Different types of self-injurious behavior in bulimia nervosa

In a previous study, we demonstrated the validity of the distinction, in bulimia nervosa (BN), between compulsive self-injurious behavior (SIB), such as hair pulling and onycophagia, and impulsive SIB, such as skin cutting and burning. The aim of the present study is to investigate the clinical and psychological correlates of these two categories of SIB in BN. The sample consisted of 175 consecutive patients with BN, diagnosed according to DSM-IV criteria. Subjects were assessed by means of a semistructured interview and self-reported questionnaires (Eating Disorders Inventory [EDI] and Hopkins Symptom Checklist [SCL-90]). In our sample, impulsive SIB appeared to be associated with suicide attempts, a history of sexual abuse, and depression. On the other hand, compulsive SIB seemed to be related to a lack of awareness towards emotions and body sensations, greater obsessionality, and a shorter duration of illness.