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Awad E, Obeid S, Sacre H, Salameh P, Strahler J, Hallit S. Association between impulsivity and orthorexia nervosa: any moderating role of maladaptive personality traits? Eat Weight Disord 2022; 27:483-493. [PMID: 33840074 DOI: 10.1007/s40519-021-01186-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/26/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To explore the possible moderating relation between impulsive behavior and maladaptive personality traits in regards to orthorexia nervosa (ON). METHODS This cross-sectional study was conducted between July and December 2019 and recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. The Teruel Orthorexia Scale (TOS) was employed to assess orthorexic eating tendencies, the I-8 measured impulsivity and the Personality Inventory for DSM-5 (PID) evaluated maladaptive personality traits. RESULTS Our results showed that, for I-8 subscales, only higher perseverance (B = 0.31) was significantly associated with higher ON. In regard to PID-5 subscales, only higher negative affect (B = - 0.34) was significantly associated with lower ON. Furthermore, significant interactions were found between personality traits and impulsivity to predict TOS-ON. CONCLUSION The current results show that female gender, maladaptive personality traits and impulsivity present contributing factors regarding orthorexic eating. Certain impulsivity dimensions were confirmed to interact with personality traits in the prediction of orthorexic eating thereby highlighting possible risk factors and psychopathological mechanisms. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Emmanuelle Awad
- Faculty of Social Sciences, Psychology Department, Lund University, Lund, Sweden
| | - Sahar Obeid
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon. .,Research and Psychology Departments, Psychiatric Hospital of the Cross, Jall-Eddib, Lebanon.
| | - Hala Sacre
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Jana Strahler
- Department of Health Psychology and Applied Diagnostics, Faculty of Human-Social Sciences, University of Wuppertal, Wuppertal, Germany.,Department of Psychotherapy and Systems Neuroscience, Faculty of Psychology and Sport Science, University of Giessen, Giessen, Germany
| | - Souheil Hallit
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon. .,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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2
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Kostrzewa-Nowak D, Nowak R, Kubaszewska J, Gos W. Interdisciplinary Approach to Biological and Health Implications in Selected Professional Competences. Brain Sci 2022; 12:brainsci12020236. [PMID: 35203999 PMCID: PMC8870650 DOI: 10.3390/brainsci12020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 01/09/2023] Open
Abstract
Everyday life’s hygiene and professional realities, especially in economically developed countries, indicate the need to modify the standards of pro-health programs as well as modern hygiene and work ergonomics programs. These observations are based on the problem of premature death caused by civilization diseases. The biological mechanisms associated with financial risk susceptibility are well described, but there is little data explaining the biological basis of neuroaccounting. Therefore, the aim of the study was to present relationships between personality traits, cognitive competences and biological factors shaping behavioral conditions in a multidisciplinary aspect. This critical review paper is an attempt to compile biological and psychological factors influencing the development of professional competences, especially decent in the area of accounting and finance. We analyzed existing literature from wide range of scientific disciplines (including economics, psychology, behavioral genetics) to create background to pursuit multidisciplinary research models in the field of neuroaccounting. This would help in pointing the best genetically based behavioral profile of future successful financial and accounting specialists.
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Affiliation(s)
- Dorota Kostrzewa-Nowak
- Institute of Physical Culture Sciences, University of Szczecin, 17C Narutowicza St., 70-240 Szczecin, Poland; (R.N.); (J.K.)
- Correspondence:
| | - Robert Nowak
- Institute of Physical Culture Sciences, University of Szczecin, 17C Narutowicza St., 70-240 Szczecin, Poland; (R.N.); (J.K.)
| | - Joanna Kubaszewska
- Institute of Physical Culture Sciences, University of Szczecin, 17C Narutowicza St., 70-240 Szczecin, Poland; (R.N.); (J.K.)
| | - Waldemar Gos
- Institute of Economy and Finance, University of Szczecin, 64 Mickiewicza St., 71-101 Szczecin, Poland;
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3
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Awad E, Salameh P, Sacre H, Malaeb D, Hallit S, Obeid S. Association between impulsivity and orthorexia nervosa / healthy orthorexia: any mediating effect of depression, anxiety, and stress? BMC Psychiatry 2021; 21:604. [PMID: 34861836 PMCID: PMC8640965 DOI: 10.1186/s12888-021-03594-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/08/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is a lack of studies investigating the possible mediating role of psychological factors, such as depression, anxiety and stress on orthorexic eating behaviors. Given that personality attributes might affect the manifestation of psychological disorders, it was hypothesized that depression, anxiety and stress mediate the relationship between impulsivity-related traits and orthorexic eating, noting that previous research had evaluated the role of depression as a mediator between impulsivity and other pathological eating behaviors. The study objectives were to explore the mediating effect of depression, anxiety, and stress, on impulsivity and orthorexia nervosa, and healthy orthorexia. METHODS This cross-sectional study conducted between July and December 2019 recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. RESULTS Our results showed that depression and anxiety were positively correlated with ON. We also found a notable gender difference in findings: higher anxiety and female gender were significantly associated with higher TOS healthy orthorexia, while higher stress was associated with lower TOS healthy orthorexia. Finally, higher urgency was associated with lower TOS healthy orthorexia, while higher perseverance was significantly associated with higher TOS healthy orthorexia. Depression and anxiety partially mediated the association between perseverance and ON while anxiety and stress partially mediated the association between urgency and healthy orthorexia. CONCLUSION Our study suggests that depression, anxiety and stress play a mediating role between impulsivity and orthorexia nervosa/healthy orthorexia. Our findings provide a ground for future investigations of impulsive behaviors, psychopathology, and orthorexia in different populations.
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Affiliation(s)
- Emmanuelle Awad
- grid.4514.40000 0001 0930 2361Faculty of Social Sciences, Psychology Department, Lund University, Lund, Sweden
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon ,grid.411324.10000 0001 2324 3572Faculty of Pharmacy, Lebanese University, Hadat, Lebanon ,grid.413056.50000 0004 0383 4764University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Diana Malaeb
- grid.444421.30000 0004 0417 6142School of Pharmacy, Lebanese International University, Beirut, Lebanon ,grid.466400.0Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon. .,Psychology Department, Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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4
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Liley LJ, Watson HJ, Seah E, Priddis LE, Kane RT. A controlled study of personality traits in female adolescents with eating disorders. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Lois J. Liley
- Eating Disorders Program, Princess Margaret Hospital for Children, Curtin University, Perth, Western Australia, Australia,
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Hunna J. Watson
- Eating Disorders Program, Princess Margaret Hospital for Children, Curtin University, Perth, Western Australia, Australia,
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
- Centre for Clinical Interventions, Department of Health in Western Australia, The University of Western Australia, Perth, Western Australia, Australia,
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia,
| | - Elizabeth Seah
- Eating Disorders Program, Princess Margaret Hospital for Children, Curtin University, Perth, Western Australia, Australia,
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Lynn E. Priddis
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Robert T. Kane
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
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Chapuis-de-Andrade S, Moret-Tatay C, Costa DB, Abreu da Silva F, Irigaray TQ, Lara DR. The Association Between Eating-Compensatory Behaviors and Affective Temperament in a Brazilian Population. Front Psychol 2019; 10:1924. [PMID: 31551850 PMCID: PMC6736602 DOI: 10.3389/fpsyg.2019.01924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 08/05/2019] [Indexed: 12/16/2022] Open
Abstract
Eating-compensatory behaviors are associated with biological and psychological complications, with high rates of morbidity and mortality. Different elements may contribute to the development of eating-compensatory behaviors, such as genetic, physiological, environmental, and temperamental factors. Therefore, the aim of this study was to examine the association between affective temperaments and eating-compensatory behaviors. A sample of 27,501 volunteers, between 18 and 55 years old, mean age 28.9 ± 8.7 years (69.6% women), were assessed by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). The results showed that eating-compensatory behaviors were associated with distinctive affective temperaments. Cyclothymic types were more associated with eating-compensatory behaviors. The avoidant and irritable types presented lower percentages of eating-compensatory behaviors in women and men, respectively. In conclusion, this study highlighted that participants who adopted frequent eating-compensatory behaviors are more likely to have dysfunctional affective traits. Consequently, the affective temperaments should be considered as a strategy to build capacity for prevention, treatment, and care of eating-compensatory behaviors.
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Affiliation(s)
| | - Carmen Moret-Tatay
- Departamento de Neuropsicobiología, Metodología y Psicología Social, Facultad de Psicología, Universidad Católica de Valencia "San Vicente Mártir," Sede de San Juan Bautista, Valencia, Spain
| | - Dalton Breno Costa
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | | | | | - Diogo R Lara
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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6
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Slepecky M, Kotianova A, Prasko J, Majercak I, Kotian M, Gyorgyova E, Zatkova M, Chupacova M, Ociskova M, Sollar T. Relation of personality factors and life events to waist/height ratio and percentage of visceral fat in women and men. Psychol Res Behav Manag 2019; 12:499-511. [PMID: 31308771 PMCID: PMC6613611 DOI: 10.2147/prbm.s214303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 05/30/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The investigation aimed to explore the association between personality traits, stressful life events, quality of life on anthropometric characteristics (waist/height ratio and percentage of visceral fat). METHOD A total of 227 participants took part in this cross-sectional study. Participants completed the Social Readjustment Rating Scale (SRRS), Temperament and Character Inventory-Revised, Type-D Scale (DS-14), EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D), and demographic questionnaire. Two anthropometric parameters were measured: Waist/height ratio and Percentage of the visceral fat. RESULTS The average age of participants was 39.6±12.9 years, 60.4% women. The 41.8% of participants were overweight or obese. Regression analysis found a significant link between Harm-avoidance and EQ-5D visual analog scale (VAS) with Waist/height ratio in women and Reward dependence and Cooperativeness with Waist/height ratio in men. In regression analysis, the score of life events (SRRS) has statistically significant linked to Percentage of the visceral fat in women. The regression analysis also found a significant link between Novelty seeking, DS14, Negative affectivity, and EQ-5D VAS with Percentage of the visceral fat in women. CONCLUSION Significant associations between live events, personality traits, and body anthropometric measures were recognized. The differences were recognized between women and men. Outcomes propose some promising tools by which personality factors may influence overweight and obesity.
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Affiliation(s)
- Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Antonia Kotianova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Jan Prasko
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.,Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc 77520, The Czech Republic
| | - Ivan Majercak
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Josef Safarik University in Košice, Košice, The Slovak Republic.,Internal Medicine and Cardiology, Private practice MUDr Ivan Majercak, Košice, The Slovak Republic
| | - Michal Kotian
- Department of clinical psychology, Psychagogia, Liptovsky Mikulas, 03101, The Slovak Republic
| | - Erika Gyorgyova
- Internal Medicine and Cardiology, Private practice MUDr Ivan Majercak, Košice, The Slovak Republic
| | - Marta Zatkova
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
| | - Michaela Chupacova
- Department of clinical psychology, Psychagogia, Liptovsky Mikulas, 03101, The Slovak Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc 77520, The Czech Republic
| | - Tomas Sollar
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.,Institute of Applied Psychology, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
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7
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Sanchez-Ruiz MJ, El-Jor C, Abi Kharma J, Bassil M, Zeeni N. Personality, emotion-related variables, and media pressure predict eating disorders via disordered eating in Lebanese university students. Eat Weight Disord 2019; 24:313-322. [PMID: 28421473 DOI: 10.1007/s40519-017-0387-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/02/2017] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Disordered eating behaviors are on the rise among youth. The present study investigates psychosocial and weight-related variables as predictors of eating disorders (ED) through disordered eating (DE) dimensions (namely restrained, external, and emotional eating) in Lebanese university students. METHODS The sample consisted of 244 undergraduates (143 female) aged from 18 to 31 years (M = 20.06; SD = 1.67). Using path analysis, two statistical models were built separately with restrained and emotional eating as dependent variables, and all possible direct and indirect pathways were tested for mediating effects. The variables tested for were media influence, perfectionism, trait emotional intelligence, and the Big Five dimensions. RESULTS In the first model, media pressure, self-control, and extraversion predicted eating disorders via emotional eating. In the second model, media pressure and perfectionism predicted eating disorders via restrained eating. DISCUSSION Findings from this study provide an understanding of the dynamics between DE, ED, and key personality, emotion-related, and social factors in youth. Lastly, implications and recommendations for future studies are advanced.
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Affiliation(s)
- Maria Jose Sanchez-Ruiz
- Department of Social Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 36, Byblos, Lebanon
| | - Claire El-Jor
- Department of Social Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 36, Byblos, Lebanon.,Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 36, Byblos, Lebanon
| | - Joelle Abi Kharma
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 36, Byblos, Lebanon
| | - Maya Bassil
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 36, Byblos, Lebanon
| | - Nadine Zeeni
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, P.O. Box: 36, Byblos, Lebanon.
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8
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Özyurt G, Çatlı G, Cingöz G, Dündar BN, Pekcanlar AA, Abacı A. Personality and subjective psychiatric symptoms of parents of obese youth: a controlled study. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1510676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Gonca Özyurt
- Child and Adolescent Psychiatry Department, Izmir Katip Celebi University, İzmir, Turkey
| | - Gönül Çatlı
- Department of Pediatric Endocrinology, Izmir Katip Celebi University, İzmir, Turkey
| | - Gülten Cingöz
- Department of Pediatrics, İzmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Bumin Nuri Dündar
- Department of Pediatric Endocrinology, Izmir Katip Celebi University, İzmir, Turkey
| | - Aynur Akay Pekcanlar
- Child and Adolescent Psychiatry Department, Dokuz Eylül University, İzmir, Turkey
| | - Ayhan Abacı
- Department of Pediatric Endocrinology, Dokuz Eylül University, İzmir, Turkey
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9
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Gil S. Predicting Suicidal Ideation among Psychiatric Patients: The Tridimensional Personality Theory Perspective. OMEGA-JOURNAL OF DEATH AND DYING 2016. [DOI: 10.2190/dm2k-a41n-e65l-0fve] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The main objective of the present study was to enrich our understanding regarding the role of personality traits in the explanation of suicidal ideation among psychiatric patients. It employed Cloniger's Tridimensional Personality Theory in order to draw a personality profile that predicts suicidal ideation among this population. A total of 172 psychiatric outpatients participated in the study. Subjects were randomly selected from a psychiatric clinic in northern Israel. All subjects were evaluated individually with three measures: the Tridimensional Personality Questionnaire (Cloninger, 1987; TPQ); the Beck Suicide Inventory (Beck, Steer, Handerson,&Skeie, 1991; BSI); and the Structured Clinical Interview for Axis I DSM-IV Disorders (SCID; First, Spitzer, Gibbon,&Williams, 1994). Data analysis was conducted using the Linear Structural Relations (LISREL VI) program. The findings of the present study indicate that among psychiatric patients, suicidal ideation can be explained by the combination of five personality traits: impulsiveness, stoic rigidity, confidence, disorderliness, and, indirectly, pessimism through confidence and rigidity.
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10
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Cuzzocrea F, Costa S, Larcan R, Toffle ME. Differences between adolescents exhibiting moderate binging and non-binging eating behaviors. SPRINGERPLUS 2015; 4:593. [PMID: 26543728 PMCID: PMC4628073 DOI: 10.1186/s40064-015-1372-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/24/2015] [Indexed: 01/30/2023]
Abstract
Much research has been conducted to study the association between personality and eating disorders using clinical samples. However, less research has been done on personality variables in non-clinical cases of adolescents prone to binge eating. The purpose of this study is to compare a group of 53 adolescents without binge eating with a group of 28 adolescents with moderate binging behaviors and to investigate the relationship between personality traits and eating behaviors. All participants completed BES, STAY, EPQ-R, IVE and EDI-2. The results demonstrated that the group with moderate binging presented higher scores in state and trait anxiety, psychoticism, neuroticism, and impulsivity than the adolescents without binge eating. The second hypothesis of this research was to analyze the relationship between personality characteristics and eating behaviors. In the group of adolescents without binge eating both neuroticism and psychoticism correlated with ED symptomatology. Similarly extraversion, impulsivity and venturesomeness correlated with ED symptomatology. In the group of adolescents with moderate binge eating, there was an association of trait anxiety, extraversion, venturesomeness and empathy with ED symptomatology in university samples. The results of this study represent a new stimulus to thoroughly investigate those aspects of personality that may be predictive of ED symptomatology and to develop preventative strategies. It is our opinion that it is necessary to focus attention not only on clinical or non-clinical samples, but also on adolescents who could be considered at risk.
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Affiliation(s)
- Francesca Cuzzocrea
- Department of Human and Social Sciences, University of Messina, Via Tommaso Cannizzaro, 278, Messina, Italy
| | - Sebastiano Costa
- Department of Human and Social Sciences, University of Messina, Via Tommaso Cannizzaro, 278, Messina, Italy
| | - Rosalba Larcan
- Department of Human and Social Sciences, University of Messina, Via Tommaso Cannizzaro, 278, Messina, Italy
| | - Mary Ellen Toffle
- Department of Law and History of Institutions, University of Messina, Piazza XX Settembre, 4, Messina, Italy
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11
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Atiye M, Miettunen J, Raevuori-Helkamaa A. A meta-analysis of temperament in eating disorders. EUROPEAN EATING DISORDERS REVIEW 2014; 23:89-99. [PMID: 25546554 DOI: 10.1002/erv.2342] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 11/09/2022]
Abstract
Although suggested as an important contributor to the development and maintenance of eating disorders, temperament has not previously been studied adopting a meta-analytical approach. We therefore pooled data (N = 14 studies; N = 3315 cases, N = 3395 controls) on Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders not otherwise specified. Persistence was significantly higher than in the controls in all eating disorders except for BED the highest levels being observed in AN. Correspondingly, the highest effect sizes for harm avoidance were seen in AN. Novelty seeking was significantly elevated relative to the controls only in BN. Harm avoidance was significantly lower, and reward dependence was significantly higher in individuals who had recovered from AN than in those who remained ill. Future studies with a longitudinal design are needed to explore the temporal relationships between eating disorders and temperament traits.
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Affiliation(s)
- Minna Atiye
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
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12
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Baños RM, Cebolla A, Moragrega I, Van Strien T, Fernández-Aranda F, Agüera Z, de la Torre R, Casanueva FF, Fernández-Real JM, Fernández-García JC, Frühbeck G, Gómez-Ambrosi J, Jiménez-Murcia S, Rodríguez R, Tinahones FJ, Botella C. Relationship between eating styles and temperament in an Anorexia Nervosa, Healthy Control, and Morbid Obesity female sample. Appetite 2014; 76:76-83. [DOI: 10.1016/j.appet.2014.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 01/07/2014] [Accepted: 01/16/2014] [Indexed: 12/15/2022]
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13
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Dalle Grave R, Calugi S, Marchesini G, Beck-Peccoz P, Bosello O, Compare A, Cuzzolaro M, Grossi E, Mannucci E, Molinari E, Tomasi F, Melchionda N. Personality features of obese women in relation to binge eating and night eating. Psychiatry Res 2013; 207:86-91. [PMID: 23017653 DOI: 10.1016/j.psychres.2012.09.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 09/02/2012] [Accepted: 09/05/2012] [Indexed: 02/08/2023]
Abstract
Personality traits can affect eating behaviors, the development of obesity, and obesity treatment failure. We investigated the personality characteristics and their relation with disordered eating in 586 obese women consecutively seeking treatment at eight Italian medical centers (age, 47.7±9.8 years) and 185 age-matched, normal weight women without symptoms of eating disorders (Eating Attitude Test<20). The assessment included anthropometry, the Temperament and Character Inventory (TCI), the Binge Eating Scale (BES) and the Night Eating Questionnaire (NEQ). Logistic regression analyses were carried out in different models with BES score≥27 and NEQ≥30 as dependent variables and TCI scores as independent factors. Personality traits of obese individuals included significantly lower self-directedness and cooperativeness on TCI. BES and NEQ scores were higher in obese women, and values above the defined cut-offs were present in 77 and 18 cases (14 with high BES), respectively. After controlling for age and BMI, high BES values were associated with high novelty seeking and harm avoidance and low self-directedness, the last two scales being also associated with high NEQ. We conclude that personality traits differ between obese patients seeking treatment and controls, and the presence of disordered eating is associated with specific personality characteristics.
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14
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von Lojewski A, Fisher A, Abraham S. Have personality disorders been overdiagnosed among eating disorder patients? Psychopathology 2013; 46:421-6. [PMID: 23407268 DOI: 10.1159/000345856] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 11/11/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is persuasive evidence for a relationship between eating disorders (EDs) and personality disorders (PDs). Research studies over the last three decades have used various tools to explore PDs in EDs with differing results. We investigated PDs derived from an interview--the International Personality Disorder Examination. METHODS 132 female inpatients with restrictive anorexia nervosa (AN-R), binge-purging AN, bulimia nervosa (BN) and ED not otherwise specified were interviewed. MANCOVA was used to test for differences in dimensional PD scores for the ED diagnostic and behavioural groups. RESULTS Twenty-one percent of patients had a definite DSM-IV PD diagnosis and 37% of patients had ≥1 definite or probable DSM-IV PD diagnoses. Cluster C PDs were most commonly found [avoidant (25%), obsessive-compulsive (9%), dependent (2%)], followed by cluster B PDs [borderline (13%), histrionic (2%)]. Comparison of PD dimensional scores revealed significantly lower PD scores for borderline PD in AN-R when compared to the other diagnostic groups; and significantly higher scores for histrionic, narcissistic, antisocial, and not otherwise specified PDs for BN when compared to the other diagnostic groups. Self-induced vomiting was the only behaviour significantly associated with any PD dimensional scores (borderline and narcissistic). CONCLUSIONS Assessment of PDs using a highly structured interview administered by trained interviewers results in less PD diagnoses compared with previous studies of inpatients with an ED. Avoidance is the most common PD and those patients who induce vomiting are more likely to have borderline features.
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Affiliation(s)
- Astrid von Lojewski
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St Leonards, N.S.W., Australia
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Agüera Z, Krug I, Sánchez I, Granero R, Penelo E, Peñas-Lledó E, Jiménez-Murcia S, Menchón JM, Fernández-Aranda F. Personality changes in bulimia nervosa after a cognitive behaviour therapy. EUROPEAN EATING DISORDERS REVIEW 2012; 20:379-85. [PMID: 22367847 DOI: 10.1002/erv.2163] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The goals of this study were to evaluate changes in personality traits in outpatients with bulimia nervosa and specific clinical predictors of such personality changes, after cognitive behaviour therapy (CBT). METHOD The sample comprised 100 purging bulimia nervosa outpatients (DSM-IV-TR). Assessment measures included the Eating Disorders Inventory-2, Symptom Check List Revised and Temperament and Character Inventory-Revised, as well as other clinical and psychopathological indices. All measures were administered before and after 22 weeks of group CBT. RESULTS The temperament traits of Harm Avoidance and Reward Dependence and the character traits of Self-Directedness and Self-Transcendence changed after CBT. Pre-post CBT reduction in Eating Disorders Inventory-2 total score predicted the decrease and increase in Harm Avoidance and Self-Directedness, respectively. CONCLUSIONS Results suggest that group CBT in outpatient women settings influence changes in some personality traits, which appear mainly related to an overall improvement in eating pathology.
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Affiliation(s)
- Zaida Agüera
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Spain
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Miettunen J, Raevuori A. A meta-analysis of temperament in axis I psychiatric disorders. Compr Psychiatry 2012; 53:152-66. [PMID: 21565334 DOI: 10.1016/j.comppsych.2011.03.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 03/06/2011] [Accepted: 03/12/2011] [Indexed: 12/20/2022] Open
Abstract
This article reports on a meta-analysis of Cloninger's temperament dimensions (novelty seeking, harm avoidance, reward dependence, and persistence) in individuals with lifetime psychiatric disorders compared with controls and on interdisorder comparisons between these disorders. Nine disorders from 75 studies were included in the meta-analyses. The most consistent feature was elevated harm avoidance: compared with the controls, harm avoidance was higher in all diagnostic groups studied except for those with alcohol use disorders. The increase in effect sizes in harm avoidance scores varied from a very large (d = 2.66) in social phobia to a small effect (effect size, d = 0.29) in alcohol use disorders. In other dimensions, differences between cases and controls were relatively small. However, in pairwise comparisons, notable differences also in other dimensions emerged: in novelty seeking, the lowest scores were in social phobia (d = -0.87) and the highest in bulimia nervosa (d = 0.33); in reward dependence, the lowest scores were in schizophrenia (d = -0.36) and the highest in social phobia (d = 0.12); and in persistence, the lowest scores were in social phobia (d = -0.30) and the highest in anorexia nervosa (d = 0.49). The provided data should be taken into account in the future studies on suggestive vulnerability markers for psychiatric morbidity.
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Affiliation(s)
- Jouko Miettunen
- Department of Psychiatry, University of Oulu, PO Box 5000, 90014 Oulu, Finland.
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17
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Forcano L, Alvarez E, Santamaría JJ, Jimenez-Murcia S, Granero R, Penelo E, Alonso P, Sánchez I, Menchón JM, Ulman F, Bulik CM, Fernández-Aranda F. Suicide attempts in anorexia nervosa subtypes. Compr Psychiatry 2011; 52:352-8. [PMID: 21683172 DOI: 10.1016/j.comppsych.2010.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 09/13/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The risk for suicide attempts is elevated in anorexia nervosa (AN), yet we know little about the relation between suicide and personality in this group. We explored the prevalence of lifetime suicide attempts in women with AN and compared those who had and had not attempted suicide on eating disorder symptoms, general psychopathology, and personality both relative to a healthy control group and then across AN subtypes. METHOD One hundred four outpatients with restricting AN, 68 outpatients with purging AN, and 146 comparison individuals participated in the study. RESULTS The prevalence of suicide attempts differed significantly across the 3 groups (P = .003), with 0% in the controls, 8.65% in the restricting AN group, and 25.0% in the purging AN group. Depression measures were elevated in those with suicide attempts. Within the restricting AN group, those who attempted suicide scored significantly higher on Phobic Anxiety, measured by means of the Symptom Checklist-Revised, than those who did not (P = .001). CONCLUSION The presence of purging and depressive symptoms in individuals with AN should increase vigilance for suicidality; and among restrictors, greater anxiety may index greater suicide risk.
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Affiliation(s)
- Laura Forcano
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
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Hartmann AS, Czaja J, Rief W, Hilbert A. Personality and psychopathology in children with and without loss of control over eating. Compr Psychiatry 2010; 51:572-8. [PMID: 20965302 DOI: 10.1016/j.comppsych.2010.03.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 12/07/2009] [Accepted: 03/03/2010] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND In children with loss of control (LOC) over eating, recent research has revealed evidence for distinct personality features, such as more impulsivity. The aim of this study was to assess parent- and child-report personality profiles in children with and without LOC over eating and to relate these profiles to general and eating-disorder psychopathology. METHOD A total of 120 children (60 with LOC over eating; 68 girls) aged 8 to 13 years were recruited from the community. Clinical interview, self-report, and parent-report questionnaires were administered to assess personality as well as both general and eating-disorder psychopathology. RESULTS The group with LOC over eating showed lower self-directedness and cooperativeness compared to the group without LOC. The children with LOC were significantly more impulsive. Personality dimensions were significantly correlated with greater general but not eating-disorder psychopathology and frequency of LOC over eating. CONCLUSION A distinct pattern of personality traits in children with LOC over eating was found that is partly in line with research on binge-eating disorder, bulimia nervosa, and obesity in adulthood. The findings suggest that longitudinal studies should examine whether certain patterns of personality in children with LOC over eating account for differences in psychopathology later in life.
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Affiliation(s)
- Andrea Sabrina Hartmann
- Philipps University of Marburg, Department of Psychology Gutenbergstr. 18 D-35032 Marburg, Germany.
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Harrison A, O'Brien N, Lopez C, Treasure J. Sensitivity to reward and punishment in eating disorders. Psychiatry Res 2010; 177:1-11. [PMID: 20381877 DOI: 10.1016/j.psychres.2009.06.010] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 06/08/2009] [Accepted: 06/11/2009] [Indexed: 11/28/2022]
Abstract
The aim of this review was to collate and summarise the self-report data regarding anomalies in sensitivity to reward and punishment in eating disorders (ED) with use of a meta-analysis where possible. Electronic databases were searched to December 2008. Studies were required to have a non-eating disorder healthy control group and include at least one self-report measure of sensitivity to reward or punishment in an eating disorder population. Findings were very heterogeneous and inconsistencies between studies and measures were highlighted. In general, patients with anorexia nervosa (restricting type) were less sensitive to reward than healthy controls, whereas patients with bulimia nervosa and anorexia nervosa (binge/purge) type were more sensitive. All ED groups report higher sensitivity to punishment than healthy controls. Individuals with eating disorders differ from healthy controls in measures of reward and punishment sensitivity as measured using the Temperament and Character Inventory, Tridimensional Personality Questionnaire and BIS/BAS scales, but further work is required as there is some heterogeneity in the data. Generating more research using behavioural measures may increase understanding of the findings.
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Affiliation(s)
- Amy Harrison
- Institute of Psychiatry, Kings College London, UK.
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Cloninger CR, Zohar AH, Cloninger KM. Promotion of Well-Being in Person-Centered Mental Health Care. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2010; 8:165-179. [PMID: 26146491 PMCID: PMC4486313 DOI: 10.1176/foc.8.2.foc165] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An understanding of the mechanisms of personality development provides a systematic way to promote health as an integrated state of physical, mental, social, and spiritual well-being. Individual differences in personality are causal antecedents of the full range of psychopathology. The maturation with integration of personality appears to be an important mechanism by which diverse modalities of treatment promote wellness and reduce illness. First, the authors review the relationship between personality and a wide range of psychiatric disorders. Second, the authors evaluate the impact of character structure on a wide range of measures of well-being, including positive emotions, negative emotions, life satisfaction, perceived social support, and perceived health. Third, the authors describe a practical and inexpensive clinical method for facilitating the maturation and integration of personality based on an understanding of the processes of human thought, which underlie changes in personality and well-being.
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Affiliation(s)
- C Robert Cloninger
- Director, Center for Well-Being, Washington University School of Medicine, St. Louis, MO
| | - Ada H Zohar
- Chair of Psychology, Department of Behavioral Sciences, Ruppin Academic Center, Israel
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21
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Abstract
BACKGROUND Etiological hypotheses of eating disorders, anorexia nervosa and bulimia nervosa have not produced informative research for predictably effective treatment. METHODS The rationale for applying a model of allostasis, a dysregulation of reward circuits with activation of brain and hormonal stress responses to maintain apparent stability, is developed for eating disorders. RESULTS The neurotransmitter systems involved in the allostatic state of a reward system in anorexia nervosa and bulimia nervosa may be similar to those present in drug addiction. CONCLUSION The biological vulnerabilities underlying the unique features of eating disorders should be intensively investigated with the advancing techniques in genetics and neuroimaging. Preventing chronicity with early diagnosis and adequate treatment before age 18 is necessary.
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Affiliation(s)
- Katherine A Halmi
- Weill Cornell Medical College, 21 Bloomingdale Rd., White Plains, NY 10605, USA.
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22
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Kaye WH, Bulik CM, Plotnicov K, Thornton L, Devlin B, Fichter MM, Treasure J, Kaplan A, Woodside DB, Johnson CL, Halmi K, Brandt HA, Crawford S, Mitchell JE, Strober M, Berrettini W, Jones I. The genetics of anorexia nervosa collaborative study: methods and sample description. Int J Eat Disord 2008; 41:289-300. [PMID: 18236451 PMCID: PMC3755506 DOI: 10.1002/eat.20509] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Supported by National Institute of Mental Health (NIMH), this 12-site international collaboration seeks to identify genetic variants that affect risk for anorexia nervosa (AN). METHOD Four hundred families will be ascertained with two or more individuals affected with AN. The assessment battery produces a rich set of phenotypes comprising eating disorder diagnoses and psychological and personality features known to be associated with vulnerability to eating disorders. RESULTS We report attributes of the first 200 families, comprising 200 probands and 232 affected relatives. CONCLUSION These results provide context for the genotyping of the first 200 families by the Center for Inherited Disease Research. We will analyze our first 200 families for linkage, complete recruitment of roughly 400 families, and then perform final linkage analyses on the complete cohort. DNA, genotypes, and phenotypes will form a national eating disorder repository maintained by NIMH and available to qualified investigators.
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Affiliation(s)
- Walter H. Kaye
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine Plotnicov
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Laura Thornton
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bernie Devlin
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Manfred M. Fichter
- Department of Psychiatry, University of Munich (LMU), Munich, Germany
- Roseneck Hospital for Behavioral Medicine, Prien, Germany
| | - Janet Treasure
- Department of Academic Psychiatry, Kings College London, Institute of Psychiatry, London, United Kingdom
| | - Allan Kaplan
- Department of Psychiatry, Toronto General Hospital, Toronto, Ontario, Canada
| | - D. Blake Woodside
- Department of Psychiatry, Toronto General Hospital, Toronto, Ontario, Canada
| | | | - Katherine Halmi
- Department of Psychiatry, Weill Cornell Medical College, White Plains, New York
| | - Harry A. Brandt
- Department of Psychiatry, Sheppard Pratt Health System, Towson, Maryland
| | - Steve Crawford
- Department of Psychiatry, Sheppard Pratt Health System, Towson, Maryland
| | - James E. Mitchell
- Department of Psychiatry, Neuropsychiatric Research Institute, Fargo, North Dakota
| | - Michael Strober
- Department of Psychiatry, Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, California
| | - Wade Berrettini
- Department of Psychiatry, Center of Neurobiology and Behavior, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ian Jones
- Department of Psychological Medicine, University of Birmingham, England
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Alvarez-Moya EM, Jiménez-Murcia S, Granero R, Vallejo J, Krug I, Bulik CM, Fernández-Aranda F. Comparison of personality risk factors in bulimia nervosa and pathological gambling. Compr Psychiatry 2007; 48:452-7. [PMID: 17707254 DOI: 10.1016/j.comppsych.2007.03.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The objective of the study was to assess the predictive value of personality profiles to classify individuals with bulimia nervosa (BN), pathological gambling (PG), and a nonpsychiatric comparison group while controlling for sex. METHODS The sample comprised 270 BN (241 women, 29 men), 429 PG (42 women, 387 men), and 96 comparison (nonpsychiatric) subjects (35 women, 61 men). All patients were consecutively admitted to our Psychiatry Department and were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. We administered the Temperament and Character Inventory-Revised as well as other clinical indices. Multinomial and binary logistic regression models adjusted for age and stratified by sex were used to assess the predictive value of personality in relation to group status. RESULTS In comparison to controls, high Novelty Seeking (P < .001) was specifically associated with a diagnosis of PG. Independently of sex, low Self-Directedness was associated with both BN (P < .001) and PG (P < .001). Some sex-specific differences were also observed; namely, women with BN and PG displayed higher Harm Avoidance and Cooperativeness than control women, whereas men with PG reported higher Reward Dependence and Persistence than control men. CONCLUSIONS Our results suggested that, whereas there are some shared personality traits between BN and PG when compared with healthy controls, there are also some sex- and diagnostic-specific personality traits that weigh against the consideration of BN as an impulse control disorder.
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Affiliation(s)
- Eva M Alvarez-Moya
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
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24
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Dalle Grave R, Calugi S, Brambilla F, Abbate-Daga G, Fassino S, Marchesini G. The effect of inpatient cognitive-behavioral therapy for eating disorders on temperament and character. Behav Res Ther 2007; 45:1335-44. [PMID: 17074299 DOI: 10.1016/j.brat.2006.09.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 09/12/2006] [Accepted: 09/20/2006] [Indexed: 11/24/2022]
Abstract
Personality traits seem to have an important role in the development, clinical expression, course, and treatment response in eating disorders (EDs). We investigated the effects of an inpatient cognitive-behavioral treatment (CBT) on the measures of temperament and character (Temperament and Character Inventory (TCI)) in 149 consecutive patients with EDs. Baseline assessment included anthropometry, the Eating Disorder Examination (EDE), the Beck Depression Inventory (BDI), and the TCI. Treatment was based on the transdiagnostic cognitive behavior theory and treatment of ED, adapted for an inpatient setting. Treatment effects were tested by paired ANOVA, adjusted for covariates. No effects were found on Novelty Seeking, Reward Dependence, and Cooperativeness. Harm Avoidance (F=18.17, p<0.001), Persistence (F=7.71, p=0.006), Self-Directedness (F=27.55, p<0.001), and Self Transcendence (F=16.38, p<0.001) significantly changed after treatment. Changes in TCI scores were wholly dependent on the changes in BDI and EDE, and independent of ED diagnosis and behavior and of BMI changes. We conclude that in ED, a few scales of both temperament and character are significantly modified by CBT, in relation to changes in psychopathology and depression, independently of nutrition. These results are relevant for future studies based on TCI.
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Affiliation(s)
- Riccardo Dalle Grave
- Department of Eating and Weight Disorder, Villa Garda Hospital, Garda, Verona, Italy.
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25
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Sullivan S, Cloninger CR, Przybeck TR, Klein S. Personality characteristics in obesity and relationship with successful weight loss. Int J Obes (Lond) 2006; 31:669-74. [PMID: 16953251 PMCID: PMC4450078 DOI: 10.1038/sj.ijo.0803464] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Personality influences lifestyle behaviors. Therefore, certain personality traits could contribute to obesity and the response to behaviorally based weight loss therapy. PURPOSE The aims of this study were to test the hypothesis that personality characteristics differ between lean and obese persons in the community, obese persons in the community and obese persons seeking weight loss therapy by enrolling in a comprehensive weight loss program, and in obese persons who were successful and unsuccessful in achieving behavioral therapy-induced weight loss. METHODS The Temperament and Character Inventory was administered to 264 lean (body mass index (BMI) <25 kg/m(2)) and 56 obese (BMI> or =35 kg/m(2)) subjects from the St Louis community and 183 obese patients (BMI=44+/-10 kg/m(2)) enrolled in the Washington University Weight Management Program (WUWMP), which involved weekly group behavioral therapy and diet education sessions for 22 weeks. RESULTS Compared with lean subjects, obese subjects in the community scored higher in novelty seeking (19.7+/-5.9 vs 16.2+/-6.0, P<0.05), lower in Persistence (4.1+/-1.8 vs 4.8+/-1.7, P<0.05) and lower in self-directedness (32.1+/-7.6 vs 34.3+/-6.6, P<0.05.) Patients enrolled in the WUWMP scored higher than obese persons in the general population in both Reward Dependence (17.1+/-4.2 vs 15.7+/-4.3, P<0.05) and cooperativeness (36.9+/-5.4 vs 34.5+/-6.2, P<0.05). Patients who were successful in losing weight (>10% weight loss) after 22 weeks of behavioral therapy scored lower in novelty seeking than those who were unsuccessful in losing weight (<5% weight loss) (17.6+/-5.9 vs 20.2+/-5.9, P<0.05). DISCUSSION These results suggest that personality traits differ between lean and obese persons, and between obese persons who enroll and who do not enroll in a comprehensive weight management program. Moreover, high scores in novelty seeking are associated with decreased success in achieving behavioral therapy-induced weight loss.
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Affiliation(s)
- S Sullivan
- Department of Internal Medicine, Center for Human Nutrition, Washington University School of Medicine, St Louis, MO, USA
| | - CR Cloninger
- Department of Psychiatry, Center for Human Nutrition, Washington University School of Medicine, St Louis, MO, USA
| | - TR Przybeck
- Department of Psychiatry, Center for Human Nutrition, Washington University School of Medicine, St Louis, MO, USA
| | - S Klein
- Department of Internal Medicine, Center for Human Nutrition, Washington University School of Medicine, St Louis, MO, USA
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Wagner A, Barbarich-Marsteller NC, Frank GK, Bailer UF, Wonderlich SA, Crosby RD, Henry SE, Vogel V, Plotnicov K, McConaha C, Kaye WH. Personality traits after recovery from eating disorders: do subtypes differ? Int J Eat Disord 2006; 39:276-84. [PMID: 16528697 DOI: 10.1002/eat.20251] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We compared individuals recovered from anorexia (AN) and bulimia nervosa (BN) to determine characteristics that are shared by or distinguish eating disorder (ED) subtypes. METHOD Sixty women recovered for > or = 1 year from AN or BN were compared with 47 control women (CW). Assessments included the Yale-Brown-Cornell Eating Disorder Scale, the Spielberger State-Trait Anxiety Inventory, the Beck Depression Inventory, the Yale-Brown Obsessive Compulsive Scale, the Temperament and Character Inventory, and Structured Clinical Interviews for DSM-IV. RESULTS Individuals recovered from an ED had similar scores for mood and personality variables that were significantly higher than the scores for CW. Few recovered subjects had Cluster B personality disorder. Most individuals recovered within 6 years of their ED onset. A latent profile analysis identified an "inhibited" and "disinhibited" cluster based on personality traits. CONCLUSION A wide range of symptoms persist after recovery and do not differ between subtypes of ED. These findings may aid in identifying traits that create vulnerabilities for developing an ED.
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Affiliation(s)
- Angela Wagner
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania 15213, USA
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27
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van den Bree MBM, Przybeck TR, Robert Cloninger C. Diet and personality: Associations in a population-based sample. Appetite 2006; 46:177-88. [PMID: 16527617 DOI: 10.1016/j.appet.2005.12.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Accepted: 12/09/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND Large portions of the population of the United States of America fail to follow dietary recommendations. Psychological factors may contribute to non-adherence. OBJECTIVE Establish the associations between heritable personality styles, attitudes towards food, and habitual eating behavior. DESIGN Variables were assessed by questionnaire in a population-based sample of 629 subjects. Associations were established using correlation and regression analysis, taking gender, demographic, lifestyle and other factors into account. RESULTS Differences in personality style were reflected in diet. For example, hostility and anxiety-proneness was associated with greater likelihood to continue eating when satiated, while sociability and low impulsivity correlated with greater monitoring and control of dietary intake and body weight. Immaturity, aloofness, self-consciousness and self-gratification were associated with greater susceptibility to hunger and lack of persistence with increased snack and alcohol consumption. These associations differed for the sexes and were stronger for attitudes towards food than actual eating behavior. Taking other factors into account reduced the number of significant associations between diet and personality, particularly for habitual eating behavior. CONCLUSIONS Associations exist between personality and diet. However, the strength of these associations is influenced by demographic, lifestyle and other factors. These findings have implications for future studies and efforts aimed at changing unhealthy dietary habits.
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28
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Carter JC, Bewell C, Blackmore E, Woodside DB. The impact of childhood sexual abuse in anorexia nervosa. CHILD ABUSE & NEGLECT 2006; 30:257-69. [PMID: 16524628 DOI: 10.1016/j.chiabu.2005.09.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2005] [Revised: 08/31/2005] [Accepted: 09/24/2005] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). METHOD The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. RESULTS Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p<.02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. CONCLUSIONS Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.
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Affiliation(s)
- Jacqueline C Carter
- Department of Psychiatry, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Eaton Wing North, Toronto, Ontario, Canada M5G 2C4
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Miller JL, Schmidt LA, Vaillancourt T, McDougall P, Laliberte M. Neuroticism and introversion: a risky combination for disordered eating among a non-clinical sample of undergraduate women. Eat Behav 2006; 7:69-78. [PMID: 16360625 DOI: 10.1016/j.eatbeh.2005.07.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2005] [Revised: 07/06/2005] [Accepted: 07/12/2005] [Indexed: 10/25/2022]
Abstract
Recent evidence suggests that people who score low on measures of sociability may be at risk for certain types of psychopathology, including mood and anxiety disorders. In an attempt to extend these findings to other forms of psychopathology, we examined levels of neuroticism and extraversion in relation to eating problems in a non-clinical sample of undergraduate women. The Eysenck Personality Questionnaire (EPQ), Eating Disorders Inventory (EDI), and the Eating Attitudes Test (EAT-26) were completed by 196 first-year undergraduate females. We found that high neuroticism was related to high scores on both of the EDI subscales (Bulimia and Drive for Thinness) as well as high scores on the EAT-26 measure, replicating previous work. In addition, neuroticism served as a moderator such that lower extraversion (i.e., introversion) was related to greater disordered eating, but only for those women who scored high on neuroticism. Thus, a combination of neuroticism and introversion may be a risk-factor for symptoms of eating disorders in a non-clinical sample of university women.
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Affiliation(s)
- Jessie L Miller
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada.
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Tavares H, Zilberman ML, Hodgins DC, el-Guebaly N. Comparison of Craving Between Pathological Gamblers and Alcoholics. Alcohol Clin Exp Res 2005; 29:1427-31. [PMID: 16131850 DOI: 10.1097/01.alc.0000175071.22872.98] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Craving is a central phenomenon in addiction. Temperament factors are also important for pathologic gambling and other addictions. The aim of this study was to compare craving between pathologic gamblers (PG) and alcohol-dependent subjects (ADS), correlating craving with personality. METHODS Forty-nine PG and 101 ADS willing to start treatment were recruited. A trained psychiatrist diagnosed them according to DSM-IV criteria. To be included in this study, subjects had to be abstinent for at least five days and no longer than 21 days. Alcoholics should have no significant physical withdrawal symptoms by the time of craving assessment. Subjects with current comorbidity with other addictions were excluded, except nicotine. ADS rated craving for alcohol and PG rated craving for gambling on the same questions, respectively. Both answered a semistructured interview, the Temperament and Character Inventory and the Beck Scales for anxiety and depression. RESULTS Pathologic gamblers scored higher than ADS on craving measures (p<0.001) and novelty seeking (p=0.01). ADS scored higher in harm avoidance (p=0.01). Alcohol craving correlated positively with anxiety and novelty seeking and negatively with length of abstinence and persistence. Gambling craving correlated positively with depression and negatively with length of abstinence and reward dependence CONCLUSIONS Pathologic gamblers experienced stronger cravings than did ADS. This may be a disturbing experience for PG and a potential cause for relapse. The higher scores on novelty seeking concur with previous studies that associate PG and impulsivity. ADS higher scores on harm avoidance suggest anxiety vulnerability. The positive relation between alcohol craving, anxiety, and harm avoidance suggests that ADS rely on alcohol to deal with a proclivity to negative emotions. The positive relation of gambling craving to depression and negative relation to reward dependence suggests that individuals who have a lesser susceptibility to experience positive emotions are the ones who most miss gambling when abstaining.
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Affiliation(s)
- Hermano Tavares
- Department of Psychiatry, Gambling Outpatient Unit, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
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Perkins PS, Klump KL, Iacono WG, McGue M. Personality traits in women with anorexia nervosa: evidence for a treatment-seeking bias? Int J Eat Disord 2005; 37:32-7. [PMID: 15690463 DOI: 10.1002/eat.20064] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Several personality traits have been associated with anorexia nervosa (AN) in treatment-seeking samples of patients. The current study used a population-based sample to compare the personality characteristics of women with AN who sought treatment versus those who did not. METHOD Participants included 27 (14 treatment-seekers, 13 non-treatment-seekers) women with threshold or subthreshold AN and 273 (64 treatment seekers, 209 non-treatment seekers) comparison women from the Minnesota Twin Family Study. Personality was assessed with the higher-order factors and primary scales of the Multidimensional Personality Questionnaire (MPQ). RESULTS Non-treatment-seeking women showed lower levels of negative emotionality, stress reaction, and alienation than treatment-seeking women. DISCUSSION These results suggest that personality deviations may be overestimated in treatment-seeking samples.
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Affiliation(s)
- Patrick S Perkins
- Department of Psychology, Michigan State University, East Lansing, Michigan 48824, USA
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Serpell L, Teasdale JD, Troop NA, Treasure J. The development of the P-CAN, a measure to operationalize the pros and cons of anorexia nervosa. Int J Eat Disord 2004; 36:416-33. [PMID: 15558651 DOI: 10.1002/eat.20040] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Research has suggested that a fundamental aspect of anorexia nervosa (AN) is its egosyntonic nature, the fact that it is often valued by individuals with the disorder. The current study describes the development of the P-CAN, a quantitative measure of both positive (valued) and negative aspects of AN. METHOD Items were derived from a previous qualitative study (Serpell, Treasure, Teasdale, & Sullivan. 1999. International Journal of Eating Disorders, 25, 177-186). Data from 233 women with AN were subjected to a principal components analysis. RESULTS Ten subscales were identified, six describing the pros of AN and four describing the cons of the illness. DISCUSSION The P-CAN shows good psychometric properties and should prove a useful tool for the measurement of attitudes towards AN, as well as offer insights into the maintenance of the disorder.
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Affiliation(s)
- Lucy Serpell
- Department of Mental Health, St. Georges Hospital Medical School, London, UK.
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Abstract
Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders of eating and weight-related behavior that together afflict some 1-3% of women in the United States. One of the remarkable features about each of the eating disorders is how persistent the disordered eating behavior becomes once it has begun. Substantial psychological, social, and physiological disturbances are associated with eating disorders, and it has been very difficult to disentangle those factors that may result from the disturbed behavior from the factors that may have predisposed individuals to, or precipitated the development of, the disorder. This article will briefly review the definitions, phenomenology, and identified risk factors for development of each of the major eating disorders. Pathophysiology will be discussed, with a particular focus on candidate factors that might sustain disordered eating behavior, as informed by clinical and basic science research. Future research directions will be suggested.
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Affiliation(s)
- Diane Alix Klein
- Columbia University/NYSPI, Unit #98, 1051 Riverside Drive, New York, NY 10032, USA.
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Fassino S, Pierò A, Gramaglia C, Abbate-Daga G. Clinical, psychopathological and personality correlates of interoceptive awareness in anorexia nervosa, bulimia nervosa and obesity. Psychopathology 2004; 37:168-74. [PMID: 15237246 DOI: 10.1159/000079420] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2003] [Accepted: 04/13/2004] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the levels of interoceptive awareness (IA), which measures the ability of an individual to discriminate between sensations and feelings, and between the sensations of hunger and satiety, in eating disorder patients and to identify the clinical, psychopathological and personal variables correlated with IA. SAMPLING AND METHODS Sixty-one restrictor anorectics, 61 binge-purging anorectics, 104 purging bulimics, 49 obese subjects with binge eating disorder (BED) and 47 obese subjects without BED were compared. They were assessed with the Eating Disorder Inventory-2, the Temperament and Character Inventory, and the Beck Depression Inventory, and their clinical and sociodemographic features were recorded. RESULTS In all patients, the levels of IA were higher than the 'normal' ones; in bulimia nervosa, they were higher than in anorexia nervosa and obesity. Similar personal features and eating attitudes are shared by patients with bulimia nervosa and BED. In the total sample, the following variables independently correlate with IA: the Beck Depression Inventory, self- directedness and persistence. CONCLUSIONS The importance of an altered IA in eating disorders is supported. Both depression and a perfectionist and poorly self-directive personality can lead to greater difficulties in discriminating hunger and satiety.
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Affiliation(s)
- Secondo Fassino
- Department of Neurosciences, Psychiatry Section, Eating Disorders Center, Turin University, Turin, Italy.
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Fassino S, Amianto F, Gramaglia C, Facchini F, Abbate Daga G. Temperament and character in eating disorders: ten years of studies. Eat Weight Disord 2004; 9:81-90. [PMID: 15330074 DOI: 10.1007/bf03325050] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In recent years a number of studies of personality have been performed in subjects with Eating Disorders (EDs) to investigate the clinical differences between controls and ED patients and among EDs subtypes, and its role in the development and course of symptoms. The Tridimensional Personality Questionnaire (TPQ) and the Temperament and Character Inventory (TCI) have been widely used at this purpose, allowing the description of specific temperament and character profiles for EDs. High Harm Avoidance (HA) and low Self-Directedness (SD) are shared by all EDs. Slight differences on some facets have been found among ED subgroups. Nevertheless, HA is influenced by mood and both high HA and low SD are personality traits shared by many mental disorders, whose specificity is rather low. Restrictor anorectics are characterized by high Persistence (P) and a relatively higher SD, and bulimics by higher Novelty Seeking (NS) and the lowest SD, while binge/purging and purging anorectics share some traits with anorexia and some with bulimia. Though current data justify the discrimination among anorexia subtypes, they are not in contrast with the thesis of a continuum in ED personality traits. Since some personality traits display a prognostic value with regard to therapy and clinical outcome, further studies are needed on treatments and prognostic factors in EDs. Moreover, studies attempting to define the neurobiological and genetic correlates of temperament should be supported by clinical pharmacological trials.
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Affiliation(s)
- S Fassino
- Department of Neurosciences, Psychiatry Section, Turin University, Turin, Italy.
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Ramacciotti CE, Paoli RA, Ciapparelli A, Marcacci G, Placidi GE, Dell'Osso L, Garfinkel PE. Affective temperament in the eating disorders. Eat Weight Disord 2004; 9:114-9. [PMID: 15330078 DOI: 10.1007/bf03325054] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In this study, we investigate the affective temperamental characteristics in a sample of ED (eating disorder) patients. METHODS 49 ED patients diagnosed by the SCID (Structured Clinical Interview for DSM-IV), were divided into two groups on the basis of the presence or absence of Binge Eating (restricting-anorexia nervosa [R-AN]= 16; Binge Eaters= 33). All patients were administered the TEMPS-I (Temperament Evaluation Memphis Pisa Semistructured - Interview), to assess affective temperament. A third group of controls (N= 1010), derived from a study with the TEMPS-I on normal subjects, was included for comparison. RESULTS A full affective temperament was not found in patients of the restricting group. By contrast 24% of the binge eating group had a full affective temperament of one of three types. Comparing the three temperaments for the three groups, only cyclothymic temperament proved to be significant, with higher levels in the binge eating group (p<0.01). CONCLUSIONS In this study, people with R-AN do not show a full affective temperament. However, people with binge eating, had depressive and hyperthymic temperament, and displayed higher level of cyclothymic temperament than the normal population. The findings of this study add to a growing literature on temperament in people with ED; particularly, they add to the view that may be various paths leading to R-AN, and these may differ from those of binge eating.
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Rybakowski F, Slopien A, Zakrzewska M, Hornowska E, Rajewski A. Temperament and Character Inventory (TCI) in adolescents with anorexia nervosa. Acta Neuropsychiatr 2004; 16:169-74. [PMID: 26984170 DOI: 10.1111/j.0924-2708.2004.00073.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Female patients with anorexia nervosa differ significantly from the control women in various dimensions of personality. OBJECTIVE To investigate the personality dimensions measured with the Temperament and Character Inventory (TCI) in adolescent patients with restrictive-type and bulimic/purging-type anorexia nervosa (ANR and ANB, respectively), and contrast them with the results of control females. METHODS Sixty-one patients with anorexia nervosa (36 ANR and 25 ANB) and 60 controls were tested with the TCI. A concomitant assessment of depression, body mass index and age was made to evaluate the possible correlation with personality dimensions. RESULTS Adolescent ANR patients scored higher in persistence, harm avoidance and cooperativeness, and lower in novelty seeking and self-transcendence than control women. ANB patients scored in the middle between ANR and control females, but differences did not reach the significance level with either group, except for the self-transcendence dimension where they scored significantly higher than those with ANR. CONCLUSIONS The deviations in temperamental profile of adolescent ANR are similar to those reported in adult patients. The ANB adolescent patients with anorexia nervosa show less prominent deviations from the personality of control women. With regard to the character dimension of cooperativeness, adolescents with ANR scored higher than controls, in contrast to the observations in adult patients. This may reflect the effect of illness on the development of character.
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Affiliation(s)
- Filip Rybakowski
- 1Department of Child and Adolescent Psychiatry, University of Medical Sciences
| | - Agnieszka Slopien
- 1Department of Child and Adolescent Psychiatry, University of Medical Sciences
| | - Marzena Zakrzewska
- 2Department of Basic Psychological Research, University of Adam Mickiewicz, Poznan, Poland
| | - Elzbieta Hornowska
- 2Department of Basic Psychological Research, University of Adam Mickiewicz, Poznan, Poland
| | - Andrzej Rajewski
- 1Department of Child and Adolescent Psychiatry, University of Medical Sciences
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Kaye WH, Devlin B, Barbarich N, Bulik CM, Thornton L, Bacanu SA, Fichter MM, Halmi KA, Kaplan AS, Strober M, Woodside DB, Bergen AW, Crow S, Mitchell J, Rotondo A, Mauri M, Cassano G, Keel P, Plotnicov K, Pollice C, Klump KL, Lilenfeld LR, Ganjei JK, Quadflieg N, Berrettini WH. Genetic analysis of bulimia nervosa: methods and sample description. Int J Eat Disord 2004; 35:556-70. [PMID: 15101071 DOI: 10.1002/eat.10271] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Twin and family studies suggest that genetic variants contribute to the pathogenesis of bulimia nervosa (BN) and anorexia nervosa (AN). The Price Foundation has supported an international, multisite study of families with these disorders to identify these genetic variations. The current study presents the clinical characteristics of this sample as well as a description of the study methodology. METHOD All probands met modified criteria for BN or bulimia nervosa with a history of AN (BAN) as defined in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). All affected relatives met DSM-IV criteria for BN, AN, BAN, or eating disorders not otherwise specified (EDNOS). Probands and affected relatives were assessed diagnostically using both trained-rater and self-report assessments. DNA samples were collected from probands, affected relatives, and available biologic parents. RESULTS Assessments were obtained from 163 BN probands and 165 BAN probands. Overall, there were 365 relative pairs available for linkage analysis. Of the affected relatives of BN probands, 62 were diagnosed as BN (34.8%), 49 as BAN (27.5%), 35 as AN (19.7%), and 32 as EDNOS (18.0%). For the relatives of BAN probands, 42 were diagnosed as BN (22.5%), 67 as BAN (35.8%), 48 as AN (25.7%), and 30 as EDNOS (16.0%). DISCUSSION This study represents the largest genetic study of eating disorders to date. Clinical data indicate that although there are a large number of individuals with BN disorders, a range of eating pathology is represented in the sample, allowing for the examination of several different phenotypes in molecular genetic analyses.
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Affiliation(s)
- Walter H Kaye
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Stewart ME, Ebmeier KP, Deary IJ. The structure of Cloninger's Tridimensional Personality Questionnaire in a British sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2004. [DOI: 10.1016/s0191-8869(03)00237-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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40
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Rousset I, Kipman A, Adès P, Gorwood P. Personnalité, tempérament et anorexie mentale. ANNALES MEDICO-PSYCHOLOGIQUES 2004. [DOI: 10.1016/j.amp.2003.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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Bloks H, Hoek HW, Callewaert I, van Furth E. Stability of personality traits in patients who received intensive treatment for a severe eating disorder. J Nerv Ment Dis 2004; 192:129-38. [PMID: 14770057 DOI: 10.1097/01.nmd.0000110284.12816.fe] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A longitudinal prospective design with four assessments was used to examine the stability of personality traits and their relation to recovery in patients with restrictive anorexia nervosa (N=35), bingeing/purging anorexia nervosa (N=37), bulimia nervosa (N=47), and eating disorder not otherwise specified (N=27). Recovery is associated with changes in personality traits in the direction of healthy control women. Recovered patients still show higher harm avoidance and higher persistence than healthy control women. These temperament factors seem to be a vulnerability factor for developing an eating disorder. Novelty seeking seems to define the type of eating disorder one is prone to develop. The character dimensions contribute the most to recovery. High self-directedness contributes to a favorable prognosis of bulimic symptomatology, whereas high cooperativeness contributes to an unfavorable prognosis in patients with anorexia nervosa.
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Affiliation(s)
- Hans Bloks
- National Centre for Eating Disorders, Robert Fleury Stichting, Leidschendam, The Netherlands
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42
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Vervaet M, van Heeringen C, Audenaert K. Personality-related characteristics in restricting versus binging and purging eating disordered patients. Compr Psychiatry 2004; 45:37-43. [PMID: 14671735 DOI: 10.1016/j.comppsych.2003.09.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The current study sought to examine differences in personality-related characteristics between restricting anorexia nervosa (RAN), binging/purging anorexia (BPAN), and purging bulimia nervosa (BN) patients. Scores on the Temperament and Character Inventory (TCI) and on the Dutch Eating Behaviour Questionnaire (DEBQ) were compared for 166 RAN, 78 BPAN, and 151 BN patients. Bingers/purgers showed a higher score for restrained, external and emotional eating and a lower score for a subscale of "self-directedness" compared to patients who never binge and purge. Personality differences were most marked between RAN and BN patients, while personality characteristics of BPAN patients tended to be similar to those of BN patients. BN patients showed higher scores on "novelty seeking" and the subscales "exploratory excitability," "impulsivity," and "extravagance," and lower scores on "self-directedness," compared to restricting patients. Moreover RAN patients also showed higher scores on subscales of character dimensions, compared to BN patients. The higher the scores on novelty seeking, the lower the scores on several character scales, which has important implications for the reinforcement of behavior and the treatment of eating disorders.
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Affiliation(s)
- M Vervaet
- Centre for Eating Disorders, University Department of Psychiatry, Ghent University Hospital, Belgium
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Abstract
Eating disorders rank among the most debilitating psychiatric disturbances that affect young women. Knowledge has increased in recent years about the two major eating disorders, anorexia nervosa (AN) and bulimia nervosa (BN); however, much remains unknown. This review article will provide an overview of the epidemiology, proposed risk factors and clinical features of AN, and BN, as well as current recommendations for evaluation and treatment of these disorders.
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Affiliation(s)
- D A Klein
- New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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Abstract
Scale scores on the Tridimensional Personality Questionnaire (TPQ)-novelty seeking (NS), harm avoidance (HA), and reward dependence (RD)-can predict response to antidepressants. This study examined 89 patients with Bipolar Disorder (I, II) or Major Depressive Disorder, both with recurrent winter seasonal pattern. The TPQ was administered while the patients were depressed, following 10-14 days of bright light therapy (30 min, 10,000 lux) and after spontaneous springtime remission. The Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD) assessed the severity of depression. At baseline, there were no significant differences between diagnostic subgroups or responders and non-responders on the TPQ or SIGH-SAD scales, though baseline RD scores were significantly higher in women than men. Furthermore, neither severity of depression nor magnitude of post-treatment clinical improvement was significantly correlated with baseline TPQ scores. Only HA scores decreased after treatment, with responders showing the greatest effect. HA scores also decreased from the baseline to springtime assessments for the group as a whole, with no difference between responders and non-responders. This is the first study to demonstrate that HA is state- rather than trait-dependent in seasonal affective disorder. The TPQ dimensions of temperament do not predict response to light therapy.
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Affiliation(s)
- Namni Goel
- Department of Psychiatry, Columbia University, 10032, New York, NY, USA.
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45
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Tomotake M, Harada T, Ishimoto Y, Tanioka T, Ohmori T. Temperament, character, and eating attitudes in Japanese college women. Psychol Rep 2003; 92:1162-8. [PMID: 12931935 DOI: 10.2466/pr0.2003.92.3c.1162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study investigated associations between dimensions of personality characteristics and eating attitudes in Japanese college women. 91 college women with a mean age of 20.7 yr. (SD=2.3 yr.), attending a School of Nursing or a School for Kindergarten Teachers, voluntarily responded to the Japanese version of the Temperament and Character Inventory and the Eating Attitudes Test. A significant positive correlation was found between the scores on the Temperament and Character Inventory subscale of Harm Avoidance and the Eating Attitudes Test total scores (Spearman p = .24, p = .02) and the scores on the Eating Attitudes Test subscale of Food Preoccupation (Spearman p = .33, p =.002). The scores on the Temperament and Character Inventory subscale of Self-directedness showed significant negative correlations with the Eating Attitudes Test total scores (Spearman p = -.35, p = .001) and the scores on the Eating Attitudes Test subscales of Dieting (Spearman p = -.29, p = .005) and Food Preoccupation (Spearman p = -.43, p = .0001). The present results suggest that Japanese college women who score high on Harm Avoidance and low on Self-directedness may be more likely to develop inappropriate eating attitudes.
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Affiliation(s)
- Masahito Tomotake
- Department of Psychiatry, The University of Tokushima School of Medicine, Tokushima-shi, Japan.
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Nagata T, Oshima J, Wada A, Yamada H, Iketani T, Kiriike N. Temperament and character of Japanese eating disorder patients. Compr Psychiatry 2003; 44:142-5. [PMID: 12658623 DOI: 10.1053/comp.2003.50023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Previous studies consistently reported a link between bulimic behaviors and high Novelty Seeking (NS), as measured by the Temperament and Character Inventory (TCI). However, it remains unclear whether this relationship is universal and occurs in different environments. Subjects of the present study consisted of 66 patients with anorexia nervosa restricting type (AN-R), 59 patients with anorexia nervosa binge eating/ purging type (AN-BP), 101 patients with bulimia nervosa purging type (BN), and 75 controls. NS score in AN-R patients was significantly lower than that in controls, although NS in BN patients did not differ from that in controls. The temperament of AN-R patients seems to be universal, even in different environments. Conversely, something other than temperament might be important in the development of bulimia nervosa in Japan.
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Affiliation(s)
- Toshihiko Nagata
- Department of Neuropsychiatry, Osaka City University Medical School, Abenoku, Osaka, Japan
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47
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Karwautz A, Troop NA, Rabe-Hesketh S, Collier DA, Treasure JL. Personality disorders and personality dimensions in anorexia nervosa. J Pers Disord 2003; 17:73-85. [PMID: 12659548 DOI: 10.1521/pedi.17.1.73.24057] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Information on the relationship between anorexia nervosa (AN) and personality disorders (PDs) and dimensions of temperament and character (measured by the Temperament and Character Inventory [TCI; Cloninger, Przybeck Svrakic, & Wetzel, 1994]) is limited. This study examines the predictive validity of the TCI for PD diagnoses assessed by the International Personality Disorder Examination-ICD-10 (IPDE-ICD-10; Loranger, Janca, & Sartorius, 1997) interviews of 46 women with DSM-IV-defined AN. Patients with a PD reported higher levels of harm-avoidance and lower levels of self-directedness than those without a PD. Scores on the TCI were predictive of the number of PD features present, particularly for those PDs in the anankastic, anxious, and dependent groups accounting for 40% to 51% of the variance. Cluster analysis based on scores on the TCI identified a subgroup of patients characterized by low levels of novelty seeking, self-directedness, and cooperativeness and high levels of harm avoidance. This cluster included the majority of those with avoidant, anxious, or dependent PDs. Assessment of particular personality dimensions was able to predict PDs in an anorexic sample. Since normal personality dimensions have greater validity than the categorical PDs, a consideration of normal temperament and character may assist in clinical decisionmaking and considerations concerning treatment.
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48
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Lawrence AD, Dowson J, Foxall GL, Summerfield R, Robbins TW, Sahakian BJ. Impaired visual discrimination learning in anorexia nervosa. Appetite 2003; 40:85-9. [PMID: 12631509 DOI: 10.1016/s0195-6663(02)00138-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The primate dopamine system is involved in appetitively motivated behaviours, including certain forms of learning, for example, visual discrimination learning. Furthermore, food restriction in animals and anorexia in humans is associated with impaired dopamine signaling. Based on this, we hypothesized that patients with anorexia nervosa (AN) would show a deficit in visual discrimination learning. In a dynamic categorization task involving the learning of a series of two-alternative forced-choice visual discriminations, conceptually identical to one shown to activate dopamine neurons in primates, and sensitive to dopaminergic manipulations in humans, patients with AN showed a deficit in learning that was most pronounced in the early stages of acquisition. In contrast, AN showed spared performance on a pattern recognition memory test sensitive to medial temporal lobe lesions, but insensitive to dopaminergic manipulations. We conclude that impaired appetitive function in patients with AN extends to include deficits in visual discrimination learning, and that this deficit represents indirect evidence for altered dopaminergic neurotransmission in AN.
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Affiliation(s)
- Andrew D Lawrence
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge, CB2 2EF, UK.
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TOMOTAKE MASAHITO. TEMPERAMENT, CHARACTER, AND EATING ATTITUDES IN JAPANESE COLLEGE WOMEN. Psychol Rep 2003. [DOI: 10.2466/pr0.92.3.1162-1168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Höglund K, Normén L. A high exercise load is linked to pathological weight control behavior and eating disorders in female fitness instructors. Scand J Med Sci Sports 2002; 12:261-75. [PMID: 12383071 DOI: 10.1034/j.1600-0838.2002.10323.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Demographic data, exercise habits, weight control behavior, attitudes towards body shape, eating disorder (ED) experience, and menstrual regularity among female fitness instructors were descriptively assessed. A 60-item questionnaire was sent to 295 female fitness instructors at eight fitness centers. Responders (57%) reported a mean weekly exercise load of 5.5 h week(-1) (SD 2.6), which indicates frequent training, however, less than that of athletes. Overall, 35% reported ED experience (DSM-IV criteria), with an onset at 15-17 years of age. The problems had lasted 5-7 years, and 20% of the entire group reported recovery, however, 11% still had EDs. For the entire group, it was found that a high weekly exercise load was linked to a pathological weight control behavior. Fitness instructors with an active ED exercised more than instructors who never had an ED or who had a past ED. Menstrual irregularity was more common among instructors who did not use contraceptives (14%), compared to those who did (5%). As ED experience and pathological weight control behavior were common in the studied group, the importance of guidelines regarding communication from female fitness instructors about healthy training habits to regular exercisers is discussed in the article.
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Affiliation(s)
- K Höglund
- Department of Clinical Nutrition, Sahlgrensha Academy at Göteborg University, Göteborg, Sweden
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