LAXATIVE ABUSE AMONG WOMEN WITH EATING DISORDERS - AN INDICATION OF PSYCHOPATHOLOGY

Objective: The results of the scant research on laxative abuse among w omen with eating disorders suggest that laxative abuse is a diagnostic indicator of greater psychopathology. We further investigated the rel ationship of history of laxative abuse to eating and related attitudes , impulsivity, and personality pathology. Method: Women assessed in an outpatient clinical setting and diagnosed with anorexia nervosa, bing e-eating/purging type (n = 51) or bulimia nervosa, purging type (n = 2 80) completed measures of laxative abuse, eating and related attitudes , and personality psychopathology at intake. Results: More than one-ha lf of both groups had abused laxatives at some point. History of laxat ive abuse was unrelated to eating disorder diagnostic category, curren t age or body weight, history of stealing, self-induced injury, having attempted suicide, interpersonal distrust, maturity fears, or compuls ive or dependent personality features. Compared to nonabusers, laxativ e abusers demonstrated more perfectionism and avoidant personality fea tures. Significant statistical interactions among variables revealed t hat bulimia nervosa patients who had abused laxatives exhibited the mo st pathological scores on scales measuring drive for thinness, body di ssatisfaction, ineffectiveness, lack of interoceptive awareness, and p assive-aggressive and borderline personality features. Anorexia nervos a patients who had abused laxatives had the highest scores on the hist rionic scale. Discussion: Results are discussed with regard to past re search and clinical implications. We propose that laxative abuse among eating disordered women may serve different functions depending on di agnosis and underlying personality dynamics. (C) 1996 by John Wiley & Sons, Inc.