A Controlled Family Study of Anorexia Nervosa and Bulimia Nervosa

Lilenfeld, Lisa R.; Kaye, Walter H.; Greeno, Catherine G.; Merikangas, Kathleen R.; Plotnicov, Katherine; Pollice, Christine; Rao, R. Govinda; Strober, Michael; Bulik, Cynthia M.; Nagy, Linda M.

doi:10.1001/archpsyc.55.7.603

Cited by 517 publications

(132 citation statements)

References 45 publications

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“…The diagnosis of an ED was established with the Eating Disorders Family History Interview (EDFHI) [35]. This is a structured clinical interview designed to gather detailed information for the diagnosis of AN, bulimia nervosa, binge eating disorder, or any combination of ED not otherwise specified, which has been extensively used in the study of ED patients [36]. The existence of current and previous suicide attempts was established according to data gathered from the participants, the treating physicians and the medical files.…”

Section: Methodsmentioning

confidence: 99%

Suicidal Tendencies and Body Image and Experience in Anorexia nervosa and Suicidal Female Adolescent Inpatients

Stein

Orbach

Shani-Sela

et al. 2002

Psychother Psychosom

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Background: The aim of this study was to assess the relationship between body image and suicidal tendencies in anorexia nervosa (AN). Methods: Three groups of hospitalized female adolescents – nonsuicidal AN, suicidal psychiatric and nonsuicidal psychiatric patients, as well as a community control group with no psychiatric disturbances were compared with regard to suicidal tendencies (in the form of attitudes to life and death), body image and experience, depression and anxiety. Results: The AN and suicidal patients showed less attraction to but more repulsion by life, and more attraction to and less repulsion by death compared with the other two groups. The AN and suicidal patients were also different from either one or both control groups in showing more negative attitudes and feelings towards their bodies, lower sensitivity to body clues, less body control, and elevated depression and anxiety. These between-group differences in suicidal tendencies were retained after controlling for age, body mass index, the different body image dimensions, anxiety and depression. Conclusions: Our findings suggest that female AN inpatients with no evidence of overt suicidal behavior demonstrate elevated suicidal tendencies that are similar to those of suicidal psychiatric inpatients. These self-destructive tendencies are highly associated with a pervasive sense of disturbance of body image and experience.

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Section: Methodsmentioning

confidence: 99%

Suicidal Tendencies and Body Image and Experience in Anorexia nervosa and Suicidal Female Adolescent Inpatients

Stein

Orbach

Shani-Sela

et al. 2002

Psychother Psychosom

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“…Despite a call for family studies in eating disorders to focus on temperament as providing the greatest utility in informing etiological processes (6), to date, most family studies of AN have focused attention on shared risk factors with other psychiatric disorders rather than with dimensional temperament styles (7)(8)(9)(10)(11). A recent review (5) identified only one study that examined dimensional temperaments and AN using a family design, which showed women with lifetime AN to be less impulsive and more restrained than their unaffected sisters (12).…”

Section: Introductionmentioning

confidence: 99%

Shared Temperament Risk Factors for Anorexia Nervosa: A Twin Study

Wade

Tiggemann

Bulik

et al. 2008

Psychosomatic Medicine

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Objective: To answer two questions about the nature of the relationship between anorexia nervosa (AN) and dimensional temperament traits: Which traits are comorbid with AN? Which traits share transmitted liabilities with AN? Methods: A community sample of 1002 same-gender female twins was selected with respect to participation in two earlier waves of data collection. Measures of eating disorder diagnoses and features were ascertained through interview and continuous measures of temperament were ascertained from self-report measures. Results: Four temperaments were comorbid with AN, namely, higher levels of perfectionism (concern over mistakes, personal standards, doubt about actions), and higher need for organization. Comparison between the female co-twins of AN probands and controls (who had never had an eating disorder) showed that the former group reported higher levels of personal standards, organization, and reward dependence. The association between personal standards and reward dependence remained when controlling for the temperament of the proband or control in monozygotic twins. Conclusions:The evidence overall supports the suggestion that AN may represent the expression of a common underlying familial liability to a temperament style that reflects a striving for perfectionism, a need for order, and a sensitivity to praise and reward. The nature of the shared risk factors is likely to be, in part, genetic.

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“…Finally, research on the causes of eating disorders has also pointed to certain personality traits [36, 37, 38, 39, 40, 41], such as low self-esteem, which may trigger eating disorders at a later age.…”

Section: Introductionmentioning

confidence: 99%

Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

Mangweth

Hausmann

Danzl

et al. 2005

Psychother Psychosom

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Background: The risk factors for adolescent eating disorders are poorly understood. It is generally agreed, however, that interactions with one’s body and interactions with others are two important features in the development of anorexia and bulimia nervosa. Therefore, we assessed a variety of childhood body-focused behaviors and childhood social behaviors in eating-disordered patients as compared to non-eating-disordered subjects. Method: We compared 50 female inpatients with eating disorders (anorexia or bulimia nervosa), 50 female inpatients with polysubstance dependence, and 50 nonpatient female control subjects with no history of eating or substance abuse disorders (all defined by DSM-IV criteria), using a semi-structured interview of our own design. We asked questions about (1) childhood body-focused behaviors (e.g. thumb-sucking) and body-focused family experiences (e.g. bodily caresses), and (2) childhood social behaviors (e.g. numbers of close friends) and family social styles (e.g. authoritarian upbringing). Results: Many body-focused measures, such as feeding problems, auto-aggressive behavior, lack of maternal caresses, and family taboos regarding nudity and sexuality, characterized eating-disordered patients as opposed to both comparison groups, as did several social behaviors, such as adjustment problems at school and lack of close friends. However, nail-biting, insecure parental bonding, and childhood physical and sexual abuse were equally elevated in both psychiatric groups. Conclusion: It appears that eating-disordered patients, as compared to substance-dependent patients and healthy controls, show a distinct pattern of body-focused and social behaviors during childhood, characterized by self-harm, a rigid and ‘body-denying’ family climate, and lack of intimacy.

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A Controlled Family Study of Anorexia Nervosa and Bulimia Nervosa

Abstract: Background:We used contemporary familyepidemiological methods to examine patterns of comorbidity and familial aggregation of psychiatric disorders for anorexia and bulimia nervosa.

Cited by 517 publications

References 45 publications

Suicidal Tendencies and Body Image and Experience in Anorexia nervosa and Suicidal Female Adolescent Inpatients

Suicidal Tendencies and Body Image and Experience in Anorexia nervosa and Suicidal Female Adolescent Inpatients

Shared Temperament Risk Factors for Anorexia Nervosa: A Twin Study

Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

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