Skip to main content Accessibility help
×
Home

Toward an understanding of risk factors for anorexia nervosa: a case-control study

  • K. M. Pike (a1), A. Hilbert (a2), D. E. Wilfley (a3), C. G. Fairburn (a4), F.-A. Dohm (a5), B. T. Walsh (a1) and R. Striegel-Moore (a6)...

Abstract

Background

Prospective, longitudinal studies of risk factors for anorexia nervosa (AN) are lacking and existing cross-sectional studies are generally narrow in focus and lack methodological rigor. Building on two studies that used the Oxford Risk Factor Interview (RFI) to establish time precedence and comprehensively assess potential risk correlates for AN, the present study advances this line of research and represents the first case-control study of risk factors for AN in the USA.

Method

The RFI was used for retrospective assessment of a broad range of risk factors, while establishing time precedence. Using a case-control design, 50 women who met DSM-IV criteria for AN were compared to those with non-eating disorder DSM-IV psychiatric disorders (n=50) and those with no psychiatric disorder (n=50).

Results

Women with psychiatric disorders reported higher rates of negative affectivity, maternal and paternal parenting problems, family discord, parental mood and substance disorder, and physical and sexual abuse than women with no psychiatric disorder. Women with AN specifically reported greater severity and significantly higher rates of negative affectivity, perfectionism and family discord, and higher parental demands than women with other psychiatric disorders. The role of weight and shape concerns was most salient in the year preceding onset of AN.

Conclusions

Convergent data identifying common risk factors as well as those more severe in the development of AN are emerging to inform longitudinal risk factor and prevention studies for this disorder.

Copyright

Corresponding author

*Address for correspondence: Dr K. M. Pike, Department of Psychiatry, Unit 98, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive, NY, NY 10032, USA. (Email: kmp2@columbia.edu)

References

Hide All
Anderluh, M, Tchanturia, K, Rabe-Hesketh, S, Treasure, J (2003). Childhood obsessive-compulsive personality traits in adult women with eating disorders: defining a broader eating disorder phenotype. American Journal of Psychiatry 160, 242247.
Bastiani, AM, Rao, R, Weltzin, T, Kaye, WH (1995). Perfectionism in anorexia nervosa. International Journal of Eating Disorders 17, 147152.
Bruch, H (2001). The Golden Cage: The Enigma of Anorexia Nervosa. Harvard University Press: Cambridge.
Bulik, C, Tozzi, F, Anderson, C, Mazzeo, S, Aggen, S, Sullivan, P (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry 160, 366368.
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd edn.Erlbaum: Hillsdale, NJ.
Commission on Adolescent Eating Disorders (2005). Prevention of eating disorders. In Treating and Preventing Adolescent Mental Health Disorders: What We Know and What We Don't Know (ed. Evans, D. L., Foa, E. B., Gur, R. E., Hendin, H., O'Brien, C. P., Seligman, M. E. P. and Walsh, B. T.), pp. 304323. Oxford University Press: New York.
Fairburn, CG, Cooper, Z (1993). The eating disorder examination. In Binge Eating (ed. Fairburn, C. G. and Wilson, G. T.), pp. 317360. Guilford Press: New York.
Fairburn, CG, Cooper, Z, Doll, HA, Welch, SL (1999). Risk factors for anorexia nervosa: three integrated case-control comparisons. Archives of General Psychiatry 56, 468476.
Fairburn, CG, Doll, HA, Welch, S, Hay, PJ, Davies, BA, O'Connor, ME (1998). Risk factors for binge eating disorder: a community-based, case-control study. Archives of General Psychiatry 55, 425432.
Fairburn, CG, Welch, SL, Doll, HA, Davies, BA, O'Connor, ME (1997). Risk factors for bulimia nervosa: a community-based case-control study. Archives of General Psychiatry 54, 509517.
Field, AE, Camargo, CS, Taylor, CB, Berkey, CS, Colditz, GA (1999). Relation of peer and media influences to the development of purging behaviours among preadolescent and adolescent girls. Archives of Pediatric Adolescent Medicine 153, 11841189.
First, MB, Spitzer, RL, Gibbon, MA, Williams, JB (1996). Structured Clinical Interview for DSM-IV Axis I Disorders – Non-Patient Edition. New York State Psychiatric Institute: New York.
Gowers, SG, North, CD, Byram, V (1996). Life event precipitants of adolescent anorexia nervosa. Journal of Child Psychology and Psychiatry 37, 469477.
Halmi, KA, Sunday, SR, Strober, M, Kaplan, A, Woodside, DB, Fichter, M, Treasure, J, Berrettini, WH, Kaye, WH (2000). Perfectionism in anorexia nervosa: variation by clinical subtype, obsessionality, and pathological eating behavior. American Journal of Psychiatry 157, 17991805.
Hinney, A, Friedel, S, Remschmidt, H, Hebebrand, J (2004). Genetic risk factors in eating disorders. American Journal of Pharmacogenomics 4, 209223.
Hoek, HW (2002). Distribution of eating disorders. In Eating Disorders and Obesity: A Comprehensive Handbook (ed. Fairburn, C. G. and Brownell, K. D.), pp. 233237. Guilford Press: New York.
Hoek, HW, van Hoeken, D (2003). Review of the prevalence and incidence of eating disorders. International Journal of Eating Disorders 34, 383396.
Horesh, N, Apter, A, Lepkifker, E, Ratzoni, G, Weizmann, R, Tyano, S (1995). Life events and severe anorexia nervosa in adolescence. Acta Psychiatrica Scandinavica 91, 59.
Jacobi, C, Hayward, C, deZwaan, M, Kraemer, HD, Agras, WS (2004). Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for general taxonomy. Psychological Bulletin 130, 1965.
Karwautz, A, Rabe-Hesketh, S, Hu, X, Zhao, J, Sham, P, Collier, DA, Treasure, JL (2001). Individual-specific risk factors for anorexia nervosa: a pilot study using a discordant sister-pair design. Psychological Medicine 31, 317329.
Kendler, KS, Walters, EE, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1995). The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Archives of General Psychiatry 52, 374383.
Kraemer, HC, Kazdin, AE, Offord, DR, Kessler, RC, Jensen, PS, Kupfer, DJ (1997). Coming to terms with the terms of risk. Archives of General Psychiatry 54, 337343.
Mazzeo, SE, Slof-Op't Landt, MCT, van Furth, EF, Bulik, CM (2006). Genetics of eating disorders. In Annual Review of Eating Disorders (ed. Wonderlich, S., Mitchell, J. E., Zwaan, M. de and Steiger, H.), pp. 1734. Radcliffe Publishing: Oxford.
McKnight Investigators (2003). Risk factors for the onset of eating disorders in adolescent girls: results of the McKnight longitudinal risk factor study. American Journal of Psychiatry 160, 248254.
Parker, G, Tupling, H, Brown, LB (1979). A parental bonding instrument. British Journal of Medical Psychology 52, 110.
Pike, KM, Wilfley, D, Hilbert, A, Fairburn, GC, Dohm, FA, Striegel-Moore, RH, (2006). Antecedent life events of binge eating disorder. Psychiatry Research 142, 1929.
Pope, HG, Hudson, JL (1992). Is childhood sexual abuse a risk factor for bulimia nervosa? American Journal of Psychiatry 149, 455463.
Rastam, M, Gillberg, C (1992). Background factors in anorexia nervosa: a controlled study of 51 teenage cases including a population sample. European Child and Adolescent Psychiatry 1, 5465.
Schmidt, U, Tiller, J, Blanchard, M, Andrews, B, Treasure, J (1997). Is there a specific trauma precipitating anorexia nervosa? Psychological Medicine 27, 523530.
Srinivasagam, NM, Kaye, WH, Plotnicov, KH, Greeno, C, Weltzin, TE, Rao, R (1995). Persistent perfectionism, symmetry, and exactness after long-term recovery from anorexia nervosa. American Journal of Psychiatry 152, 16301634.
Stice, E (2001). A prospective test of the dual pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology 110, 124135.
Stice, E, Agras, WS (1998). Predicting onset and cessation of bulimic behaviors during adolescence: a longitudinal grouping analyses. Behavior Therapy 29, 257276.
Striegel-Moore, RH, Dohm, FA, Pike, KM, Wilfley, DE, Fairburn, CG (2002). Abuse, bullying and discrimination as risk factors for binge eating disorder. American Journal of Psychiatry 159, 19021907.
Striegel-Moore, RH, Fairburn, CG, Wilfley, DE, Pike, KM, Dohm, FA, Kraemer, H (2005). Toward an understanding of risk factors for binge eating disorder in black and white women: a community-based case-control study. Psychological Medicine 35, 907917.
Troop, NA, Treasure, JL (1997). Psychosocial factors in the onset of eating disorders: responses to life-events and difficulties. British Journal of Medical Psychology 70, 373385.
Vitousek, KB, Ewald, LS (1993). Self-representation in eating disorders: a cognitive perspective. In The Self in Emotional Distress: Cognitive and Psychodynamic Perspectives (ed. Segal, A. and Blatt, S.), pp. 221257. Guilford Press: New York.
Vitousek, KB, Hollon, SD (1990). The investigation of schematic content and processing in eating disorders. Cognitive Therapy and Research 14, 191214.
Wonderlich, SA, Mitchell, JE (1997). Eating disorders and comorbidity: empirical, conceptual, and clinical implications. Psychopharmacology Bulletin 33, 381390.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed