Shoplifting
in Bulimia
Nervosa
James E. Mitchell, Linda Fletcher, Lynn Gibeau, Richard L. Pyle, and Elke Eckert This study compared the shoplifting patterns of 27 bulimic and 25 nonbulimic shoplifters. Bulimic shoplifters often stole food, but usually also stole other items. Nonbulimic shoplifters reported starting to steal at an
T
HERE APPEARS to be an association between eating disorders and shoplifting. This was first documented in patients with anorexia nervosa, with bulimic anorectics being the subgroup most likely to engage in stealing behavior.‘-3 Early reports of patients with normal-weight bulimia also suggested an association with shoplifting. In a 1981 report by our group, we noted that 18 of 34 patients with bulimia had started shoplifting after the onset of their eating disorder and four had continued a preexisting pattern of stealing.4 The most common item first stolen had been food, and 15 admitted to stealing food on a regular basis. Weiss and Ebert5 documented an increased rate of stealing in normal-weight bulimic women compared with a normal-weight control group, and Fairburn and Cooper noted that a third of their sample of 35 patients with bulimia had a history of shoplifting.‘j Most recently, Krahn et al. compared bulimic subjects with and without stealing behavior. These investigators found that those who reported stealing had more dysfunctional eating behavior and more psychopathology than those who did not report stealing. The relationship between psychopathology and shoplifting remains controversial. Beck and McIntyre8 administered the Minnesota Multiphasic Personality Inventory (MMPI) to college students who engaged in shoplifting, and found that they tended to have psychological problems. These investigators concluded that shoplifting is symptomatic of maladjustment. However, Moore,9 using the California PersonFrom the Eating Disorder Program, Department of Psychiatry, University of Minnesota Hospital, Minneapolis, MN. Supported in part by National Institute of Mental Health Grants No. MH 43077 and MH 43296. Address reprint requests to James E. Mitchell, M.D., Box 393 UMHC, 420 Delaware St SE, Minneapolis, MN 55455. Copyright 0 I992 by W B. Saunders Company OOIO-440X/9213305-0018$03.OOlO
342
earlier age, weighed more than bulimic shoplifters, and were more likely to endorse antisocial reasons for shoplifting. Copyright 0 1992 by W.B. Saunders Company
ality Index, did not find significant differences between shoplifters and controls. Other studies have documented a relationship between shoplifting and both depression and female sex,1o,*1 both of which are also associated with eating disorders. In the current research, we were interested in evaluating further the relationship between shoplifting and eating disorders. We were interested in determining if the patterns of shoplifting were similar in these two populations and, in particular, whether the shoplifting associated with bulimia nervosa might be in the service of the eating disorder (e.g., stealing food or money with which to buy food). METHOD In this study, we compared data on female bulimic patients who presented for treatment for their eating disorder who gave a history of shoplifting as adults, to a group of women who served as paid volunteers recruited through newspaper advertisements who admitted to shoplifting after the age of 18, but who denied symptoms of an eating disorder. Both groups of subjects were initially screened by phone and then scheduled for a clinic appointment. Each completed a questionnaire designed to elicit a detailed history of their problems with shoplifting, as well as the Eating (a database designed to gather Disorder Questionnaire’* detailed data regarding eating problems, weight, and family history). All also underwent a psychiatric interview.
RESULTS
Descriptive data on the two populations are shown in Table 1. The two groups were comparable as to age at evaluation. However, the nonbulimic shoplifters began shoplifting at an earlier age, and had a higher mean percent ideal body weight. The two groups did not differ as to the average amount of money they reported having for spending money during a typical month, or the number of stealing episodes during the last 6 months, although the number was twice as high among bulimic shoplifters (BS) compared with nonbulimic shoplift-
Comprehensive Psychiatry, Vol. 33, No. 5 (September/October),
1992:
pp342-345
343
SHOPLIFTING IN SULIMIA NERVOSA
Table 1. Descriptive Data on Bulimic Shoplifters and Nonbulimic Shoplifters Bulimic Shapiifters (N = 27)
Variables
Nonbulimic Shoplifters IN = 25)
F Ratio
Significance I4
Age at evaluation
25.7 * 6.2
26.3 i 5.8
0.37
,725
Age at onset of shoplifting
17.3 _t 6.5
13.2 rt 5.7
2.40
,020
100.6 + 6.7
113.9 i 29.0
% Ideal body weight No. of stealing episodes last 6 months Available spending monsy/mo
($1
12.2 r 35.0 154.7 i_ 122.7
ers (NBS). The vast majority of subjects in both groups were white (BS, n = 26, 93.0%; NBS, n = 24, 96.0%; x2 = .OOO,P = 1.000) and the social class distribution of the two groups of patients was similar (social class 1: BS = 1,4%, NBS = 3, 13%; social class 2: BS = 4, 15%, NBS = 3, 13%; social class 3: BS = 10, 39%, NBS = 11, 46%; social class 4: BS = 10, 39%, NBS = 7, 29%; social class 5: BS = 1, 4%, NBS = 0, 0%, x2 = 2.644, P = .619). Interestingly, the nonbulimic shoplifters were significantly more Iikely to have never married, and none were married at the time of evaluation (married: BS = 10, 37%, NBS = 0, 0%; divorced: BS = 3, ll%, NBS = 4, 16%; never married: BS = 14, 52%, NBS = 21, 84%; x’ = 11.483, P = .003f. Also, nonbnlimic shoplifters were more Iikely to be living in a dormitory or in a shared apartment, while the bulimic shoplifters were likely to be living with their parents or in conjugal relationships (with parents or relatives: BS = 8, 30%, NBS = 3, 12%; dorm/shared apartment: BS = 5, 19%, NBS = 14, 56%; conjugal: BS = 31, 41%, NBS = 4, 16%; alone: BS = 3, ll%, NBS = 4, 16%; x” = 9.883, P = .020). Subjects in both groups were asked what the first item they had stolen had been. Bulimic shoplifters were most likely to first steal cosmetics (N = 8, 35%), food (N = 3, f3%), clothes (N = 3, 13%), money (N = 2, 9%), or candy/ gum (N = 2,9%). Nonbulimic shoplifters were most IikeIy to first report stealing candy/gum (N = 6,30%), clothes (N = 4,20%) or cosmetics (N = 3, 15%). A similar percentage of individuals in both groups reported stealing during the previous week (BS = 4,15%; NBS = 7,28%), during the previous month (BS = 9,33%; NBS = 9,36%), and during the previous year (BS = 17, 63%; NBS = 13,56%).
6.1 it 13‘5 124.3 + 116.0
-2.23
,034
0.64
.408
0.87
.388
We also asked about the most frequently stolen items for each group. Bulimic shoplifters were most likely to steal food (N = 8: 36%) jewelry (N = 3, 14%), money (N = 3, 14%), cosmetics (N = 3, 14%), and laxatives, diuretics, or diet pilis (N = Z&9%). ~onbulimic shoplifters were most fikely to steal ctothes (N = 11, 52%), cosmetics (N = 2, lo%), or cigarettes (N = 2, 10%). Similar percentages of the two groups had been arrested for shoplifting (BS = 15, 56%; NBS = 15, 60%; x’ = .0021 P = .966) and had been prosecuted for shoplifting (BS = 9, 35%; NBS = 9, 36%; xx = ,013, P = .X93). Subjects were also asked to rank on a scale from 1 to 6 how important (from not to very) certain factors were in determining their shoplifting. These factors were taken from the work of Kraut,13 who examined motivations of shoplifters. The last factor “unable to stop self’ was added in our survey. These data are summarized in Table 2. There were significant differences on four of 14 variables. The nonbufimic shoplifters were more likely to report shoplifting to “get back” at the store, for the challenge and excitement of stealing, and because they perceived themselves as dishonest, while bulimic shoplifters indicated more importance on the variable that they stole things which ehey were embarrassed to buy.
Before turning to a discussion of the data, several caveats must be offered concerning the study. Subjects in the study were recruited from individuals being seen for treatment for their eating disorders or symptomatic volunteers with a history of shoplifting who responded to an advertisement seeking subjects for a study. It is difficult to know how representative our sample of bulimic subjects was of bulimic individuals in
344
MITCHELL ET AL
Table 2. Reported Reasons for Stealing Among Bulimic and Nonbufimic Shoptiiers
Variables
Didn’t want to pay
Bulimic
Nonbulimic
Shoplifters
Shoplifters
IN = 27)
(N = 25)
F Ratio
(P)
3.8 r 2.1
4.7 t 1.9
-1.66
,103
3.9 5 1.8
4.0 r 1.8
-0.14
.893
Significance
Small risk af getting caught Wanted but could have done without
3.7 % 1.8
3.9 ir 1.9
Uneble to p8y
3.5 2 1.9
3.8 t- 1.8
-0.57
,572
Needed item badly
2.9 -c 1.8
2.8 2 1.9
-0.19
‘853 .014
0.26
.797
Challenge and ex2.3 -c 1.6
3.6 f 1.9
-2.55
Took by accident
citement
1.7 2 1.6
1.7 c 1.1
-0.19
,847
Get back at store
1.7k1.4
3.OirZ.O
-2.86
,008
1.4 t 1.2
1.8 -c 1.5
-1.63
.306
-0.40
,690
Consider shoplifting acceptable Social pressure to steai
I am
dishonest
1.4 k 1.2
1.6 + 1.2
2.8 * 7.7
1.7 * 1.2
2.56
,014
3.29
.003
Too embarrassed to 2.3 f 1.7
1.1 r 0.3
Political motives
buy
I.0 c 1.9
1.3 + 1.1
-1.18
249
Uable to ston self
2.7 t 1.9
2.8 e 1.7
-6.16
.870
the general population. Because of the nature of our clinic, we frequently see patients who lack insurance and who seek treatment in our facility because of free treatment in research protocols. Also, it is difficult to know what motivated them to participate in this study, other than the financial incentive that was offered. By analogy, we do not know how representative our sample of shoplifter is. It would be diEcult or impossible to obtain a truly random sample of this group. Second, the data presented here are all selfreport data, and it is possible, if not likely, that
some of these subjects were not truthful in their responses to our questions. These data show that the nonbulimic shoplifters tend to start shoplifting at an earlier age, are less likely to have married, and on average weighed more than the bulimic shoplifters. While a si~ificant subgroup of bulimics primarily steal food, the majority were more likely to steal other items such as jewelry, money, and cosmetics. However, if we assume that the bulimics who were more hkefy to steal money did so because of the financial problems caused by their illness, then the majority of the bulimic shoplifters reported most commonly stealing something involved with their eating disorder: food, money, laxatives, diuretics, or diet pills. The nonbulimic shoplifters were more likely to endorse reasons for stealing that one might consider antisocial, e.g., to “get back” at the store or for excitement. The bulimic shoplifters as a group indicated that a more important reason for them to shopIift was embarrassment over buying certain items. We know that many bulimics who abuse diet pills, diuretics, and, in particular, laxatives, steal them to avoid embarrassment. These data suggest that shoplifting in the context of an eating disorder does differ in some interesting ways from shoplifting in the general population. To some extent, the eating disorder may directly contribute to the problem of stealing by virtue of the costs involved, as well as because of embarrassment associated with buying certain over-the-mounter medications for some individuaIs. The current study does not directly address the relationship between shoplifting and psychopathology in general.
REFERENCES 1. Casper RC, Eckert ED, Halmi KA, Goldberg SC, Davis JM. Bulimia-its incidence and clinical importance in patients with anorexia nervosa. Arch Gen Psychiatry 19SO; 37:1030-1035. 2. Crisp AH, Hsu LKG, Harding B. The starving hoarder and voracious spender: stealing in anorexia nervosa. J Psychosom Res 1980;24:225-231. 3. Garfinkel PE, Moldofsky H, Garner DM. The heterogeneity of anorexia nervosa-bulimia as a distinct subgroup. Arch Gen Psychiatry 1980;37:1036-1040. 4. Pyle RL, Mitchell JE, Eckert ED. Bulimia: a report of 34 cases. J Clin Psychiatry 1981;42:60-64.
5. Weiss BR, Ebert MH. ~sychoIog~~a1 and beba~~rai characteristics of normal-weight bulimic and normal-weight controls. Psychosom Med 1983;45:292-303. 6. Fairburn CC, Cooper PJ. The clinical features of bulimia nervosa. Br J Psychiatry 1984;144:238-246. 7. Krahn DD, Nairn K, Gosnell BA, et al. Stealing in eating disordered patients. J Clin Psychiatry 1991;52:11211.5. 8. Beck EA, McIntyre SC. MMPI patterns of shoplifters within a college population. Psycho1 Rep 1977;41:10351040.
SHOPLIFTING
IN BULIMIA
NERVOSA
9. Moore RH. College shoplifters: rebuttal of Beck and McIntyre. Psycho1 Rep 1983;53:1111-1116. 10. Bradford J. Balmaceda R. Shoplifting: is there a specific psychiatric syndrome? Can J Psychiatry 1983;28:248_)C? ‘22. 11. Ray JB, Solomon GS, Doncaster MG, Mellina R.
345
First offender adult shoplifters: a preliminary profile. J Clin Psycho1 1983;39:769-770. 12. Mitchell JE, Hatsukami D, Eckert E, et al. Eating Disorder Questionnaire. Psychopharmacol Bull 1985;21: 1025-1043. 13. Kraut RE. Deterrent and Definitional Influences on Shoplifting. Social Problems 1976;25:358-368.
in Bulimia
Nervosa
James E. Mitchell, Linda Fletcher, Lynn Gibeau, Richard L. Pyle, and Elke Eckert This study compared the shoplifting patterns of 27 bulimic and 25 nonbulimic shoplifters. Bulimic shoplifters often stole food, but usually also stole other items. Nonbulimic shoplifters reported starting to steal at an
T
HERE APPEARS to be an association between eating disorders and shoplifting. This was first documented in patients with anorexia nervosa, with bulimic anorectics being the subgroup most likely to engage in stealing behavior.‘-3 Early reports of patients with normal-weight bulimia also suggested an association with shoplifting. In a 1981 report by our group, we noted that 18 of 34 patients with bulimia had started shoplifting after the onset of their eating disorder and four had continued a preexisting pattern of stealing.4 The most common item first stolen had been food, and 15 admitted to stealing food on a regular basis. Weiss and Ebert5 documented an increased rate of stealing in normal-weight bulimic women compared with a normal-weight control group, and Fairburn and Cooper noted that a third of their sample of 35 patients with bulimia had a history of shoplifting.‘j Most recently, Krahn et al. compared bulimic subjects with and without stealing behavior. These investigators found that those who reported stealing had more dysfunctional eating behavior and more psychopathology than those who did not report stealing. The relationship between psychopathology and shoplifting remains controversial. Beck and McIntyre8 administered the Minnesota Multiphasic Personality Inventory (MMPI) to college students who engaged in shoplifting, and found that they tended to have psychological problems. These investigators concluded that shoplifting is symptomatic of maladjustment. However, Moore,9 using the California PersonFrom the Eating Disorder Program, Department of Psychiatry, University of Minnesota Hospital, Minneapolis, MN. Supported in part by National Institute of Mental Health Grants No. MH 43077 and MH 43296. Address reprint requests to James E. Mitchell, M.D., Box 393 UMHC, 420 Delaware St SE, Minneapolis, MN 55455. Copyright 0 I992 by W B. Saunders Company OOIO-440X/9213305-0018$03.OOlO
342
earlier age, weighed more than bulimic shoplifters, and were more likely to endorse antisocial reasons for shoplifting. Copyright 0 1992 by W.B. Saunders Company
ality Index, did not find significant differences between shoplifters and controls. Other studies have documented a relationship between shoplifting and both depression and female sex,1o,*1 both of which are also associated with eating disorders. In the current research, we were interested in evaluating further the relationship between shoplifting and eating disorders. We were interested in determining if the patterns of shoplifting were similar in these two populations and, in particular, whether the shoplifting associated with bulimia nervosa might be in the service of the eating disorder (e.g., stealing food or money with which to buy food). METHOD In this study, we compared data on female bulimic patients who presented for treatment for their eating disorder who gave a history of shoplifting as adults, to a group of women who served as paid volunteers recruited through newspaper advertisements who admitted to shoplifting after the age of 18, but who denied symptoms of an eating disorder. Both groups of subjects were initially screened by phone and then scheduled for a clinic appointment. Each completed a questionnaire designed to elicit a detailed history of their problems with shoplifting, as well as the Eating (a database designed to gather Disorder Questionnaire’* detailed data regarding eating problems, weight, and family history). All also underwent a psychiatric interview.
RESULTS
Descriptive data on the two populations are shown in Table 1. The two groups were comparable as to age at evaluation. However, the nonbulimic shoplifters began shoplifting at an earlier age, and had a higher mean percent ideal body weight. The two groups did not differ as to the average amount of money they reported having for spending money during a typical month, or the number of stealing episodes during the last 6 months, although the number was twice as high among bulimic shoplifters (BS) compared with nonbulimic shoplift-
Comprehensive Psychiatry, Vol. 33, No. 5 (September/October),
1992:
pp342-345
343
SHOPLIFTING IN SULIMIA NERVOSA
Table 1. Descriptive Data on Bulimic Shoplifters and Nonbulimic Shoplifters Bulimic Shapiifters (N = 27)
Variables
Nonbulimic Shoplifters IN = 25)
F Ratio
Significance I4
Age at evaluation
25.7 * 6.2
26.3 i 5.8
0.37
,725
Age at onset of shoplifting
17.3 _t 6.5
13.2 rt 5.7
2.40
,020
100.6 + 6.7
113.9 i 29.0
% Ideal body weight No. of stealing episodes last 6 months Available spending monsy/mo
($1
12.2 r 35.0 154.7 i_ 122.7
ers (NBS). The vast majority of subjects in both groups were white (BS, n = 26, 93.0%; NBS, n = 24, 96.0%; x2 = .OOO,P = 1.000) and the social class distribution of the two groups of patients was similar (social class 1: BS = 1,4%, NBS = 3, 13%; social class 2: BS = 4, 15%, NBS = 3, 13%; social class 3: BS = 10, 39%, NBS = 11, 46%; social class 4: BS = 10, 39%, NBS = 7, 29%; social class 5: BS = 1, 4%, NBS = 0, 0%, x2 = 2.644, P = .619). Interestingly, the nonbulimic shoplifters were significantly more Iikely to have never married, and none were married at the time of evaluation (married: BS = 10, 37%, NBS = 0, 0%; divorced: BS = 3, ll%, NBS = 4, 16%; never married: BS = 14, 52%, NBS = 21, 84%; x’ = 11.483, P = .003f. Also, nonbnlimic shoplifters were more Iikely to be living in a dormitory or in a shared apartment, while the bulimic shoplifters were likely to be living with their parents or in conjugal relationships (with parents or relatives: BS = 8, 30%, NBS = 3, 12%; dorm/shared apartment: BS = 5, 19%, NBS = 14, 56%; conjugal: BS = 31, 41%, NBS = 4, 16%; alone: BS = 3, ll%, NBS = 4, 16%; x” = 9.883, P = .020). Subjects in both groups were asked what the first item they had stolen had been. Bulimic shoplifters were most likely to first steal cosmetics (N = 8, 35%), food (N = 3, f3%), clothes (N = 3, 13%), money (N = 2, 9%), or candy/ gum (N = 2,9%). Nonbulimic shoplifters were most IikeIy to first report stealing candy/gum (N = 6,30%), clothes (N = 4,20%) or cosmetics (N = 3, 15%). A similar percentage of individuals in both groups reported stealing during the previous week (BS = 4,15%; NBS = 7,28%), during the previous month (BS = 9,33%; NBS = 9,36%), and during the previous year (BS = 17, 63%; NBS = 13,56%).
6.1 it 13‘5 124.3 + 116.0
-2.23
,034
0.64
.408
0.87
.388
We also asked about the most frequently stolen items for each group. Bulimic shoplifters were most likely to steal food (N = 8: 36%) jewelry (N = 3, 14%), money (N = 3, 14%), cosmetics (N = 3, 14%), and laxatives, diuretics, or diet pilis (N = Z&9%). ~onbulimic shoplifters were most fikely to steal ctothes (N = 11, 52%), cosmetics (N = 2, lo%), or cigarettes (N = 2, 10%). Similar percentages of the two groups had been arrested for shoplifting (BS = 15, 56%; NBS = 15, 60%; x’ = .0021 P = .966) and had been prosecuted for shoplifting (BS = 9, 35%; NBS = 9, 36%; xx = ,013, P = .X93). Subjects were also asked to rank on a scale from 1 to 6 how important (from not to very) certain factors were in determining their shoplifting. These factors were taken from the work of Kraut,13 who examined motivations of shoplifters. The last factor “unable to stop self’ was added in our survey. These data are summarized in Table 2. There were significant differences on four of 14 variables. The nonbufimic shoplifters were more likely to report shoplifting to “get back” at the store, for the challenge and excitement of stealing, and because they perceived themselves as dishonest, while bulimic shoplifters indicated more importance on the variable that they stole things which ehey were embarrassed to buy.
Before turning to a discussion of the data, several caveats must be offered concerning the study. Subjects in the study were recruited from individuals being seen for treatment for their eating disorders or symptomatic volunteers with a history of shoplifting who responded to an advertisement seeking subjects for a study. It is difficult to know how representative our sample of bulimic subjects was of bulimic individuals in
344
MITCHELL ET AL
Table 2. Reported Reasons for Stealing Among Bulimic and Nonbufimic Shoptiiers
Variables
Didn’t want to pay
Bulimic
Nonbulimic
Shoplifters
Shoplifters
IN = 27)
(N = 25)
F Ratio
(P)
3.8 r 2.1
4.7 t 1.9
-1.66
,103
3.9 5 1.8
4.0 r 1.8
-0.14
.893
Significance
Small risk af getting caught Wanted but could have done without
3.7 % 1.8
3.9 ir 1.9
Uneble to p8y
3.5 2 1.9
3.8 t- 1.8
-0.57
,572
Needed item badly
2.9 -c 1.8
2.8 2 1.9
-0.19
‘853 .014
0.26
.797
Challenge and ex2.3 -c 1.6
3.6 f 1.9
-2.55
Took by accident
citement
1.7 2 1.6
1.7 c 1.1
-0.19
,847
Get back at store
1.7k1.4
3.OirZ.O
-2.86
,008
1.4 t 1.2
1.8 -c 1.5
-1.63
.306
-0.40
,690
Consider shoplifting acceptable Social pressure to steai
I am
dishonest
1.4 k 1.2
1.6 + 1.2
2.8 * 7.7
1.7 * 1.2
2.56
,014
3.29
.003
Too embarrassed to 2.3 f 1.7
1.1 r 0.3
Political motives
buy
I.0 c 1.9
1.3 + 1.1
-1.18
249
Uable to ston self
2.7 t 1.9
2.8 e 1.7
-6.16
.870
the general population. Because of the nature of our clinic, we frequently see patients who lack insurance and who seek treatment in our facility because of free treatment in research protocols. Also, it is difficult to know what motivated them to participate in this study, other than the financial incentive that was offered. By analogy, we do not know how representative our sample of shoplifter is. It would be diEcult or impossible to obtain a truly random sample of this group. Second, the data presented here are all selfreport data, and it is possible, if not likely, that
some of these subjects were not truthful in their responses to our questions. These data show that the nonbulimic shoplifters tend to start shoplifting at an earlier age, are less likely to have married, and on average weighed more than the bulimic shoplifters. While a si~ificant subgroup of bulimics primarily steal food, the majority were more likely to steal other items such as jewelry, money, and cosmetics. However, if we assume that the bulimics who were more hkefy to steal money did so because of the financial problems caused by their illness, then the majority of the bulimic shoplifters reported most commonly stealing something involved with their eating disorder: food, money, laxatives, diuretics, or diet pills. The nonbulimic shoplifters were more likely to endorse reasons for stealing that one might consider antisocial, e.g., to “get back” at the store or for excitement. The bulimic shoplifters as a group indicated that a more important reason for them to shopIift was embarrassment over buying certain items. We know that many bulimics who abuse diet pills, diuretics, and, in particular, laxatives, steal them to avoid embarrassment. These data suggest that shoplifting in the context of an eating disorder does differ in some interesting ways from shoplifting in the general population. To some extent, the eating disorder may directly contribute to the problem of stealing by virtue of the costs involved, as well as because of embarrassment associated with buying certain over-the-mounter medications for some individuaIs. The current study does not directly address the relationship between shoplifting and psychopathology in general.
REFERENCES 1. Casper RC, Eckert ED, Halmi KA, Goldberg SC, Davis JM. Bulimia-its incidence and clinical importance in patients with anorexia nervosa. Arch Gen Psychiatry 19SO; 37:1030-1035. 2. Crisp AH, Hsu LKG, Harding B. The starving hoarder and voracious spender: stealing in anorexia nervosa. J Psychosom Res 1980;24:225-231. 3. Garfinkel PE, Moldofsky H, Garner DM. The heterogeneity of anorexia nervosa-bulimia as a distinct subgroup. Arch Gen Psychiatry 1980;37:1036-1040. 4. Pyle RL, Mitchell JE, Eckert ED. Bulimia: a report of 34 cases. J Clin Psychiatry 1981;42:60-64.
5. Weiss BR, Ebert MH. ~sychoIog~~a1 and beba~~rai characteristics of normal-weight bulimic and normal-weight controls. Psychosom Med 1983;45:292-303. 6. Fairburn CC, Cooper PJ. The clinical features of bulimia nervosa. Br J Psychiatry 1984;144:238-246. 7. Krahn DD, Nairn K, Gosnell BA, et al. Stealing in eating disordered patients. J Clin Psychiatry 1991;52:11211.5. 8. Beck EA, McIntyre SC. MMPI patterns of shoplifters within a college population. Psycho1 Rep 1977;41:10351040.
SHOPLIFTING
IN BULIMIA
NERVOSA
9. Moore RH. College shoplifters: rebuttal of Beck and McIntyre. Psycho1 Rep 1983;53:1111-1116. 10. Bradford J. Balmaceda R. Shoplifting: is there a specific psychiatric syndrome? Can J Psychiatry 1983;28:248_)C? ‘22. 11. Ray JB, Solomon GS, Doncaster MG, Mellina R.
345
First offender adult shoplifters: a preliminary profile. J Clin Psycho1 1983;39:769-770. 12. Mitchell JE, Hatsukami D, Eckert E, et al. Eating Disorder Questionnaire. Psychopharmacol Bull 1985;21: 1025-1043. 13. Kraut RE. Deterrent and Definitional Influences on Shoplifting. Social Problems 1976;25:358-368.
