Subtyping women with bulimia nervosa along dietary and negative affect dimensions: a replication in a treatment-seeking sample.

Recent cluster-analysis studies of women with bulimia nervosa (BN) have suggested two subtypes, a pure dietary subtype and a mixed dietary-negative affect. We aimed to replicate the subtyping findings in a clinical study group of 48 adult women with BN. Cluster analyses revealed a dietary-negative affect subtype (56% of cases) and a pure dietary subtype (44% of cases). The dietary-negative affect subtype was characterized by significantly greater eating-related attitudinal psychopathology and associated psychological disturbance. Our findings suggest that severe restraint is a central feature of BN and that affective disturbance, which occurs in roughly half of cases, is associated with greater eating-related attitudinal psychopathology and psychological symptomatology.