Clinical characteristics and perceptions of family of origin were examined in I6 bulimic women with comorbid alcohol abuse or dependence, 77 women with bulimia alone, and 30 normal controls. Family Environment Scale self-report and Family Environment Q-sort analysis of taped semi-structured interviews about family environment revealed that while there were no differences across groups in global family environment items, differences existed in specific parental characteristics. Fathers of bulimic women (with or without alcohol abuse or dependence) were perceived as being significantly more seductive than fathers of normal controls. Bulimic women (with or without alcohol abuse or dependence) tended to view their mothers as more neurotic and to have experienced less enjoyment in their maternal role. Mothers of bulimic women with alcohol abuse tended to place the greatest emphasis on weight, exercise, and appearance. 0 1993 by john Wiley & Sons, Inc.
Comorbid substance abuse and dependence have been frequently reported in women with bulimia nervosa. Estimates ranged from 18-50% of bulimic women who experience lifetime alcohol abuse or dependence (Russell, 1979; Hudson, Pope, Jonas, & Yurgelun-Todd, 1983; Mitchell, Hatsukami, Eckert, & Pyle, 1985; Lacey & Moureli, 1986; Hudson, Pope, Jonas, Yurgelun-Todd, & Frankenburg, 1987; Bulik, 1987a). These findings have important implications for both research and treatment.
Of critical interest is how bulimic women with and without comorbid substance abuse differ. This question has been addressed by clinical and psychometric comparisons as well as by examining differences in familial psychopathology across the two groups.
Hatsukami, Mitchell, Eckert, and Pyle (1986) found that bulimic women with substance abuse evidenced more diuretic use, disruption in work areas, frequent stealing, and had more previous inpatient psychiatric hospitalizations than bulimic women