Reflective functioning in 70 patients suffering from bulimia nervosa.

OBJECTIVE

This study is the first to evaluate the reflective functioning abilities of patients suffering from bulimia nervosa (BN).

METHOD: Seventy patients fulfilling Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for BN were interviewed with the Adult Attachment Interview, which was subsequently coded for reflective functioning (RF).

RESULTS

On average, the sample of patients suffering from BN had close to normal mentalizing abilities. However, the distribution of RF scores was significantly different from the distribution of RF in a non-clinical control group, showing a more polarized pattern with more low and high RF scores.

CONCLUSION

The study indicates that the theory of mentalization may contribute to understanding BN. However, bulimic pathology may develop and be maintained despite good mentalizing abilities.