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Originalarbeit/Original article

Overt and Covert Aggression in College Women with Bulimia Nervosa

Published Online:October 26, 2011https://doi.org/10.1024/1422-4917/a000139

Abstract

Objective: This study examines the prevalence of overt and covert aggression in women with bulimia nervosa (BN) as well as the relationship between the severity of BN and the frequency of aggressive acts. Patients and methods: 20 female college students with BN and 20 control subjects completed self-report measures of aggressive behavior and eating disorder pathology. They also completed the Juvenile Health and Wellness Survey-76 to assess general risk taking and indices of sexual behavior and mental health. Results: BN subjects reported higher levels of both overt and covert aggression (p < .001). Overt aggression tended to be more premeditated, while the self-report of covert aggression behavior was more impulsive. Levels of aggressive behavior were significantly correlated with severity of BN (p < .01). Subjects with BN reported higher levels of risk-taking and sexual behaviors. Conclusions: Aggression is an important clinical issue in BN. Subtypes of aggression suggest different pathways for overt and covert aggressive acts with impulsive covert aggression being more closely related to the binge-purge cycle. Awareness of subtypes of aggression in BN may have important clinical and treatment implications.


Offene und verdeckte Aggression bei Studentinnen mit Bulimia nervosa

Fragestellung: Die vorliegende Studie untersucht die Prävalenz von offener und verdeckter Aggression bei Frauen mit Bulimia nervosa (BN) und das Verhältnis zwischen Schweregrad der BN und Häufigkeit von aggressiven Handlungen. Methodik: 20 weibliche Studentinnen mit BN und 20 Kontrollen füllten Fragebögen zur Erfassung von aggressivem Verhalten und von Essstörungspathologie aus. Weiters wurde das Instrument “Juvenile Health and Wellness Survey-76” angewandt, um allgemeine Risikofreudigkeit sowie sexuelles Verhalten und psychische Gesundheit zu erfassen. Ergebnisse: BN-Patientinnen berichteten über ein größeres Ausmaß an offener und verdeckter Aggression (p < .001). Offene Aggression wurde tendenziell stärker vorgeplant, während hingegen die verdeckte Aggression als impulsiver von den Patientinnen beschrieben wurde. Das Ausmaß an aggressivem Verhalten korrelierte signifikant mit dem Schweregrad der BN (p < .01). Studentinnen mit BN berichteten über eine gesteigerte Risikobereitschaft und gesteigertes Sexualverhalten. Schlussfolgerungen: Aggression hat eine hohe klinische Relevanz bei BN-Patientinnen. Der offenen und verdeckten Aggression liegen jeweils unterschiedliche Pathomechanismen zu Grunde, impulsive verdeckte Aggression ist in diesem Zusammenhang stärker mit dem “binge-purge” Zyklus assoziiert. Das Wahrnehmen von Subtypen der Aggression bei BN-Patienten kann wichtige klinische und therapeutische Implikationen nach sich ziehen.

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