Academic journal article Journal of Eating Disorders

Are Personality Disturbances in Anorexia Nervosa Related to Emotion Processing or Eating Disorder Symptomatology?

Academic journal article Journal of Eating Disorders

Are Personality Disturbances in Anorexia Nervosa Related to Emotion Processing or Eating Disorder Symptomatology?

Article excerpt

Author(s): Andrea Phillipou[sup.1,2,3,8], Caroline Gurvich[sup.4], David Jonathan Castle[sup.5,2,6] and Susan Lee Rossell[sup.7,4,5]


Anorexia Nervosa (AN) is a psychiatric illness characterised by an intense fear of weight gain, low body weight, and a disturbance in the experience of one's own body shape or weight. The condition is also frequently associated with a number of personality traits, including perfectionism [1-5], rigid thinking patterns [6] and obsessive compulsive behaviours and thoughts [7].

Relatedly, AN has been associated with high levels of comorbid obsessive compulsive personality disorder, as well as avoidant, borderline and dependent personality disorders [8-11]. Personality disorders are related to poor emotion processing and negative mood states [12, 13], which are similarly reported in AN [14, 15]. Thus, it is unclear whether personality disturbances in AN interact with eating disorder symptomatology, or whether they relate to difficulties in emotion regulation. Thus, the aim of this study was to investigate these relationships in AN. Furthermore, given the lack of current treatment options for AN [16], this research is warranted to determine which personality variables are associated with mood regulation or eating disorder symptomatology to help guide the development of more tailored and effective interventions for AN.

It was hypothesised that the AN group would demonstrate higher scores on a number of personality disturbances relative to healthy controls, namely, obsessive compulsive, avoidant, borderline and dependent personality disorders. Given the lack of research investigating relationships of other psychological processes with personality disturbances in AN, the primary aim of this study was exploratory, to examine whether personality disturbances in AN relate to mood states or emotion regulation within the self (i.e. alexithymia) and eating disorder symptomatology.


This study was approved by the human research ethics departments at The University of Melbourne, Swinburne University of Technology, The Melbourne Clinic, The Austin Hospital and St Vincent's Hospital; all in Melbourne, Australia. Informed written consent was obtained from all participants. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.


Participants were 24 right-handed females with AN and 25 healthy controls (HC) matched for age and premorbid intelligence quotient (IQ) to ensure comparability between groups. HCs were recruited through public advertisements, whereas AN participants were recruited through public advertisements; the Body Image and Eating Disorders Treatment and Recovery Service at the Austin and St Vincent's Hospitals; and The Melbourne Clinic; all in Melbourne, Australia. The Austin and St Vincent's Hospitals are public hospitals accepting referrals from Northern, Eastern and Hume regions of Melbourne. The Melbourne Clinic is a private mental health service, and unlike the public health services, only accepts patients on a voluntary basis.

All participants were English speaking and had no history of significant brain injury or neurological condition. Controls were required to have no history of an eating disorder or other mental illness. The Mini International Neuropsychiatric Interview, 5.0.0 (MINI) [17] was used to screen all participants for major Axis I psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It was also used to confirm diagnoses of AN, with the exception of the amenorrhea criterion which is no longer included in the current DSM-5. AN was required to be the primary diagnosis of the AN group. AN participants with comorbid psychiatric conditions, other than psychotic conditions, were not excluded as this would not have represented a typical AN sample. …

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