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The anorectic bulimic conflict. An alternative diagnostic approach to anorexia nervosa and bulimia
Author(s) -
Holmgren Sven,
Humble Kristina,
Norring Claes,
Roos BjornErik,
Rosmark Borje,
Sohlberg Staffan
Publication year - 1983
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/1098-108x(198321)2:2<3::aid-eat2260020202>3.0.co;2-h
Subject(s) - anorexia nervosa , bulimia nervosa , psychology , context (archaeology) , anorectic , eating disorders , anorexia , psychiatry , psychotherapist , psychogenic disease , clinical psychology , body weight , medicine , paleontology , biology
The reported increase over the last decades in the incidence of eating disorders seems to be accompanied by a shift in the symptomatic spectrum, so that the clinician now more often comes in contact with individuals not matching the picture of the “typical” anorexia nervosa patient. Seventy‐nine patients assessed at the clinic over the last two and a half years were studied with respect to the differential diagnostic problems arising in this context. A considerable overlap in symptomatology was found between all sub‐ categories (anorexia nervosa, bulimia, double diagnosis of anorexia nervosa/bulimia according to the DSM‐III, and “anorexic‐like”). Furthermore, 49% had previously passed through at least one phase when a diagnosis other than that currently applicable would have been appropriate. These results, in combination with similar observations reported several times in the literature, imply the existence of some common feature among all the patients. In the ABC‐model, a conflict between anorectic and bulimic impulses is suggested as a concept capable of expressing this commonality while still representing a phenomenon identifiable at a clinical‐descriptive level. The possible difficulties in detecting the conflict in the everyday clinical work are discussed along with the practical and theoretical advantages associated with applying the ABC‐model to diagnosis, prognosis and treatment in eating disorders.