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ISSN 2007-1523 (Electronic)
Revista Mexicana de Trastornos Alimentarios

2019, Number 1

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Revista Mexicana de Trastornos Alimentarios 2019; 10 (1)

Personality in patients with eating disorders depending on the presence/absence of comorbidity with borderline personality disorder

Molina-Ruiza RM, Alberdi-Páramo I, de Castro OM, Gutiérrez FN, Carrasco PJL, Díaz-Marsá M

Language: Spanish
References: 63
Page: 109-120
PDF size: 144.90 Kb.


ABSTRACT

Studies on comorbidity between eating disorders (ED) and personality disorders yield rates of 20-80%, a condition that makes difficult the diagnosis and complicates prognosis, especially regarding their comorbidity with borderline personality disorder (BPD). The objective of this study was to assess whether pathological personality alterations make it possible to distinguish not only between different types of ED, but also in terms of their comorbidity with BPD. Participants included 29 patients with ED, 10 with comorbid ED with BPD (EDc), 27 with BPD and 22 healthy controls, who completed the Millon Multiaxial Clinical Inventory (MCMI-II), and two other measures, one on impulsivity and other aimed at assess symptoms of bulimia nervosa (BN). The ED group was characterized by greater compulsivity, mainly in the subgroup with anorexia nervosa vs. BPD and EDc groups; however, these last two groups shared many features that show emotional instability, although less that the subgroup with BN. These findings support a continuum of severity in terms of compulsivity-impulsivity, with important etiopathogenic, diagnostic and psychotherapeutic implications.


REFERENCES

  1. Abbate-Daga, G., Delsedime, N., Nicotra, B., Giovannone, C., Marzola, E., Amianto, F. et al. (2013). Psychosomatic syndromes and anorexia nervosa. BMC Psychiatry, 13(1), e-14. http://doi. org/10.1186/1471-244X-13-14

  2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

  3. Basurte, E., Díaz-Marsá, M., Martín, O. y Carrasco, J. L. (2004). Traumatic childhood background, impulsiveness and hypothalamus- pituitary-adrenal axis dysfunction in eating disorders: A pilot study. Actas Españolas de Psiquiatría, 32(3), 149-152.

  4. Becker, D. F. y Grilo, C. M. (2015). Comorbidity of mood and substance use disorders in patients with binge-eating disorder: Associations with personality disorder and eating disorder pathology. Journal of Psychosomatic Research, 79(2), 159- 164. https://doi.org/10.1016/j.jpsychores.2015.01.016

  5. Bussolotti, D., Fernández-Aranda, F., Solano, R., Jiménez-Murcia, S., Turón, V. y Vallejo, J. (2002). Marital status and eating disorders: An analysis of its relevance. Journal of Psychosomatic Research, 53(6), 1139-1145. https://doi.org/10.1016/ S0022-3999(02)00336-7

  6. Casper, R. C. (1990). Personality features of women with good outcome from restricting anorexia nervosa. Psychosomatic Medicine, 52(2), 156-170.

  7. Cassin, S. E. y von Ranson, K. M. (2005). Personality and eating disorders: A decade in review. Clinical Psychology Review, 25(7), 895-916. https://doi.org/10.1016/j.cpr.2005.04.012

  8. Del Río, C., Torres, I. y Borda, M. (2002). Comorbilidad entre bulimia nerviosa purgativa y trastornos de la personalidad según el Inventario Clínico Multiaxial de Millon (MCMI-II). International Journal of Clinical and Health Psychology, 2(3), 425-438.

  9. Díaz-Marsá, M., Alberdi-Páramo, I. y Niell-Galmés, L. (2017). Nutritional supplements in eating disorders. Actas Españolas de Psiquiatría, 45(1), 26-36.

  10. Díaz-Marsá, M., Carrasco, J. L. y Sáiz, J. (2000). A study of temperament and personality in anorexia and bulimia nervosa. Journal of Personality Disorders, 14(4), 352-359. http://doi. org/10.1521/pedi.2000.14.4.352.

  11. Espelage, D. L., Mazzeo, S. E., Sherman, R. y Thompson, R. (2002). MCMI-II profiles of women with eating disorders: A cluster analytic investigation. Journal of Personality Disorders, 16(5), 453-463. https://doi.org/10.1521/pedi.16.5.453.22127

  12. Fahy, T. y Eisler, I. (1993). Impulsivity and eating disorders. British Journal of Psychiatry, 162(2), 193-197. http://doi. org/10.1192/bjp.162.2.193

  13. First, M. B., Spitzer, R. L., Gibbon, M. y Williams, J. B. W. (2008). Structured Clinical Interview for DSM-IV axis I disorders (SCID-I). En A. J. Rush, M. B. First y D. Blacker (Eds.), Handbook of psychiatric measures. Washington, DC: American Psychiatric Publishing.

  14. Friborg, O., Martinussen, M., Kaiser, S., Øvergård, K. T., Martinsen, E. W., Schmierer, P. et al. (2014). Personality disorders in eating disorder not otherwise specified and binge eating disorder. Journal of Nervous and Mental Disease, 202(2), 119- 125. http://doi.org/10.1097/NMD.0000000000000080

  15. Gartner, A. F., Marcus, R. N., Halmi, K. y Loranger, A. W. (1989). DSM-III-R personality disorders in patients with eating disorders. American Journal of Psychiatry, 146(12), 1585-1591.

  16. Grilo, C. M., Sanislow, C. A., Skodol, A. E., Gunderson, J. G., Stout, R. L., Shea, M. T. et al. (2003). Do eating disorders co-occur with personality disorders? Comparison groups matter. International Journal of Eating Disorders, 33(2), 155-164. http:// doi.org/10.1002/eat.10123

  17. Henderson, M. y Freeman, C. P. (1987). A self-rating scale for bulimia: The “BITE”. British Journal of Psychiatry, 150(1), 18-24. https://doi.org/10.1192/bjp.150.1.18

  18. Herzog, D. B., Keller, M. B., Lavori, P. W., Kenny, G. M. y Sacks, N. R. (1992). The prevalence of personality disorders in 210 women with eating disorders. Journal of Clinical Psychiatry, 53(5), 147-152.

  19. Hollander, E. y Evers, M. (2004). Review of obsessive-compulsive spectrum disorders: What do we know? Where are we going? Clinical Neuropsychiatry: Journal of Treatment Evaluation, 1(1), 32-51.

  20. Jáuregui, I., Santiago, M. J. y Estébanez, S. (2009). Eating behaviour disorders and personality: A study using MCMI-II. Atención Primaria, 41(4), 201-206. http://doi.org/10.1016/j. aprim.2008.06.002

  21. Johnson, C. y Wonderlich, S. (1992). Personality characteristics as a risk factor in the development of eating disorders. En J. H. Crowther, S. E. Hobfoll, M. A. Stephens y D. L. Tennenbaum (Eds.), The etiology of bulimia nervosa: The individual and familial context (pp. 179-196). Nueva York: Hemisphere Publishing Corporation.

  22. Kennedy, S. H., McVey, G. y Katz, R. (1990). Personality disorders in anorexia nervosa and bulimia nervosa. Journal of Psychiatric Research, 24(3), 259-269. http://doi.org/ 10.1016/0022-3956(90)90015-I

  23. Koepp, W., Schildbach, S., Schmager, C. y Rohner, R. (1993). Borderline diagnosis and substance abuse in female patients with eating disorders. International Journal of Eating Disorders, 14(1), 107-110. http://doi.org/10.1002/1098-10 8X(199307)14:1<107: AID-EAT2260140114>3.0.CO;2-Q

  24. Kruedelbach, N., McCormick, R. A., Schulz, S. C. y Grueneich, R. (1993). Impulsivity, coping styles, and triggers for craving in substance abusers with borderline personality disorder. Journal of Personality Disorders, 7(3), 214-222. http://doi. org/10.1521/pedi.1993.7.3.214

  25. Levallius, J., Roberts, B. W., Clinton, D. y Norring, C. (2016). Take charge: Personality as predictor of recovery from eating disorder. Psychiatry Research, 246, 447-452. http://doi.org/ 10.1016/j.psychres.2016.08.064

  26. Levin, A. P. y Hyler, S. E. (1986). DSM-III personality diagnosis in bulimia. Comprehensive Psychiatry, 27(1), 47-53. http://doi. org/10.1016/0010-440X(86)90068-4

  27. Magallón-Neri, E., González, E., Canalda, G., Forns, M., De la Fuente, J. E., Martínez, E. et al. (2014). Prevalence and severity of categorical and dimensional personality disorders in adolescents with eating disorders. European Eating Disorders Review, 22(3), 176-184. http://doi.org/10.1002/erv.2268

  28. Martinussen, M., Friborg, O., Schmierer, P., Kaiser, S., Øvergård, K. T., Neunhoeffer, A. L. et al. (2017). The comorbidity of personality disorders in eating disorders: A meta-analysis. Eating and Weight Disorders, 22(2), 201-209. http://doi. org/10.1007/s40519-016-0345-x

  29. Matsunaga, H., Kiriike, N., Nagata, T. y Yamagami, S. (1998). Personality disorders in patients with eating disorders in Japan. International Journal of Eating Disorders, 23(4), 399-408. https:// doi.org/10.1002/(SICI)1098-108X(199805)23:4<399::AI D-EAT7>3.0.CO;2-D

  30. Millon, T. (1987). Millon Clinical Multiaxial Inventory (MCMI-II). Minneapolis, MN: National Computer Systems.

  31. Millon, T. (1992). Millon Clinical Multiaxial Inventory: I & II. Journal of Counseling and Development, 70(3), 421-426. https://doi. org/10.1002/j.1556-6676.1992.tb01627.x

  32. Millon, T. (1999). MCMI-II: Inventario Clínico Multiaxial de Millon, manual. Madrid: TEA.

  33. Millon, T., Grossman, S., Millon, C., Meagher, S. y Ramnath, R. (2012). Personality disorders in modern life. Hoboken, NJ: John Wiley & Sons.

  34. Nasiri, H., Abedi, A., Ebrahimi, A., Ameli, S. S. y Samouei, R. (2013). Personality profile of women affected with borderline personality disorder. Materia Socio-Médica, 25(1), 60-63.

  35. O’Brien, B. y Sher, L. (2013). Child sexual abuse and the pathophysiology of suicide in adolescents and adults. International Journal of Adolescent Medicine and Health, 25(3), 201-205. https://doi.org/10.1515/ijamh-2013-0053.

  36. Orozco-Cabal, L., Rodríguez, M., Herin, D. V, Gempeler, J. y Uribe, M. (2010). Validity and reliability of the abbreviated Barratt Impulsiveness Scale in Spanish (BIS-15S). Revista Colombiana de Psiquiatría, 39(1), 93-109. https://doi.org/10.1016/ S0034-7450(14)60239-0

  37. Patton, J. H., Stanford, M. S. y Barratt, E. S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51(6), 768-774.

  38. Pearson, C. M., Pisetsky, E. M., Goldschmidt, A. B., Lavender, J. M., Wonderlich, S. A., Crosby, R. D. et al. (2016). Personality psychopathology differentiates risky behaviors among women with bulimia nervosa. International Journal of Eating Disorders, 49(7), 681-688. https://doi.org/10.1002/eat.22570

  39. Pearson, C. M., Riley, E. N., Davis, H. A. y Smith, G. T. (2014). Research review: Two pathways toward impulsive action. An integrative risk model for bulimic behavior in youth. Journal of Child Psychology and Psychiatry, 55(8), 852-864. http://doi. org/10.1111/jcpp.12214

  40. Piran, N., Lerner, P., Garfinkel, P. E., Kennedy, S. H. y Brouillette, C. (1988). Personality disorders in anorexic patients. International Journal of Eating Disorders, 7(5), 589-599. https:// doi.org/10.1002/1098-108X(198809)7:5<589::AID-EAT2260070502> 3.0.CO;2-H

  41. Pisetsky, E. M., Wonderlich, S. A., Crosby, R. D., Peterson, C. B., Mitchell, J. E., Engel, S. G. et al. (2015). Depression and personality traits associated with emotion dysregulation: Correlates of suicide attempts in women with bulimia nervosa. European Eating Disorders Review, 23(6), 537-544. http://doi. org/10.1002/erv.2401

  42. Reas, D. L., Rø, Ø., Karterud, S., Hummelen, B. y Pedersen, G. (2013). Eating disorders in a large clinical sample of men and women with personality disorders. International Journal of Eating Disorders, 46(8), 801-809. http://doi.org/10.1002/ eat.22176.

  43. Rivas, T., Bersabé, R. y Jiménez, M. (2004). Reliability and validity of Bulimic Investigatory Test, Edinburgh (BITE). Behavioral Psychology, 12(3), 447-461.

  44. Rosnow, R. L. y Rosenthal, R. (1976). The volunteer subject revisited. Australian Journal of Psychology, 28(2), 97-108. http:// doi.org/10.1080/00049537608255268

  45. Rossiter, E. M., Agras, W. S., Telch, C. F. y Schneider, J. A. (1993). Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa. International Journal of Eating Disorders, 13(4), 349-357. https://doi.org/10.10 02/1098-108X(199305)13:4<349:AID-EAT2260130403>3.0. CO;2-C

  46. Skodol, A. E., Oldham, J. M., Hyler, S. E., Kellman, H. D., Doidge, N. y Davies, M. (1993). Comorbidity of DSM-III-R eating disorders and personality disorders. International Journal of Eating Disorders, 14(4), 403-416. https://doi.org/10.1002/1098- 108X(199312)14:4<403::AID-EAT2260140403>3.0.CO;2-X

  47. Sohlberg, S. y Strober, M. (1994). Personality in anorexia nervosa: An update and a theoretical integration. Acta Psychiatrica Scandinavica, 89(378), 1-15. https://doi.org/ 10.1111/j.1600-0447.1994.tb05809.x

  48. Steiger, H., Jabalpurwala, S. y Champagne, J. (1996). Axis II comorbidity and developmental adversity in bulimia nervosa. Journal of Nervous and Mental Disease, 184(9), 555-560.

  49. Steiger, H., Leung, F., Thibaudeau, J. y Houle, L. (1993). Prognostic utility of subcomponents of the borderline personality construct in bulimia nervosa. British Journal of Clinical Psychology, 32(2), 187-197. https://doi.org/10.1111/j.2044-8260.1993. tb01043.x

  50. Strober, M. (1985). Personality factors in anorexia nervosa. Pediatrician, 12(2-3), 134-138.

  51. Vaz-Leal, F. J., Rodríguez-Santos, L., García-Herráiz, M. A. y Ramos- Fuentes, M. I. (2011). Neurobiological and psychopathological variables related to emotional instability: A study of their capability to discriminate patients with bulimia nervosa from healthy controls. Neuropsychobiology, 63(4), 242- 251. http://doi.org/10.1159/000323445

  52. Vervaet, M., van Heeringen, C. y Audenaert, K. (2004). Personality- related characteristics in restricting versus binging and purging eating disordered patients. Comprehensive Psychiatry, 45(1), 37-43. http://doi.org/10.1016/j.comppsych. 2003.09.008

  53. Vitousek, K. y Manke, F. (1994). Personality variables and disorders in anorexia nervosa and bulimia nervosa. Journal of Abnormal Psychology, 103(1), 137-147.

  54. Von Lojewski, A., Fisher, A. y Abraham, S. (2013). Have personality disorders been overdiagnosed among eating disorder patients? Psychopathology, 46(6), 421-426. http://doi. org/10.1159/000345856

  55. Wiederman, M. W. y Pryor, T. (1996). Substance use and impulsive behaviors among adolescents with eating disorders. Addictive Behaviors, 21(2), 269-272. http://doi.org/10.1016/0306- 4603(95)00062-3

  56. Wiederman, M. W. y Pryor, T. L. (1997). MCMI-II personality scale scores among women with anorexia nervosa or bulimia nervosa. Journal of Personality Assessment, 69(3), 508-516. http://doi.org/10.1207/s15327752jpa6903_6

  57. Wildes, J. E., Marcus, M. D., Crosby, R. D., Ringham, R. M., Dapelo, M. M., Gaskill, J. A. et al. (2011). The clinical utility of personality subtypes in patients with anorexia nervosa. Journal of Consulting and Clinical Psychology, 79(5), 665-674. http://doi. org/10.1037/a0024597

  58. Wonderlich, S. A., Fullerton, D., Swift, W. J. y Klein, M. H. (1994). Five-year outcome from eating disorders: Relevance of personality disorders. International Journal of Eating Disorders, 15(3), 233-243. https://doi.org/10.1002/1098-108X(199404) 15:3<233:AID-EAT2260150306>3.0.CO;2-9

  59. Wonderlich, S. A. y Swift, W. J. (1990). Borderline versus other personality disorders in the eating disorders: Clinical description. International Journal of Eating Disorders, 9(6), 629– 638. http://doi.org/10.1002/1098-108X(199011)9:6<629::AI D-EAT2260090605>3.0.CO;2-N

  60. Wonderlich, S. A., Swift, W. J., Slotnick, H. B. y Goodman, S. (1990). DSM-III-R personality disorders in eating-disorder subtypes. International Journal of Eating Disorders, 9(6), 607–616. http://doi.org/10.1002/1098-108X(199011)9:6<607::AID -EAT2260090603>3.0.CO;2-0

  61. Zaitsoff, S. y Grilo, C. (2010). Eating disorder psychopathology as a marker of psychosocial distress and suicide risk in female and male adolescent psychiatric inpatients. Comprehensive Psychiatry, 51(2), 142-150. http://doi.org/10.1016/j.comppsych. 2009.03.005

  62. Zanarini, M. C., Frankenburg, F. R., Dubo, E. D., Sickel, A. E., Trikha, A., Levin, A. et al (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry, 155(12), 1733-1739. http://doi.org/10.1176/ajp.155.12.1733

  63. Zanarini, M. C., Frankenburg, F. R., Pope, H. G., Hudson, J. I., Yurgelun- Todd, D. y Cicchetti, C. J. (1990). Axis II comorbidity of normal-weight bulimia. Comprehensive Psychiatry, 31(1), 20-24. http://doi.org/10.1016/0010-440X(90)90050-3




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