16 - Vulnerability and resilience in the age of eating disorders: risk and protective factors for bulimia nervosa

Summary

Over the past two decades, bulimia nervosa has emerged as a significant mental health problem. The syndrome of bulimia nervosa is characterized by recurrent episodes of binge eating, during which the individual experiences a lack of control, followed by regular engagement in self-induced vomiting, laxative use, or severely restrictive dieting. Today, as a female passes through adolescence and enters adulthood, she is at considerable risk for developing bulimia nervosa (Striegel-Moore, Silberstein, & Rodin, 1986b). The pioneering work of Garmezy on risk and protective factors in the development of psychopathology (Garmezy, 1974, 1976, 1981; Garmezy & Streitman, 1974) has stimulated us to consider further in this chapter those factors that serve a risk or protective function in the development of bulimia nervosa. Following Garmezy's ground-breaking work on schizophrenia, we suggest that research on bulimia nervosa must encompass not only the study of bulimic individuals but also the study of women who appear resistant to the disorder.

In this chapter we consider what is known about the risk and protective factors for bulimia nervosa.1 The information is incomplete and often tentative. Research on protective factors, in particular, has been virtually nonexistent in the study of eating disorders. We propose that they merit empirical study in the important tradition of theory and research begun by Garmezy and his students and colleagues (Garmezy, 1984, 1985a).