We are family—parents, siblings, and eating disorders in a prospective total‐population study of 250,000 Swedish males and females

Ahrén, Jennie C.; Chiesa, Flaminia; Koupil, Ilona; Magnusson, Cecilia; Dalman, Christina; Goodman, Anna

doi:10.1002/eat.22146

Cited by 35 publications

(55 citation statements)

References 47 publications

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“…On the contrary, a larger absolute number of cases occurred among daughters of less educated parents (Table 1), because they represent a larger share of the population. Nevertheless, the higher rate of female ED in high SEP families supports three previous large studies [5]–[7] and extends these by suggesting that the same is true for anorexia nervosa in males (see also [28]). …”

Section: Discussionsupporting

confidence: 85%

“…Compared to previous large studies [5]–[7], we used a wider range of socio-economic indicators and had sufficient power, at least in females, to subdivide these more finely (e.g. distinguishing post-graduate versus tertiary-level education).…”

Section: Discussionmentioning

confidence: 99%

“…Several British and Swedish studies also suggest that hospitalisation for ED may be unusual among physical and mental disorders in showing a positive association with higher family socio-economic position (SEP) [5]–[7], although other population-based studies (based upon fewer ED cases) report mixed or null results [8]–[10]. There thus remains some uncertainty as to whether, or in what settings, high SEP predicts an increased risk of ED, but the potential importance of this issue is highlighted by the large population health impacts that might plausibly accompany any effect.…”

Section: Introductionmentioning

confidence: 99%

“…There thus remains some uncertainty as to whether, or in what settings, high SEP predicts an increased risk of ED, but the potential importance of this issue is highlighted by the large population health impacts that might plausibly accompany any effect. For example, one recent large Swedish study reported a population attributable fraction of 24% between mother's education and daughter's ED [5]. Further understanding of the nature and causes of this association, and how any association is changing over time, may inform the design of public health prevention programmes.…”

Section: Introductionmentioning

confidence: 99%

“…Most previous large studies (>500 cases) have, however, focussed either upon anorexia nervosa alone [6], [7] or else upon ED as a group [5]. This has prompted the critique that such studies could distract from or obscure a possible negative association between SEP and non-anorexia ED (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Family History of Education Predicts Eating Disorders across Multiple Generations among 2 Million Swedish Males and Females

2014

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PurposeTo investigate which facets of parent and grandparent socio-economic position (SEP) are associated with eating disorders (ED), and how this varies by ED subtype and over time.MethodsTotal-population cohort study of 1,040,165 females and 1,098,188 males born 1973–1998 in Sweden, and followed for inpatient or outpatient ED diagnoses until 2010. Proportional hazards models estimated associations with parental education, income and social class, and with grandparental education and income.Results15,747 females and 1051 males in our sample received an ED diagnosis, with rates increasing in both sexes over time. ED incidence in females was independently predicted by greater educational level among the father, mother and maternal grandparents, but parent social class and parental income showed little or no independent effect. The associations with education were equally strong for anorexia nervosa, bulimia nervosa and ED not-otherwise-specified, and had increased over time. Among males, an apparently similar pattern was seen with respect to anorexia nervosa, but non-anorexia ED showed no association with parental education and an inverse association with parental income.ConclusionsFamily history of education predicts ED in gender- and disorder-specific ways, and in females the effect is observed across multiple generations. Particularly given that these effects may have grown stronger in more recent cohorts, these findings highlight the need for further research to clarify the underlying mechanisms and identify promising targets for prevention. Speculatively, one such mechanism may involve greater internal and external demands for academic success in highly educated families.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Family History of Education Predicts Eating Disorders across Multiple Generations among 2 Million Swedish Males and Females

2014

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Parental mental illness and eating disorders in offspring

Bould

Koupil

Dalman

et al. 2014

Intl J Eating Disorders

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“Holy anorexia”—relevant or relic? Religiosity and anorexia nervosa among Finnish women

Sipilä

Harrasova

Mustelin

et al. 2017

Intl J Eating Disorders

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Since medieval times, an association between religiosity and anorexia nervosa has been suggested, but few systematic studies exist. This study examines in a nationwide setting whether personal or family religiosity is associated with lifetime anorexia nervosa among women in adolescence and early adulthood. Women (N = 2,825) from the 1975 to 1979 birth cohorts of Finnish twins were screened for lifetime DSM-5 anorexia nervosa (N = 92). Parental religiosity was assessed by self-report when the women were aged 16 years. The women self-reported their religiosity at ages 16 and 22 to 27 years. Parental religiosity did not increase the risk of lifetime anorexia nervosa, and neither did religiosity of the women themselves in adolescence. In early adulthood, a J-shaped curve was compatible with the data, indicating increased risk both at low and high levels of religiosity, but this result was statistically non-significant. Religiosity was weakly negatively correlated with body dissatisfaction. There was some suggestive evidence for socioregional variation in the association of religiosity with lifetime anorexia nervosa. In this first population study to directly address religiosity and anorexia nervosa, no evidence was found for a significant association of religiosity with anorexia nervosa either at the personal or family level. Some regional differences are possible. A modest protective association of religiosity with body dissatisfaction is also possible. Despite compelling case descriptions of "holy anorexia," religiosity does not appear to be a central factor in the development of anorexia nervosa in Finland, a highly secularized Christian country.

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We are family—parents, siblings, and eating disorders in a prospective total‐population study of 250,000 Swedish males and females

Cited by 35 publications

References 47 publications

Family History of Education Predicts Eating Disorders across Multiple Generations among 2 Million Swedish Males and Females

Family History of Education Predicts Eating Disorders across Multiple Generations among 2 Million Swedish Males and Females

Parental mental illness and eating disorders in offspring

“Holy anorexia”—relevant or relic? Religiosity and anorexia nervosa among Finnish women

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