Outcome Prediction by MMPI in Subtypes of Anorexia Nervosa

Abstract

Sixty-seven discharged, chronically anorectic inpatients were followed eight to 60 months after discharge at normal weight: 39 with anorexia nervosa, restricting subtype (ANR), and 27 with anorexia nervosa, bulimic subtype (ANB). The groups did not differ demographically. ANB patients produced more elevated MMPI profiles; they were distinguished by profile type as well as by discriminant function analysis, which identified ANB patients as higher in both depression and impulsivity. Outcome criteria, i.e., follow-up weight, bulimic behavior, social functioning, revealed that 39% of all patients maintained treatment gains while 61% relapsed. Forty-nine percent of ANR patients maintained improvement, compared with only 22% of ANB. Minnesota Multiphasic Personality Inventory (MMPI) profiles did not predict outcome across all patients, but did within each subtype. Successful ANR patients were more distressed and dramatic, while greater distress and impulsivity predicted failure among ANB. Prediction of ability to maintain improvement after inpatient treatment was markedly enhanced by first classifying anorectics into clinical subtypes. Higher subjective distress predicted negative outcome in one group and positive outcome in the other. These results may clarify apparent contradictions in the literature and contribute to more focused treatment.