Patients Who Vomit and Coping with Bulimia Nervosa

Two distinct patterns were used to cope with anxiety and compulsions.

Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
©2014 iaedp

In a small study of patients with severe bulimia nervosa (BN), researchers at the University of Chester, Chester, UK, identified two distinct patterns patients use to cope with distressing symptoms.

The study evaluated the self-reported coping strategies used by 12 individuals diagnosed with severe and enduring purging type BN, who had been referred to an outpatient clinic for psychotherapy (J Psychiatr Ment Health Nurs 2014; Sep 12 doi:10.111/jpm.12167 [Epub ahead of print]). The authors collected the data from vomiting activities of participants through analysis of their self-management activities recorded in patient diaries. All 12 study subjects had complex and lengthy BN histories complicated by comorbid psychopathology (often including substance use disorders).

As M. Thomas and A. Lovell reported, patients reported using vomiting to manage two distinct types of symptoms: anxiety and compulsions. There was a clear relationship between anxiety and controlled weekly vomiting patterns, as well as between compulsions, and daily bouts of vomiting.

The authors note that the differences in patterns of vomiting may provide useful clues as to how patients are self-managing their symptoms, and can also help the treatment team direct interventions targeting anxiety or patterns of compulsive activities.

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