Differences and similarities in personality functioning across different types of eating disorders

Jens Rohde; Alexander Obbarius; Barbara Voigt; Lea Sarrar; Silke Biesenthal-Matthes; Clara-Sophia Kind; Matthias Rose; Tobias Hofmann

doi:10.3389/fpsyt.2023.1155725

Differences and similarities in personality functioning across different types of eating disorders

Front Psychiatry. 2023 Jun 1:14:1155725. doi: 10.3389/fpsyt.2023.1155725. eCollection 2023.

Authors

Jens Rohde^#¹, Alexander Obbarius^#^{1

2}, Barbara Voigt¹, Lea Sarrar³, Silke Biesenthal-Matthes⁴, Clara-Sophia Kind⁵, Matthias Rose^{1

6}, Tobias Hofmann^{1

7}

Affiliations

¹ Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
² Dornsife Center for Self-Report Science, University of Southern California, Los Angeles, CA, United States.
³ Department of Psychology, Faculty of Sciences, Medical School Berlin, Berlin, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany.
⁵ Department of Psychosomatic Medicine and Psychotherapy, Kliniken im Theodor-Wenzel-Werk, Berlin, Germany.
⁶ Quantitative Health Sciences, Outcomes Measurement Science, University of Massachusetts Medical School, Worcester, MA, United States.
⁷ Department of Psychosomatic Medicine and Psychotherapy, DRK Kliniken Berlin Wiegmann Klinik, Berlin, Germany.

^# Contributed equally.

Abstract

Objective: The classification of anorexia nervosa (AN) into subtypes is relevant due to their different symptomatology. However, subtypes (restricting type: AN-R; purging type: AN-P) differ also in terms of their personality functioning. Knowledge about these differences would allow for better treatment stratification. A pilot study indicated differences in structural abilities that can be assessed by the operationalized psychodynamic diagnosis (OPD) system. The aim of this study was therefore to systematically explore differences in personality functioning and personality between the two AN subtypes and bulimia nervosa (BN) using three personality (functioning) constructs.

Methods: A total of N = 110 inpatients with AN-R (n = 28), AN-P (n = 40), or BN (n = 42) were recruited in three clinics for psychosomatic medicine. Assignment to the three groups was performed using a comprehensive questionnaire validated for diagnostic purposes (Munich-ED-Quest). Personality functioning was examined using OPD Structure Questionnaire (OPD-SQ), personality by using the Personality Inventory for DSM-5-Brief Form and Big Five Inventory-10. (M)ANOVAs were used to examine differences across eating disorder groups. In addition, correlation and regression analyses were conducted.

Results: We observed differences on several sub- and main scales of the OPD-SQ. Whereas patients with BN showed the lowest levels, AN-R patients displayed the highest levels of personality functioning. On some sub- and main scales, such as "affect tolerance," the subtypes of AN differed from BN, whereas on the scale "affect differentiation," AN-R, differed from the other two groups. The total eating disorder pathology score of the Munich-ED-Quest best predicted overall personality structure [stand. β = 0.650; t(104) = 6.666; p < 0.001] and self-regulation [stand. β = 0.449; t(104) = 3.628; p < 0.001].

Discussion: Our findings confirm most of the results of the pilot study. These findings can facilitate the development of stratified treatment approaches for eating disorders.

Keywords: anorexia nervosa; bulimia nervosa; eating disorder (ED); operationalized psychodynamic diagnosis (OPD); personality functioning; purging type; restricting type.

Grants and funding

We acknowledge financial support from the Open Access Publication Fund of Charité – Universitätsmedizin Berlin and the German Research Foundation (DFG).