Psychopathology of bulimia nervosa: a multidimensional model

Abstract

Introduction: In recent years, a number of studies have been carried out with the intention of isolating clinical dimensions in the psychopathology of bulimia nervosa. Although borderline personality has been considered a core element of the bulimic psychopathology by most of the authors, it has not been incorporated into any of these models. In this context, the present study was aimed at testing the consistence of the more complex model proposed until now, including in the analysis borderline personality as a clinical variable.

Sample and methods: A group of 66 female patients fulfilling DSM-IV criteria for bulimia nervosa were assessed using a set of clinical instruments. The isolated items were processed using factor analysis techniques.

Results: Five basic dimensions of bulimia nervosa were obtained: 1. body disatisfaction; 2. restrictive eating behaviors; 3. purging behaviors; 4. emotional instability; and 5. disocial behavior.

Conclusions: Our results support the idea that bulimia nervosa is a multidimensional condition. In our model, the dimension «emotional instability» incorporated borderline features, which tended to be strongly associated to selfdefeating behaviors and depressive symptoms.