Dependent and autonomous interpersonal styles and level of differentiation among male patients with eating disorders

This study examined whether difficulties in maintaining a balance between the personality variables of relatedness (dependency) and self-definition (autonomy) together with a low level of differentiation would distinguish male patients with eating disorders (EDs) from controls. The study is based on Blatt's dual model of personality configurations: relatedness (anaclitic) versus self-definition (introjective). It is further based on conceptualizations of differentiation put forward by Mahler (1968); Blatt and Luyten (2009), and by Bowen (1978). In the study we compared 25 male patients between the ages of 14-24 years hospitalized because of EDs to 25 non-ED male controls matched for age. We found that male patients with EDs exhibited elevated levels of both dependency and autonomy and a lower level of differentiation compared to non-ED controls. Moreover, these personality characteristics were significantly associated with elevated ED symptomatology, above and beyond the effect of emotional distress. These findings highlight the potential role played by these personality attributes in the predisposition to develop and sustain an ED, especially the ability to differentiate one's own mental experiences from those of others.