Divergent forms of purging behavior in bulimia nervosa patients.
Tobin D.L. | Johnson C.L. | Dennis A.B.
Though DSM-III-R equates several different forms of purging behavior, including use of vomiting, laxatives, diuretics, dieting, and exercise, there is little work that has examined patient subgroups based on divergent forms of purging. An attempt to investigate subgroups based on purging criteria was thwarted because of low base rates for specific purging behaviors, despite having a relatively large clinic sample of bulimia nervosa patients (n = 245). As an intermediary step to the investigation of functional equivalence of different forms of purging, we propose classifying patients based on the number of purging behaviors they employ to control weight. Our findings suggest that patients who employ more than one strategy are generally more disturbed on a number of psychiatric indices, including state and trait depression. This contrasts with recent findings that the frequency of any one purging behavior is unrelated to level of depression or course of treatment in clinical samples. This study suggests that clinicians who must evaluate and effectively triage bulimia nervosa patients would benefit from utilizing the number of purging strategies rather than the frequency of any one purging behavior as an indication of severity and possible comorbidity.
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