The possible influence of personality dysfunctioning on individuals with an eating disorder.

Abstract

Abstract Objective: The new proposals of the DSM-5 implement that personality dysfunctioning should be used as a new diagnostic variable. Over the last couple of years research examined possible other factors that might significantly differentiate the types of eating disorders besides the existing DSM-IV criteria. Currently, of the diagnosed eating disorders 50% doesn’t fulfill the criteria needed for the diagnosis of anorexia or bulimia. Lilenfed et al. (2006) discovered that there are significant difference between patients with an eating disorder and those without an eating disorder in terms of personality traits. Other investigations showed that - in terms of personality dysfunctioning – anorexia is comorbid with cluster C and bulimia with cluster B personality disorders. Conversely, little research has been done about the characteristics of the NOS group. In line with the proposed implementations for the DSM-5 criteria, what is the exact relationship between personality dysfunctioning and the eating disorders? Method: The present study investigated the data of 117 patients with an eating disorder (28 AN, 24 BN and 65 NOS) that applied for treatment at the Rembrandthof between 2005 and 2011. Personality dysfunctioning was assessed by the self-administered questionnaires SIPP-118 and the derived Personality Severity Index (PSI) of the SCL-90. The EDI-II-NL assessed the eating characteristics of the different eating disorders. Results: The correlations revealed that AN is characterized by the drive for thinness and the absence of bulimic criteria and body dissatisfaction of the EDI-II-NL. BN only has a medium correlation with the bulimic criteria of the EDI-II-NL and for the NOS group the domain body dissatisfaction seems to be a good predictor. According to the correlations the emerged personality profiles are characterized by weak self-control, relational functioning and social concordance in patients with AN. Low self-control, identity integration and relational functioning characterize the profile for patients with BN. The profile for patients with NOS is not significantly distinguishable. The influence of personality dysfunctioning is very small in each of the different eating disorders. For AN personality dysfunctioning is not a good predictor. For patients with BN and NOS personality dysfunctioning plays a very small role in the prediction of these eating disorders. Discussion: The results from the present study seem to be in line with the new proposals of the DSM-5 to integrate personality dysfunctioning as a diagnostic variable. However, the discovered results are small. Further research is needed to confirm the influence of personality dysfunctioning in eating disorders.