Abstract

BEHAR A., Rosa. Ineffectiveness in eating disorders. Rev. Mex. de trastor. aliment [online]. 2011, vol.2, n.2, pp.113-124. ISSN 2007-1523.

Background: The sense of personal ineffectiveness is one of the core clinical characteristics in eating disorders (ED). Objective: To describe the evidence on the sense of personal ineffectiveness in patients suffering from anorexia nervosa and/or bulimia nervosa. Method: Medline/Pubmed databases were used to look for evidence on ineffectiveness in ED. Results: The "paralyzing sense of personal ineffectiveness" described by Bruch (1973) in anorexic patients, related to a deficit in the sense of self, due to early distortions in mother-child attachment, is still a valid concept in everyday clinical practice. Although ineffectiveness is also a characteristic of a depressive disorder, in ED it is related mainly to drive for thinness, perfectionism, shyness, lack of assertiveness and interoceptive awareness (alexythimia), laxative and substance abuse, diet, physical exercise, obsessive-compulsive symptomatology, low self-esteem, body dissatisfaction, stress and severity of ED. Conclusions: There is strong evidence supporting the sense of ineffectiveness, both in non clinical populations at risk to develop ED and also in anorexic and/or bulimic patients. It may be considered as a predisposing, perpetuating and prognosis factor of an ED. Nevertheless, ineffectiveness as a feature of depressive disorder questions its exclusiveness to ED.

Keywords : Eating disorders; Anorexia nervosa; Bulimia nervosa; Depressive disorder; Ineffectiveness.

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