The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.

The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.

Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.

The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.

The aim of this study was to asses the impact of different psychological and/or biological effects in the recovery from surgery.

The sample was composed of 42 patients waiting for a surgical intervention. Patients with cognitive impairment were removed from the sample. Prior to surgical intervention (48 to 72 hours), patients were administered the Millon Clinical Multiaxial Inventory-II (Millon, 1986) and salivary cortisol were measured 24 hours before surgery. Following surgical intervention, recovery was coded as good or poor accordingly to Moix et als criteria (1995). Dietary intake, resting and sleeping hours, as well as the existence of fever, perceived pain and related surgery complications were daily registered and controlled for.

The cortisol values were increased in patients with high score in Histrionic Scale (t = 2.10, p = 0.043). There was a significant relation between personality, cortisol and recovery. the patients with low score in Dependent Scale (t = 2.33, p = 0.029), Histrionic Scale ( t = 2.51, p = 0.020), Alcohol Dependence Scale (t = 2.01, p = 0.049), Drug Dependence Scale (t = 2.08, p = 0.050) and cortisol show better recovery from surgery.

The results of this study indicate that psychological factors and levels of cortisol may have a critical rol in post-operatory recovery. Taking these data into account, it seems necessary to assess psychopathology on a regular basis in all the patients waiting for surgically interventions.

The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.

The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.

Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.

The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.

The aim of the study was to assess the impact of several psychological and/or biological variables in the recovery from surgery.

The selected sample was composed of 42 patients (age range: 25–70) admited for surgical treatment to a University Hospital. The patients who presented impaired cognitive functioning were excluded from the study. Prior to surgical intervention (48 to 72 hours), patients were administered the Family Adaptability and Cohesion Evaluation Scale (FACES-II). Salivary cortisol was measured 24 hours before surgery. Following surgical intervention, recovery was coded as “good” or “poor” accordingly to Moix et al.’s criteria (1995). Dietary intake, resting and sleeping time, fever, perceived pain and surgery-related complications were assessed on a daily basis.

Significant relationships between better recovery, family cohesion and salivary cortisol level were found. The patients with lower scores in the cohesion dimension of the FACES-II and higher cortisol levels had more complications during the recovery phase (F = 10.96, p = 0.006).

Our results suggest that social support (family cohesion) and the activity of the hypothalamus-pituitary-adrenal axis (cortisol levels) can have a significant influence on postoperatory recovery. Taking these data into account, it would be suitable to assess psychopathology and social support in patients waiting for surgically interventions.

In the past few decades, new and more efficient techniques to help solve fertility problems have become widely available throughout the developed world. The aim of this study was to determine whether there were differences on psychopathology factors between women who had conceived after in vitro fertilization (IVF) and women who had conceived naturally.

The sample was composed of 41 pregnant women of whom 28 women had conceived through assisted reproductive technology (IVF) and 13 had conceived naturally. Women were evaluated by week 20 of pregnancy at the Infanta Cristina University Hospital Obstetrics and Gynecology Service, in Badajoz. Women consented to complete the Symptom Checklist-90-Revised (SCL-90-R).

IVF women were characterized by higher scores on Anxiety Scale (t = 3.90; p = 0.045) and lower scores on Hostility Scale (t = 4.35; p = 0.041) than women who had conceived naturally. There were no differences in the others scales.

IVF women appear to present a temperamental profile characterized by a tendency to anxiety. Further research is needed to firstly, confirm these preliminary findings, and secondly, to longitudinally explore its impact on pregnancy outcome and mother-infant attachment.

To isolate clinical predictors of Expressed Emotion (EE) in relatives of patients with eating disorders.

Forty-three families of patients with anorexia and bulimia nervosa were assessed using the Camberwell Family Inventory (CFI). In addition, the eating symptoms, the general psychopathology and the personality of the patients was assessed using the Eating Disorders Inventory (EDI-II), the Symptom Checklist (SCL-90-R) and the Structured Clinical Interview for the Diagnosis of Axis II DSM-IV Disorders (SCID-II). Binary logistic regression methods (Forward Wald) were used for statistical analysis.

Maturity fear, depressive features and anxiety of patients were predictors of parental EE level.

Althoug more clinical research is needed, the results of our study suggest that the severity of the symptomathology and some personality features of the patients with eating disorders can influence the EE observed in their relatives.

In last years, studies on the families of patients with eating disorders (ED) have tried to identify family needs, as well as to determine their coping strategies.

To identify the coping strategies in families of patients with eating disorders.

Forty relatives were evaluated (mean age=49.4 years, S.D.=6.7); 52% women and 48% men; 94.6% married. COPE scale (Carver et al., 1989) was used to measure individual coping strategies, and F-COPES scale (Olson and Larsen, 1987) was used to evaluate family coping strategies. Statistical analysis was realized using SPSS.19.

The relatives had higher scores in the following COPE subscales: planning, suppression of competing activities, active coping; they had lower scores in drug/alcohol intake, behavioral disengagement and denial. In F-COPES subscale the higher scores were in reframing and the lower ones in passive appraisal.

It of patients relatives faces their trying change, avoiding other activities or thoughts that distract them. As family, they identify the problems and try to handle them looking for support in nearby persons.

Disturbed body image perception and personality features and the way they influence eating disorders have been frequently studied in patients with eating disorders, but not in children's non clinical samples.

To analyze the influence of body image perception and personality features on eating disturbances in a non clinical sample of children

Longitudinal study. The sample was composed of 100 children, who were assessed at eleven and thirteen. Emotional, cognitive and behavioral aspects of the body image were evaluated using BPSS, BSQ, DST, BIAQ and body mass index (BMI). To assess personality features the EPQ was used and to assess eating disorders three scale of EDI-2 (drive for thinness, bulimia and body dissatisfaction) were used. For the statistic analysis, stepwise regression was used.

In the boys’ group, introversion ate 11 positively correlated with drive for thinness at 13. Neuroticism predicted higher bulimia score and body mass index predicted body dissatisfaction. In the girls’ group, neuroticism predicted drive for thinness, psychoticism predicted higher bulimia and higher BMI predict body dissatisfaction.

Personality features and BMI seem to predict at eleven the eating disturbances that will be detected later, at thirteen.

Perfectionism is considered a risk factor and is very close related to Eating Disorders (EDs). It estimates heritability of 29-42%. However, it has also been related to psychosocial factors such as the insecure attachment style.

To study the relationship of perfectionism with personality dimensions, its likelihood of improvement and its treatment.

To analyze if Perfectionism is associated with dimensions of Temperament or dimensions of Character and therefore more psychosocial.

Participants were 151 female outpatients who consecutively started treatment at the Eating Disorders Unit (Ciudad Real University General Hospital). Personality was assessed by using the Temperament and Character Inventory (TCI). Perfectionism was assessed by using the Edinburg Investigatory Test (EDI-2) subscale (t0). One year later, patients were re-assessed with the EDI-2 (t1).

The scores on Perfectionism significantly improved from t0 to t1, (repeated measures ANOVA, F = 6.6, P < 0.01). At baseline, Perfectionism was related to any of the Temperament dimensions, but the Character variable Purposefulness (SD2) (β = .25 95% CI .17, 98), 2.7% of variance). Responsibility (SD1) and Self-Aceptance (SD4) were inversely associated with Perfectionism. At t1, Responsibility still was a protective factor for Perfectionism, regardless the effect of Perfectionism at t0.

Perfectionism is also related to psychosocial and developmental factors. People with an internal locus of control tend to take responsibility for their own actions and are resourceful in solving problems. Thus, Self-directedness, mainly Responsibility for their own actions, is a protective factor for Perfectionism in EDs.

The authors have not supplied their declaration of competing interest.

Perfectionism is considered a multidimensional key risk factor for Eating Disorders (EDs). There are discrepancies regarding if it is mainly associated to Anorexia nervosa (AN) but not to other EDs.

To study if Perfectionism is not only related with AN, but it is present in all EDs and associated with more transdiagnostic attitudes and behaviors.

To see if there were significant differences among EDs subgroups concerning Perfectionism and to study which abnormal eating attitudes were more associated with this trait.

Participants were 151 outpatients with EDs. DSM-IVTR diagnoses were: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders not Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2) subscale; general psychopathology with the Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self-Esteem Questionnaire (RSE). Eating psychopathology was measured with the Bulimic Investigatory Test (BITE), Eating Attitude Test (EAT-40), EDI-2 and the Body Shape Questionnaire (BSQ).

No significant differences were found regarding Perfectionism among the three groups. Body dissatisfaction was the variable most associated with Perfectionism (β = 0.330, F = 14.2, P < 0.001, 10.9% of the variance) adjusting for general and eating psychopathology. Ascetism and Interoceptive awareness were the EDI-2 subscales most associated with Perfectionism.

The findings confirm that Perfectionism is present in all EDs and there is a relationship between body dissatisfaction and Perfectionism. Interplay has been suggested between these two factors for the development of EDs.

The authors have not supplied their declaration of competing interest.

Body dissatisfaction is one of the core psychopathological components in Eating Disorders (EDs) and it tends to persist over time regardless treatment interventions. Perfectionism is considered as a mediator and moderator between body dissatisfaction and disordered eating.

To study the influence of Perfectionism in EDs outcome.

To analyze changes in body dissatisfaction at one year follow-up in patients with eating disorders and the effect of perfectionism over these changes.

Participants were 151 patients with eating disorders. DSM-IVTR diagnoses were as follows: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders no Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2). The Body Shape Questionnaire (BSQ) was also distributed. One year after the beginning of their treatment, patients were reassessed.

Patients with BN showed significantly higher scores on BSQ than those with AN. There was a significant improvement in BSQ after one year of treatment regardless the diagnostic (repeated measures ANOVA: F 8.4, P<.01). Perfectionism was a co-variable that influenced in those changes.

The results confirm the interaction between perfectionism and body dissatisfaction in the treatment outcome of EDs. It has been described an interplay between Perfectionism, body dissatisfaction and disordered eating attitudes and behaviours, being Perfectionism a moderator factor. The results highlight the need of dealing not only with the core symptoms of EDs, but also with the moderator factors such as Perfectionism to enhance the outcome.

The authors have not supplied their declaration of competing interest.