Impulsivity and dyscontrol in bulimia nervosa: is impulsivity an independent phenomenon or a marker of severity?

Fifty-eight normal-weight DSM-III-R bulimia nervosa patients were compared with 27 normal controls on measures of bulimia nervosa, depression, impulsivity, obsessionality and impulse control (dyscontrol) behaviours. Patients scored higher than controls on all these measures. Almost half the patient cohort met Lacey's multi-impulsive bulimia criteria. When bulimic symptoms were controlled for in an analysis of covariance, multi-impulsive bulimics did not score significantly differently to non-impulsive bulimics on psychometric measures of impulsivity, obsessionality and depression. The concept of impulsivity is critically reviewed and newer concepts linking obsessionality and impulsivity are explored.