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Personality and Temperament

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Book cover Behavioral Neurobiology of Eating Disorders

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 6))

Abstract

The assessment of personality and temperament in the context of eating disorders (EDs) poses unique challenges because of the physiological symptoms and sequelae of these illnesses. Four models of the relationship between personality and EDs are presented, along with a discussion of the different methodological designs which can evaluate these models. Current data support the likelihood that neuroticism and perfectionism are risk factors for EDs. Perfectionism and the related obsessive–compulsive personality disorder may also share a common cause with anorexia nervosa. High harm avoidance and low self-directedness also characterize all EDs, though more data are needed to confirm their role as risk factors; importantly however, this combination of traits may diminish one’s ability to cope with stressful life events. At the other end of the spectrum, considering impulsivity multidimensionally may be important to understanding the role of this personality trait in EDs, though existing data do not yet allow for conclusions regarding its role as a risk factor versus a consequence of the ED. All of the identified traits that may be risk factors are also exacerbated as a consequence of having, or having had, an ED. Finally, the role of personality disorders in influencing the course and outcome of EDs is still unclear. A fruitful avenue for future research in this area is to utilize personality and temperament to classify individuals in a way that allows for the best chance of identifying genetic loci that confer increased risk for EDs.

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References

  • Anderluh MB, Tchanturia K, Rabe-Hesketh S, Treasure J (2003) Childhood obsessive compulsive personality traits in adult women with eating disorders: defining a broader eating disorder phenotype. Am J Psychiatry 160:242–247

    Article  PubMed  Google Scholar 

  • Anderluh MB, Tchanturia K, Rabe-Hesketh S, Collier D, Treasure J (2009) Lifetime course of eating disorders: design and validity testing of a new strategy to define the eating disorders phenotype. Psychol Med 39:105–114

    Article  CAS  PubMed  Google Scholar 

  • Bacanu S, Bulik CM, Klump KL et al (2005) Linkage analysis of anorexia and bulimia nervosa cohorts using selected behavioral phenotypes as quantitative traits or covariates. Am J Med Genet B Neuropsychiatr Genet 139B:61–68

    Article  CAS  PubMed  Google Scholar 

  • Bardone-Cone AM, Abramson LY, Vohs KD, Heatherton TF, Joiner TE Jr (2006) Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status. Behav Res Ther 44:27–42

    Article  CAS  PubMed  Google Scholar 

  • Bardone-Cone AM, Wonderlich SA, Frost RO et al (2007) Perfectionism and eating disorders: current status and future directions. Clin Psychol Rev 27:384–405

    Article  PubMed  Google Scholar 

  • Bardone-Cone AM, Weishuhn AS, Boyd CA (2009) Perfectionism and bulimic symptoms in African American college women: Dimensions of perfectionism and their interactions with perceived weight status. J Couns Psychol 56:266–275

    Article  Google Scholar 

  • Bruce KR, Steiger H (2005) Treatment implications of axis-II comorbidity in eating disorders. Eat Disord 13:93–108

    Article  PubMed  Google Scholar 

  • Bulik CM (2005) Exploring the gene-environment nexus in eating disorders. J Psychiatry Neurosci 30:335–339

    PubMed  Google Scholar 

  • Bulik CM, Tozzi F, Anderson C, Mazzeo SE, Aggen S, Sullivan PF (2003) The relation between eating disorders and components of perfectionism. Am J Psychiatry 160:366–368

    Article  PubMed  Google Scholar 

  • Bulik CM, Klump KL, Thornton L et al (2004) Alcohol use disorder comorbidity in eating disorders: a multicenter study. J Clin Psychiatry 65:1000–1006

    Article  PubMed  Google Scholar 

  • Bulik CM, Bacanu S, Klump KL et al (2005) Selection of eating-disorder phenotypes for linkage analysis. Am J Med Genet B Neuropsychiatr Genet 139B:81–87

    Article  PubMed  Google Scholar 

  • Bulik CM, Sullivan PF, Tozzi F, Furberg H, Lichtenstein P, Pedersen NL (2006) Prevalence, heritability, and prospective risk factors for anorexia nervosa. Arch Gen Psychiatry 63:305–312

    Article  PubMed  Google Scholar 

  • Bulik CM, Hebebrand J, Keski-Rahkonen A et al (2007) Genetic epidemiology, endophenotypes, and eating disorder classification. Int J Eat Disord 40:S52–S60

    Article  PubMed  Google Scholar 

  • Cassin SE, von Ranson KM (2005) Personality and eating disorders: a decade in review. Clin Psychol Rev 25:895–916

    Article  PubMed  Google Scholar 

  • Castro-Fornieles J, Gual P, Lahortiga F et al (2007) Self-oriented perfectionism in eating disorders. Int J Eat Disord 40:562–568

    Article  PubMed  Google Scholar 

  • Cervera S, Lahortiga F, Martínez-González MA, Gual P, Irala-Estévez J, Alonso Y (2003) Neuroticism and low self-esteem as risk factors for incident eating disorders in a prospective cohort study. Int J Eat Disord 33:271–280

    Article  PubMed  Google Scholar 

  • Claes L, Nederkoorn C, Vandereycken W, Guerrieri R, Vertommen H (2006a) Impulsiveness and lack of inhibitory control in eating disorders. Eat Behav 7:196–203

    Article  PubMed  Google Scholar 

  • Claes L, Vandereycken W, Luyten P, Soenens B, Pieters G, Vertommen H (2006b) Personality prototypes in eating disorders based on the big five model. J Pers Disord 20:401–416

    Article  PubMed  Google Scholar 

  • Clark LA, Watson D, Mineka S (1994) Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol 103:103–116

    Article  CAS  PubMed  Google Scholar 

  • Cloninger CR, Svrakic DM, Przybeck TR (1993) A psychobiological model of temperament and character. Arch Gen Psychiatry 50:975–990

    CAS  PubMed  Google Scholar 

  • Crane AM, Roberts ME, Treasure J (2007) Are obsessive-compulsive personality traits associated with a poor outcome in anorexia nervosa? A systematic review of randomized controlled trials and naturalistic outcome studies. Int J Eat Disord 40:581–588

    Article  PubMed  Google Scholar 

  • Drews CD, Greenland S (1990) The impact of differential recall on the results of case-control studies. Int J Epidemiol 19:1107–1112

    Article  CAS  PubMed  Google Scholar 

  • Eddy KT, Keel PK, Dorer DJ, Delinsky SS, Franko DL, Herzog DB (2002) Longitudinal comparison of anorexia nervosa subtypes. Int J Eat Disord 31:191–201

    Article  PubMed  Google Scholar 

  • Fairburn CG, Welch SL, Doll HA, Davies BA (1997) Risk factors for bulimia nervosa: A community-based case-control study. Arch Gen Psychiatry 54:509–517

    CAS  PubMed  Google Scholar 

  • Fairburn CG, Doll HA, Welch SL, Hay PJ, Davies BA, O'Connor ME (1998) Risk factors for binge eating disorder: a community-based, case-control study. Arch Gen Psychiatry 55:425–432

    Article  CAS  PubMed  Google Scholar 

  • Fairburn CG, Cooper Z, Doll HA, Welch SL (1999) Risk factors for anorexia nervosa: three integrated case-control comparisons. Arch Gen Psychiatry 56:468–476

    Article  CAS  PubMed  Google Scholar 

  • Fairburn CG, Bohn K (2005) Eating disorder NOS (EDNOS): an example of the troublesome “not otherwise specified” (NOS) category in DSM-IV. Behav Res Ther 43:691–701

    Article  PubMed  Google Scholar 

  • Fassino S, Amianto F, Gramaglia C, Facchini F, Abbate-Daga G (2004) Temperament and character in eating disorders: ten years of studies. Eat Weight Disord 9:81–90

    CAS  PubMed  Google Scholar 

  • Favaro A, Tenconi E, Santonastaso P (2008) The relationship between obstetric complications and temperament in eating disorders: a mediation hypothesis. Psychosom Med 70:372–377

    Article  PubMed  Google Scholar 

  • Fischer S, Smith GT, Cyders MA (2008) Another look at impulsivity: a meta-analytic review comparing specific dispositions to rash action in their relationship to bulimic symptoms. Clin Psychol Rev 28:1413–1425

    Article  PubMed  Google Scholar 

  • Ghaderi A, Scott B (2000) The big five and eating disorders: a prospective study in the general population. Eur J Pers 14:311–323

    Article  Google Scholar 

  • Grilo CM, Pagano ME, Skodol AE et al (2007) Natural course of bulimia nervosa and of eating disorder not otherwise specified: 5-year prospective study of remissions, relapses, and the effects of personality disorder psychopathology. J Clin Psychiatry 68:738–746

    Article  PubMed  Google Scholar 

  • Holliday J, Uher R, Landau S, Collier D, Treasure J (2006) Personality pathology among individuals with a lifetime history of anorexia nervosa. J Pers Disord 20:417–430

    Article  PubMed  Google Scholar 

  • Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras WS (2004) Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychol Bull 130:19–65

    Article  PubMed  Google Scholar 

  • Jacobs MJ, Roesch S, Wonderlich SA et al (2009) Anorexia nervosa trios: behavioral profiles of individuals with anorexia nervosa and their parents. Psychol Med 39:451–461

    Article  CAS  PubMed  Google Scholar 

  • Kaye WH, Greeno CG, Moss H et al (1998) Alterations in serotonin activity and psychiatric symptoms after recovery from bulimia nervosa. Arch Gen Psychiatry 55:927–935

    Article  CAS  PubMed  Google Scholar 

  • Keel PK, Fichter M, Quadflieg N et al (2004) Application of a latent class analysis to empirically define eating disorder phenotypes. Arch Gen Psychiatry 61:192–200

    Article  PubMed  Google Scholar 

  • Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ (1993) A longitudinal twin study of personality and major depression in women. Arch Gen Psychiatry 50:853–862

    CAS  PubMed  Google Scholar 

  • Keys A, Brozek J, Henschel A, Mickelsen O, Taylor HL (1950) The biology of human starvation. University of Minnesota Press, Minnesota

    Google Scholar 

  • Killen JD, Taylor CB, Hayward C et al (1996) Weight concerns influence the development of eating disorders: A 4-year prospective study. J Consult Clin Psychol 64:936–940

    Article  CAS  PubMed  Google Scholar 

  • Klein DN, Riso LP (1993) Psychiatric disorders: problems of boundaries and comorbidity. In: Costello CG (ed) Basic issues in psychopathology. Guildford, New York

    Google Scholar 

  • Klump KL, Strober M, Bulik CM et al (2004) Personality characteristics of women before and after recovery from an eating disorder. Psychol Med 34:1407–1418

    Article  PubMed  Google Scholar 

  • Kim Y-K (ed) (2009) Handbook of behavioral genetics. Springer, New York

    Google Scholar 

  • Lilenfeld LR, Kaye WH, Greeno CG et al (1997) Psychiatric disorders in women with bulimia nervosa and their first-degree relatives: effects of comorbid substance dependence. Int J Eat Disord 22:253–264

    Article  CAS  PubMed  Google Scholar 

  • Lilenfeld LR, Kaye WH, Greeno CG et al (1998) A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch Gen Psychiatry 55:603–610

    Article  CAS  PubMed  Google Scholar 

  • Lilenfeld LR, Stein D, Bulik CM et al (2000) Personality traits among current eating disordered, recovered, and never ill first-degree female relatives of bulimic and control women. Psychol Med 30:1399–1410

    Article  CAS  PubMed  Google Scholar 

  • Lilenfeld LR, Devlin B, Bulik CM et al (2001) Deriving behavioural phenotypes in an international, multi-centre study of eating disorders. Psychol Med 31:635–645

    Google Scholar 

  • Lilenfeld LR, Wonderlich S, Riso LP, Crosby R, Mitchell J (2006) Eating disorders and personality: a methodological and empirical review. Clin Psychol Rev 26:299–320

    Article  PubMed  Google Scholar 

  • Lilenfeld LR, Jacobs CH, Woods AM, Picot AK (2008) A prospective study of obsessive-compulsive and borderline personality traits, race and disordered eating. Eur Eat Disord Rev 16:124–132

    Article  PubMed  Google Scholar 

  • Matsunaga H, Kaye WH, McConaha C, Plotnicov K, Pollice C, Rao R (2000) Personality disorders among subjects recovered from eating disorders. Int J Eat Disord 27:353–357

    Article  CAS  PubMed  Google Scholar 

  • Mazzeo SE, Landt MC, Jones I et al (2006) Associations among postpartum depression, eating disorders, and perfectionism in a population-based sample of adult women. Int J Eat Disord 39:202–211

    Article  PubMed  Google Scholar 

  • Pearson CA, Gleaves DH (2006) The multiple dimensions of perfectionism and their relation with eating disorder features. Pers Individ Dif 41:225–235

    Article  Google Scholar 

  • Perkins PS, Klump KL, Lacono WG, McGue M (2005) Personality traits in women with anorexia nervosa: Evidence for a treatment-seeking bias? Int J Eat Disord 37:32–37

    Google Scholar 

  • Pope HG Jr, Hudson JI (1989) Are eating disorders associated with borderline personality disorder? A critical review. Int J Eat Disord 8:1–9

    Article  Google Scholar 

  • Rastam M (1992) Anorexia nervosa in 51 Swedish adolescents: premorbid problems and comorbidity. Academy of Child and Adolescent Psychiatry 31:819–829

    Article  CAS  Google Scholar 

  • Rosenvinge JH, Mouland SO (1990) Outcome and prognosis of anorexia nervosa: a retrospective study of 41 subjects. Br J Psychiatry 156:92–97

    Article  CAS  PubMed  Google Scholar 

  • Rybakowski F, Slopien A, Dmitrzak-Weglarz M, Czerski P, Rajewski A, Hauser J (2006) The 5-HT2A-1438 A/G and 5-HTTLPR polymorphisms and personality dimensions in adolescent anorexia nervosa: association study. Neuropsychobiology 53:33–39

    Article  CAS  PubMed  Google Scholar 

  • Sansone RA, Levitt JL, Sansone LA (2005) The prevalence of personality disorders among those with eating disorders. Eat Disord 13:7–21

    Article  PubMed  Google Scholar 

  • Santonastaso P, Friederici S, Favaro A (1999) Full and partial syndromes in eating disorders: a 1-year prospective study of risk factors among female students. Psychopathology 32:50–56

    Article  CAS  PubMed  Google Scholar 

  • Shaw HE, Stice E, Springer DW (2004) Perfectionism, body dissatisfaction, and self-esteem in predicting bulimic symptomatology: lack of replication. Int J Eat Disord 36:41–47

    Article  PubMed  Google Scholar 

  • Skodol AE, Bender DS (2009) The future of personality disorders in DSM-V? Am J Psychiatry 166:388–391

    Article  PubMed  Google Scholar 

  • Steele A, Corsini N, Wade TD (2007) The interaction of perfectionism, perceived weight status, and self-esteem to predict bulimic symptoms: the role of ‘benign’ perfectionism. Behav Res Ther 45:1647–1655

    Article  PubMed  Google Scholar 

  • Steiger H, Richardson J, Schmitz N, Israel M, Bruce KR, Gauvin L (2009) Trait-defined eating-disorder subtypes and history of childhood abuse. Int J Eat Disord. doi:10.1002/eat.20711

    Google Scholar 

  • Stein D, Kaye WH, Matsunaga H et al (2002) Eating-related concerns, mood, and personality traits in recovered bulimia nervosa subjects: a replication study. Int J Eat Disord 32:225–229

    Article  CAS  PubMed  Google Scholar 

  • Steinhausen H (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284–1293

    Article  PubMed  Google Scholar 

  • Stice E (2002) Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull 128:825–848

    Article  PubMed  Google Scholar 

  • Stice E, Agras WS (1998) Predicting onset and cessation of bulimic behaviors during adolescence: a longitudinal grouping analysis. Behav Ther 29:257–276

    Article  Google Scholar 

  • Strober M, Freeman R, Morrell W (1997) The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10-15 years in a prospective study. Int J Eat Disord 22:339–360

    Article  CAS  PubMed  Google Scholar 

  • Strober M, Freeman R, Lampert C, Diamond J (2007) The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: Evidence from a family study with discussion of nosological and neurodevelopmental implications. Int J Eat Disord 40:S46–S51

    Article  PubMed  Google Scholar 

  • Sutandar-Pinnock K, Woodside DB, Carter JC, Olmsted MP, Kaplan AS (2003) Perfectionism in anorexia nervosa: a 6-24-month follow-up study. Int J Eat Disord 33:225–229

    Article  PubMed  Google Scholar 

  • The Wellcome Trust Case Control Consortium (2007) Genome-wide association study of 14, 000 cases of seven common diseases and 3,000 shared controls. Nature 447:661–678

    Article  Google Scholar 

  • Thompson-Brenner H, Westen D (2005) Personality subtypes in eating disorders: validation of a classification in a naturalistic sample. Br J Psychiatry 186:516–524

    Article  PubMed  Google Scholar 

  • Thompson-Brenner H, Eddy KT, Franko D et al (2008a) A personality classification system for eating disorders: a longitudinal study. Compr Psychiatry 49:551–560

    Article  PubMed  Google Scholar 

  • Thompson-Brenner H, Eddy KT, Satir DA, Boisseau CL, Westen D (2008b) Personality subtypes in adolescents with eating disorders: validation of a classification approach. J Child Psychol Psychiatry 49:170–180

    Article  PubMed  Google Scholar 

  • Tissot AM, Crowther JH (2008) Self-oriented and socially prescribed perfectionism: risk factors within an integrative model for bulimic symptomatology. J Soc Clin Psychol 27:734–755

    Article  Google Scholar 

  • Tozzi F, Aggen SH, Neale BM et al (2004) The structure of perfectionism: a twin study. Behav Genet 34:483–494

    Article  PubMed  Google Scholar 

  • Tyrka AR, Waldron I, Graber JA, Brooks-Gunn J (2002) Prospective predictors of the onset of anorexic and bulimic syndromes. Int J Eat Disord 32:282–290

    Article  PubMed  Google Scholar 

  • Vitousek KM, Stumpf RE (2005) Difficulties in the assessment of personality traits and disorders in eating-disordered individuals. Eat Disord 13:37–60

    Article  PubMed  Google Scholar 

  • Vohs KD, Bardone AM, Joiner TE Jr, Abramson LY, Heatherton TF (1999) Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptom development. J Abnorm Psychol 108:695–700

    Article  CAS  PubMed  Google Scholar 

  • Vrabel KR, Rø Ø, Martinsen EW, Hoffart A, Rosenvinge JH (2010) Five-year prospective study of personality disorders in adults with longstanding eating disorders. Int J Eat Disord 43:22–28

    PubMed  Google Scholar 

  • Wade TD, Bulik CM (2007) Shared genetic and environmental risk factors between undue influence of body shape and weight on self-evaluation and dimensions of perfectionism. Psychol Med 37:635–644

    Article  PubMed  Google Scholar 

  • Wade TD, Tiggemann M, Bulik CM, Fairburn CG, Wray NR, Martin NG (2008) Shared temperament risk factors for anorexia nervosa: a twin study. Psychosom Med 70:239–244

    Article  PubMed  Google Scholar 

  • Wentz E, Gillberg IC, Anckarsäter H, Gillberg C, Råstam M (2009) Adolescent-onset anorexia nervosa: 18-year outcome. Br J Psychiatry 194:168–174

    Article  PubMed  Google Scholar 

  • Westen D, Harnden-Fischer J (2001) Personality profiles in eating disorders: rethinking the distinction between axis I and axis II. Am J Psychiatry 158:547–562

    Article  CAS  PubMed  Google Scholar 

  • Whiteside SP, Lynam DR (2001) The five factor model and impulsivity: using a structural model of personality to understand impulsivity. Pers Individ Dif 30:669–689

    Article  Google Scholar 

  • Wilksch SM, Wade TD (2009) An investigation of temperament endophenotype candidates for early emergence of the core cognitive component of eating disorders. Psychol Med 39:811–821

    Article  CAS  PubMed  Google Scholar 

  • Wonderlich SA, Connolly KM, Stice E (2004) Impulsivity as a risk factor for eating disorder behavior: assessment implications with adolescents. Int J Eat Disord 36:172–182

    Article  PubMed  Google Scholar 

  • Wonderlich SA, Crosby RD, Joiner TE Jr et al (2005) Personality subtyping and bulimia nervosa: psychopathological and genetic correlates. Psychol Med 35:649–657

    Article  PubMed  Google Scholar 

  • Wonderlich SA, Crosby RD, Engel SE, Mitchell JE, Smyth J, Miltenberger R (2007a) Personality-based clusters in bulimia nervosa: differences in clinical variables and ecological momentary assessment. J Pers Disord 21:340–357

    Article  PubMed  Google Scholar 

  • Wonderlich SA, Joiner TE Jr, Keel PK, Williamson DA, Crosby RD (2007b) Eating disorder diagnoses: empirical approaches to classification. Am Psychol 62:167–180

    Article  PubMed  Google Scholar 

  • Zimmerman M (1994) Diagnosing personality disorders: a review of issues and research methods. Arch Gen Psychiatry 51:225–245

    CAS  PubMed  Google Scholar 

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Correspondence to Lisa Rachelle Riso Lilenfeld .

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Lilenfeld, L.R.R. (2010). Personality and Temperament. In: Adan, R., Kaye, W. (eds) Behavioral Neurobiology of Eating Disorders. Current Topics in Behavioral Neurosciences, vol 6. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2010_86

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