Mather AA, Cox BJ, Enns MW, Sareen J. Associations between body weight and personality disorders in a nationally representative sample

Departments of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
Psychosomatic Medicine (Impact Factor: 3.47). 10/2008; 70(9):1012-9. DOI: 10.1097/PSY.0b013e318189a930
Source: PubMed


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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    • "Among women, avoidant PD was associated with higher likelihood of being in the extremely obese category (OR 1.7), and among women, antisocial PD was associated with higher likelihood of being classified as overweight (OR 1.5) or extremely obese (OR 1.9). In another study, controlling for Axis I diagnoses and other relevant demographic variables, obese individuals had higher odds of meeting criteria for at least one Cluster A PD (Mather et al., 2008). Extremely obese individuals had higher odds of having at least one Cluster B PD, such as antisocial and avoidant PD. "
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    ABSTRACT: Personality disorders have been associated with a wide swath of adverse health outcomes and correspondingly high costs to healthcare systems. To date, however, there has not been a systematic review of the literature on health conditions among individuals with personality disorders. The primary aim of this article is to review research documenting the associations between personality disorders and health conditions. A systematic review of the literature revealed 78 unique empirical English-language peer-reviewed articles examining the association of personality disorders and health outcomes over the past 15 years. Specifically, we reviewed research examining the association of personality disorders with sleep disturbance, obesity, pain conditions, and other chronic health conditions. In addition, we evaluated research on candidate mechanisms underlying health problems in personality disorders and potential treatments for such disorders. Results underscore numerous deleterious health outcomes associated with PD features and PD diagnoses, and suggest potential biological and behavioural factors that may account for these relations. Guidelines for future research in this area are discussed.
    Canadian Psychology 10/2015; 56(2):168-190. DOI:10.1037/cap0000024 · 1.54 Impact Factor
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    • "The relationship between impulsivity, eating disorders and alcohol misuse is complex. Correlation between obesity and addictive disorders is frequently low (Riggs et al. 2012) and may be absent or negative (Kleiner et al. 2004; Mather et al. 2008). The prevalence of impulse control disorders have been found to be elevated in obesity and particularly high in obesity with binge eating (Schmidt et al. 2012). "
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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 · 5.94 Impact Factor
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    • "BMI was calculated by dividing mass (in pounds) by height [2] (in inches) multiplied by 703, which is in accordance with previous studies [9]. Research has found acceptable to good concordance between self-report and physical health measures or medical records in other health surveys [25] [27] "
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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 · 2.61 Impact Factor
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