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Women with bulimia nervosa and bipolar disorder share affective dysregulation and impulsivity, with inattentive impulsivity and negative urgency driving binge eating and external impulsive behaviors in comorbid cases.
Women with bulimia nervosa (BN) and bipolar disorder (BD) share key emotional and behavioral traits, with unique patterns emerging in those affected by both conditions, according to new research. Bo-Ya Chiu and other researchers analyzed data from 263 women, including 115 with BN, 76 with BD, 37 with comorbid BN–BD, and 72 healthy controls.
Volunteers were recruited from a psychiatric outpatient clinic and underwent structured diagnostic interviews alongside self-reported assessments of mood, impulsivity, and behavioral traits. Compared with healthy controls, all clinical groups illustrated higher levels of mood instability, attentional impulsivity, sensitivity to punishment, negative urgency, and both externally and internally directed impulsive behaviors. The comorbidity group (BN–BD) stood out for more severe symptoms in several areas, including:
Interestingly, negative urgency—the tendency to act rashly in response to distress—was more pronounced in both BN-only and BN–BD groups than in the BD-only group, underscoring its strong link to binge eating behaviors. Meanwhile, attentional impulsivity was markedly higher in the comorbidity group than in either disorder alone, suggesting it may drive the elevated risk of outwardly impulsive actions when BN and BD co-occur.
The findings indicate that while BN and BD share broad patterns of emotional dysregulation and impulsivity, certain traits—especially negative urgency and attentional impulsivity—play a fundamental role in shaping binge eating and impulsive behaviors in women with both ailments. Researchers emphasized that treatment approaches must address not only emotion regulation but also behavioral control strategies to help mitigate binge eating episodes and harmful impulsive actions.
This study advances understanding of the complex link between BN and BD, providing valuable insights for tailoring therapies. By focusing on emotion regulation skills and targeted interventions for impulsivity, clinicians may be better equipped to support those struggling with these challenging comorbid conditions.
Journal of Eating Disorders
Multidimensional assessments of impulsivity in women with bulimia nervosa, bipolar disorders, and comorbidity
Bo-Ya Chiu et al.
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