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In the pre-bariatric psychological assessment of 102 morbidly obese women, two personality subtypes emerged: a resilient/high functioning subtype with a 'normal' personality profile and an emotional dysregulated/ undercontrolled subtype, characterized by high neuroticism and low extraversion/conscientiousness. Emotional dysregulated/ undercontrolled patients showed more concerns about eating/weight/shape, more binge eating driven by emotions and external triggers, more psychological complaints (such as depression and anxiety) and more avoidance and depressive coping reactions than resilient/high functioning patients. Further research should clarify whether these clearly different psychological profiles are related to different outcomes (weight loss or well-being) of bariatric surgery., (Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.)

Eating disorders belong to the broad category of self-harming behaviours which may be acquired in a social learning process of imitation, identification and competition. Hence, we should question the possible dangers or unwanted side-effects in treating patients together within a common therapeutic setting. But little is known about the frequency and extent of possibly negative influences of treatment in a group format, the so-called risk of 'peer contagion' in group therapy and/or inpatient treatment. We review in this paper the rather scarce literature on this subject in order to stimulate more critical thinking and systematic research., (Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.)

This study examines the affect regulation function of different types of nonsuicidal self-injury (NSSI) in 177 female eating-disordered inpatients. Almost 45% of the eating-disordered patients displayed at least 1 type of NSSI. Cutting and scratching were the most common forms of NSSI followed by bruising and burning oneself. For all types of NSSI except bruising, the affect regulation function was most strongly endorsed. Affect states reported to precede and follow NSSI were also examined to determine the particular affect states regulated by NSSI. In general, positively valenced low-arousal affect states increased and negatively valenced high-arousal affect states decreased from before to after NSSI. Finally, affective changes associated with NSSI were related to different NSSI characteristics, indicating that the increase in positive affect after NSSI is significantly related to the frequency of NSSI and the numbers of functions reported for NSSI. Theoretical and treatment implications are discussed., (Copyright 2010 Elsevier Inc. All rights reserved.)

Objective: To get an idea of how (ex-)patients deal with the recognition of an emergent eating disorder., Method: A retrospective survey was carried out via the websites of two organizations for (ex-)patients with an eating disorder., Results: The respondents (N = 401) reported a variety of attempts to conceal their eating disorder: excuses to avoid eating together, methods to give the false impression of having eaten, avoidance of being weighed and falsifying weight. Often these methods were described as a deliberate strategy. Information about possible health risks had little or no impact on most respondents, who were familiar with the notion of eating disorder but did not apply it to themselves. Many believed they would have recognized their eating disorder earlier if they had met a clinician who was familiar with this disorder., Conclusion: Denial of illness together with concealment often reflects a deliberate refusal of self-disclosure within a specific interpersonal context., ((c) 2008 John Wiley & Sons, Ltd and Eating Disorders Association)

Although often used as synonyms, "self-injury" and "self-harm" may refer to different behaviors with different meanings. Because the literature is quite confusing in this respect, we propose a more specific delineation of the notion of self-injurious behavior (SIB), differentiated from other self-harming behaviors. For this purpose, we present a flowchart for differential diagnosis. This brings us to the question: are we dealing here with a sign of pathology or a meaningful behavior? We compare the structuralist approach, in which SIB is viewed as either a syndrome or a symptom, with the functionalist approach, focusing on the psychosocial functions of SIB.

A reduced pain sensitivity has been found in eating disorder (ED) patients. These patients often show various types of self-injurious behaviors (SIB) which some experience as painful, while others report analgesia during episodes of SIB. How can we explain these differences? We studied female ED patients (N=185) of whom 84 had admitted some form of SIB in their recent history. The presence/absence of pain report during SIB was not significantly related to the type of ED. The longer the history of SIB, the less pain was reported. Ratings of dissociation and traumatic experiences were higher in patients who did not experience pain while injuring themselves. We discuss several biopsychosocial explanations for these findings with suggestions for future research.

Objective: The family environment is known to be an important contributor to the course of psychiatric disorders. In this study, we examined the family context of eating disordered (ED) patients with and without self-injurious behaviors (SIB)., Method: A Dutch adaptation of the Family Environment Scale "Sci Eng 57(9-B):1997;5927" was completed by 131 ED patients of whom 47% showed at least one form of SIB (e.g., cutting, burning, hair pulling, etc.)., Results: Results showed a significant difference in family environment between patients with and without SIB. The family environment of self-injuring ED patients was less cohesive, expressive and socially oriented, and more conflictual and disorganized than the family environment of those without SIB. No significant differences in perceived family environment were found with respect to the number or form of SIB and the subtype of ED. Neither did we find a significant interaction effect between ED subtype and presence/absence of SIB.