Object Relations and Identity Features in Women with Bulimia Nervosa: An Exploratory Clinical Pilot Study

Background: Psychodynamic models of bulimia nervosa emphasize disturbances in object relations and identity organization, but quantitative evidence from clinical samples remains limited. Objective: To examine associations between object-relations characteristics and identity indicators in women with bulimia nervosa. Methods: This exploratory cross-sectional pilot study included 28 women (16–40 years) with clinically confirmed bulimia nervosa (ICD-10 F50.2), recruited from a specialized eating-disorders center. Participants completed the Bell Object Relations Inventory (BORI) and Erwin Identity Scale (EIS-III). Analyses included descriptive statistics, Pearson correlations, and multiple linear regressions. Results: Insecure attachment (M = 6.57, SD = 3.08) and alienation (M = 6.07, SD = 3.64) were the most pronounced object-relations features (Table 1). Identity domains were strongly interrelated (confidence with body/appearance: r = 0.91,p < 0.001; confidence with sexual-identity indicators: r = 0.87, p < 0.001). Crossdomain analyses showed inverse associations between object-relations disturbance and identity indicators (e.g., alienation with confidence: r = −0.75, p < 0.01;Table 3). Regression models explained 58% of variance in confidence, 62% in sexualidentity indicators, and 39% in body/appearance indicators (R2 = 0.58, 0.62, and 0.391; Table 4). Conclusions: In this pilot clinical sample, object-relations disturbances were robustly associated with identity-related difficulties. Findings are consistent with integrative psychodynamic case formulation but should be interpreted as exploratory given design and sample-size constraints.