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Published on: September 12, 2014
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Comorbid Anxiety and Substance Use Disorders and Fear and Approach-Based Traits in Bulimic Syndromes
Inge Estefania Guerrero1, Alejandra Medina Fernandez1, Pamela K Keel1
1Department of Psychology, Florida State University, Tallahassee, Florida, USA.
Summary
Fear and reward sensitivities influence bulimia nervosa (BN-S) symptom severity. These traits, alongside anxiety and substance use disorders, impact BN-S presentation, suggesting overlap with externalizing disorders.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Bulimia nervosa and related syndromes (BN-S) are complex and heterogeneous.
- Frequent comorbidity with anxiety disorders (ADs) and substance use disorders (SUDs) is observed in BN-S.
- Fear- and approach-based tendencies are implicated in BN-S development and presentation.
Purpose of the Study:
- To investigate how comorbid ADs and SUDs influence BN-S.
- To clarify the role of fear- and approach-based traits in BN-S.
- To determine the impact of these factors on BN-S presentation and severity.
Main Methods:
- A cohort of 399 women, including 321 with BN-S and 78 controls, participated.
- Participants completed diagnostic interviews (Eating Disorder Examination, Structured Clinical Interview for DSM-5 Disorders).
- Psychometric scales assessed behavioral inhibition/activation and sensitivity to punishment/reward.
Main Results:
- Comorbidity with ADs or SUDs did not significantly alter diagnostic features or eating pathology.
- BN-S participants exhibited higher fear-based traits (controlling for ADs) and reward sensitivity (controlling for SUDs).
- Elevated fear and approach traits independently predicted increased bulimic symptom severity.
Conclusions:
- Fear- and approach-based traits are present in BN-S and linked to symptom severity.
- Findings suggest BN-S may overlap with the externalizing spectrum, challenging current classifications.
- Understanding these traits is crucial for BN-S diagnosis and treatment.
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