Week 4
INTEGRATION AND PROJECTIVE MATERIAL
P1
- Report the associations between personality and eating disorders
E.g. which personality traits uniquely predict AN, BN, and BED, and which traits predict more
than one eating disorder?
- Discuss the role of motivation in treating eating disorders
Cassin & Ranson
PERSONALITY AND EATING DISORDERS
Personality traits have been implicated in the onset, symptomatic expression, and maintenance
of eating disorders (EDs).
NOTE:
Anorexia nervosa restricting type (ANR)
Anorexia nervosa binge eating/purging type (ANB)
Bulimia nervosa (BN)
& Binge eating disorder (BED)
Aim: (1) update understanding of associations between personality and EDs, (2) incorporate
information regarding BED, a disorder only recently defined, and (3) conduct a meta-analysis of
the comorbidity of personality disorders (PDs) among individuals with EDs
Why is it important? – integrating info gained from disparate studies has clinical implications
because personally may make an important contribution to the prediction of general functioning,
clinical phenomenology, prognosis, and treatment outcome.
1. Personality traits and eating disorders
// NOTE that these studies mostly rely on self-report measures of hypothetical constructs and
are largely correlational in nature; interpret with caution, particularly with respect to the direction
of causality.
● Perfectionism = tendency to set and pursue unrealistically high standards despite the
occurrence of adverse consequences
Eg. food and weight preoccupation persistent hunger
,Has several multidimensional conceptualizations
- Neurotic perfectionism - maladaptive(e.g. overconcern with mistakes, anxiety about
performance) – higher among those with ED, whereas they have similar levels of normal
perfectionism - adaptive(e.g. high personal standards, need for order)
The multidimensional perfectionism scale
- Self-oriented perfectionism
- Other oriented
- Socially prescribed perfectionism (can diminish with remission, whereas other elements
of perfectionism don't)
The self oriented and socially prescribed perfectionism associated with ANR, BN, and BED.
So it can be said that people with EDs set unrealistic personal standards for themselves and
believe that others evaluate them harshly and exert excessive demands for perfection.
Other aspects of perfectionism:
- Concern over mistakes
- Doubts about actions
[these two are more obsessive compulsive traits]
- Personal standards
- Parental expectations and criticism
Those with EDs, → doubt the quality of their performance and react negatively to mistakes,
interpreting them as equivalent to failure.
NOTE: while the findings consistently support the association between perfectionism and EDs, it
is uncertain whether perfectionism is associated specifically with disordered eating, or more
generally with maladjustment.
● Obsessive-compulsive traits = includes doubting, checking, and need for symmetry
and exactness - have been associated with disordered eating and are more common
among individuals with EDs than other psychiatric control groups.
Childhood obsessive-compulsive traits → tend to precede and predict the development of EDs
- ANR - compulsive
- BN- impulsive & compulsive
- These obsessional traits persist after recovery from AN and BN (this suggests it is a trait
characteristic and not state-dependent, kinda like proof)
NOTE: perfectionism and obsessive-compulsiveness share many features and appear to be
strongly associated with one another
● Impulsivity = lack of forethought and failure to contemplate risks and consequences
before acting (e.g. sudden decision to binge and purge, w/o considering the associated
dysphoria and physical risks
- BN – impulsive (more than AN), both inpatients and outpatients
However, impulsivity may be attributed to the erratic dietary patterns and emotional instability
associated with BN rather than reflecting an enduring personality trait (because it improves
following recovery, so more state-dependent)
, ● Sensation seeking = a need for varied, novel, and complex sensations and experiences
and the willingness to take physical and social risks for the sake of such experiences
EDs that are characterized by bingeing behavior, purging behavior, or both (ANB,BN,BED) tend
to score higher than individuals with ANR and controls
● Narcissism = pathological concern with physical appearance and presentation, need for
external validation from the social environment, intense interpersonal sensitivity, and
proneness to deflation of self-esteem
Has been suggested to be a unique risk factor for EDs – those with AN or BN score higher, also
when compared to other psychiatric disturbances (i.e. anxiety, affective, and adjustment
disorders)
- Persist after remission – trait characteristic that makes them vulnerable
● sociotropy-autonomy
Sociotropy = concern with acceptance and approval from others
Autonomy = personality style oriented towards independence, control, and achievement
- Disordered eating associated with both
- Heightened vulnerability for an ED may be associated with a sociotropy-autonomy
conflict. That is, individuals with EDs may strive to maintain independence (autonomy),
but also rely on interpersonal relationships for validation and self-esteem (sociotropy)
Low self-esteem — may mediate the relationship between autonomy and disordered eating
Ambivalence over emotional expression — may mediate the relationship between sociotrophy
and disordered eating.
That is, those characterized by high sociotrophy may be reluctant to express emotions that may
threaten their interpersonal relationships (e.g. anger), but suppression of these emotions may
make them vulnerable to ED symptomatology.
Further examining the relationship via variety of self-reported personality measures:
NEO personality inventory and Eysenck personality questionnaire
They both assess neuroticism and extraversion; NEO → conscientiousness, agreeableness,
and openness to experience; EPQ → psychoticism
Neuroticism = predisposition towards emotionality, hypersensitivity, anxiety, worry moodiness,
and depression
- EDs score higher, and studies consistently associate neuroticism with ED
symptomatology
High extraversion = sociability and liveliness & low extraversion = introspection and reservation
- Weak to nonexistent associations
Others: conscientiousness, agreeableness, and openness to experience
INTEGRATION AND PROJECTIVE MATERIAL
P1
- Report the associations between personality and eating disorders
E.g. which personality traits uniquely predict AN, BN, and BED, and which traits predict more
than one eating disorder?
- Discuss the role of motivation in treating eating disorders
Cassin & Ranson
PERSONALITY AND EATING DISORDERS
Personality traits have been implicated in the onset, symptomatic expression, and maintenance
of eating disorders (EDs).
NOTE:
Anorexia nervosa restricting type (ANR)
Anorexia nervosa binge eating/purging type (ANB)
Bulimia nervosa (BN)
& Binge eating disorder (BED)
Aim: (1) update understanding of associations between personality and EDs, (2) incorporate
information regarding BED, a disorder only recently defined, and (3) conduct a meta-analysis of
the comorbidity of personality disorders (PDs) among individuals with EDs
Why is it important? – integrating info gained from disparate studies has clinical implications
because personally may make an important contribution to the prediction of general functioning,
clinical phenomenology, prognosis, and treatment outcome.
1. Personality traits and eating disorders
// NOTE that these studies mostly rely on self-report measures of hypothetical constructs and
are largely correlational in nature; interpret with caution, particularly with respect to the direction
of causality.
● Perfectionism = tendency to set and pursue unrealistically high standards despite the
occurrence of adverse consequences
Eg. food and weight preoccupation persistent hunger
,Has several multidimensional conceptualizations
- Neurotic perfectionism - maladaptive(e.g. overconcern with mistakes, anxiety about
performance) – higher among those with ED, whereas they have similar levels of normal
perfectionism - adaptive(e.g. high personal standards, need for order)
The multidimensional perfectionism scale
- Self-oriented perfectionism
- Other oriented
- Socially prescribed perfectionism (can diminish with remission, whereas other elements
of perfectionism don't)
The self oriented and socially prescribed perfectionism associated with ANR, BN, and BED.
So it can be said that people with EDs set unrealistic personal standards for themselves and
believe that others evaluate them harshly and exert excessive demands for perfection.
Other aspects of perfectionism:
- Concern over mistakes
- Doubts about actions
[these two are more obsessive compulsive traits]
- Personal standards
- Parental expectations and criticism
Those with EDs, → doubt the quality of their performance and react negatively to mistakes,
interpreting them as equivalent to failure.
NOTE: while the findings consistently support the association between perfectionism and EDs, it
is uncertain whether perfectionism is associated specifically with disordered eating, or more
generally with maladjustment.
● Obsessive-compulsive traits = includes doubting, checking, and need for symmetry
and exactness - have been associated with disordered eating and are more common
among individuals with EDs than other psychiatric control groups.
Childhood obsessive-compulsive traits → tend to precede and predict the development of EDs
- ANR - compulsive
- BN- impulsive & compulsive
- These obsessional traits persist after recovery from AN and BN (this suggests it is a trait
characteristic and not state-dependent, kinda like proof)
NOTE: perfectionism and obsessive-compulsiveness share many features and appear to be
strongly associated with one another
● Impulsivity = lack of forethought and failure to contemplate risks and consequences
before acting (e.g. sudden decision to binge and purge, w/o considering the associated
dysphoria and physical risks
- BN – impulsive (more than AN), both inpatients and outpatients
However, impulsivity may be attributed to the erratic dietary patterns and emotional instability
associated with BN rather than reflecting an enduring personality trait (because it improves
following recovery, so more state-dependent)
, ● Sensation seeking = a need for varied, novel, and complex sensations and experiences
and the willingness to take physical and social risks for the sake of such experiences
EDs that are characterized by bingeing behavior, purging behavior, or both (ANB,BN,BED) tend
to score higher than individuals with ANR and controls
● Narcissism = pathological concern with physical appearance and presentation, need for
external validation from the social environment, intense interpersonal sensitivity, and
proneness to deflation of self-esteem
Has been suggested to be a unique risk factor for EDs – those with AN or BN score higher, also
when compared to other psychiatric disturbances (i.e. anxiety, affective, and adjustment
disorders)
- Persist after remission – trait characteristic that makes them vulnerable
● sociotropy-autonomy
Sociotropy = concern with acceptance and approval from others
Autonomy = personality style oriented towards independence, control, and achievement
- Disordered eating associated with both
- Heightened vulnerability for an ED may be associated with a sociotropy-autonomy
conflict. That is, individuals with EDs may strive to maintain independence (autonomy),
but also rely on interpersonal relationships for validation and self-esteem (sociotropy)
Low self-esteem — may mediate the relationship between autonomy and disordered eating
Ambivalence over emotional expression — may mediate the relationship between sociotrophy
and disordered eating.
That is, those characterized by high sociotrophy may be reluctant to express emotions that may
threaten their interpersonal relationships (e.g. anger), but suppression of these emotions may
make them vulnerable to ED symptomatology.
Further examining the relationship via variety of self-reported personality measures:
NEO personality inventory and Eysenck personality questionnaire
They both assess neuroticism and extraversion; NEO → conscientiousness, agreeableness,
and openness to experience; EPQ → psychoticism
Neuroticism = predisposition towards emotionality, hypersensitivity, anxiety, worry moodiness,
and depression
- EDs score higher, and studies consistently associate neuroticism with ED
symptomatology
High extraversion = sociability and liveliness & low extraversion = introspection and reservation
- Weak to nonexistent associations
Others: conscientiousness, agreeableness, and openness to experience
