Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa

✍ Scribed by Rossiter, Elise M. ;Agras, W. Stewart ;Telch, Christy F. ;Schneider, John A.

• Publisher: Wiley (John Wiley & Sons)
• Year: 1993
• Tongue: English
• Weight: 642 KB
• Volume: 13
• Category: Article
• ISSN: 0276-3478
• DOI: 10.1002/1098-108x(199305)13:4<349::aid-eat2260130403>3.0.co;2-c

✦ Synopsis

The Personality Disorders Examination (PDE) was administered to 7 1 bulimia nervosa patients at baseline assessment in a study comparing the effectiveness of cognitive-behavioral treatment with desipramine or the combination of both treatments. Personality disorder subscales were combined into single DSM-Ill-R cluster scores. A high cluster B score (consisting of antisocial, borderline, histrionic, and narcissistic features) significantly predicted poor outcome at 16 weeks and was a better predictor of outcome than borderline personality characteristics alone or any other DSM-Ill-R cluster score or Combination of cluster scores.

In contrast pretreatment depression level, self-esteem, degree of dietary restraint, frequency of purging, and history of anorexia nervosa were not significantly related to outcome. At 1-year follow-up there was still a trend toward high cluster B scores predicting poor treatment outcome. Cluster B score was not significantly correlated with percentage of sessions attended nor did subjects with higher cluster B scores have a better outcome with either specific treatment. These results suggest that further investigation of alternative treatments is warranted with high cluster B individuals to determine if treatment effectiveness can be improved. 0 1993 by john Wiley & Sons, lnc.

Relatively few studies have evaluated predictors of outcome in the treatment of bulimia nervosa. reported that nonresponders to cognitive-behavioral treatment had significantly lower self-reported past weights than treatment responders. Similarly, Agras, Dorian, found that in bulimics treated with imipramine, those with lower reported body mass indices (BMIs) did less well than those with higher BMIs. , found that self-esteem, as measured by the Rosenberg Self-Esteem Scale (Rosenberg, 1965), was a significant predictor of treatment out-