PERSONALITY AND EATING DISORDERS

Holly Cook

CO-MORBIDITY OF PERSONALITY DISORDERS AND EATING DISORDERS

Borderline Personality Disorder (BPD) Obsessive Compulsive Personality Disorder

(OCPD) Avoidant Personality Disorder (AvPD) Narcissistic Personality Disorder (NPD) Histrionic Personality Disorder(HPD)

Up to 48% of those with eating disorders also suffer from one or

more personality disorders

BORDERLINE PERSONALITY DISORDER(BPD)

Mostly occurs in relation to Bulimia Nervosa

Self-image Report many “ups and downs”

Risky and Impulsive

2% of general population Up to 40% of those with eating disorders

Suicide occurs in 8%-10% of individuals with this disorder

OBSESSIVE COMPULSIVE PERSONALITY DISORDER (OCPD)

Occurs mostly in restrictive anorexia nervosa 25%-40% of cases

Value control, inflexibility and perfectionism

o Anxiety usually is usually onset in childhood

o Obsessive compulsive disorder values rituals and obsessions. This is present in some with ED, but OCPD is more common

AVOIDANT PERSONALITY

DISORDER (AVPD) Prevalent among all types of eating

disorders

As many a third of people with eating disorders are avoidant personalities

Avoid interpersonal contact because of a sense of inadequacy

Possible Reasons AN: tendency to refuse help from others BN: shame surrounding binging and purging behaviors

Main goal is to avoid criticism

NARCISSISTIC PERSONALITY DISORDER (NPD)

Many ED patients have narcissistic issues, however NPD is rarely diagnosed

Obsessed with their image in the mirror

Egocentric and self-focused behavior

Diagnosed in roughly 2% of ED patients

HISTRIONIC PERSONALITY DISORDER (HPD)

Mostly seen in patients with bulimia

Self esteem depends on others and does not arise from a true feeling of self worth

Driving need to be in the spotlight Dangerous behavior to get

attention i.e. binging/purging to lose

dramatic amounts of weight

GENERAL PERSONALITY TRAITS- ANOREXIA

Compulsive Indecisiveness Extreme perfectionism Counting calories Checking body constantly Cutting and re-cutting of food Need to exercise

GENERAL PERSONALITY TRAITS-BULIMIA

Impulsive Kleptomania 65%-67% Addictions/substance abuse Emotional eating Purging feels “out of their

control”

CONSIDERATIONS

Knowing links between eating disorders and personality can help to provide better and more effective treatment for patients with eating disorders

Knowing these links can also have a predictive value

A person with an eating disorder does not necessarily have a personality disorder and visa-versa