ABSTRACT
The prevalence and severity of eating disorders (EDs) have been increasing globally, and better understanding the role of different personality styles that occur in adults with EDs may optimize diagnosis and treatment. This study therefore aimed to investigate the relationship between personality styles, diagnostic characteristics, therapeutic techniques and therapeutic alliance in the treatment of adults with EDs. It is the first known study to directly explore personality styles and therapeutic alliance specifically with an ED sample. Data was collected via an online survey from 126 licenced therapists who reported on their treatment of an adult with an ED. Therapists provided ED diagnostic information (diagnosis and symptoms); rated their patients on three personality prototypes (emotionally dysregulated, constricted and high-functioning/perfectionistic); their use of cognitive-behavioural (CB), psychodynamic-interpersonal (PI) and adjunctive (AT) ED interventions utilized in treatment; and their therapeutic alliance with a randomly selected patient. Results reveal that patients who have both more constricted and more dysregulated features have more challenging diagnostic profiles. In addition, patients with more dysregulated features, in particular, elicit the integrative technique use from therapists with diverse primary theoretical orientations and pose more difficulty in forming a strong therapeutic alliance. In all, our findings have direct clinical application in the treatment of adults with EDs with differing personality features, such as emphasizing conceptualization and treatment planning for patients with more constricted and dysregulated features, integrating techniques outside of a clinician’s primary theoretical orientation and emphasizing alliance formation for patients with more dysregulated features.