normative group compared. Patients diagnosed of AN-R had significantly higher scores than patients diagnosed of BN on the internal control of anger scale. The emotional dysregulation, interpersonal deficit, low self-esteem, and asceticism scales correlated significantly with different anger dimensions. No significant relation was found between body mass index (BMI) and anger.

These results show the importance of including anger management in any therapeutic approach to EDs.