Bulimia nervosa: a descriptive and therapeutic study

This study examined a sample of 24 Ss who met strict criteria for a diagnosis of bulimia nervosa. Assessments were made on: (1) demographic characteristics, (2) eating attitudes and behaviour and (3) personality measures. The effectiveness of two types of therapeutic intervention (cognitive-behavioural group therapy vs cognitive-behavioural group therapy plus specific behavioural instruction) was examined in a baseline, therapy intervention, follow-up design.The group was characterized prior to therapy by high N, Depression and Anxiety and low Self-esteem scores compared with control group data. Following therapy, Depression and Anxiety scores were significantly lower and Self-esteem scores higher, whereas N scores remained high. Binge-purging frequencies were significantly reduced in some of the Ss but the reduction could not unequivocally be attributed to the therapeutic interventions. The pattern of results suggested that bulimia nervosa (defined by a binge-purging pattern in association with high neuroticism) should be distinguished from bulimia (defined by a binge pattern not related to purging or high neuroticism) and that DSM-III should be revised to reflect this distinction. A theory is advanced to account for the rapid association of binging and purging in Ss high in neuroticism but not in Ss low in neuroticism.