Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence

Abstract

Background: Cross-sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent-reported anxiety in mid-childhood (age 10) and childreported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population-based sample. Methods: Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14. Results: Parent-reported anxiety symptoms at age 10 yielded 5 factors: obsessive-compulsive disorder (OCD) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 (OR = 1.11, p = .007), whereas Factor 4 predicted diagnoses of anorexia nervosa (OR = 1.10, p = .01) and disordered eating by age 16 (OR = 1.08, p = .001). Conclusions: Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescentonset ED symptoms and ED diagnoses.Anxiety-related symptoms at age 10 and eating disorder symptoms during adolescence were examined in a population-based, epidemiological sample of children.Worries and physical anxiety at age 10 predict eating disorder symptoms and diagnoses in adolescence.Clinicians should be attentive to weight fluctuations and eating concerns among anxious children. Childhood worries about physical symptoms might predispose to eating and body related worries that can convert into full blown ED.

Understanding the nature of association between anxiety phenotypes and anorexia nervosa: a triangulation approach

“…This conclusion is consistent with those of smaller retrospective studies that have found greater general childhood anxiety (i.e. not specific to any given disorder) in individuals who later developed AN (for review see [12,16]).…”

“…The evidence for a causal influence of worry on both anxiety disorders and AN supports the possibility that anxiety disorders and AN are related due to the two sharing causal risk factors. A recent study probed associations between independent transdiagnostic anxiety disorder factors (measured at age 10) and lifetime AN by age 16, in the same population cohort as that of Study One [16]. In this earlier investigation, a quantitative worry component (derived from a factor analysis, and reflecting worry across multiple domains) predicted AN development, while alternative anxiety disorder components did not.…”

Anxiety disorders predict fasting to control weight: A longitudinal large cohort study of adolescents

“…A recent study in the same population cohort identified associations of physical anxiety disorder symptoms assessed at age 10 with fasting behaviour at the 13–14 wave (Schaumberg et al, ). We build upon this finding to identify more proximal predictive effects of anxiety disorders on fasting, and effects beyond early adolescence, that is, the mid‐late adolescent period.…”

“…A recent investigation observed a prospective association between certain latent anxiety factors, derived from broad anxiety symptoms, with fasting. In this study anxiety disorder pathology was assessed at age 10, and disordered eating behaviour at age 14 (Schaumberg et al, ). Whether the reported associations are maintained over time, and particularly during the mid‐late adolescent period in which AN incidence is highest (Micali et al, ), remains unclear.…”

Parental deployment and distress, and adolescent disordered eating in prevention‐seeking military dependents

“…Elevated anxiety was determined by a score of ≥32 on the STAIC trait scale (Spielberger, Lushene, Vagg, & Jacobs, 1983). Lossof-control eating and anxiety are highly correlated cross-sectionally and prospectively (Shomaker et al, 2010;Tanofsky-Kraff et al, 2011) and each construct has been shown to predict excess weight gain (Sonneville et al, 2013;Staiano, Marker, Martin, & Katzmarzyk, 2016;Tanofsky-Kraff et al, 2009) and eating disorders (Schaumberg et al, 2019), specifically binge-eating disorder (Hilbert, Hartmann, Czaja, & Schoebi, 2013;Tanofsky-Kraff et al, 2011).…”