Trait-level and momentary correlates of bulimia nervosa with a history of anorexia nervosa

Abstract

Objective: Some investigators have suggested subtyping bulimia nervosa (BN) by anorexia nervosa (AN) history. We examined trait-level and momentary eating-related and psychosocial factors in BN with and without an AN history.

Method: Interview, questionnaire, and ecological momentary assessment data of eating-related and psychological symptoms were collected from 122 women with BN, including 43 with (BN+) and 79 without an AN history (BN-).

Results: Body mass index (kg/m(2) ) was lower in BN+ than BN- (p = 0.001). Groups did not differ on trait-level anxiety, shape/weight concerns, psychiatric comorbidity, or dietary restraint; or on momentary anxiety, dietary restriction, binge eating, purging, or exercise frequency, or affective patterns surrounding binge/purge behaviors. Negative affect increased prior to exercise and decreased thereafter in BN+ but not BN-, although groups did not statistically differ.

Discussion: Results do not support formally subtyping BN by AN history. Exercise in BN+ may modulate negative affect, which could have important treatment implications.

Figure 1

Patterns of negative affect surrounding eating and activity behaviors in bulimic individuals with and without a history of anorexia nervosa Note: BN−=bulimia nervosa without a history of anorexia nervosa; BN+=bulimia nervosa with a history of anorexia nervosa. Negative affect was measured by the Positive and Negative Affect Scale (range=11–55). The purging variable comprised the combined frequency of vomiting and laxative abuse.