Characteristics of self-regulation in adolescent patients with anorexia nervosa

The purpose of the study was to investigate the different modes of self-reg ulation in adolescent anorexia nervosa (AN). A self-system questionnaire, c he Narcissism Inventory, was given to 61 adolescent females with AN and 61 controls. Patients with AN reported higher overall disturbances in self-reg ulation than controls. In particular, a highly unstable self-system, a tend ency to use idealization as modus of regulation, and high narcissistic gain from their illness was found in the patient group; however, che patients d id not report a 'classic narcissistic sellf'. Furthermore, we were able to differentiate between two clusters of patients, one with high (n = 34) and one with low (n = 27) disturbance in self-regulation; the latter reported a shorter duration of illness and lower oral control but did not differ on a ny other clinical variables. Stronger relationships were found between the dimension 'endangered self' and the overall scores of the Earing Attitudes Test (EAT) and the facing Disorder Inventory (EDI) as well as two subscales of the EAT and five of the EDI. Our study in anorexic adolescents demonstr ated chat the self-system is experienced as highly unstable, that idealizat ion is used as mode of regulation, and that the dimension of the 'classic n arcissistic self' is less important in this patient group. It is important to evaluate the system of self-regulation for planning treatment in the ind ividual patient according to their needs.