Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa

• Published in: The International journal of eating disorders 1993-05, Vol.13 (4), p.349-357
• Main Authors: Rossiter, E.M. (Stanford University School of Medicine), Agras, W.S, Telch, C.F, Schneider, J.A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Body Image; Borderline Personality Disorder - psychology; Borderline Personality Disorder - therapy; Bulimia - psychology; Bulimia - therapy; Cognitive Therapy; Combined Modality Therapy; Depressive Disorder - psychology; Depressive Disorder - therapy; Desipramine - therapeutic use; Eating behavior disorders; Feeding Behavior - psychology; Female; Humans; Medical sciences; Personality Assessment; Personality Disorders - psychology; Personality Disorders - therapy; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Concept; TECHNIQUE DE PREVISION; TECNICAS DE PREDICCION; TRASTORNOS DEL SISTEMA NERVIOSO; TRASTORNOS DIGESTIVOS; TROUBLE DIGESTIF; TROUBLE DU SYSTEME NERVEUX
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/1098-108X(199305)13:4<349::AID-EAT2260130403>3.0.CO;2-C

The Personality Disorders Examination (PDE) was administered to 71 bulimia nervosa patients at baseline assessment in a study comparing the effectiveness of cognitive-behavioral treatment with desipramine or the combination of both treatments. Personality disorder subscales were combined into single DSM-III-R cluster scores. A high cluster B score (consisting of antisocial, borderline, histrionic, and narcissistic features) significantly predicted poor outcome at 16 weeks and was a better predictor of outcome than borderline personality characteristics alone or any other DSM-III-R cluster score or combination of cluster scores. In contrast pretreatment depression level, self-esteem, degree of dietary restraint, frequency of purging, and history of anorexia nervosa were not significantly related to outcome. At 1-year follow-up there was still a trend toward high cluster B scores predicting poor treatment outcome. Cluster B score was not significantly correlated with percentage of sessions attended nor did subjects with higher cluster B scores have a better outcome with either specific treatment. These results suggest that further investigation of alternative treatments is warranted with high cluster B individuals to determine if treatment effectiveness can be improved