Stressful life events associated with bulimia in anorexia nervosa. Empirical findings and theoretical speculations

The present study examines the relation of life event stress to the occurrence of bulimia in young anorexia nervosa patients. Life events recorded in the 18 months preceding symptomatic onset were analyzed in 25 anorexics with bulimia and a matched group of 25 anorexics characterized by strict dietary control (restricters). Scores were derived by summing life change unit values for events experienced during successive six-month time blocks and were subjected to repeated measures analysis of variance. Findings indicated that bulimics experienced significantly more life stress than restricters in each six-month period (all ps < .001) and experienced 21/2 times the magnitude of life stress observed in normal adolescents (Codding-ton, 1972) for a comparable time period. Results are discussed with respect to biological, psychological, and cognitive processes of possible relevance to the genesis of binge eating in anorexic patients. It is suggested that concepts drawn from developmental theory, attribution theory, and psycho-biology are relevant to our understanding of the genesis and maintenance of deranged eating patterns in bulimic anorexics.