Prognostic value of pretreatment social adaptation in bulimia nervosa

We evaluated several indices of pretreatment social adaptation (social and vocational adjustment, DSM-III-R Axis-V ratings, and "object-relations" capacities) as predictors of the response of 44 completers of a multimodal therapy for bulimia nervosa. Response was assessed using standard measures of eating and psychiatric symptoms. Hierarchical regressions revealed that pretreatment social adjustment explained substantial (and significant) proportions of variance in posttreatment binge/purge symptoms, after variance associated with (a) initial severity of eating symptoms and (b) concurrent psychiatric symptoms (at posttreatment) was accounted for. Hence, social adjustment emerged as a somewhat specific predictor of response of bulimic behaviors. Possible clinical implications of this apparent predictive effect are discussed.