Associations between body weight and personality disorders in a nationally representative sample.
ABSTRACT To determine whether, in the general population, individuals in numerous abnormal body weight categories had higher odds of having personality disorders (PDs) than normal-weight individuals. Although personality functioning is hypothesized to be associated with body weight, there is a dearth of empirical evaluation of this topic.
The association of body weight (five categories: underweight [body mass index [BMI] <18.5]; normal [18.5 <or= BMI <25]; overweight [25 <or= BMI <30]; obese [30 <or= BMI <40]; and extremely obese [BMI >or=40]) with personality disorders was investigated using data from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (n = 43,093). Lifetime paranoid, schizoid, antisocial, histrionic, avoidant, dependent, and obsessive-compulsive PDs were examined, as assessed by the Alcohol Use Disorders and Associated Disabilities Interview Schedule-DSM-IV version (AUDADIS-IV).
After adjusting for sociodemographics, Axis I disorders, schizophrenia, physical health conditions, and comorbid PDs, extreme obesity was associated with antisocial or avoidant PDs (adjusted odds ratio (AOR) range = 1.66-1.73), whereas underweight was associated with increased odds of schizoid PD (AOR = 1.89). The pattern of associations differed when stratified by gender. Overweight men had lower odds of paranoid PD (AOR = 0.73). Women with higher-than-normal body weights had higher odds of paranoid, antisocial, and avoidant PDs (AOR range = 1.33-2.50), whereas underweight women more often met the criteria for schizoid PD (AOR = 1.95).
Higher-than-normal body weight is associated with paranoid, antisocial, and avoidant PDs for women, whereas overweight men have lower rates of paranoid PD and underweight women have higher odds of schizoid PD. Possible clinical implications of this research are discussed.
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ABSTRACT: Background. Evidence suggests some overlap between the pathological use of food and drugs, yet how impulsivity compares across these different clinical disorders remains unclear. Substance use disorders are commonly characterized by elevated impulsivity, and impulsivity subtypes may show commonalities and differences in various conditions. We hypothesized that obese subjects with binge-eating disorder (BED) and abstinent alcohol-dependent cohorts would have relatively more impulsive profiles compared to obese subjects without BED. We also predicted decision impulsivity impairment in obesity with and without BED. Method. Thirty obese subjects with BED, 30 without BED and 30 abstinent alcohol-dependent subjects and age- and gender-matched controls were tested on delay discounting (preference for a smaller immediate reward over a larger delayed reward), reflection impulsivity (rapid decision making prior to evidence accumulation) and motor response inhibition (action cancellation of a prepotent response). Results. All three groups had greater delay discounting relative to healthy volunteers. Both obese subjects without BED and alcohol-dependent subjects had impaired motor response inhibition. Only obese subjects without BED had impaired integration of available information to optimize outcomes over later trials with a cost condition. Conclusions. Delay discounting appears to be a common core impairment across disorders of food and drug intake. Unexpectedly, obese subjects without BED showed greater impulsivity than obese subjects with BED. We highlight the dissociability and heterogeneity of impulsivity subtypes and add to the understanding of neurocognitive profiles across disorders involving food and drugs. Our results have therapeutic implications suggesting that disorder-specific patterns of impulsivity could be targeted.Psychological Medicine 08/2014; 45(04):1-12. DOI:10.1017/S0033291714001834 · 5.43 Impact Factor
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ABSTRACT: We examine the impact of Axis II personality disorders (PDs) on body weight. PDs are psychiatric conditions that develop early in life from a mixture of genetics and environment, are persistent, and lead to substantial dysfunction for the affected individual. The defining characteristics of PDs conceptually link them with body weight, but the direction of the relationship likely varies across PD type. To investigate these links, we analyze data from Wave II of the National Epidemiological Survey of Alcohol and Related Conditions. We measure body weight with the body mass index (BMI) and a dichotomous indicator for obesity (BMI≥30). We find that women with PDs have significantly higher BMI and are more likely to be obese than otherwise similar women. We find few statistically significant or economically meaningful effects for men. Paranoid, schizotypal, and avoidant PDs demonstrate the strongest adverse impacts on women's body weight while dependent PD may be protective against elevated body weight among men. Findings from unconditional quantile regressions demonstrate a positive gradient between PDs and BMI in that the effects are greater for higher BMI respondents.Economics and human biology 11/2013; 12. DOI:10.1016/j.ehb.2013.10.002 · 2.46 Impact Factor
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ABSTRACT: Posttraumatic stress disorder (PTSD) is significantly and positively associated with several physical conditions. We aimed to examine whether the nature and number of trauma(s) experienced may be related to physical conditions using a population-based sample. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653; age 20 years and older). Participants indicated lifetime trauma experiences and physical conditions experienced over the past year. Multiple logistic regressions examined the association between type and number of trauma(s) and physical conditions. After adjusting for sociodemographics, Axis I and II mental disorders, and all other trauma, injurious and witnessing trauma were significantly associated with all the assessed physical conditions. Psychological trauma was associated with cardiovascular and gastrointestinal diseases, diabetes and arthritis. Natural disaster/terrorism was associated with cardiovascular disease, gastrointestinal disease and arthritis only. Finally, combat-related trauma and other trauma were not positively associated with any physical condition. Our results also suggested a dose-response relationship between number of traumatic events and physical conditions. These data suggest that the impact of certain types and number of traumas may differ with respect to their relationship with physical health problems independent of PTSD.General hospital psychiatry 10/2013; 36(1). DOI:10.1016/j.genhosppsych.2013.06.003 · 2.90 Impact Factor