Anorexic self-control and bulimic self-hate: differential outcome prediction from initial self-image

Int J Eat Disord. 2009 Sep;42(6):522-30. doi: 10.1002/eat.20642.

Abstract

Objective: The study investigated initial self-image (structural analysis of social behavior) and its relation to 36-month outcome, among patients with anorexia nervosa and bulimia nervosa. Hypotheses were that degree of different aspects of self-image would predict outcome in the groups.

Method: Participants were 52 patients with anorexia and 91 with bulimia from a longitudinal naturalistic database, and outcome measures included eating disorder and psychiatric symptoms and a general outcome index. Stepwise regression was used to investigate which self-image variables were related to outcome, and multiple regression contrasted the groups directly on each obtained predictor.

Results: Consistent with hypotheses, in bulimia degree of self-hate/self-love moderately predicted outcome, whereas self-control-related variables powerfully predicted outcome in anorexia.

Discussion: It is important to focus on self-image in the treatment of both diagnostic groups, but especially in anorexia nervosa, where control-submission interactions between patient and therapist should be handled with care.

MeSH terms

  • Adolescent
  • Adult
  • Anorexia Nervosa / diagnosis
  • Anorexia Nervosa / psychology*
  • Bulimia Nervosa / diagnosis
  • Bulimia Nervosa / psychology*
  • Hate*
  • Humans
  • Internal-External Control*
  • Longitudinal Studies
  • Middle Aged
  • Models, Psychological
  • Patient Admission
  • Personality Inventory / statistics & numerical data
  • Professional-Patient Relations
  • Psychometrics
  • Psychotherapy*
  • Self Concept*
  • Sweden
  • Treatment Outcome
  • Young Adult