Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)




The current study was designed to investigate the effectiveness of an inpatient stay followed by outpatient treatment for bulimia nervosa, in comparison to an outpatient program only. It was hypothesized that bulimics in the inpatient/outpatient group would be receiving the combined benefits of both inpatient and outpatient treatment, thereby demonstrating greater changes in reduction of bulimic symptomatology than subjects in the less intensive outpatient treatment. Thirty-four, adult, caucasian females meeting the DSM-III-R criteria for bulimia nervosa served as subjects. Nineteen subjects received inpatient/outpatient treatment, while fifteen received outpatient treatment. Subjects completed an initial test packet, including the Beck Depression Inventory (BDI),the Eating Disorders Inventory (EDI), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Diagnostic Survey for Eating Disorder-Revised (DSED-R). After six months of treatment, subjects were asked to complete all of the previously mentioned tests, excluding the MMPI-2, which was given only at initial testing.

Results of the present study indicated that the two groups were not significantly different at intake on symptom severity variables nor demographic variables. The outpatient group, however, had significantly more first degree relatives who abused alcohol and/or drugs than the inpatient/outpatient group. Further analyses revealed that both groups significantly decreased their reported binge frequency, purge frequency, BDI scores, and EDI Drive for Thinness scores over time. A Time X Treatment Group interaction on the EDI Bulimia subscale revealed that the outpatient group had significantly decreased scores from intake to follow-up. There was a significant main effect for treatment group on the EDI Interoceptive Awareness subscale, indicating that the inpatient/outpatient group had higher scores than the outpatient group collapsed over time. A significant positive correlation between the MMPI-2 Psychopathic Deviate (Pd) subscale and change in reported binge frequency was found, indicating elevations on the Pd subscale were associated with decreases in reported binge frequency.

In summary, results of the current study indicated that the outpatient group demonstrated superior treatment gains in comparison with the inpatient/outpatient group. Based on the results of the current investigation, outpatient treatment of bulimia nervosa would be recommended for making the most treatment gains in a shorter period of time than inpatient/outpatient treatment.