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A range of eating disorders is common among female, but not male, relatives of diagnostically pure bulimia nervosa (BN) probands. This finding arose from research designed to test the hypothesis that a wide range of subclinical eating disorders, rather than pure subtypes, would aggregate among the mothers and sisters of BN probands. It seems likely that there is a familial aggregation of a wide spectrum of eating disorders that goes beyond traditional diagnostic boundaries. A contemporary family-epidemiology study design could maximize the identification of the complete range of eating disorders among family members.

A study of 47 women with bulimia nervosa concludes that those with psychiatric disorders, and who come from families with anxiety and substance abuse disorders, are more likely to be substance dependent. It is suggested that first-degree relatives who are vulnerable to instability and impulsivity may contribute to the development of substance dependence in bulimic women.

A study was conducted to understand the relation between perfectionism and obsessionality and thus be able to identify relevant behavioral endophenotypes for eating disorders (ED), by assessing a group of people for perfectionism, obsessive-compulsive personality disorder (OCPD), and obsessive-compulsive disorder (OCD). Perfectionism was found to be closely related to obsessive-compulsive personality symptoms compared to OCD.

Evidence is presented about personality variables that are closely related to anorexia nervosa (AN) and may represent familial-based risk factors. Studies of the relationship of personality and AN will be greatly enhanced by careful consideration and specification of the conceptual model and associated hypotheses that are tested with empirical data.

Twin and family studies were examined and it was suggested that genetic variants contribute to the pathogens of bulimia nervosa (BN) and anorexia nervosa (AN). This study represents the largest genetic study of eating disorders.

The differences in the onset pattern of comorbid disorder in women with eating disorder, with and without a history of parasuicide is examined to elucidate potential etiologic differences between them. The result showed that depression and anxiety disorders occurred in the parasuicidal group, more often, before the onset of eating disorder.

Recent data linking sexual abuse to eating disorders remains uncertain. To test such hypothesis, women with three subtypes of eating disorders were studied. The first group was composed of 26 women with anorexia nervosa. The second group had 20 bulimics who were substance dependent while the third group was made up of 27 bulimics who were not substance dependent. The second group had the highest rate of sexual abuse at 65%. However, only 40% of all women in the study were sexually abused. No conclusive findings have been established that clearly link sexual abuse and eating disorders.