Serotonin Function, Personality-Trait Variations, and Childhood Abuse in Women With Bulimia-Spectrum Eating Disorders
J Clin Psychiatry 2004;65:830-837
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Across populations,
findings associate impulsivity, behavioral disinhibition, or
hostility with reduced central serotonin (5-hydroxytryptamine:
5-HT) activity and increased likelihood of childhood abuse.
Inconsistently, findings associate compulsivity, behavioral
inhibition, or anxiousness with elevated 5-HT neurotransmission.
We explored relationships among measures of 5-HT system
functioning, behavioral inhibition/disinhibition, and childhood
abuse in women with bulimia-spectrum eating syndromes.
Method: In 73 bulimic (body mass index [kg/m2]
under 30, binge eating at least once weekly) and 50 normal-eater
control women, we obtained indices of platelet paroxetine binding
and 5-HT agonist (m-CPP)-stimulated neuroendocrine
responses. Cluster analysis was used to classify the bulimic
women according to 5-HT "profiles." Resulting groups
were then compared on symptom and trait measures.
Results: Measures of paroxetine-binding density
(Bmax) and affinity (Kd) contributed
significantly (p < .001 and p < .02, respectively) to a
classification of bulimic women into groups with "low
density/high affinity" (N = 52) or "high density/low
affinity" (N = 21) binding. The 5-HT based classification
did not predict eating-symptom severity. However, the "high
density" pattern was associated with increased perfectionism
and compulsivity, reduced risk of childhood sexual abuse, and (to
some extent) reduced probability of borderline personality
Discussion: In women with bulimic syndromes,
serotonergic factors, personality-trait variations, and
developmental typologies converge in principled fashion. Our
findings corroborate (with neurobiological evidence) the concept
of underregulated and overregulated subtypes within the bulimic