Beth, aged 18, has been trying to keep a secret from her family and friends. She is a binge eater. When others are not around, she gorges on cakes, ice cream and other food so fast that she hardly has time to chew. Once she begins there is no stopping until her stomach aches. After her binge, Beth feels disgusted with herself and makes herself vomit, then takes a double dose of laxative. Her life is totally dominated by her obsession with food. Beth is suffering from which disorder?

The correct answer is Bulimia Nervosa.

Step-by-Step Explanation:

To identify the psychological disorder Beth is experiencing, we can analyze the clinical features described in the scenario and compare them with the diagnostic criteria for eating disorders:

1. Presence of Binge Eating Episodes:
The scenario states that Beth gorges on large quantities of food (cakes, ice cream, etc.) in a rapid manner, to the point of physical discomfort (until her stomach aches), and experiences a loss of control ("there is no stopping"). This is the defining characteristic of "binge eating."

2. Compensatory Behaviors (Purging):
Following a binge, Beth feels disgusted with herself and engages in inappropriate compensatory behaviors to prevent weight gain. Specifically, she makes herself vomit and takes a double dose of laxatives. These actions are classified as purging behaviors.

3. Bulimia Nervosa vs. Other Disorders:

- Bulimia Nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, fasting, or excessive exercise. Beth's symptoms align perfectly with this description.
- Anorexia Nervosa primarily involves extreme restriction of food intake leading to significantly low body weight, accompanied by an intense fear of gaining weight and a distorted body image. While some individuals with Anorexia Nervosa also purge, the primary hallmark is self-starvation and low body weight, which is not indicated here.
- Body Dysmorphic Disorder involves an obsessive focus on a perceived flaw in physical appearance, which is not the central theme of Beth's eating-and-purging cycle.
- Conduct Disorder is a repetitive and persistent pattern of behavior in children and adolescents in which the basic rights of others or major age-appropriate societal norms are violated, which is unrelated to Beth's symptoms.

Therefore, based on the presentation of binge eating accompanied by immediate compensatory purging behaviors (vomiting and laxative misuse), Beth is suffering from Bulimia Nervosa.