Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study

Abstract Background Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this populatio...

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Autores principales:	Dennis Gibson, Jodie Benabe, Ashlie Watters, Judy Oakes, Philip S. Mehler
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Anorexia nervosa binge-purge Laxative Barium enema Cathartic colon Beck Depression Inventory Tri-dimensional Personality Questionnaire-Short Form Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/1625c0d6c05946e0920008ff5190f868
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spelling	oai:doaj.org-article:1625c0d6c05946e0920008ff5190f8682021-11-07T12:13:34ZPersonality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study10.1186/s40337-021-00502-92050-2974https://doaj.org/article/1625c0d6c05946e0920008ff5190f8682021-11-01T00:00:00Zhttps://doi.org/10.1186/s40337-021-00502-9https://doaj.org/toc/2050-2974Abstract Background Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. Methods Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. Results Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. Conclusion There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Plain English Summary Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.Dennis GibsonJodie BenabeAshlie WattersJudy OakesPhilip S. MehlerBMCarticleAnorexia nervosa binge-purgeLaxativeBarium enemaCathartic colonBeck Depression InventoryTri-dimensional Personality Questionnaire-Short FormPsychiatryRC435-571ENJournal of Eating Disorders, Vol 9, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Anorexia nervosa binge-purge Laxative Barium enema Cathartic colon Beck Depression Inventory Tri-dimensional Personality Questionnaire-Short Form Psychiatry RC435-571
spellingShingle	Anorexia nervosa binge-purge Laxative Barium enema Cathartic colon Beck Depression Inventory Tri-dimensional Personality Questionnaire-Short Form Psychiatry RC435-571 Dennis Gibson Jodie Benabe Ashlie Watters Judy Oakes Philip S. Mehler Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
description	Abstract Background Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. Methods Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. Results Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. Conclusion There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Plain English Summary Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.
format	article
author	Dennis Gibson Jodie Benabe Ashlie Watters Judy Oakes Philip S. Mehler
author_facet	Dennis Gibson Jodie Benabe Ashlie Watters Judy Oakes Philip S. Mehler
author_sort	Dennis Gibson
title	Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
title_short	Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
title_full	Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
title_fullStr	Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
title_full_unstemmed	Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
title_sort	personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1625c0d6c05946e0920008ff5190f868
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Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study

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