National Eating Disorders Association

Our personalities are molded by both the genes we inherit and our life experiences. Psychologists have been trying for decades to identify the different aspects of personality or temperament that help make us tick. Over the years, scientists have found distinct personality traits in individuals with eating disorders. They appear relatively specific to each disorder and can distinguish eating disorder sufferers from healthy people.

Some studies have associated aspects of these personality traits with alterations in serotonin and dopamine signaling.

Anorexia Nervosa

People who suffer from anorexia nervosa tend to have high levels of harm avoidance, a personality trait characterized by worrying, pessimism, and shyness, and low levels of novelty seeking, which includes impulsivity and preferring new or novel things (Fassino et al., 2002). The different subtypes of anorexia have slightly different personality traits, with the binge/purge subtype showing slightly higher levels of impulsivity and novelty-seeking (Bulik et al., 1995). The restricting subtype had higher levels of persistence (Klump et al., 2000). Researchers have linked higher levels of harm avoidance with higher levels of serotonin in the brain (Cloninger, 1985), and scientists have linked harm avoidance with specific alterations in the serotonin system in women recovered from anorexia (Bailer et al., 2005).

A study measuring slightly different facets of personality found that women with either the restricting or binge/purge subtype of anorexia had higher levels of neuroticism (characterized by depression, anxiety, worry, and moodiness) than controls, and that women with restricting anorexia scored higher on measures of agreeableness and conscientiousness than those with the binge/purge type (Bollen & Wojciechowski, 2004).

Bulimia Nervosa

Individuals with bulimia nervosa have high levels of harm avoidance like anorexia sufferers, but instead it’s paired with high levels of novelty seeking (Fassino et al., 2002). This study found that those with the binge/ purge subtype of anorexia show traits that are midway between restricting anorexia and bulimia. Other research has found high levels of impulsivity, emotion dysregulation, and anxiety in women with bulimia, and greater impulsivity was associated with more frequent purging behaviors (Brown, Haedt-Matt, & Keel, 2011).

Scientists found that people who have trouble regulating the amount of dopamine in their brains have higher levels of novelty-seeking (Zald et al., 2008), and that this also occurs in women with bulimia (Groleau et al., 2012).

Anorexia and bulimia

Although some personality traits are specific to each eating disorder diagnosis, other traits are more general and appear to be shared by many or most individuals with eating disorders. Researchers at King’s College London identified a set of five obsessive-compulsive personality traits (perfectionism, inflexibility, rule driven, drive-for-order and symmetry, excessive doubt and cautiousness) and found that women with anorexia and bulimia were significantly more likely to have shown signs of these in childhood (they were almost never seen in healthy controls). What’s more, the presence of each of these traits increased a person’s odds of developing an eating disorder by seven. A person who had all five of these traits is thirty-five times more likely to develop an eating disorder than someone who shows none of these traits (Anderluh et al., 2003).

Separately from other obsessive-compulsive traits, individuals with eating disorders show high levels of perfectionism, especially a type known as self-oriented perfectionism, in which a person has unreasonably high standards for themselves but not others. Researchers found equally high levels of perfectionism in women with either anorexia or bulimia in two separate studies (Halmi et al., 2005; Bulik et al., 2003).

Binge Eating Disorder

Personality traits are less well-defined in binge eating disorder than in anorexia or bulimia. Preliminary research in Comprehensive Psychology found that people with binge eating disorder had higher levels of harm avoidance and novelty seeking and lower levels of self-directedness than healthy controls (Grucza, Przybeck, & Cloninger, 2007).

References:

Anderluh, M. B., 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. American Journal of Psychiatry, 160(2), 242-247. doi:10.1176/appi.ajp.160.2.242

Bailer, U. F., Frank, G. K., Henry, S. E., Price, J. C., Meltzer, C. C., Weissfeld, L., ... & Kaye, W. H. (2005). Altered brain serotonin 5-HT1A receptor binding after recovery from anorexia nervosa measured by positron emission tomography and [carbonyl11C] WAY-100635. Archives of general psychiatry, 62(9), 1032. doi:10.1001/archpsyc.62.9.1032.

Bollen, E., & Wojciechowski, F. L. (2004). Anorexia nervosa subtypes and the big five personality factors. European Eating Disorders Review, 12(2), 117-121. DOI: 10.1002/erv.551

Brown, T. A., Haedt‐Matt, A. A., & Keel, P. K. (2011). Personality pathology in purging disorder and bulimia nervosa. International Journal of Eating Disorders, 44(8), 735- 740. DOI: 10.1002/eat.20904

Bulik, C. M., Sullivan, P. F., Weltzin, T. E., & Kaye, W. H. (1995). Temperament in eating disorders. International Journal of Eating Disorders, 17(3), 251- 261. DOI: 10.1002/1098-108X(199504)17:3<251::AIDEAT2260170306>3.0.CO;2-V

Bulik, C. M., Tozzi, F., Anderson, C., Mazzeo, S. E., Aggen, S., & Sullivan, P. F. (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry, 160(2), 366-368. doi:10.1176/appi.ajp.160.2.366

Fassino, S., Abbate‐Daga, G., Amianto, F., Leombruni, P., Boggio, S., & Rovera, G. G. (2002). Temperament and character profile of eating disorders: a controlled study with the Temperament and Character Inventory. International Journal of Eating Disorders, 32(4), 412-425. DOI: 10.1002/ eat.10099

Groleau, P., Steiger, H., Joober, R., Bruce, K. R., Israel, M., Badawi, G., ... & Sycz, L. (2012). Dopamine-system genes, childhood abuse, and clinical manifestations in women with Bulimia-spectrum Disorders. Journal of psychiatric research, 46(9), 1139-1145. doi: 10.1016/j.jpsychires.2012.05.018

Grucza, R. A., Przybeck, T. R., & Cloninger, C. R. (2007). Prevalence and correlates of binge eating disorder in a community sample. Comprehensive psychiatry, 48(2), 124-131. doi: 10.1016/j.comppsych.2006.08.002

Halmi, K. A., Tozzi, F., Thornton, L. M., Crow, S., Fichter, M. M., Kaplan, A. S., ... & Bulik, C. M. (2005). The relation among perfectionism, obsessive‐compulsive personality disorder and obsessive‐compulsive disorder in individuals with eating disorders. International Journal of Eating Disorders, 38(4), 371- 374. DOI: 10.1002/eat.20190

Klump, K. L., Bulik, C. M., Pollice, C., Halmi, K. A., Fichter, M. M., Berrettini, W. H., ... & Kaye, W. H. (2000). Temperament and character in women with anorexia nervosa. The Journal of nervous and mental disease, 188(9), 559-567.

Zald, D. H., Cowan, R. L., Riccardi, P., Baldwin, R. M., Ansari, M. S., Li, R., ... & Kessler, R. M. (2008). Midbrain dopamine receptor availability is inversely associated with noveltyseeking traits in humans. The Journal of Neuroscience, 28(53), 14372-14378. doi: 10.1523/JNEUROSCI.2423-08.2008

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