Date of Award

1999

Document Type

Dissertation

Degree Name

Doctor of Philosophy

School

School of Education

Program

Counseling Psychology, Ph.D.

First Advisor

Frederick A. Kosinski, Jr.

Second Advisor

Jimmy Kijai

Third Advisor

Lenore S. Brantley

Abstract

Problem. Although diagnostic criteria of bulimia center on weight- and food-related issues, eating disorders may be viewed as a response to deficits in self-regulatory functions. The purpose of this study was to investigate the relationship between the severity of bulimia, object relations, and identity. This study tested the hypotheses that women with a more severe eating pathology have high scores on object-relations disturbance as well as identity disturbance. It was postulated that women who have been assessed as having a more cohesive ego might respond to cognitive behavioral therapy while those who are assessed as having less intact ego resources may require more intensive psychodynamic approaches.

Method. The study involved the administration of three tests by therapists who were treating women diagnosed with bulimia nervosa according to DSM-IV criteria. The test instruments included the following: Bulimia Test-Revised, Bell Object Relations Inventory, and the Erwin Identity Scale. An interview was conducted on a selected group of 12 subjects.

Results. There were statistically significant correlations between the severity of bulimia and the severity of object relations and identity disturbance. Specifically, the Alienation subscale of the Bell Object Relations Inventory and the Confidence subscale of the Erwin Identity Scale had the strongest correlation with the BULIT-R. The qualitative results indicated that a number of themes were strongly identified by both "High Bulimics" and "Low Bulimics."

Conclusions. The quantitative analysis indicated there was a relationship between the severity of object relations, identity disturbance, and bulimia. However, the qualitative analysis identified many of the women, in the "Low Bulimic" group, had significant disturbances in their relationships as well as their opinion of their body. It was concluded that both groups exhibited significant object relations and identity disturbances. Therefore, it is suggested that a more psychodynamic approach is useful for understanding the adaptive functions of bulimia.

Subject Area

Bulimia--Treatment, Psychodynamic psychotherapy, Identity (Psychology)

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