Is History of Abuse Predictive of Eating Disorders With Binge-Eating Episodes Through An Effect Mediated By Impulsivity?

The research paper titled “Is history of abuse predictive of eating disorders with binge-eating episodes through an effect mediated by impulsivity? A French longitudinal study” by Clémence Cabelguen et al. explores the complex relationship between a history of abuse, impulsivity, and the clinical outcomes of eating disorders characterized by binge-eating episodes (EDBE). Conducted on 186 patients with a diagnosis of EDBE, including bulimia nervosa, anorexia nervosa binge-eating/purging type, and binge-eating disorder, this study aims to determine if a history of abuse is directly associated with the non-recovery from EDBE through an effect that is mediated by impulsivity.

The study utilizes the MINI International Neuropsychiatric Interview for diagnosis, the UPPS-P Impulsive Behavior Scale to measure impulsivity, and a revised version of the French life events questionnaire (EVE) to assess the history of abuse. Recovery is defined as the absence of any eating disorder according to the MINI at the 12-month follow-up. The main findings reveal that a history of abuse was not directly associated with the absence of recovery from EDBE at one year. Instead, factors such as anxiety disorders, vomiting, physical hyperactivity, and specific aspects of impulsivity like negative urgency and lack of perseverance were negatively associated with recovery. Interestingly, positive urgency, an aspect of impulsivity characterized by rash actions under positive emotional states, was positively associated with recovery.

The study suggests that while a history of abuse does not directly impede recovery from EDBE, the presence of anxiety disorders and certain impulsive behaviors may. The positive correlation between positive urgency and recovery hints at a complex interaction between impulsivity and the treatment of eating disorders, suggesting that certain impulsive tendencies might actually enhance receptivity to care.

This research contributes to the ongoing discussion about the factors influencing the clinical outcomes of eating disorders, specifically those with binge-eating episodes. It challenges some existing beliefs about the role of traumatic experiences in the treatment of eating disorders and underscores the need for a nuanced understanding of the role of impulsivity. Further research is encouraged to explore the dynamics of impulsivity and eating disorder recovery in greater depth.

Cabelguen, C., M.D., Saillard, A., C.R.T., Vanier, A.,M.D.PhD., Laslandes, M., M.D., Leboucher, J., C.R.T., Rousselet, M., C.R.T., . . . Challet-Bouju, G. (2023). Is history of abuse predictive of eating disorders with binge-eating episodes through an effect mediated by impulsivity? A french longitudinal study. Journal of Psychiatry & Neuroscience : JPN, 48(1), E13-E22. doi:https://doi.org/10.1503/jpn.210218