Sex Role Identity and Anorexia Nervosa

Much controversy surrounds the issue of sex role identity in anorexia nervosa. In this study, 76 inpatient and 13 nonhospitalized anorectic women were compared with each other on the Bem Sex Role Inventory and with two non-eating-disordered control groups of women, one consisting of 16 undergraduate students and the other of 16 students pursuing graduate degrees in social work. No significant differences in scores were found between the two groups of anorectic subjects, and both control group scores also showed no significant differences. However, while femininity item scores were similar in all four groups, both groups of anorectic subjects scored significantly lower on the masculinity Items than both control groups. No significant correlations were found in the anorectic subjects between masculinity Item score and percentage of ideal body weight, duration of illness, or extent of education. An interpretation of anorexia nervosa as primarily a rejection or a caricature of the feminine role is challenged by this study. Rather, the results suggest that one characteristic of those women vulnerable to developing this syndrome may be a failure to develop adequately those '^masculine" traits that are also necessary for optimal adult female functioning in contemporary society. Anorexia nervosa remains an enigmatic condition. One aspect that has been of particular interest to many in the field is the role of sexual identity in the pathogenesis of the disorder. It has been speculated, for example, that anorexia nervosa is a rejection of adult femininity, a refusal to accept the inevitability of becoming a sexually mature woman (Frick & Schindler, 1972; Muller & Beck, 1973), Toby Sitnick, Ph.D., is Research Fellow, and Jack L. Katz. M.D.. is Clinical Director, Department of Psychiatry, Montefiore Medical Center, Albert Einstein College of Medicine. Please address reprint requests and correspondence to: Dr. Jack L. Katz. Department of Psychiatry, tVlontefiore tVledical Center, 111 East 210th Street. Bronx, New York 10467. INT'LIOURNALOFEATINCDISORDERS/VOL. 3NO. 3/SPRINC1984 81