Despite evidence of a link between the behavioral
and cognitive dimensions of aggressiveness and eating disorders, only few
studies have tested this relation empirically.
Hostility and
aggressiveness may interfere with treatment adherence: people who are likely to
report feelings of hostility and aggressiveness, have also a stronger tendency
to neglect the physicianÕs advice, showing a lower compliance with treatment.
Hostility,
anger and aggressiveness may also play a role in the worst outcomes of eating
disorders, from self-harming behaviors to suicide.
In a recent
study, Dr Paola Miotto, Eating Disorders Unit, Department of Mental Health,
ULSS 7, Conegliano, Italy, in collaboration with Dr Antonio Preti, investigated
levels of aggressiveness, anger and hostility in patients with eating disorders.
They found that
patients with anorexia nervosa scored lower than controls on the Physical
aggression and on the Verbal aggression subscales of the Aggression
Questionnaire.
On the other
hand, patients with bulimia nervosa scored higher than controls on the Anger
subscale of the Aggression Questionnaire, but did not differ from them on the
other subscales of the questionnaire.
Despite
limitations, the study shows that patients with anorexia nervosa have a lower
propensity to aggression, and it remains to be investigated whether this lack
of assertiveness is a feature of the disorder or it is a predating risk factor,
which could be specifically addressed in preventive intervention during
adolescence.
On the other
hand, the study confirmed the higher propensity to anger in patients with
bulimia nervosa, which may be a risk factor for suicidal behavior in these
patients.
Hostile
feelings may be associated to early, unresolved, severe negative experiences,
such as physical and sexual abuse, which occur more often in patients affected
by these disorders than in controls.
Interventions
aimed at allowing a better disclosure of unresolved feelings related to anger
could be appropriate for patients with anorexia or bulimia nervosa.
References:
Miotto P,
Pollini B, Restaneo A, Favaretto G, Preti A.
Aggresiveness,
anger and hostility in eating disorders.
Comprehensive
Psychiatry, 2008; 49: 364-373.