Perception of Autonomy and Connectedness Prior to the Onset of Anorexia Nervosa and Bulimia Nervosa

2012 ◽  
Vol 40 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Julia Huemer ◽  
Maria Haidvogl ◽  
Fritz Mattejat ◽  
Gudrun Wagner ◽  
Gerald Nobis ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Risk Factor ◽  
Bulimia Nervosa ◽  
Family Environment ◽  
Significant Influence ◽  
Diagnostic Interview ◽  
Individual Autonomy ◽  
Mothers And Fathers ◽  
Image Test ◽  
Restrictive Type

Objective: This study examines retrospective correlates of nonshared family environment prior to onset of disease, by means of multiple familial informants, among anorexia and bulimia nervosa patients. Methods: A total of 332 participants was included (anorexia nervosa, restrictive type (AN-R): n = 41 plus families); bulimic patients (anorexia nervosa, binge-purging type; bulimia nervosa: n = 59 plus families). The EATAET Lifetime Diagnostic Interview was used to establish the diagnosis; the Subjective Family Image Test was used to derive emotional connectedness (EC) and individual autonomy (IA). Results: Bulimic and AN-R patients perceived significantly lower EC prior to onset of disease compared to their healthy sisters. Bulimic patients perceived significantly lower EC prior to onset of disease compared to AN-R patients and compared to their mothers and fathers. A low family sum – sister pairs sum comparison – of EC had a significant influence on the risk of developing bulimia nervosa. Contrary to expectations, AN-R patients did not perceive significantly lower levels of IA compared to their sisters, prior to onset of disease. Findings of low IA in currently ill AN-R patients may represent a disease consequence, not a risk factor. Conclusions: Developmental child psychiatrists should direct their attention to disturbances of EC, which may be present prior to the onset of the disease.

Setting the scene for eating disorders: childhood care, classification and course of illness

1993 ◽  
Vol 23 (3) ◽  
pp. 663-672 ◽  
Author(s):  
Ulrike Schmidt ◽  
Jane Tiller ◽  
Janet Treasure
Keyword(s):  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Family Environment ◽  
Parental Control ◽  
Childhood Adversity ◽  
Normal Weight ◽  
Semistructured Interview ◽  
Childhood Experiences ◽  
Course Of Illness ◽  
Childhood Care

SynopsisThe aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN).There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.

Neurobiological and Clinical Predictors of Impulsivity in Bulimia Nervosa

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
F.J. Vaz Leal ◽  
L. Rodríguez Santos ◽  
M.I. Ramos Fuentes ◽  
M.J. Cardoso Moreno ◽  
N. Fernández Sánchez
Keyword(s):  
Bulimia Nervosa ◽  
Family Environment ◽  
Expressed Emotion ◽  
Specific Treatment ◽  
Serum Cortisol ◽  
Diagnostic Interview ◽  
Clinical Feature ◽  
Clinical Predictors ◽  
Treatment Needs ◽  
Before And After

Objective:The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.Methods:The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.Results:Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.Conclusions:The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.

Anxiety disorders in anorexia nervosa and bulimia nervosa: co-morbidity and chronology of appearance

2000 ◽  
Vol 15 (1) ◽  
pp. 38-45 ◽  
Author(s):  
N.T. Godart ◽  
M.F. Flament ◽  
Y. Lecrubier ◽  
P. Jeammet
Keyword(s):  
Anorexia Nervosa ◽  
Anxiety Disorder ◽  
Bulimia Nervosa ◽  
Anxiety Disorders ◽  
Separation Anxiety ◽  
Age Of Onset ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Separation Anxiety Disorder ◽  
Co Morbidity

SummaryThe objectives of the study were to assess lifetime prevalence of specific anxiety disorders, and their age of onset relative to that of eating disorders (ED), in a French sample of patients with anorexia nervosa (AN) or bulimia nervosa (BN). We assessed frequencies of seven anxiety disorders and childhood histories of separation anxiety disorder among 63 subjects with a current DSM-IV diagnosis of an ED, using the Composite International Diagnostic Interview (CIDI). Eighty-three percent of subjects with AN and 71% of those with BN had at least one lifetime diagnosis of an anxiety disorder. By far, the most frequent was social phobia (55% of the anorexics and 59% of the bulimics). When present, the co-morbid anxiety disorder had predated the onset of the ED in 75% of subjects with AN, and 88% of subjects with BN. Our results are consistent with those of studies conducted in other countries, and show that an anxiety disorder frequently exists before an ED. This has to be taken in consideration for successful treatment of patients with AN or BN.

scholarly journals Urbanisation and the incidence of eating disorders

2006 ◽  
Vol 189 (6) ◽  
pp. 562-563 ◽  
Author(s):  
Gabriëlle E. Van Son ◽  
Daphne Van Hoeken ◽  
Aad I. M. Bartelds ◽  
Eric F. Van Furth ◽  
Hans W. Hoek
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Risk Factor ◽  
Bulimia Nervosa ◽  
Rural Areas ◽  
Urban Areas ◽  
Urban Life ◽  
Environmental Risk Factor ◽  
Promising Avenue

SummaryThe link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose–response relation with degree of urbanisation and was five times higher in cities than in rural areas. Remarkably, anorexia nervosa showed no association with urbanisation. We conclude that urban life is a potential environmental risk factor for bulimia nervosa but not for anorexia nervosa. These findings provide a promising avenue for further research into the aetiology of eating disorders.

Psychosocial Risk Factors for Eating Disorders

2017 ◽  
Author(s):  
Corinna Jacobi ◽  
Kristian Hütter ◽  
Eike Fittig
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Risk Factor ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Psychosocial Risk ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
Sample Case

This chapter provides an updated overview of risk factors for eating disorders, on the basis of the risk factor taxonomy described by (Kraemer et al., 1997). It summarizes risk factors identified in longitudinal studies and markers and retrospective correlates from cross-sectional studies through April 2002 for anorexia nervosa, bulimia nervosa, and binge eating disorder, identifies new studies published between May 2002 and June 2015, and integrates them into the earlier review. The updated review confirms that longitudinal evidence on risk factors is strongest for nonspecific eating disorder diagnoses including subclinical forms and weakest for participants with diagnoses of anorexia nervosa. When strict criteria for caseness are applied, the majority of risk factors were not able to predict distinct diagnoses and only very few risk factors were confirmed in more than one sample. Case prediction, specificity, and replication therefore remain the biggest challenges in risk factor research for eating disorders.

Neurobiological and Clinical Predictors of Impulsivity in Bulimia Nervosa

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F.J. Vaz Leal ◽  
L. Rodríguez Santos ◽  
M.I. Ramos Fuentes ◽  
M.J. Cardoso Moreno ◽  
N. Fernández Sánchez
Keyword(s):  
Bulimia Nervosa ◽  
Family Environment ◽  
Expressed Emotion ◽  
Specific Treatment ◽  
Serum Cortisol ◽  
Diagnostic Interview ◽  
Clinical Feature ◽  
Clinical Predictors ◽  
Treatment Needs ◽  
Before And After

Objective:The main aim of this study was to analyze the association between a set of neurobiological/clinical factors and impulsivity in patients suffering from bulimia nervosa, as well as the capability of this factors to predict the severity of impulsivity.Methods:The Impulsive Behaviors Scale (IBS), the Diagnostic Interview for Bordeline Patients - Revised (DIB-R), the Beck Depression Inventory (BDI), the Millon Multiaxial Clinical Inventory (MMCI-II) and the Family Environment Scale (FES) were applied to 70 female patients with DSM-IV BN (purging subtype). Twenty-four hour urinary excretion of norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), serotonin (5-HT), 5-hydroxi-indol-acetic acid (5-HIAA), dopamine (DA), homovallinic acid (HVA), and morning serum cortisol levels before and after the administration of 1 mg of dexamethasone were determined.Results:Impulsivity was associated to lower levels of urinary 5-HT and 5-HIAA, borderline features, and lower family expressed emotion.Conclusions:The consideration of impulsivity as a core clinical feature in patients with bulimia nervosa could lead us to identify clinical subtypes of patients, with specific clinical profiles and specific treatment needs.

Persönlichkeitsstörungen und psychiatrische Morbidität im Verlauf der adoleszenten Anorexia nervosa

2000 ◽  
Vol 28 (2) ◽  
pp. 81-91 ◽  
Author(s):  
B. Müller ◽  
S. Herpertz ◽  
N. Heussen ◽  
A. Neudörfl ◽  
Ch. Wewetzer ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview

Zusammenfassung: Fragestellung: Es war das Ziel der vorliegenden prospektiven Studie, den Verlauf der Essstörungssymptomatik und die psychiatrische (Ko-)Morbidität einschließlich der Persönlichkeitsstörungen bei jugendlichen Patienten, die die DSM-III-R-Kriterien für Anorexia nervosa erfüllten, in regelmäßigen Zeitabständen zu untersuchen. Zehn Jahre nach Entlassung konnten alle 39 Patienten (100%) sowie eine in Bezug auf Alter, Geschlecht und beruflichen Status parallelisierte Kontrollgruppe persönlich nachuntersucht werden.Methodik: Zur Erfassung der Essstörungssymptomatik wurde das Standardisierte Interview für Anorexia und Bulimia nervosa verwandt, das Composite International Diagnostic Interview für die Diagnostik der psychiatrischen (Ko-)Morbidität und das Strukturierte Klinische Interview für Persönlichkeitsstörungen. Ergebnisse: Im Vergleich zu der Kontrollgruppe litten zum Nachuntersuchungszeitpunkt signifikant mehr Patienten an einer psychiatrischen Störung, vorwiegend an einer Angststörung, affektiven Erkrankung oder Drogen- bzw. Alkoholabusus. Bei annähernd einem Viertel der Patienten wurden Persönlichkeitsstörungen, vorwiegend aus dem ängstlich-vermeidenden Formenkreis des DSM-III-R diagnostiziert.Schlussfolgerungen: Unsere Befunde weisen darauf hin, dass die Anorexia nervosa keine auf die Pubertät beschränkte, entwicklungsbedingte Erkrankung ist, sondern sowohl im Querschnitt als auch im Längsschnitt mit anderen psychiatrischen Erkrankungen assoziiert ist.

Psychosocial Risk Factors for Eating Disorders

2010 ◽  
pp. 122-136 ◽  
Author(s):  
Corinna Jacobi ◽  
Eike Fittig
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Risk Factor ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Previous Analysis ◽  
Psychosocial Risk ◽  
Cross Sectional ◽  
Cross Sectional Studies

The objective of this chapter is to provide an updated overview of risk factors for eating disorders on the basis of the risk factor taxonomy described by Kraemer et al. (1997). The chapter summarizes risk factors identified in longitudinal studies and markers and retrospective correlates from cross-sectional studies through April 2002 for the eating disorder syndromes anorexia nervosa, bulimia nervosa, and binge eating disorder. Limitations of these earlier studies are indicated. As part of an update of the previous analysis, results of studies identified between May 2002 and November 2008 are integrated into results of our earlier review. The updated review indicates that longitudinal evidence on risk factors is still much stronger for bulimia nervosa and binge related syndromes, whereas our knowledge of risk factors for anorexia nervosa remains limited. While recent studies were able to overcome some of the limitations of the earlier studies, results of our earlier review are mostly confirmed.

Childhood Maltreatment and Eating Disorders: A Prospective Investigation

2021 ◽  
pp. 107755952098878
Author(s):  
Anat Talmon ◽  
Cathy Spatz Widom
Keyword(s):  
Eating Disorders ◽  
Sexual Abuse ◽  
Anorexia Nervosa ◽  
Risk Factor ◽  
Bulimia Nervosa ◽  
Childhood Maltreatment ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Case Definitions ◽  
Family Socioeconomic Status

Objectives: To determine whether childhood maltreatment is a risk factor for two eating disorders (anorexia nervosa and bulimia nervosa) using objective and subjective case definitions. Methods: Using a prospective cohorts design, children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) from 1967 to 1971 in a Midwestern metropolitan county area were matched on age, race, sex, and approximate family socioeconomic status with non-maltreated children. Both groups were followed up. Retrospective self-reports about childhood maltreatment were collected at age 29. DSM-IV anorexia nervosa (AN) and bulimia nervosa (BN) disorders were assessed at age 41 ( N = 807). Logistic and linear regression results are reported. Results: Using documented cases, childhood maltreatment was not a significant risk factor for AN or BN diagnoses or symptoms in adulthood. However, adults who retrospectively reported any maltreatment and physical and sexual abuse reported significantly more symptoms of AN than those who did not. Conclusions: The prediction that childhood maltreatment is a risk factor for anorexia nervosa and bulimia nervosa was partially supported in this longitudinal study. While misattribution of cases might have occurred, these results suggest that researchers and clinicians should use caution in drawing inferences about these relationships and designing interventions.

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