Ego boundary disturbance in anorexia nervosa: preliminary findings

Boundary disturbance and the developmental level of the Rorschach human representations of anorectic patients were studied. A group of 12 anorectics was compared with a control group in regard to their degree of boundary disturbance, the developmental level of their human responses, the degree to which they attribute affect to their percepts, and the nature and degree of drive-dominated ideation. The anorectic patients showed significantly more contamination responses, reflective of a breakdown in their self-other boundaries. The affect elaboration, human representations, and drive-dominated ideation measures failed to differentiate the two groups. These findings provide preliminary support for clinical observations from both individual and family perspectives that families of anorectics show greater boundary disturbance which appears to be internalized by these patients. Thus, much of their symptomatology might be understood as an attempt to gain autonomy through an overaccentuation of the boundary between themselves and others. The failure of the drive-dominated ideation measures to differentiate the two groups supports the deemphasis of the role of psychosexual factors.