Interpersonal problems in anorexia nervosa: Social inhibition as defining and detrimental

Interpersonal difficulties are thought to play a central role in both the development and maintenance of anorexia nervosa (AN). The primary aims of this study were to examine the nature of interpersonal problems in AN and to determine whether interpersonal problems are related to AN psychopathology and treatment outcome. The participants were 218 individuals with AN admitted to a specialized treatment program. Overall, in comparison with a normative community sample, a pattern of difficulties with submissiveness, nonassertiveness and social inhibition emerged among patients with AN. Results indicated a positive association between interpersonal problems and eating disorder psychopathology at baseline. The overall level of interpersonal problems decreased from baseline to post-treatment and higher levels of social inhibition at baseline predicted treatment noncompletion. Our findings suggest that AN is associated with a pattern of submissive and socially inhibited interpersonal behavior which contributes to the maintenance of eating disorder pathology and interferes with treatment completion. The theoretical and clinical implications of the findings are discussed.

► We examine the nature of interpersonal problems in anorexia nervosa (AN).
► We examine how interpersonal problems relate to AN psychopathology and treatment outcome.
► AN patients reported high submissiveness, nonassertiveness and social inhibition.
► Greater interpersonal problems was positively correlated with AN psychopathology.
► Higher levels of social inhibition at baseline predicted treatment noncompletion.