Disordered Eating and Obsessive-Compulsive Symptoms in a Sub-Clinical Student Population

The link between anorexia nervosa and obsessive-compulsive disorder has been well established in the clinical literature. However, little research has explored this relationship in terms of the specific subtypes of obsessive-compulsive disorder (e. g. checking, ordering, contamination). The present study aimed to add to this small body of research by investigating the self-report disordered eating and obsessive-compulsive tendencies of 141 female undergraduate students. A significant relationship was found between disordered eating and obsessive-compulsive tendencies, with one third of participants exhibiting disordered eating patterns. High comorbid obsessive-compulsive disorder rates were observed among those with high disordered eating scores. Whereas hoarding was the most endorsed obsessive-compulsive characteristic in the disordered eating group, ordering/arranging was found to be most predictive of disordered eating symptomology across measures. It is suggested that routine screening for obsessive-compulsive disorder should be carried out on identification of an eating disorder. ********** Anorexia Nervosa (AN), an eating disorder (ED) predominantly found among young western females, is characterised by a deliberate weight loss that is both initiated and maintained by the individual affected (World Health Organisation, 1992). AN presents as a refusal to maintain at least 85% of expected body weight, accompanied by an intense fear of gaining weight (American Psychiatric Association [APA], 2000). Perceived shape and weight are significantly distorted; despite vast evidence to the contrary, the anorectic still believes that they are 'fat'. In some cases of AN, additional behaviours such as excessive exercise and laxative use are employed to assist weight loss. Amenorrhea is a further characteristic of AN among females. Clinical AN affects an estimated 1% of the adolescent population in western countries (Carr, 1999), however community studies have reported prevalence rates from 0.5% (Patton, Selzer, Coffey, Carlin & Wolfe, 1999) to 20% (Nelson, Hughes, Katz & Searight, 1999). Females with AN outnumber males 9:1 during adolescence (Carr, 1999). New Zealand specific research concurs with these findings, with the Christchurch Psychiatric Epidemiology Study (CPES) placing lifetime prevelance of clinical AN at 0.3% for females and 0% for males (Wells, Bushnell, Homblow, Joyce & Oakley-Browne, 1989). An investigation into the eating habits of 1514 adolescent schoolgirls in Auckland, New Zealand found that 14% of girls scored above the cutoff on the Eating Attitudes Test, indicating the possible presence of an ED (Lowe, Miles & Richards, 1985). More recently, Fear, Bulik, and Sullivan (1996) administered the Eating Disorder Inventory-2 to 363 14-year-old Christchurch schoolgirls. It was found that 54% engaged in dieting behaviour, where the average age of first dieting was 12.9 years. An overwhelming 71% of these girls desired to be a smaller size than their current weight for height. The DSM-IV-TR (APA, 2000) distinguishes between two disordered eating pattems in AN: restrictive type (ANr) and binge-eating-purging type (ANbp). ANr refers to where food intake is either significantly limited or completely refused. ANbp refers to restrictive eating coupled with periods of excessive food consumption and self-induced purging episodes. Such behaviours can see the development of social withdrawal, depression, fine body hair (lanugo), dental erosion (in ANbp), and long-term health complications such as chronically low blood pressure and heart rate (Barlow & Durand, 2005). Though the aetiology of AN remains largely unknown, theories encompass sociocultural, neurochemical, genetic, and familial factors (for a review, see Carr, 1999). Cognitive-behavioural models of AN have received perhaps the most attention. These theories are largely based on the cognitive distortions identified by Beck in his cognitive-behavioural model of depression (Beck, 1976). …