Risk factors across the eating disorders

Abstract

This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs.

Emotions mediate the relationship between autistic traits and disordered eating: A new autistic-emotional model for eating pathology

“…A number of inter-related risk factors have been associated with the development of eating disorders (EDs) (Culbert et al, 2015;Hilbert et al, 2014). One theoretical model of EDs, the cognitive-interpersonal model, asserts that traits associated with autism spectrum disorders (ASD), such as problems navigating interpersonal relationships and social-emotional difficulties, may act as both risk and maintaining factors for EDs .…”

Epidemiology of eating disorders part III: social epidemiology and case definitions revisited

“…However, both approaches to case definitions rely on observed (behavioral) as well as latent criteria (i.e., weight phobia and unjust evaluations of self and one's body), yet the number of latent criteria is increased within a transdiagnostic approach by the introduction of maintenance factors, i.e., dysfunctional perfectionism, mood intolerance, interpersonal difficulties and a profound low self-esteem. Such factors are also core clinical features of the DSM cluster B and C personality disorders associated with high anxiety and arousal, disorders which do occur in eating disorders.The transdiagnostic approach has received scientific support (e.g., Allan & Goss, 2014;Hinrichsen, Waller & Emanuelli, 2004;Hoiles, Egan & Kane, 2012; Dakanalis et al, 6 2014; Lampard, Byrne, McLean & Fursland, 2011;Tasca et al, 2011;Wade et al, 2006), yet tempered by gender (i.e., less support using male samples), diagnosis-specific pathways (i.e., more interpersonal problems related to unspecific eating disorders and more dysfunctional perfectionism related to anorexia and bulimia nervosa) and risk factors (Hilbert et al, 2014).Further validations will need research data generated from for instance, genetics and cognitive neuroscience. Following this track of science the NIMH 1 initiated in 2008 research within neuroscience, psychology and genetics to develop a future classification system based on latent variables or "constructs" (Cuthbert & Insel, 2014;Insel, 2014;Clark, Watson & Reynolds, 1995;Hyman, 2010;Insel et al, 2010;van Prag, 2000, Kendell & Jablensky, 2003 to understand the panorama of illnesses in the population beyond the accidential heritage of the ICD and DSM.…”

Análisis de las variables clínicas y sociodemográficas de los pacientes diagnosticados de un trastorno de la conducta alimentaria que buscan ayuda y su remisión a diferentes dispositivos sanitarios

“…Estudiar los resultados en los TCA es sumamente complejo, debido al curso de la enfermedad, la alta transición entre las categorías diagnósticas de los trastornos alimentarios y las frecuentes recaídas (Ackard et al, 2011;Carter et al, 2012;Eddy et al, 2008;Hilbert et al, 2014;Milos et al, 2005;Stice y Fairburn, 2003). A pesar de estas dificultades, existen ya algunas investigaciones que se han centrado en estudiar los predictores que median en el resultado de los TCA (Agencia de Investigación y Calidad de la Salud, 2015; Berkman, Lohr y Shapiro et al, 2007;Vall y Wade, 2015).…”

“…En el caso de la AN; la información encontrada acerca de los factores predictores del resultado para la AN es inconsistente Hilbert et al, 2014), aunque en general los predictores de resultado en la AN con mayor evidencia son la edad de inicio, el bajo peso, la gravedad de las preocupaciones y comportamientos relacionados con el trastorno alimentario, conductas purgativas como el atracón y el vómito autoinducido, la existencia de comorbilidades psiquiátricas y duración de la enfermedad (Bachner-Melman et al, 2006;Berkman et al, 2007;Couturier y Lock, 2006;Fichter et al, 2006;Keski-Rahkonen et al, 2014;Strober et al, 1997;Steinhausen, 2002;Yackobovitch-Gavan et al, 2009;Zerwas et al, 2013).…”

“…Por su parte, los predictores de resultado en la BN se relacionan con antecedentes personales y familiares de obesidad, la presencia de otros diagnósticos comórbidos psiquiátricos, problemas en el entorno familiar, dificultad de adaptación en el entorno social y baja motivación Carter et al, 2012;Fichter y Quadglieg, 2004;Hilbert et al, 2014). Entre las variables de pretratamiento asociadas a un pobre resultado en el tratamiento de la BN se encuentran en la literatura la baja autoestima (Baell y Wertheim, 1992;Fairburn, Kirk, O´Connor, Cooper, 1987;Fairburn, Peveler, Jones, Hope, Doll, 1993), bajo peso o diagnóstico de anorexia nerviosa previo (Lacey, 1983;Wilson, Rossiter, Kiefield, Lindholm, 1986), una elevada frecuencia o gravedad del atracón (Baell y Wertheim, 1992;Bossert, Schmeolz, Wiegand, Junker y Krieg, 1992;Bulik, Sullivan, Joyce, Carter, McIntosh, 1998;Garner, Olmsted, Davis, Rockert, Goldbloom y Eagle, 1990;Tumbull, Schmidt, Troop, Tiller, Todd y Treasure, 1997; Wilson, Loeb, Walsh, Labouvie, Petkova, Liu y Watermaux, 1999), la existencia de comorbilidad con trastornos de personalidad (Garner et al, 1990;Rossiter, Agras, Telch, Schneider, 1993;Stieger, Leung, Thibaudeau y Houle, 1993;Waller, 1997) o depresión mayor (Bossert, 1992;Bulik, 1998;Davis, Olmsted y Rockert, 1992) e historia previa de obesidad (Bulik, 1998).…”