Interpersonal problems in eating disorders.
OBJECTIVE
Eating disorders are often chronic in nature and lead to a number of problems among which interpersonal issues are suggested to be central. Although research has shown that individuals with disturbed patterns of eating consistently report problems in social interactions, this study is unique in assessing a range of interpersonal problems among patients with all types of eating disorders before and after intensive hospital-based treatment.


METHODS
A total of 208 patients receiving a primary diagnosis of restrictive anorexia nervosa, bulimia nervosa, or anorexia nervosa of the binge/purging-subtype were included in the study. Eating pathology, symptom severity, and interpersonal patterns were examined before and after treatment.


RESULTS
Patients with eating disorders exhibited a generally nonassertive, submissive interpersonal style, with anorexic patients of the binge/purging-subtype reporting more difficulties with social inhibition and nonaffiliation. These patterns were found to change over the course of treatment with interpersonal problems at intake predictive of greater binge severity at discharge. Furthermore, issues of dominance and social avoidance predicted outcome for specific subgroups of patients.


CONCLUSIONS
Results underscore the importance of interpersonal problems in eating disorders and suggest that interpersonal patterns remain a focus of treatment and future research.
Hartmann
Armin
A
Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Hauptstrasse 8, Freiburg, Germany. armin.hartmann@uniklinik-freiburg.de
Zeeck
Almut
A
Barrett
Marna S
MS
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D007398:Interpersonal Relations; D010551:Personality; D011613:Psychotherapy; D012720:Severity of Illness Index; D012919:Social Behavior; D016896:Treatment Outcome; D015430:Weight Gain; D055815:Young Adult