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Barakat S, McLean SA, Bryant E, Le A, Marks P, Touyz S, Maguire S. Risk factors for eating disorders: findings from a rapid review. J Eat Disord 2023; 11:8. [PMID: 36650572 PMCID: PMC9847054 DOI: 10.1186/s40337-022-00717-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/04/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Risk factors represent a range of complex variables associated with the onset, development, and course of eating disorders. Understanding these risk factors is vital for the refinement of aetiological models, which may inform the development of targeted, evidence-based prevention, early intervention, and treatment programs. This Rapid Review aimed to identify and summarise research studies conducted within the last 12 years, focusing on risk factors associated with eating disorders. METHODS The current review forms part of a series of Rapid Reviews to be published in a special issue in the Journal of Eating Disorders, funded by the Australian Government to inform the development of the National Eating Disorder Research and Translation Strategy 2021-2031. Three databases were searched for studies published between 2009 and 2021, published in English, and comprising high-level evidence studies (meta-analyses, systematic reviews, moderately sized randomised controlled studies, moderately sized controlled-cohort studies, or population studies). Data pertaining to risk factors for eating disorders were synthesised and outlined in the current paper. RESULTS A total of 284 studies were included. The findings were divided into nine main categories: (1) genetics, (2) gastrointestinal microbiota and autoimmune reactions, (3) childhood and early adolescent exposures, (4) personality traits and comorbid mental health conditions, (5) gender, (6) socio-economic status, (7) ethnic minority, (8) body image and social influence, and (9) elite sports. A substantial amount of research exists supporting the role of inherited genetic risk in the development of eating disorders, with biological risk factors, such as the role of gut microbiota in dysregulation of appetite, an area of emerging evidence. Abuse, trauma and childhood obesity are strongly linked to eating disorders, however less conclusive evidence exists regarding developmental factors such as role of in-utero exposure to hormones. Comorbidities between eating disorders and mental health disorders, including personality and mood disorders, have been found to increase the severity of eating disorder symptomatology. Higher education attainment, body image-related factors, and use of appearance-focused social media are also associated with increased risk of eating disorder symptoms. CONCLUSION Eating disorders are associated with multiple risk factors. An extensive amount of research has been conducted in the field; however, further studies are required to assess the causal nature of the risk factors identified in the current review. This will assist in understanding the sequelae of eating disorder development and in turn allow for enhancement of existing interventions and ultimately improved outcomes for individuals.
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Affiliation(s)
- Sarah Barakat
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia. .,Faculty of Medicine and Health, Charles Perkins Centre (D17), InsideOut Institute, University of Sydney, Level 2, Sydney, NSW, 2006, Australia.
| | - Siân A McLean
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Emma Bryant
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, Australia
| | - Peta Marks
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | | | - Stephen Touyz
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
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2
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Pappaianni E, Barona M, Doucet GE, Clark C, Frangou S, Micali N. Neurocognitive Endophenotypes for Eating Disorders: A Preliminary High-Risk Family Study. Brain Sci 2023; 13:brainsci13010099. [PMID: 36672080 PMCID: PMC9856317 DOI: 10.3390/brainsci13010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Eating disorders (EDs) are psychiatric disorders with a neurobiological basis. ED-specific neuropsychological and brain characteristics have been identified, but often in individuals in the acute phase or recovered from EDs, precluding an understanding of whether they are correlates and scars of EDs vs. predisposing factors. Although familial high-risk (FHR) studies are available across other disorders, this study design has not been used in EDs. We carried out the first FMH study in EDs, investigating healthy offspring of women with EDs and controls. We preliminarily aimed to investigate ED-related neurocognitive and brain markers that could point to predisposing factors for ED. Sixteen girls at FHR for EDs and twenty control girls (age range: 8−15), completed neuropsychological tests assessing executive functions. Girls also underwent a resting-state fMRI scan to quantify functional connectivity (FC) within resting-state networks. Girls at FHR for EDs performed worse on a cognitive flexibility task compared with controls (F = 5.53, p = 0.02). Moreover, they showed different FC compared with controls in several resting-state networks (p < 0.05 FDR-corrected). Differences identified in cognitive flexibility and in FC are in line with those identified in individuals with EDs, strongly pointing to a role as potential endophenotypes of EDs.
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Affiliation(s)
- Edoardo Pappaianni
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark
| | - Manuela Barona
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Gaelle E. Doucet
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA
| | - Christopher Clark
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Nadia Micali
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
- Correspondence:
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Poletti M, Preti A, Raballo A. Eating Disorders and Psychosis as Intertwined Dimensions of Disembodiment: A Narrative Review. CLINICAL NEUROPSYCHIATRY 2022; 19:187-192. [PMID: 35821871 PMCID: PMC9263683 DOI: 10.36131/cnfioritieditore20220307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although psychosis is not one of the most commonly recognized psychiatric comorbidities of Eating Disorders (ED), there is an increasing empirical evidence of associations between these psychopathological conditions. Indeed, ED as well as early manifestations of schizophrenic psychosis emerge during developmental years and might present some affinities in the presentation at onset. For example, adolescents with anorexia nervosa (AN) may report psychotic-like eating-related symptoms such as delusional-like body image distortions and/or "anorexic voice". Conversely, early expressions of schizophrenia spectrum vulnerability might involve altered bodily experiences, delusional ideation on food and eating as well as pseudo-anorectic behaviors. From a phenomenological perspective, this partial symptomatic overlap may lie on common features of disturbed corporeality in terms of disembodiment, although these alterations of embodiment are presumably rooted in distinct pathogenetic pathways (e.g., primary childhood ontogenetic pathway in schizophrenia vs. a secondary adolescent ontogenetic pathway in AN). A clinical-phenomenological attitude could be important not only to better discern potential overlaps and affinities between the two conditions, but also to better conceptualize and treat those background alterations of the embodied self. In particular, a phenomenological exploration of the experiential side of eating-related behaviors could be a decisive step to support early differential diagnosis and treatment appropriateness.
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Affiliation(s)
- Michele Poletti
- Department of Mental Health and Pathological Addiction, Child and Adolescent Mental Health Service, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy,Corresponding author Michele Poletti Department of Mental Health and Pathological Addiction, Child and Adolescent Neuropsychiatry Service, Azienda USL-IRCCS di Reggio Emilia, Via Amendola 2, Reggio Emilia, Italy, phone +39052233550 E-mail:
| | | | - Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy,Center for Translational, Phenomenological and Developmental Psychopathology
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Herbrich-Bowe L, Bentz LK, Correll CU, Kappel V, van Noort BM. Randomized controlled trial of cognitive remediation therapy in adolescent inpatients with anorexia nervosa: Neuropsychological outcomes. EUROPEAN EATING DISORDERS REVIEW 2022; 30:772-786. [PMID: 35607258 DOI: 10.1002/erv.2921] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/21/2022] [Accepted: 05/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Neuropsychological dysfunction exists in anorexia nervosa (AN). Cognitive Remediation Therapy (CRT), mainly evaluated in adults with AN, targets these impairments. METHODS Adolescent inpatients (age = 11-17 years) with AN were randomized to 5 weeks of either 10 sessions of individually delivered CRT or non-specific cognitive-training (NSCT). Co-primary outcomes included cognitive domain 'flexibility' [composite score of Wisconsin Card Sorting Test (WSCT) and Trail Making Test (TMT-4)] and 'central coherence' [composite score of Central Coherence Index (CCI) and Group Embedded Figures Test (GEFT)] at end of treatment (FU1). Secondary outcomes included individual test scores and self-reported everyday-life flexibility at FU1 and at 6-months post-treatment (FU2). Independent sample t-tests, Pearson chi-square-tests and mixed models for repeated measures (MMRM) analyses were conducted. RESULTS In 56 females (age = 15.1 ± 1.5 years), CRT was not superior to NSCT at FU1 regarding 'flexibility' (p = 0.768) or 'central coherence' (p = 0.354), nor at FU2 (p = 0.507; p = 0.624) (effect sizes = 0.02-0.26). Both groups improved over time in central coherence (CCI p = 0.001; GEFT p < 0.001), self-reported flexibility (p = 0.002) and WCST (p = 0.18), but not TMT-4 (p = 0.286). NSCT was superior to CRT regarding self-reported planning/organisation ability at FU1 (p < 0.001) and FU2 (p = 0.003). CONCLUSIONS CRT was not superior to NSCT in adolescent inpatients with AN. More randomized controlled studies are needed.
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Affiliation(s)
- Laura Herbrich-Bowe
- Department for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, Germany
| | - Lea K Bentz
- Department for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, Germany
| | - Christoph U Correll
- Department for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, Germany.,Department of Psychiatry, Northwell Health, Glen Oaks, New York, USA.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - Viola Kappel
- Department for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitätsmedizin Berlin, Germany
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Steegers C, Dieleman G, Moskalenko V, Santos S, Hillegers M, White T, Jansen PW. The longitudinal relationship between set-shifting at 4 years of age and eating disorder related features at 9 years of age in the general pediatric population. Int J Eat Disord 2021; 54:2180-2191. [PMID: 34716719 PMCID: PMC9298047 DOI: 10.1002/eat.23633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Individuals with anorexia nervosa (AN) tend to have rigid thoughts and behaviors regarding their body weight, body image, and eating habits. While a diagnosis of AN implies severe levels of impairment, AN traits can vary on a continuum within the population. However, little is known about how early markers of AN relate to rigid thought patterns and to what extent cognitive rigidity is already present in early childhood. We examined the association of set-shifting abilities as a measure of cognitive flexibility in preadolescents with AN-related features. METHODS Participants included 3,987 children participating in the Generation R Study, a Dutch population-based birth cohort. Set-shifting abilities (mother report) were assessed at 4 years of age, body mass index (BMI) was determined at 4 and 9 years and restrictive eating patterns (mother report) and body image (child report) were assessed at 9 years. RESULTS Lower set-shifting abilities at 4 years were associated with a lower BMI (β = -.44, p = 2.2 × 10-4 ) in girls, and more restrictive eating (β = 0.15, p = 2.7 × 10-6 ) in both boys and girls at 9 years of age. Moreover, set-shifting at age 4 was not associated with body image at age 9. CONCLUSION These findings contribute to the idea that the association between set-shifting problems and AN-related features are present early in childhood, prior to the typical range of the onset of eating disorders (EDs). Longitudinal studies that capture the peak age for the development of EDs will be important to assess whether early cognitive inflexibility is an early marker of AN.
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Affiliation(s)
- Cathelijne Steegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐Sophia Children's HospitalRotterdamThe Netherlands
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐Sophia Children's HospitalRotterdamThe Netherlands
| | - Valeria Moskalenko
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐Sophia Children's HospitalRotterdamThe Netherlands
| | - Susana Santos
- The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands,Department of Pediatrics, Erasmus MC – Sophia Children's HospitalUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐Sophia Children's HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐Sophia Children's HospitalRotterdamThe Netherlands,Department of Radiology and Nuclear MedicineErasmus MCRotterdamThe Netherlands
| | - Pauline W. Jansen
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐Sophia Children's HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands,Department of Psychology, Education, and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
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Martini MG, Barona-Martinez M, Micali N. Eating disorders mothers and their children: a systematic review of the literature. Arch Womens Ment Health 2020; 23:449-467. [PMID: 31938867 PMCID: PMC7368867 DOI: 10.1007/s00737-020-01019-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
To provide an overview of the impact of maternal eating disorders (ED) on child development in a number of domains including feeding and eating behaviour, neuropsychological profile and cognitive development, psychopathology and temperament. PubMed, Embase and PsychInfo were searched for studies exploring the impact of maternal ED on children between January 1980 and September 2018. Initial search yielded 569 studies. After exclusion, 32 studies were reviewed. Overall, available evidence shows that children of mothers with ED are at increased risk of disturbances in several domains. They exhibit more difficulties in feeding and eating behaviours, display more psychopathological and socio-emotional difficulties, and they are more likely to be described as having a difficult temperament. Maternal ED have an impact on child psychological, cognitive and eating behaviours, and might affect the development of ED in the offspring. Future research should focus on resilience and on which protective factors might lead to positive outcomes. These factors can be then used as therapeutic and preventative targets.
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Affiliation(s)
- Maria Giulia Martini
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 4th Floor, 30 Guilford Street, London, WC1N 1EH, UK.
- South London and Maudsley, NHS Foundation Trust, London, UK.
| | - Manuela Barona-Martinez
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 4th Floor, 30 Guilford Street, London, WC1N 1EH, UK
| | - Nadia Micali
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 4th Floor, 30 Guilford Street, London, WC1N 1EH, UK
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
- Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, University Hospital Geneva, Geneva, Switzerland
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7
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Abstract
PURPOSE OF REVIEW Our primary goal in this article is to review recent findings (from 2015 and on) concerning children of parents with eating disorders. This review addresses the question of whether the offspring of parents with past or present eating disorders have adverse outcomes. This update is timely and informative because recent research includes controlled studies and large cohort designs and earlier reviews relied on case report evidence. RECENT FINDINGS Despite substantial diversity in study design, sample size, and parental eating disorder definition, overall, existing research suggests that the children of parents with eating disorders exhibit compromised development: a greater risk of perinatal complications; a tendency toward extremes of growth at birth; greater problems in feeding and eating behaviors and greater incidence of eating disorder symptoms; more psychological and socioemotional difficulties; and more negative qualities to parent-child interactions. Data on children's cognitive outcomes is thus far inconsistent. Given the relatively high incidence of eating disorder history in individuals of childbearing age, research into its potential effects on children is necessary. However, the methodological shortcomings and a limited evidence base caution in drawing conclusions. Nevertheless, mental health services should address the possible problems that these children face and offer tailored programs.
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Affiliation(s)
- Hunna J Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC, 27599-7160, USA. .,School of Psychology, Curtin University, Perth, WA, Australia. .,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.
| | - Amy O'Brien
- School of Psychology, Curtin University, Perth, WA, Australia
| | - Shiri Sadeh-Sharvit
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Herzliya, Israel
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Barona M, Taborelli E, Corfield F, Pawlby S, Easter A, Schmidt U, Treasure J, Micali N. Neurobehavioural and cognitive development in infants born to mothers with eating disorders. J Child Psychol Psychiatry 2017; 58:931-938. [PMID: 28452420 DOI: 10.1111/jcpp.12736] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs. METHODS Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8 days postpartum (active ED, n = 15; past ED, n = 20; healthy controls, n = 28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1-year postpartum (active ED, n = 18; past ED, n = 19; healthy controls, n = 28). In order to maintain the largest possible sample at each time point, sample size varied across time points. RESULTS Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B = -0.34 (-1.81, -0.26)]. Infants of mothers with a past ED had poorer language [B = -0.33 (-13.6, -1.9)] and motor development [B = -0.32 (-18.4, -1.3)] compared with healthy controls. CONCLUSIONS Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1 year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED.
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Affiliation(s)
| | | | - Freya Corfield
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Susan Pawlby
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Abigail Easter
- Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Ulrike Schmidt
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Janet Treasure
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Nadia Micali
- Institute of Child Health, UCL, London, UK.,Department of Psychiatry, Icahn Medical School at Mount Sinai, New York, NY, USA.,Mindich Child Health and Development Institute, Icahn Medical School at Mount Sinai, New York, NY, USA
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Herbrich L, van Noort B, Pfeiffer E, Lehmkuhl U, Winter S, Kappel V. Follow-up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study. EUROPEAN EATING DISORDERS REVIEW 2017; 25:104-113. [DOI: 10.1002/erv.2501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/18/2016] [Accepted: 12/02/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Laura Herbrich
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Betteke van Noort
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Ernst Pfeiffer
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Ulrike Lehmkuhl
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Sibylle Winter
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
| | - Viola Kappel
- Department for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; Charité - Universitätsmedizin Berlin; Germany
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van Noort BM, Pfeiffer E, Ehrlich S, Lehmkuhl U, Kappel V. Cognitive performance in children with acute early-onset anorexia nervosa. Eur Child Adolesc Psychiatry 2016; 25:1233-1244. [PMID: 27083433 DOI: 10.1007/s00787-016-0847-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 04/06/2016] [Indexed: 01/09/2023]
Abstract
When anorexia nervosa (AN) occurs in children below the age of 14 years, it is referred to as early-onset AN (EO-AN). Over the last years, there has been an increased focus on the role of cognitive functioning in the development and maintenance of AN. Adults with AN show inefficiencies in cognitive functions such as flexibility and central coherence. Systematic neuropsychological examinations of patients with EO-AN are missing. Thirty children with EO-AN and 30 adolescents with AN, as well as 60 healthy controls (HC) underwent an extensive neuropsychological examination. ANOVAs with post hoc tests and explorative regression analyses were conducted. Patients with EO-AN (mean age = 2.17 ± 1.57 years) showed no significant differences in flexibility, inhibition, planning, central coherence, visuospatial short- and long-term memory or recognition in comparison to HC (mean age = 11.62 ± 1.29 years). Performance of adolescents with AN (mean age = 15.93 ± 0.70 years) was not significantly different compared to HC (mean age = 16.20 ± 1.26 years). Explorative regression analyses revealed a significant interaction of age and group for flexibility (adjusted R 2 = 0.30, F = 17.85, p = 0.013, η p2 = 0.32). Contrary to expectations, the current study could not confirm the presence of inefficient cognitive processing in children with EO-AN compared to HC. Nonetheless, the expected age-related improvement of flexibility might be disrupted in children and adolescents with AN. Longitudinal neuropsychological examinations are necessary to provide more information about the role of cognitive functioning in the development and maintenance of AN.
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Affiliation(s)
- Betteke Maria van Noort
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Ernst Pfeiffer
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus , Technische Universität Dresden, Dresden, Germany
| | - Ulrike Lehmkuhl
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Viola Kappel
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Seike K, Nakazato M, Hanazawa H, Ohtani T, Niitsu T, Ishikawa SI, Ayabe A, Otani R, Kawabe K, Horiuchi F, Takamiya S, Sakuta R. A questionnaire survey regarding the support needed by Yogo teachers to take care of students suspected of having eating disorders (second report). Biopsychosoc Med 2016; 10:28. [PMID: 27708695 PMCID: PMC5041275 DOI: 10.1186/s13030-016-0079-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The lowering of the age of onset and chronicity have been key problems related to eating disorders (EDs). As the proportion of teens in the estimated onset ages has increased, it has become important to detect students with EDs and to clarify how they can be supported. Though epidemiological surveys of Yogo teachers (school nurse/health science teachers) have been conducted to inquire about the number of such students, none of these were done according to ED type based on DSM-5. Thus, we conducted a wide area survey in Japan with the goal of proposing a better framework of support for Yogo teachers in their efforts to care for students with EDs. METHODS A questionnaire survey organized by ED type (based on DSM-5) was administered to Yogo teachers working at elementary/junior high/senior high/special needs schools in four prefectures of Japan in 2015, and 1,886 responses were obtained. Based on the results, the encounter rates (the proportion of Yogo teachers who had encountered a student with an ED) were calculated, and factors that could affect the rates were examined by logistic regression analysis. RESULTS The order of the encounter rates of the ED types was as follows: Anorexia Nervosa (AN) > Bulimia Nervosa (BN) > Avoidant/Restrictive Food Intake Disorder (ARFID) > Binge Eating Disorder (BED) > Others. The factors significantly affecting the rates were "location, school type, number of students, experience years, and AN knowledge" for AN, "school type, experience years, and BN knowledge" for BN, "school type, experience years, and BED knowledge" for BED, "location, experience years, and ARFID knowledge" for ARFID, and "school type, experience years, and Others knowledge" for Others. CONCLUSIONS Because the encounter rate of AN was the highest, providing support for AN would be the most effective. Moreover, one factor that affected the encounter rate of all ED types was ED knowledge. In addition to this, senior high schools had the highest encounter rates for AN, BN and BED, and special needs schools had the highest rates for Others. These findings imply that, in order to detect and support ED students at an early stage, it is necessary to offer knowledge of the most prevalent ED types to Yogo teachers at the corresponding school type.
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Affiliation(s)
- Kaoru Seike
- United Graduate School of Child Development, Osaka University, 2 Yamadaoka, Suita-city, Osaka Prefecture 565-0871 Japan ; Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan
| | - Michiko Nakazato
- United Graduate School of Child Development, Osaka University, 2 Yamadaoka, Suita-city, Osaka Prefecture 565-0871 Japan ; Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan
| | - Hisashi Hanazawa
- Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan ; Faculty of Education, Chiba University, 1-33 Yayoi, Inage-ku, Chiba-city, Chiba Prefecture 263-0022 Japan
| | - Toshiyuki Ohtani
- Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan ; Safety and Health Organization, Chiba University, 1-33 Yayoi, Inage-ku, Chiba-city, Chiba Prefecture 263-0022 Japan
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan
| | - Shin-Ichi Ishikawa
- Department of Psychiatry, Nishi-Kobe Medical Center, Kobe, 5-7-1 Koujidai, Nishi-ku, Kobe-city, Hyogo Prefecture 651-2273 Japan ; Kishibe Psychiatry Clinic, 1-24-1 Kishibe Minami, Suita-city, Osaka Prefecture 564-0011 Japan
| | - Atsuko Ayabe
- Center for Child Development and Psychosomatic Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-koshigaya, Koshigaya-city, Saitama Prefecture 343-0845 Japan
| | - Ryoko Otani
- Center for Child Development and Psychosomatic Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-koshigaya, Koshigaya-city, Saitama Prefecture 343-0845 Japan
| | - Kentaro Kawabe
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Shitsukawa Toon-City, Ehime Prefecture 791-0204 Japan ; Center for Child Health, Behavior and Development, Ehime University Hospital, Shitsukawa Toon-City, Ehime Prefecture 791-0204 Japan
| | - Fumie Horiuchi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Shitsukawa Toon-City, Ehime Prefecture 791-0204 Japan ; Center for Child Health, Behavior and Development, Ehime University Hospital, Shitsukawa Toon-City, Ehime Prefecture 791-0204 Japan
| | - Shizuo Takamiya
- Department of Psychiatry, Nishi-Kobe Medical Center, Kobe, 5-7-1 Koujidai, Nishi-ku, Kobe-city, Hyogo Prefecture 651-2273 Japan ; Takamiya Mental Clinic, Akashi, Marunouchi Bldg 5F, 2-5-2 Marunouchi, Akashi-city, Hyogo Prefecture 673-0016 Japan
| | - Ryoichi Sakuta
- Center for Child Development and Psychosomatic Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-koshigaya, Koshigaya-city, Saitama Prefecture 343-0845 Japan
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12
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Sadeh-Sharvit S, Zubery E, Mankovski E, Steiner E, Lock JD. Parent-based prevention program for the children of mothers with eating disorders: Feasibility and preliminary outcomes. Eat Disord 2016; 24:312-25. [PMID: 26940552 DOI: 10.1080/10640266.2016.1153400] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The children of mothers with eating disorders are at high risk of feeding and eating problems and broader developmental difficulties. The Parent-Based Prevention (PBP) of eating disorders targets risk factors and facilitates behavioral change in parents to mitigate potentially negative outcomes of their children. This pre/post uncontrolled study evaluated the feasibility and preliminary outcomes of PBP. PBP was found to be a feasible intervention for mothers with eating disorders and their spouses, with satisfactory retention rates. A total of 16 intact families were assessed at three measurement points for parents' feeding practices, child outcomes, and maternal functioning. Both parents reported improved feeding practices as well as more positive perceptions of their children in comparison to baseline. These pilot findings suggest that PBP is linked with decreased risk of eating and mental problems among the offspring of mothers with eating disorders.
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Affiliation(s)
- Shiri Sadeh-Sharvit
- a Department of Psychiatry and Behavioral Sciences , School of Medicine, Stanford University , Stanford , California , USA.,b Eating Disorders Treatment and Research Center, Hanotrim (Davidson) Clinic, Raanana , Shalvata Mental Health Center , Hod Hasharon , Israel
| | - Eynat Zubery
- b Eating Disorders Treatment and Research Center, Hanotrim (Davidson) Clinic, Raanana , Shalvata Mental Health Center , Hod Hasharon , Israel
| | - Esty Mankovski
- b Eating Disorders Treatment and Research Center, Hanotrim (Davidson) Clinic, Raanana , Shalvata Mental Health Center , Hod Hasharon , Israel
| | - Evelyne Steiner
- b Eating Disorders Treatment and Research Center, Hanotrim (Davidson) Clinic, Raanana , Shalvata Mental Health Center , Hod Hasharon , Israel
| | - James D Lock
- a Department of Psychiatry and Behavioral Sciences , School of Medicine, Stanford University , Stanford , California , USA
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13
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Seike K, Hanazawa H, Ohtani T, Takamiya S, Sakuta R, Nakazato M. A Questionnaire Survey of the Type of Support Required by Yogo Teachers to Effectively Manage Students Suspected of Having an Eating Disorder. Biopsychosoc Med 2016; 10:15. [PMID: 27168762 PMCID: PMC4862230 DOI: 10.1186/s13030-016-0065-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/11/2016] [Indexed: 11/29/2022] Open
Abstract
Background Many studies have focused on the decreasing age of onset of eating disorders (EDs). Because school-age children with EDs are likely to suffer worse physical effects than adults, early detection and appropriate support are important. The cooperation of Yogo teachers is essential in helping these students to find appropriate care. To assist Yogo teachers, it is helpful to clarify the encounter rates (the proportion of Yogo teachers who have encountered ED students) and kinds of requested support (which Yogo teachers felt necessary to support ED students). There are no studies that have surveyed the prevalence rates of ED children by ED type as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), nor were we able to find any quantitative study surveying the kinds of support Yogo teachers feel helpful to support ED students. Methods A questionnaire survey was administered to 655 Yogo teachers working at elementary/junior high/senior high/special needs schools in Chiba Prefecture. The questionnaire asked if the respondents had encountered students with each of the ED types described in DSM-5 (anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), and other types of EDs (Others)), and the kinds of support they felt necessary to support these students. The encounter rates and the kinds of requested were obtained and compared, taking their confidence intervals into consideration. Results The encounter rates for AN, BN, BED, ARFID, and Others were 48.4, 14.0, 8.4, 10.7, and 4.6 %, respectively. When classified by school type, AN, BN, BED, and ARFID had their highest encounter rates in senior high schools. Special needs schools had the highest rate for Others. The support most required for all ED types was “a list of medical/consultation institutions.” Conclusions Our results have clarified how to support Yogo teachers in the early detection and support of ED students. We found that the encounter rate of AN was the highest, and that it is effective to offer “a list of medical/consultation institutions” to junior and senior high schools where the encounter rates for AN are high.
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Affiliation(s)
- Kaoru Seike
- United Graduate School of Child Development, Osaka University, 2 Yamadaoka Suita-city, Osaka, Prefecture 565-0871 Japan ; Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan
| | - Hisashi Hanazawa
- Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan ; Faculty of Education, Chiba University, 1-33 Yayoi, Inage-ku, Chiba-city, Chiba Prefecture 263-0022 Japan
| | - Toshiyuki Ohtani
- Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan ; Safety and Health Organization, Chiba University, 1-33 Yayoi, Inage-ku, Chiba-city, Chiba Prefecture 263-0022 Japan
| | - Shizuo Takamiya
- Department of Psychiatry, Nishi-Kobe Medical Center, 5-7-1 Koujidai, Nishi-ku, Kobe-city, Hyogo, Prefecture 651-2273 Japan
| | - Ryoichi Sakuta
- Center for Child Development and Psychosomatic Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-koshigaya, Koshigaya-city, Saitama Prefecture 343-0845, Japan
| | - Michiko Nakazato
- United Graduate School of Child Development, Osaka University, 2 Yamadaoka Suita-city, Osaka, Prefecture 565-0871 Japan ; Research Center for Child Mental Development Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba Prefecture 260-8670 Japan
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14
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Sadeh-Sharvit S, Levy-Shiff R, Lock JD. Maternal eating disorder history and toddlers' neurodevelopmental outcomes: A brief report. Eat Disord 2016. [PMID: 26212212 DOI: 10.1080/10640266.2015.1064280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study explored the neurodevelopmental outcomes of toddlers whose mothers have eating disorder histories and the contribution of maternal eating and comorbid psychopathology to the children's cognitive functioning. Twenty-nine mothers with prenatal eating disorders and their toddlers (18-42 months old) were compared to a case-control matched group of mothers with no eating psychopathology and their toddlers. Measures included current maternal eating and co-occurring psychopathology, and a developmental assessment of each child. The children of mothers with eating disorders showed delayed mental and psychomotor development. Severity of maternal eating disorder symptoms emerged as a significant predictor of child development, but other maternal psychopathology did not. Findings suggest that maternal eating disorder history may play a unique role in the development of neurodevelopmental functions in their children.
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Affiliation(s)
- Shiri Sadeh-Sharvit
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA.,b Psychology Department , Bar Ilan University , Ramat Gan , Israel
| | | | - James D Lock
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
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15
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Postorino V, Fatta LM, Sanges V, Giovagnoli G, De Peppo L, Vicari S, Mazzone L. Intellectual disability in Autism Spectrum Disorder: Investigation of prevalence in an Italian sample of children and adolescents. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:193-201. [PMID: 26619372 DOI: 10.1016/j.ridd.2015.10.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/19/2015] [Accepted: 10/23/2015] [Indexed: 05/07/2023]
Affiliation(s)
- Valentina Postorino
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy; The Marcus Autism Center, Emory University School of Medicine, 1920 Briarcliff Road, NE, Atlanta, GA 30329, USA.
| | - Laura Maria Fatta
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Veronica Sanges
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Giulia Giovagnoli
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy; L.U.M.S.A., Libera Università Maria SS. Assunta, Dipartimento di Scienze Umane, Piazza delle Vaschette 101, 00193 Rome, Italy
| | - Lavinia De Peppo
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy; L.U.M.S.A., Libera Università Maria SS. Assunta, Dipartimento di Scienze Umane, Piazza delle Vaschette 101, 00193 Rome, Italy
| | - Stefano Vicari
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Luigi Mazzone
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
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16
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Treasure J, Zipfel S, Micali N, Wade T, Stice E, Claudino A, Schmidt U, Frank GK, Bulik CM, Wentz E. Anorexia nervosa. Nat Rev Dis Primers 2015; 1:15074. [PMID: 27189821 DOI: 10.1038/nrdp.2015.74] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. AN predominantly develops in adolescence in the peripubertal period. Without early effective treatment, the course is protracted with physical, psychological and social morbidity and high mortality. Despite these effects, patients are noted to value the beliefs and behaviours that contribute to their illness rather than regarding them as problematic, which interferes with screening, prevention and early intervention. Involving the family to support interventions early in the course of the illness can produce sustained changes; however, those with a severe and/or protracted illness might require inpatient nursing support and/or outpatient psychotherapy. Prevention programmes aim to moderate the overvaluation of 'thinness' and body dissatisfaction as one of the proximal risk factors. The low prevalence of AN limits the ability to identify risk factors and to study the timing and sex distribution of the condition. However, genetic profiles, premorbid features, and brain structures and functions of patients with AN show similarities with other psychiatric disorders and contrast with obesity and metabolic disorders. Such studies are informing approaches to address the neuroadaptation to starvation and the other various physical and psychosocial deficits associated with AN. This Primer describes the epidemiology, diagnosis, screening and prevention, aetiology, treatment and quality of life of patients with AN.
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Affiliation(s)
- Janet Treasure
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London SE5 8AF, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tuebingen, Tuebingen, Germany
| | - Nadia Micali
- University College London, Institute of Child Health, Behavioural and Brain Sciences Unit, London, UK.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Tracey Wade
- School of Psychology, Flinders University, Adelaide, Australia
| | - Eric Stice
- Oregon Research Institute, Eugene, Oregon, USA
| | - Angélica Claudino
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Ulrike Schmidt
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London SE5 8AF, UK
| | - Guido K Frank
- Eating Disorder Centre of Denver, University of Colorado, Denver, Colorado, USA
| | - Cynthia M Bulik
- University of North Carolina at Chapel Hill, North Carolina, USA.,Karolinska Institutet, Stockholm, Sweden
| | - Elisabet Wentz
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg Sweden
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17
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Kothari R, Easter A, Lewis R, Howard LM, Micali N. Intimate partner violence among women with eating disorders during the perinatal period. Int J Eat Disord 2015; 48:727-35. [PMID: 26032597 PMCID: PMC4737194 DOI: 10.1002/eat.22429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Prevalence of intimate partner violence (IPV) during pregnancy is estimated to be 4%-8%. Women with mental health difficulties are at increased risk for IPV during the perinatal period. Prevalence of IPV is high among women with eating disorders (ED); however, prevalence of IPV during the perinatal period among women with ED is unknown. METHOD We studied women from a population-based cohort, the Avon Longitudinal Study of Parents and Children. Prevalence and odds of physical and emotional IPV during and after the perinatal period was investigated among women with lifetime ED, with (n = 174) or without pregnancy shape and weight concern and/or purging behaviors (n = 189), and women with no ED (n = 8723). RESULTS Women with lifetime ED showed higher prevalence of IPV during and after the perinatal period (physical = 9.6%-14.3% and emotional = 24.1%-28.1%). Lifetime ED was associated with higher odds of physical IPV during the perinatal period (odds ratio: 2.34, 95% confidence interval: 1.11-4.93, p = .03). Lifetime ED with and without pregnancy shape and weight concerns and/or purging was associated with higher odds of IPV after the perinatal period, and higher odds of reporting emotional IPV at all time points. Associations were moderated by partner's response to pregnancy and maternal experience of childhood sexual abuse. DISCUSSION Mothers with ED and their children may be vulnerable to negative effects due to maternal ED and IPV combined, both of which have been associated with severe and long-lasting harmful consequences. Partner's response to pregnancy and maternal experience of childhood sexual abuse might contribute to the association between ED and IPV perinatally.
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Affiliation(s)
- Radha Kothari
- Behavioural and Brain Sciences Unit, UCL Institute of Child HealthUCL Division of Psychology and Language SciencesLondonUnited Kingdom
| | - Abigail Easter
- Behavioural and Brain Sciences Unit, UCL Institute of Child HealthUCL Division of Psychology and Language SciencesLondonUnited Kingdom
| | - Rebecca Lewis
- Behavioural and Brain Sciences Unit, UCL Institute of Child HealthUCL Division of Psychology and Language SciencesLondonUnited Kingdom
| | - Louise M. Howard
- Section for Women's Mental HealthKCL Institute of PsychiatryLondonUnited Kingdom
| | - Nadia Micali
- Behavioural and Brain Sciences Unit, UCL Institute of Child HealthUCL Division of Psychology and Language SciencesLondonUnited Kingdom
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18
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Kothari R, Barona M, Treasure J, Micali N. Social cognition in children at familial high-risk of developing an eating disorder. Front Behav Neurosci 2015; 9:208. [PMID: 26300753 PMCID: PMC4528178 DOI: 10.3389/fnbeh.2015.00208] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 07/22/2015] [Indexed: 01/31/2023] Open
Abstract
Objective: Diagnosis of an eating disorder (ED) has been associated with differences in social cognition. To date research investigating social cognition and ED has mainly employed patient and recovered samples. It is therefore unclear whether differences in social cognition are present prior to onset of ED, potentially contributing to development, or whether differences observed are a consequence of the disorder. We aimed to further explore whether individuals at high-risk for ED present social cognition characteristics previously found in ED groups. Methods: Our sample was drawn from a population-based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC). Data on maternal ED behaviors over the lifetime were collected through in-depth clinical interviews (n = 1128) conducted using the Structured Clinical Interview for DSM disorders (SCID), and were used to categorize mothers according to ED behaviors over the lifetime: Restricting and Excessive Exercising (n = 58), Purging (n = 70), Binge-eating (n = 72), Binging and Purging (n = 66), no ED (n = 862). High-risk status of children was determined using these maternal lifetime behavioral phenotypes. Children at high-risk (maternal ED exposure) were compared to children at low-risk (born to mothers with no ED) on three measures of social cognition: the Social Communication Disorders Checklist (SCDC) (n = 922), the faces subtest of the Diagnostic Analysis of Non-Verbal Accuracy (DANVA) (n = 722), and the Emotional Triangles Task (n = 750). Results: Children at high-risk for ED showed poorer performance on measures of social cognition compared to children at low-risk. Maternal lifetime binge-eating, and maternal lifetime binging and purging were associated with poorer social communication in children (OR: 2.4, 95% CI: 1.0, 5.7, p = 0.05; and OR: 2.7, 95% CI: 1.1, 6.5, p = 0.03 respectively). Maternal binging and purging was also found to be associated with differential facial emotion processing and poorer recognition of fear from social motion cues (B: −0.7, 95% CI: −1.1, −0.2, p = 0.004). Discussion: Children at high-risk for ED showed slight differences in some areas of social cognition when compared to children at low-risk. Characteristic patterns in social cognition are present in children at high-risk for ED, particularly among children whose mothers have binge-eating and purging behaviors over the lifetime. Our findings support the hypothesis that these differences may be part of an intermediate phenotype for ED: perhaps contributing to development, or perhaps indexing a shared liability with psychiatric disorders characterized by abnormal social cognition.
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Affiliation(s)
- Radha Kothari
- Behavioural and Brain Sciences, Institute of Child Health, University College London London, UK ; Division of Psychology and Language Sciences, University College London London, UK
| | - Manuela Barona
- Behavioural and Brain Sciences, Institute of Child Health, University College London London, UK
| | - Janet Treasure
- Psychological Medicine, King's College London Institute of Psychiatry London, UK
| | - Nadia Micali
- Behavioural and Brain Sciences, Institute of Child Health, University College London London, UK ; Department of Psychiatry, Icahn Medical School at Mount Sinai New York, NY, USA ; Mindich Child health and Development Institute, Icahn Medical School at Mount Sinai New York, NY, USA
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19
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Micali N, Kothari R, Nam KW, Gioroukou E, Walshe M, Allin M, Rifkin L, Murray RM, Nosarti C. Eating disorder psychopathology, brain structure, neuropsychological correlates and risk mechanisms in very preterm young adults. EUROPEAN EATING DISORDERS REVIEW 2015; 23:147-55. [PMID: 25645448 DOI: 10.1002/erv.2346] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 12/19/2014] [Accepted: 12/27/2014] [Indexed: 12/11/2022]
Abstract
This study investigates the prevalence of eating disorder (ED) psychopathology, neuropsychological function, structural brain correlates and risk mechanisms in a prospective cohort of very preterm (VPT) young adults. We assessed ED psychopathology and neuropsychological correlates in 143 cohort individuals born at <33 weeks of gestation. Structural brain correlates and risk factors at birth, in childhood and adolescence, were investigated using prospectively collected data throughout childhood/adolescence. VPT-born individuals had high levels of ED psychopathology at age 21 years. Executive function did not correlate with ED symptomatology. VPT adults presenting with ED psychopathology had smaller grey matter volume at age 14/15 years in the left posterior cerebellum and smaller white matter volume in the fusiform gyrus bilaterally, compared with VPT adults with no ED psychopathology. Caesarean delivery predicted engaging in compensatory behaviours, and severe eating difficulty at age 14 years predicted ED symptomatology in young adulthood. VPT individuals are at risk for ED symptomatology, with evidence of associated structural alterations in posterior brain regions. Further prospective studies are needed to clarify the pathways that lead from perinatal/obstetric complications to ED and relevant neurobiological mechanisms. © 2015 The Authors. European Eating Disorders Review published by John Wiley &Sons, Ltd.
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Affiliation(s)
- Nadia Micali
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, London, UK
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