Obsessive–compulsive symptoms in young women affected with anorexia nervosa, and their relationship with personality, psychopathology, and attachment style

Abstract Purpose Obsessive–compulsive symptoms (OC) are associated with greater morbidity and worse prognosis in anorexia nervosa (AN). We assessed the presence of non-eating OC in participants with AN and related them with their psychopathology, personality, and attachment style features. Methods Young women with AN (N = 41, 30 restrictor and 11 binge-purging type) were assessed on the Yale-Brown Obsessive–Compulsive Scale (Y-BOCS). These participants with AN and 82 healthy controls (HC) completed the Temperament and Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 (SCL-90), Toronto Alexithymia Scale (TAS-20), and Attachment Style Questionnaire (ASQ). The association between Y-BOCS scores and indexes of psychopathology, personality, and attachment were examined. Results AN had significantly higher scores than HC on the EDI-2, SCL-90, TAS-20, ASQ-Need for Approval, and TCI-Harm Avoidance and Self-directedness. The Y-BOCS scores were significantly correlated with ASQ-Need for Approval, TAS-20-Difficulty in Describing Feelings, SCL-90-Phobic Anxiety, and Anxiety, EDI-2-Drive to Thinness, and Asceticism. Need for Approval displayed the strongest correlation with OC symptoms. Difficulty in describing feelings displayed the strongest correlation with compulsive OC symptoms. Conclusions OC traits in AN were primarily associated with measures of insecure attachment rather than to their eating disorder or general psychopathology. Therapeutic approaches to correcting insecure attachment may be considered as a possible approach to treating AN patients with OC. The study supports a new psychopathological perspective for understanding the meaning of OC symptoms in AN. Level of evidence III: Evidence obtained from cohort or case–control analytic studies.

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Obsessive-compulsive symptoms in young women affected with anorexia nervosa and their relationship with personality, psychopathology and attachment style

10.21203/rs.3.rs-383271/v1 ◽

2021 ◽

Author(s):

Federico Amianto ◽

Luca Arletti ◽

Chiara Davico ◽

Ilaria Secci ◽

Benedetto Vitiello

Keyword(s):

Anorexia Nervosa ◽

Attachment Style ◽

Young Women ◽

Insecure Attachment ◽

Obsessive Compulsive ◽

Correlation Pattern ◽

Obsessive Compulsive Symptoms ◽

Need For Approval ◽

Personality Psychopathology ◽

Tas 20

Abstract Purpose Obsessive-compulsive symptoms (OC) are associated with greater morbidity and worse prognosis in anorexia nervosa (AN). We assessed the presence of non-eating OC in participants with AN and related them with their psychopathology, personality, and attachment style features. Methods Young women with AN (N = 41, 30 restricter and 11 binge-purging type) were assessed on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Participants with AN and 82 healthy controls (HC) completed the Temperament and Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 (SCL- 90), Toronto Alexithymia Scale (TAS-20), and Attachment Style Questionnaire (ASQ), and were compared to underscore the AN features. Y-BOCS scores were correlated to psychopathology, personality, and attachment features in AN participants. Results AN had significantly higher scores than HC on EDI-2, SCL-90, TAS-20, ASQ-Need for Approval, and TCI-Harm Avoidance and Self-directedness. The Y-BOCS scores were significantly correlated with ASQ-Need for Approval, TAS-20-Difficulty in Describing Feelings, SCL-90-Phobic Anxiety, and Anxiety, EDI-2-Drive to Thinness and Asceticism. Need for Approval displayed the strongest and broadest correlation pattern with OC symptoms. Difficulty in describing feelings displayed the strongest correlation with compulsive OC symptoms. Conclusions OC traits in participants with AN are primarily associated with measures of insecure attachment rather than to their eating and general psychopathology. Therapeutic approaches to correcting insecure attachment may be considered a possible choice to treat OC symptoms in AN. The study suggests a new psychopathological perspective to understand the meaning of obsessive-compulsive symptoms in AN.

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Predicting Eating Disorder and Anxiety Symptoms Using Anorexia Nervosa and Obsessive-Compulsive Disorder Polygenic Scores

10.1101/2020.07.02.20142844 ◽

2020 ◽

Author(s):

Zeynep Yilmaz ◽

Katherine Schaumberg ◽

Matt Halvorsen ◽

Erica L. Goodman ◽

Leigh C. Brosof ◽

...

Keyword(s):

Eating Disorders ◽

Sex Differences ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Obsessive Compulsive Disorder ◽

Genetic Risk ◽

Anxiety Symptoms ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Polygenic Scores

Clinical, epidemiological, and genetic findings support an overlap between eating disorders, obsessive-compulsive disorder (OCD), and anxiety symptoms. However, little research has examined the role of genetic factors in the expression of eating disorders and OCD/anxiety phenotypes. We examined whether the anorexia nervosa (AN), OCD, or AN/OCD transdiagnostic polygenic scores (PGS) predict eating disorders, OCD, and anxiety symptoms in a large population-based developmental cohort. Using summary statistics files from the Psychiatric Genomics Consortium Freeze 2 AN and Freeze 1 OCD GWAS, we first conducted an AN/OCD transdiagnostic GWAS meta-analysis and then calculated PGS for AN, OCD, and AN/OCD in participants from the Avon Longitudinal Study of Parents and Children with available genetic and phenotype data on eating disorder, OCD, and anxiety diagnoses and symptoms (sample size 3,212-5,369 per phenotype). We observed sex differences in the PGS prediction of eating disorder, OCD, and anxiety-related phenotypes, with AN genetic risk manifesting at an earlier age and playing a more prominent role in eating disorder phenotypes in boys than in girls. Compulsive exercise was the only phenotype predicted by all three PGS (e.g., PAN(boys)=0.0141 at age 14; POCD(girls)=0.0070 at age 16; PAN/OCD(all)=0.0297 at age 14). Our results suggest that earlier detection of eating disorder, OCD, and anxiety-related symptoms could be made possible by including measurement of genetic risk for these psychiatric conditions while being mindful of sex differences.

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Eating disorder and obsessive–compulsive symptoms in a sample of bulimic women: Perfectionism as a mediating factor

Personality and Individual Differences ◽

10.1016/j.paid.2012.08.042 ◽

2013 ◽

Vol 54 (2) ◽

pp. 231-235 ◽

Cited By ~ 4

Author(s):

Rebecca A. Bernert ◽

Kiara R. Timpano ◽

Carol B. Peterson ◽

Scott J. Crow ◽

Anna M. Bardone-Cone ◽

...

Keyword(s):

Eating Disorder ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Mediating Factor ◽

Bulimic Women

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Anorexia nervosa and attachment

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.785 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S552-S552

Author(s):

H. De la Red Gallego ◽

A. Alonso Sánchez ◽

A. Álvarez Astorga ◽

S. Gómez Sánchez ◽

L. Rodríguez Andrés ◽

...

Keyword(s):

Emergency Department ◽

Eating Disorders ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Clinical Case ◽

Cognitive Distortions ◽

Insecure Attachment ◽

Weight Restoration ◽

Competing Interest ◽

The One

IntroductionAttachment is an innate programming whereby a child seeks for security. There is scientific and empirical evidence that insecure attachment is usual in eating disorder patients [1].ObjectivesTo highlight the relevance of attachment between child and caregivers, as well as its significance in therapeutic approach.MethodsA 17-year-old girl hospitalized after attending to emergency department due to fainting. BMI: 12.89. She reports restrictive behavior since age 11 that her mother regards as “child issues”. Divorced parents, she grew up with her mother, diagnosed of hypochondria, who mentions not understanding why she is not the one who is hospitalized.ResultsDuring hospitalization, she turned 18-years-old. Guardianship of her younger siblings was removed to her mother. She had a secure relationship with her 24-year-old sister, so she decided to move in with her. Later on, she had a positive progress, maintaining the gained weight and mood stability, although cognitive distortions persist.ConclusionsAmong developmental and maintaining factors of eating disorders, impaired attachment is becoming increasingly interesting. Even though the main goal of treatment is weight restoration, exploring attachment patterns can facilitate to achieve that aim. This clinical case emphasizes the importance of attachment in eating disorders among child and young adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Exploring the Relationship between Obsessive-compulsive Characteristics and Symptoms of Eating Disorders in a Nonclinical Population

World Journal of Social Science ◽

10.5430/wjss.v7n1p25 ◽

2020 ◽

Vol 7 (1) ◽

pp. 25

Author(s):

John Paulson

Keyword(s):

Anorexia Nervosa ◽

Self Report ◽

Clinical Samples ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

College Sample ◽

Eating Disorder Symptoms ◽

The One ◽

The Relationship

Previous research has documented similarities between symptoms of Obsessive-Compulsive Disorder (OCD), Anorexia Nervosa, and Bulimia Nervosa and elevated comorbidity between these conditions in clinical samples, with the relationship between OCD and Anorexia being stronger than between OCD and Bulimia. Researchers adopting a continuum view of psychopathology have also found that individuals with sub-clinical expressions of obsessive-compulsive symptoms resemble their clinical counterparts in several ways. The goal of the current study was to explore whether or not the observed relationship between obsessive-compulsive symptoms and eating disorder symptoms observed in clinical populations would also be observed in a nonclinical population. 264 participants from a college sample completed self-report measures of these symptoms. A positive correlation was found between scores on obsessive-compulsive, anorexia and bulimia instruments, and reflective of their clinical counterparts the relationship between obsessive-compulsive and anorexia symptoms was more significant than the one between obsessive compulsive symptoms and bulimia symptoms. Implications and limitations for research and clinical practice are discussed.

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Prolactin response to d-fenfluramine is blunted in people with anorexia nervosa

The British Journal of Psychiatry ◽

10.1192/bjp.172.5.439 ◽

1998 ◽

Vol 172 (5) ◽

pp. 438-442 ◽

Cited By ~ 30

Author(s):

Palmiero Monteleone ◽

Francesca Brambilla ◽

Francesca Bortolotti ◽

Antonietta La Rocca ◽

Mario Maj

Keyword(s):

Anorexia Nervosa ◽

Rating Scales ◽

Normal Weight ◽

Plasma Prolactin ◽

Obsessive Compulsive ◽

Double Blind ◽

Obsessive Compulsive Symptoms ◽

Basal Cortisol ◽

Healthy Control ◽

Prolactin Response

BackgroundSeveral studies have explored serotonin (5-HT) transmission in people with anorexia nervosa, but their results have been inconsistent.MethodAccording to a double-blind placebo-controlled design, plasma prolactin response to the specific serotonergic probe d-fenfluramine was investigated in 10 underweight and two normal-weight women with anorexia, and in 12 age-matched healthy females. Eating-related psychopathology, depressive and obsessive-compulsive symptoms, and aggressiveness were measured by appropriate rating scales.ResultsCompared with healthy control subjects, the women with anorexia showed reduced baseline prolactin and oestrogen levels and increased basal Cortisol concentrations. The prolactin response to d-fenfluramine was blunted and did not correlate with psychopathological measures.ConclusionsThese results support a dysfunction of 5-HT transmission in anorexia nervosa. This dysfunction does not seem to be related to concomitant depressive or obsessive-compulsive symptoms or to the level of aggressiveness of the patients.

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Orthorexia Nervosa and the Use of Exposure and Response Prevention to Treat Eating-Related Obsessions and Compulsions

10.1093/med-psych/9780190052775.003.0007 ◽

2021 ◽

pp. 103-124

Author(s):

Hana F. Zickgraf

Keyword(s):

Anorexia Nervosa ◽

Eating Disorder ◽

Healthy Eating ◽

Eating Behaviors ◽

Food Additives ◽

Orthorexia Nervosa ◽

Obsessive Compulsive ◽

Restrictive Eating ◽

Compulsive Checking ◽

Clinically Significant

Orthorexia nervosa (ON) is a proposed diagnosis involving rigid, intrusive thoughts and unusual beliefs about healthy eating, associated with restrictive eating behaviors. People with ON may avoid specific foods, food additives, dyes, or preservatives, and non-organic or genetically modified foods seen as “impure” or “unnatural,” often engaging in compulsive checking, reassurance seeking, decontamination, or other rituals to ensure that food “rules” are followed and that food is “healthy” and “pure.” ON is distinguished from healthy orthorexia, a non-impairing interest in healthy eating and nutrition. The distinction between ON and eating disorders involving obsessions about weight and shape and restrictive eating motivated by fear of weight gain is less clear. In this chapter, ON and related eating disorder symptoms associated with the diagnoses of anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, and avoidant/restrictive food intake disorder are conceptualized as obsessive-compulsive phenomena. Special considerations for exposure and response interventions for patients with clinically significant restrictive eating are described, including recommendations for when to refer patients to eating disorder specialists.

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Obsessive-compulsive symptoms and physical activity in patients with anorexia nervosa: possible relationships.

Psychiatria Polska ◽

10.12740/pp/34810 ◽

2016 ◽

Vol 50 (1) ◽

pp. 55-64 ◽

Cited By ~ 2

Author(s):

Magda Błachno ◽

Anita Bryńska ◽

Celina Tomaszewicz-Libudzic ◽

Gabriela Jagielska ◽

Tomasz Srebnicki ◽

...

Keyword(s):

Physical Activity ◽

Anorexia Nervosa ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms

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Risk factors and the prevalence of anorexia nervosa among female students in Serbia

Vojnosanitetski pregled ◽

10.2298/vsp130709121l ◽

2016 ◽

Vol 73 (1) ◽

pp. 34-41 ◽

Cited By ~ 2

Author(s):

Jovana Lazarevic ◽

Borjanka Batinic ◽

Tatjana Vukosavljevic-Gvozden

Keyword(s):

Risk Factors ◽

Anorexia Nervosa ◽

Attachment Style ◽

Attachment Styles ◽

Body Shape ◽

Eating Attitudes ◽

Female Students ◽

The Body ◽

Insecure Attachment ◽

Acceptance And Commitment

Background/Aim. The widespread symptoms of anorexia nervosa (AN) in young women require to draw professional attention to this problem in Serbia. In previous research on AN, insecure attachment styles, perfectionism and concerns about body shape were identified as notable risk factors. The aim of this study was to identify the prevalence of AN among female students and assess the importance of these factors in its development. Methods. The Eating Attitudes Test (EAT-40), the Experiences in Close Relationships Scale (ECR), the Frost Multidimensional Perfectionism Scale (FMPS) and the Body Shape Questionnaire (BSQ) were applied to a sample of 500 randomly selected female students of the University of Belgrade, the mean age of 22.44 years (min 18, max 35). In addition, Body Mass Index (BMI) was also calculated. Results. Although 38 (7.6%) female students displayed symptoms of AN (EAT > 30) and 13 (2.6%) had BMI indicating anorexia nervosa syndrome (BMI ? 17.50 kg/m2), only 1 (0.2%) student fulfilled both criteria. The majority of female students (60.4%) had some type of insecure attachment style. There is a significant influence of attachment styles on symptoms of AN: female students with insecure attachment styles have a significantly higher mean score on the EAT compared to those with secure attachment style (F = 7.873; p < 0.01). There was a positive correlation between scores on the EAT and FMPS (r = 0.217; p < 0.01), and scores on the EAT and BSQ (r = 0.388; p < 0.01). Conclusions. The obtained results show the prevalence of AN of 0.2% among female students and indicate the importance of insecure attachment styles, perfectionism and concern about body shape as risk factors. Activities for the prevention of AN in this subpopulation should include internet-based therapy and special counseling services with specific programs focusing on emotion-regulation skills through mindfulness, acceptance and commitment techniques, as well as specific cognitive-behavioral techniques.

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Endocrinology of eating disorders

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.2243 ◽

2011 ◽

pp. 280-287

Author(s):

Gerasimos E. Krassas ◽

Luigi Bartalena

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Bulimia Nervosa ◽

Binge Eating ◽

Young Women ◽

Binge Eating Disorder ◽

Strong Association ◽

Excessive Weight ◽

The Usa

Eating disorders affect about five million Americans every year. There are three different eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. Eating disorders are complex conditions deriving from a complex interplay of long-standing behavioural, emotional, psychological, interpersonal, and social factors. The neuronal circuits that control the ingestion of food are mainly related to catecholaminergic, serotoninergic, and peptidergic systems. In this respect, while serotonin, dopamine and prostaglandin promote the ingestion of food, by contrast, neuropeptide Y, noradrenaline, γ‎-aminobutyric acid (GABA), and opioid peptides inhibit food ingestion, thus causing the development of eating disorders (1). Eating disorders typically occur in adolescent girls or young women, although 5–15% of cases of anorexia nervosa and bulimia nervosa and 40% of cases of binge eating disorder occur in boys and men. Approximately 3% of young women are affected with these disorders, and probably twice that number has clinically important variants. Although early disorders mostly develop in adolescence or young adulthood, they can occur after the age of 40 years and are increasingly seen in young children (2). Eating disorders are more prevalent in industrialized societies than in nonindustrialized societies, and occur in all socioeconomic classes and major ethnic groups in the USA. About half of those who have anorexia nervosa or bulimia nervosa fully recover, approximately 30% have a partial recovery, and 20% have no substantial improvement in symptoms (2). The aim of this chapter is to give an overview of the endocrinology of eating disorders leading to excessive weight gain or excessive weight loss in humans. It is of note that despite the strong association between obesity and eating disorders, the increase in obesity is not followed by an increase in eating disorders (3).

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