Impulsivity in Bulimia Nervosa
Background: Despite increasing evidence impulsive traits play a role in bulimia nervosa, the latest version of the Diagnostic and Statistical Manual of Mental Disorders does not include impulsivity as part of the criteria for this eating disorder. Method:Using Q sort, a methodology specifically well suited to the expression of individual viewpoints, twenty-six undergraduate women split into two categories - women with bulimia nervosa; women without bulimia nervosa - ranked a total of forty-four
... statements that were reflective of impulsivity. These statements were derived from a multitude of sources to ensure proper representativeness: academic literature, the popular press, various audio-visual media outlets, focus groups and social media sites. Results:A factor analysis was performed that generated two distinct factors that essentially split participants along the lines of a presence or absence of bulimia nervosa. Factor A, called Thinking Through, was characterized by a methodical and carefully processed approach around decision-making, thinking through consequences of actions, and a general tendency towards planning and organization. With the exception of one participant, this factor was represented by participants with no history of bulimia nervosa thus indicating individuals with this eating disorder did not endorse this factor. Factor B, called Negative Urgency and Obsessive Thinking, was characterized by an urge for pleasure-seeking, quick action, a lack of self-control and difficulty postponing reward. Endorsers of this factor often regret decisions made rashly yet tend to repeat actions that feel urgent, despite negative consequences. This factor, with the exception of one participant, consisted of individuals with a history of bulimia nervosa. Conclusion:Such finding provides additional evidence for a pattern of impulsivity in women with bulimia nervosa that is not found in their healthy counterparts. In addition, it provides clinicians treating this disorder a guidepost for a more targeted treatment of bulimia and further enhances the need for impulsivity to be included as one of its diagnostic criteria.