An attempt to understand the paradox of anorexia nervosa without drive for thinness

Giovanni Abbate-Daga, Andrea Pierò, Carla Gramaglia, Marina Gandione, Secondo Fassino

Research output: Contribution to journalArticlepeer-review

Abstract

The "atypical" subgroup of women with anorexia nervosa not characterized by drive for thinness (DT) was studied. The study group comprised 151 anorectic patients (restrictor anorectics [AN-R], n = 74; binge-purging anorectics [AN-BP], n = 77). Subjects completed the following self-administered questionnaires: Eating Disorder Inventory-2 (EDI-2), Temperament and Character Inventory (TCI), State-Trait Anger Expression Inventory (STAXI), and Beck Depression Inventory (BDI). Patients were subdivided into three groups on the basis of body mass index (BMI) and DT score: AN-I with a BMI < 15 and DT < 7 (n = 24); AN-II with a BMI > 15 and DT < 7 (n = 34); and AN-III with a BMI < 17.5 and DT > 7 (n = 93). Patients belonging to the AN-III group had a more severe disorder and form of psychopathology based on their scores on several scales. No association emerged between personality disorders and any single subgroup. Three hypotheses emerge: (1) some patients (about 38%) deny DT and provide negative answers on the questionnaires; (2) patients without DT (even when malnourished) seem to show less severe psychopathologic and personality traits; and (3) patients without DT answer questions honestly, but they have developed a character structure that enables them to feel negative and ego-dystonic emotions regarding their condition. Implications for treatment are discussed.

Original languageEnglish
Pages (from-to)215-221
Number of pages7
JournalPsychiatry Research
Volume149
Issue number1-3
DOIs
Publication statusPublished - 15 Jan 2007
Externally publishedYes

Keywords

  • Atypical anorexia
  • Eating disorders
  • Partial syndrome
  • Psychiatry
  • Psychopathology
  • Starvation

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