CORRELATES OF SEVERITY IN BULIMIA-NERVOSA

Objective: We sought to clarify the correlates of severity in women wi th bulimia nervosa. Method: We studied 114 bulimic women at entry to a randomized clinical trial. We used eight definitions of severity that encompassed the DSM-III-R criteria set for bulimia nervosa (i.e., bin ging, purging, and body dissatisfaction in the current and worst lifet ime time frames) and global functioning and symptomatology. We operati onalized 28 possible correlates of severity that covered demographic, Axis I psychiatric, personality, family background, symptoms, and neur opsychological domains. We used regression techniques to investigate t he associations between the correlates and severity indices. Results: The regression models were all statistically significant and tended to account for a sizeable proportion of variance. In particular, earlier age of onset of bulimia and lower character scores (measured by the T emperament and Character Inventory) correlated with greater severity. Worse mean parental care (from the Parental Bonding Instrument), the a bsence of any lifetime anxiety disorder, and the presence of any lifet ime mood disorder emerged as independent correlates in several models. Conclusions: As these were hypothesis-generating analyses, confirmati on or refutation of these results awaits further study. In particular, age of onset of bulimia and personality traits related to character m ay be important modifiers of the severity of illness in bulimia nervos a. (C) 1996 by John Wiley & Sons, Inc.