Overt and covert aggression in college women with bulimia nervosa

Julia Huemer, Ashwini Sagar, Kathleen Alquero, Katherine Denny, Richard J. Shaw, Hans Steiner

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: This study examines the prevalence of overt and covert aggression in women with bulimia nervosa (BN) as well as the relationship between the severity of BN and the frequency of aggressive acts. Patients and methods: 20 female college students with BN and 20 control subjects completed self-report measures of aggressive behavior and eating disorder pathology. They also completed the Juvenile Health and Wellness Survey-76 to assess general risk taking and indices of sexual behavior and mental health. Results: BN subjects reported higher levels of both overt and covert aggression (p < .001). Overt aggression tended to be more premeditated, while the self-report of covert aggression behavior was more impulsive. Levels of aggressive behavior were significantly correlated with severity of BN (p < .01). Subjects with BN reported higher levels of risk-taking and sexual behaviors. Conclusions: Aggression is an important clinical issue in BN. Subtypes of aggression suggest different pathways for overt and covert aggressive acts with impulsive covert aggression being more closely related to the binge-purge cycle. Awareness of subtypes of aggression in BN may have important clinical and treatment implications.

Original languageEnglish (US)
Pages (from-to)409-415
Number of pages7
JournalZeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie
Issue number6
StatePublished - Nov 4 2011
Externally publishedYes


  • Aggression
  • Bulimia nervosa
  • JHWS-76

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pediatrics, Perinatology, and Child Health
  • Clinical Psychology


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