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Self-damaging and Addictive Behaviour in Bulimia Nervosa

A Catchment Area Study

Published online by Cambridge University Press:  02 January 2018

J. Hubert Lacey
J. Hubert Lacey*
Affiliation:
Department of Mental Health Sciences, Division of General Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE
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Abstract

This study examines the prevalence of self-damaging and addictive behaviour in a consecutive series of 112 normal-weight bulimic women all stemming from the same urban catchment area. A quarter reported consuming over 36 units of alcohol a week, and nine drank over 50 units. Twenty-eight per cent abused drugs, 21% repeatedly stole, 18% repeatedly overdosed, and 8% regularly cut themselves. In all, 40% reported self-damaging and addictive behaviour, 80% of whom gave a history of three or more behaviours together. Alcohol abuse was significantly associated with drug abuse and repeated overdosing; repeated cutting was significantly associated with drug abuse. Repeated stealing and overdosing were markers of severity and did not occur in isolation. A core group, termed and defined by the author as ‘multi-impulsive bulimics', were older, less likely to be employed, married, or in a stable union, but were more likely to have an alcohol-abusing partner or to come from a family with a history of alcohol abuse. They were also more likely to give a history of sexual abuse.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue 2 , August 1993 , pp. 190 - 194
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Beary, M. D., Lacey, J. H. & Merry, J. (1986) Alcoholism and eating disorders in women of fertile age. British Journal of Addiction, 81, 685–689.Google Scholar
Breeze, E. (1985) Women and Drinking. Office of Population, Censuses and Surveys. London: HMSO.Google Scholar
Crisp, A. H. (1970) Anorexia nervosa: feeding disorder, nervous malnutrition or weight phobia? World Revue of Nutrition and Dietetics, 12, 452–504.CrossRefGoogle ScholarPubMed
Fairburn, C. G. & Cooper, P. J. (1984) The clinical features of bulimia nervosa. British Journal of Psychiatry, 144, 238–246.Google Scholar
Hare, R. D. (1980) A research scale for the assessment of psychopathy in criminal populations. Personality and Individual Differences, 1, 111–120.CrossRefGoogle Scholar
Hudson, J. I., Pope, H. G. & Jonas, J. M. (1984) Psychosis in anorexia nervosa and bulimia. British Journal of Psychiatry, 145, 420–423.Google Scholar
Kemsley, W. F. (1952) Body weight at different ages and heights. Annals of Eugenics, 16, 1.Google ScholarPubMed
Kennedy, H. G. & Grubin, D. H. (1990) Hot-headed or impulsive? British Journal of Addiction, 85, 639–643.Google Scholar
Lacey, J. H. (1982) The bulimic syndrome at normal body weight: reflections on pathogenesis and clinical features. International Journal of Eating Disorders, 2, 59–66.Google Scholar
Lacey, J. H. (1983) Bulimia nervosa, binge-eating and psychogenic vomiting: a controlled treatment study and longterm outcome. British Medical Journal, 286, 1609–1631.Google Scholar
Lacey, J. H. (1986) An integrated behavioural and psychodynamic approach to the treatment of bulimia. British Revue of Bulimia and Anorexia Nervosa, 1, 19–26.Google Scholar
Lacey, J. H. (1990) Incest, incestuous fantasy and indecency: a clinical catchment area study of normal-weight bulimic women. British Journal of Psychiatry, 157, 399–403.CrossRefGoogle ScholarPubMed
Lacey, J. H. (1992a) The treatment demand for bulimia: a catchment area report of referral rates and demography. Psychiatric Bulletin, 16, 203–205.CrossRefGoogle Scholar
Lacey, J. H. (1992b) Homogamy: the relationships and sexual partners of normal-weight bulimics. British Journal of Psychiatry, 161, 638–642.Google Scholar
Lacey, J. H. & Evans, C. D. H. (1986) The impulsivist: a multi-impulsive personality disorder. British Journal of Addiction, 81, 715–723.Google Scholar
Lacey, J. H. & Mourelli, E. (1986) Bulimic alcoholics: some features of a clinical subgroup. British Journal of Addiction, 81, 389–393.CrossRefGoogle Scholar
McCown, W. (1988) Multi-impulsive personality disorder and multiple-substance abuse: evidence from members of self-help groups. British Journal of Addiction, 83, 431–432.Google Scholar
McCown, W. (1989) The relationship between impulsivity, empathy and involvement in twelve-step self-help substance abuse treatment groups. British Journal of Addiction, 84, 391–393.Google Scholar
McCown, W. (1990) The effective impulsivity and empathy on abstinence of poly-substance abusers: a perspective study. British Journal of Addiction, 85, 635–637.CrossRefGoogle Scholar
Nace, E. P., Saxon, J. J. & Shore, N. (1983) A comparison of borderline and non-borderline alcholic patients. Archives of General Psychiatrics, 40, 54–56.CrossRefGoogle Scholar
Office of Population Censuses & Surveys (OPCS) (1982) Census 1981. Sex, Age and Marital Status. London: HMSO.Google Scholar
Pyle, R. L., Mitchell, J. E. & Eckert, E. D. (1981) Bulimia: a report of 34 cases. Journal of Clinical Psychiatry, 42, 60–64.Google Scholar
Russell, G. F. M. (1979) Bulimia nervosa: an ominous variant of anorexia nervosa. Psychological Medicine, 9, 429–448.Google Scholar
Schaffer, C. B., Carroll, J. & Abramowitz, S. I. (1982) Selfmutilation and the borderline personality. Journal of Nervous and Mental Disease, 170, 468–473.CrossRefGoogle ScholarPubMed
Schukit, M. A. & Morrissey, E. R. (1979) Drug abuse among alcoholic women. American Journal of Psychiatry, 136, 607–611.Google Scholar
Sohlberg, S., Norring, E. C., Holmgren, S., et al (1989) Impulsivity and long-term prognosis of psychiatric patients with anorexia nervosa/bulimia nervosa. Journal of Nervous and Mental Disease, 177, 249–258.Google Scholar
Snyder, S. & Pitt, W. M. (1984) Characterising anger in the DSM-III borderline personality disorder. Acta Psychiatrica Scandinavica, 72, 464–469.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
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