Impulsividad en mujeres con Bulimia Nerviosa

  1. Moreno, Silvia
  2. Ortega-Roldán, Blanca
  3. Rodríguez Ruiz, Sonia
Revista:
EduPsykhé: Revista de psicología y educación

ISSN: 1579-0207

Año de publicación: 2009

Volumen: 8

Número: 1

Páginas: 63-78

Tipo: Artículo

Otras publicaciones en: EduPsykhé: Revista de psicología y educación

Resumen

Lack of self-control is an essential feature of bulimia nervosa; so much so that impulsiveness has been associated with neuropsychological and physiological alterations in these patients. In this paper we review articles on this subject that confirm that the existence of a decrease of inhibitory control explains the lack of self-control in behaviors concerning food or sexual activity. Patients with bulimia nervosa succumb easily to an intense desire for food and experience frequent gluttonous behavior. Similarly, sexual activity increases and becomes uncontrollable. Both food and sexual behaviors seem to have as a main function the momentary relief of negative emotions. The literature, in addition, shows that these highly destructive behaviors reflect the existence of a very low control of impulsive ness and difficulties in decision-making. Consequently, the lack of chronic inhibitory control in emotional and physiological processes contributes to the maintenance of poor emotional regulation. Thus, patients with bulimia nervosa present increased defensive reflexes and low cardiac variability In this article, we emphasize the necessity of integrating behavioral, neuropsychological and physiological intervention techniques to improve multidisciplinary treatment of bulimia nervosa.

Referencias bibliográficas

  • Allen, M.T., Matthews, K.A., y Kenyon, K.L. (2000). The relationships of resting baroreflex sensitivity, heart rate variability and measures of impulse control in children and adolescents. International Journal of Psychophysiology, 37: 185-194.
  • Bechara, A, Damasio, A.R., Damasio, H. y Anderson, S.W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50: 7-15.
  • Boeka, A.G. y Lokken, K.L. (2006). The Iowa gambling task as a measure of decision making in women with bulimia nervosa. Journal of the International Neuropsychological Society, 12: 741-745.
  • Cacioppo, J.T. (2001, Junio). Affective space. Comunicación presentada en el II International Workshop on Emotion and the Brain, Universidad de las Islas Baleares.
  • Cash, T. F., y Deagle, E. A. (1996). The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: A meta-analysis. The International Journal of Eating Disorders, 22: 107-125.
  • Cavallo, D.A., y Pinto, A. (2001). Effects of mood induction on eating behavior and cigarette craving in dietary restrainers. Eating Behaviors, 2: 113-127.
  • Cepeda-Benito, A. y Gleaves, D. (2001). A critique of food Cravings research: Theory, measurement, and food intake. In M. Hetherington (Ed.), Foood cravings and addiction (pp. 3-29). Surrey, UK: Leatherhead.
  • Chua, J. L., Touyz, S., y Hill, A. J. (2004). Negative mood-induced overeating in obese binge eaters: An experimental study. International Journal of Obesity, 28: 606-610.
  • Claes, L., Vandereyken, W. y Vertommen, H. (2002). Impulsive and compulsive traits in eatings disordered patients compared with controls. Personality and Individual Differences, 32: 707-714.
  • Drobes, D.J., Miller, E.J., Hillman, C.H., Bradley, M.M., Cuthbert, B.N., y Lang, P.J. (2001). Food deprivation and emotional reactions to food cues: Implications for eating disorders. Biological Psychology, 57: 153-177.
  • Duchesne, M., Mattos, P., Fontenelle, L.F., Veiga, H., Rizo, L. y Appolinaro, J.C. (2004). Neuropsychology of eating disorders: a systematic review of the literature. Revista Brasileira de Psiquiatria, 26: 107-117.
  • Dykens, E. M., y Gerrard, M. (1986). Psychological profiles of purging bulimics, repeat dieters, and controls. Journal of Consulting and Clinical Psychology, 54: 283-288.
  • Engel, S.G., Corneliussen, S.J., Wonderlich, S.A., Crosby, R.D., Grange, D., Crow, S., Klein, M., Bardone-Cone, A., Peterson, C., Joiner, T., Mitchell, J.E. y Steiger, H. (2005). Impulsivity and Compusivity in Bulimia Nervosa. International Journal of Eating Disorders, 38: 244-251.
  • Evans, L., y Wertheim, E. H. (1998). Intimacy patterns and relationship satisfaction of women with eating problems and the mediating effects of depression, trait anxiety and social anxiety. Journal Psychosomatic Research, 44: 355-365.
  • Federoff, I.C., Polivy, J., y Herman, P. (1997). The effect of pre-exposure to food cues on the eating behavior of restrained and unrestrained eaters. Appetite, 28: 33-47.
  • Fischer, S. y Grange, D. (2007). Comorbidity and High-Risk Behaviors in Treatment-Seeking Adolescents with Bulimia Nervosa. International Journal of Eating Disorders, 40: 751-753.
  • Hill, A. J., Weaver, C.F.L., y Blundell, J. E. (1991). Food craving, dietary restraint and mood. Appetite, 17: 187-197.
  • Ingjaldsson, J.T., Laberg, J.C., y Thayer J.F. (2003). Reduced heart rate variability in chronic alcohol abuse: Relationship with negative mood, chronic thought suppression, and compulsive drinking. Biological Psychiatry, 54: 1427-1436.
  • Jansen, A., Elgersma, H., Nederkoorn, C. y Smeets, T. (2002). What makes treatment of bulimia nervosa successful? Paper presented at the European Associations for Behavioural and Cognitive Therapies (EABCT). Maastricht.
  • Katzman, M. A., y Wolchick, S. A. (1984). Bulimia and binge eating in college women: A comparision of personality and behavioural characteristics. Journal of Consulting and Clinical Psychology, 52: 423-428.
  • Lang P.J. (1995). The emotion probe: Studies of motivation and attention, American Psychology, 50: 372-385.
  • Lang, P.J., Bradley, M.M., y Cuthbert, B.N. (1999). The International Affective Picture System: Technical manual and affective ratings. Gainesville, Florida: The Center for Research in Psychophysiology, University of Florida
  • Lang, P.J., Davis, M., y Öhman, A. (2000). Fear and anxiety: Animals models and human cognitive psychophysiology. Journal of Affective Disorders, 61: 137-159.
  • Lehrer, P., Sasaki, Y., y Saito, Y. (1999). Zazen and Cardiac Variability. Psychosomathic Medicine, 61: 812-821.
  • Loxton, N.J., y Dawe, S. (2001). Alcohol Abuse and Dysfunctional Eating in Adolescent Girls: The Influence of Individual Differences in Sensitivity to Reward and Punishment. International Journal of Eating Disorders, 29: 455-462.
  • Mann, T. y Ward, A. (2004). To eat or not to eat: Implication of the attentional myopia model for restrained eaters. Journal of Abnormal Psychology, 113: 90-98.
  • Mauler, B.I., Hamm, A.O, Weike, A.I., y Tuschen-Caffier, B. (2006). Affect regulation and food intake in bulimia nervosa: Emotional responding to food cues after deprivation and subsequent eating. Journal of Anormal Psychology.
  • Mauler, B.I., Tuschen-Caffier, B., y Hamm, A.O. (1997). Fear or craving?: Startle reflex modulation during viewing of food cues in deprived and non-deprived bulimics [Abstract]. Psychophysiology, 34: S62.
  • McCraty, R., y Tomasino, D. (2004). Heart Rhythm Coherence feedback: A new tool for stress reduction, rehabilitation, and performance enhancement. Proceeding of the First Baltic Forum on Neuronal Regulation and Biofeedback, Riga, Latvia.
  • Moreno, S. (2003). Ansia por la comida y Trastornos de la conducta alimentaria. Tesis Doctoral no publicada, Universidad de Granada.
  • Moreno, S., Rodríguez-Ruiz, S., y Fernández-Santaella, M.C. (2009). ¿Qué es el ansia por la comida? Madrid: Manuales Prácticos, Pirámide.
  • Morgan, C. D., Wiederman, M. W., y Pryor, T. L. (1995). Sexual functioning and attitudes of eating-disordered women: A follow-up study. Journal of Sex and Marital Therapy, 21: 67-77.
  • Newman, J., Widom, C. y Nathan, S. (1985). Passive avoidance in syndromes of disinhibition: psychopathy and extraversion. Journal of Personality and Social Psychology, 48: 1.316-1.327.
  • Nolan, R., Kamath, M.V., Floras, J.S., Stanley, J., Pang, C., Picton, P., y Young, Q.R. (2005). Heart rate variability of biofeedback as a behavioural neurocardiac intervention to enhance vagal heart rate control. American Heart Journal, 149: 1.137.
  • Ortega-Roldán, B., Rodríguez, S., Moreno, S., Morandé, G. y Fernández, M.C. (2009). How do emotions govern the binge eating decision? (2009). In N Chambers (Ed.), Binge Eating: Psychological Factors, Symptoms, and Treatment. New York: Novascience.
  • Poblete, V.M., García, A., Soriano, A., Beato, L., García, I., Rodríguez, T., Cortes, M., Ruiz, S., Rodado, S. y Talavera, M.P. (2007). Assessment of cortical brain blood flood by brain perfusion spect in patients with a diagnosis of eating behavior disorders. Revista Española de Medicina Nuclear, 26: 11-18.
  • Raciti, M., y Hendrick, S. S. (1992). Relationships between eating disorder characteristics and love and sex attitudes. Sex Roles, 27: 553-564.
  • Rodríguez, S., Fernández, M.C., Cepeda-Benito, A., y Vila, J. (2005). Subjective and physiological reactivity to chocolate images in high and low cravers Biological Psychology, 70 (1): 9-18.
  • Rodríguez, S., Mata, J.L., Lameiras, M., Fernández, M.C. y Vila, J. (2007a). Dyscontrol evoked by erotic and food images in women with bulimia nervosa. European Eating Disorders Review, 15 (3): 231-239.
  • Rodríguez, S., Mata, J.L., Moreno, S., Fernández, M.C. y Vila, J. (2007b). Mecanismos psicofisiológicos implicados en la regulación afectiva y la restricción alimentaria de mujeres con riesgo de padecer bulimia nerviosa. Psicothema, 19: 30-36.
  • Rodríguez-Ruiz, S., Ruiz-Padial, E., Vera, M.N., Fernández, M.C. Anllo-Vento, L., y Vila, J. [en prensa]. Effect of heart rate variability on defensive reaction and eating disorder symptomatology in chocolate cravers. Journal of Psychophysiology.
  • Rosval, L., Steiger, H., Bruce, K., Israël, M., Richardson, J. y Aubut, M. (2006). Impulsivity in Women With Eating Disorders: Problem of Response Inhibition, Planning, or Attention?. International Journal of Eating Disorders, 39: 590-593.
  • Ruuska, J., Kaltiala-Heino, R., Rantanen, P. y Koivisto, A. (2005). Psychopathological distress predicts suicidal ideation and self-harm in adolescent eating disorder outpatients. European Child and Adolescent Psychiatry, 14: 276-281.
  • Steidl, S., Li, L., y Yeomans, J. S. (2001). Conditioned brain-stimulation reward attenuates the acoustic startle reflex in rats. Behavioral Neuroscience, 115: 710-717.
  • Thayer, J.F., y Siegle, G.J. (2002). Neurovisceral integration in cardiac and emotional regulation. IEEE Engineering in Medicine and Biology, 24-29.
  • Tchanturia, K., Anderluh, M.B., Morris, R.G. Rabe-Hesketh, S., Collier, D.A., Sánchez, P. y Treasure, J.L. (2004). Cognitive flexibility in anorexia nervosa and bulimia nervosa. Journal of the International Neuropsychological Society, 10: 513-520.
  • Troop, N. A. (1998). Eating disorders as coping strategies: A critique. European Eating Disorders Review, 6: 229-237.
  • Uher, R., Murphy, T., Brammer, M.J., Dalgleish, T., Phillips, M.L., Ng, V.W., Andrew, C.M.,Williams, S.C.R., Campbell, I., y Treasure J. (2004). Medial prefrontal cortex activity associated with symptom provocation in eating disorders. American Journal of Psychiatry, 161: 1.238-1.246.
  • Uher, R. y Treasure, J. (2005). Brain lesions and eating disorders. Journal of Neurology Neurosurgery and Psychiatry, 76: 852-857.
  • Van der Ster Wallin, G., Norring, C., y Holmgren, S. (1994). Binge eating versus nonpurged eating in bulimics: Is there a carbohydrate craving after all?. Acta Psychiatrica Scandinavica, 89: 376-381.
  • Vila, J., Guerra, P., Muñoz, M.A., Vico, C., Viedma, M.I., Delgado, L.C., Perakakis, P., Kley, E., Mata, J.L., y Rodríguez, S. (2007). Cardiac defense: From attention to action. International Journal of Psychophysiology, 66 (3): 169-182.
  • Vitousek, K. y Manke, F. (1994). Personality Variables and Disorders in Anorexia Nervosa and Bulimia Nervosa. Journal of Abnormal Psychology, 103: 137-147.
  • Waters, A., Hill, A., y Waller, G. (2001). Bulimics’ responses to food cravings: is binge-eating product of hunger or emotional state? Behavior Research and Therapy, 39: 877-886.
  • Wiederman, M. W. (1996). Women, sex, and food: A review of research on eating disorders and sexuality. The Journal of Sex Research, 33: 301-311.
  • Wiederman, M. W., y Pryor, T. (1997). A comparison of ever-married and nevermarried women with anorexia or bulimia nervosa. International Journal of Eating Disorders, 22: 395-401.
  • Wiederman, M. W., Pryor, T., y Morgan, C. D. (1996). The sexual experience of women diagnosed with anorexia nervosa or bulimia nervosa. International Journal of Eating Disorders, 19: 109-118.
  • Zerbe, K. J. (1993). The body betrayed: Women, eating disorders, and treatment. Washington, DC: American Psychiatric Press.