This work is part of a retrospective collection of 179 electronic theses and dissertations (ETDs) from the VCU Libraries pilot ETD system that were designated as available only to VCU users. Please contact us at if you have questions or if you are the author of one of these and would like to release it for online public access.

Non-VCU users: Please talk to your librarian about requesting this thesis through interlibrary loan.

Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Dr. Kenneth Kendler


Although previous research has shown a significant association between bulimia nervosa (BN) and drug use disorders (DUD), our knowledge of the underlying causes for this comorbidity remains limited. The purpose of the present study was to investigate possible influences on the comorbidity between BN and DUD. Subjects included 490 monozygotic and 354 dizygotic female twin pairs from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Multiple logistic regression analyses were used to test where putative shared correlates mediated the comorbidity between BN and DUD. Bivariate twin analyses were used to investigate the contribution of genes and environment to the correlation between BN and DUD. Regression analyses indicated a lifetime history of major depression, the personality trait of neuroticism, and childhood sexual abuse significantly mediated the associated between BN and DUD (using BN as the independent variable), while major depression, conduct disorder diagnosis, and childhood sexual abuse most significantly impacted the association when DUD was used as the independent variable. Bivariate twin analyses indicated there is additive genetic and nonshared environmental overlap between BN and DUD with genetic and unique environmental correlations of 0.39 and 0.10, respectively. Results show the reason for the association between BN and DUD is due mostly to overlapping genes with a smaller contribution from nonshared environmental influences. Major depression, the personality trait of neuroticism, and childhood sexual abuse are likely important shared correlates between BN and DUD.


Part of Retrospective ETD Collection, restricted to VCU only.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

June 2008