Skip to main content Accessibility help

Impulsivity in Disordered Eating, Affective Disorder and Substance use Disorder

  • J. A. Bushnell (a1), J. E. Wells (a2) and M. A. Oakley-Browne (a3)



Failure to control impulsive behaviour has been postulated as an underlying mechanism common to substance use disorder, sociopathy and to a substantial subgroup of women with bulimia nervosa.


Three hundred and one women recruited to a general population study were selected either at random or because they had lifetime substance use disorder, affective disorder or symptoms of bulimia. A subsequent interview determined the existence of problems with impulsivity. Behaviour that is an integral part of a DSM–III axis 1 disorder was excluded from the impulsivity measure.


Similar rates of impulsivity were found in all three of these types of disorder, and this was little different from the rate found in the women selected randomly from the general population. However, among those with comorbid disorder there was more impulsivity, and the more comorbid disorders found, the higher the proportion with problems of impulsivity.


Because those in treatment facilities are more likely to have other comorbid disorders (Berkson's bias), findings derived from observations of women with bulimia who are in treatment may be compromised by selection bias and may have limited applicability to those with the disorder who are not in treatment.


Corresponding author

Dr J. Bushnell, Department of Psychological Medicine, Wellington School of Medicine, University of Otago, P. O. Box 7343, Wellington South, Wellington, New Zealand


Hide All
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.
Bushnell, J. A., Wells, J. E., Hornblow, A. R., et al (1990) Prevalence of three bulimia syndromes in the general population. Psychological Medicine, 20, 671680.
Bushnell, J. A., Wells, J. E. & Oakley-Browne, M. A. (1993) Long term effects of intrafamilial sexual abuse. Acta Psychiatrica Scandinavica, 85, 136142.
Bushnell, J. A., Wells, J. E., McKenzie, J. N., et al (1994) Bulimia comorbidity in the community and in the clinic. Psychological Medicine, 24, 605611.
Dixon, W. J. (ed.) (1985) BMDP Statistical Software. Berkeley: University of California Press.
Fichter, M., Quadflieg, N. & Rief, W. (1994) Course of multi-impulsive bulimia. Psychological Medicine, 24, 591604.
Gardner, S., Winter, S. & Gardner, M. (1991) Confidence Interval Analysis v 1.1. London: British Medical Journal.
Lacey, J. H. (1993) Self damaging and addictive behaviour in bulimia nervosa: a catchment area study. British Journal of Psychiatry, 163, 190194.
Lacey, J. H. & Evans, C. D. H. (1986) The impulsivist: a multi-impulsive personality disorder. British Journal of Addiction, 81, 641649.
Leaf, P. J., Myers, J.K. & McEvoy, L. T. (1991) Procedures used in the Epidemiologic Catchment Area Study. In Psychiatric Disorder in America: The Epidemiologic Catchment Area Study (eds Robins, L. N. & Regier, D. A.), pp. 1132. New York: The Free Press.
Robins, L. (1985) Epidemiology: reflections on testing the validity of psychiatric interviews. Archives of General Psychiatry, 42, 918924.
Robins, L., Helzer, J., Croughan, J., et al (1981) The National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Archives of General Psychiatry, 38, 381389.
Sohlberg, S., Norring, C., Holmgren, S., et al (1989) Impulsivity and long-term prognosis of psychiatric patients with anorexia nervosa/bulimia nervosa. Journal of Nervous and Mental Disease, 177, 249258.
Wells, J. E., Bushnell, J. A., Hornblow, A. R., et al (1989) Christchurch Psychiatric Epidemiology Study, Part 1: methodology and lifetime prevalence for specific psychiatric disorders. Australian and New Zealand Journal of Psychiatry, 23, 327340.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Impulsivity in Disordered Eating, Affective Disorder and Substance use Disorder

  • J. A. Bushnell (a1), J. E. Wells (a2) and M. A. Oakley-Browne (a3)
Submit a response


No eLetters have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *