Personality variables and disorders in anorexia nervosa and bulimia nervosa

All dominant models of the eating disorders implicate personality variables in the emergence of weight concerns and the development of specific symptoms such as bingeing and purging. Standardized measures of personality traits and disorders generally confirm clinical descriptions of restricting anorexics as constricted, conforming, and obsessional individuals. A less consistent picture suggesting affective instability and impulsivity has emerged from the assessment of subjects with bulimia nervosa. Considerable heterogeneity exists within eating disorder subtypes, however, and a number of special problems complicate the interpretation of personality data in this population. These include young age at onset, the influence of state variables such as depression and starvation sequelae, denial and distortion in self-report, the instability of subtype diagnoses, and the persistence of residual problems following symptom control.