Anorexia nervosa trios: Behavioral profiles of individuals with anorexia nervosa and their parents

University of California, San Diego (UCSD) Eating Disorders Treatment and Research Center, La Jolla, CA, USA.
Psychological Medicine (Impact Factor: 5.43). 07/2008; 39(3):451-61. DOI: 10.1017/S0033291708003826
Source: PubMed

ABSTRACT Anorexia nervosa (AN) is associated with behavioral traits that predate the onset of AN and persist after recovery. We identified patterns of behavioral traits in AN trios (proband plus two biological parents).
A total of 433 complete trios were collected in the Price Foundation Genetic Study of AN using standardized instruments for eating disorder (ED) symptoms, anxiety, perfectionism, and temperament. We used latent profile analysis and ANOVA to identify and validate patterns of behavioral traits.
We distinguished three classes with medium to large effect sizes by mothers' and probands' drive for thinness, body dissatisfaction, perfectionism, neuroticism, trait anxiety, and harm avoidance. Fathers did not differ significantly across classes. Classes were distinguished by degree of symptomatology rather than qualitative differences. Class 1 (approximately 33%) comprised low symptom probands and mothers with scores in the healthy range. Class 2 ( approximately 43%) included probands with marked elevations in drive for thinness, body dissatisfaction, neuroticism, trait anxiety, and harm avoidance and mothers with mild anxious/perfectionistic traits. Class 3 (approximately 24%) included probands and mothers with elevations on ED and anxious/perfectionistic traits. Mother-daughter symptom severity was related in classes 1 and 3 only. Trio profiles did not differ significantly by proband clinical status or subtype.
A key finding is the importance of mother and daughter traits in the identification of temperament and personality patterns in families affected by AN. Mother-daughter pairs with severe ED and anxious/perfectionistic traits may represent a more homogeneous and familial variant of AN that could be of value in genetic studies.

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Available from: Blake Woodside, Aug 26, 2015
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    • "The main sample used for the selection of suitable cases was derived from the Price Foundation Consortium. All participants included in this collaborative initiative were carefully phenotyped, and these procedures and sample characteristics have been previously described in detail (Kaye et al, 2000; Kaye et al, 2004; Jacobs et al, 2009). "
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    • "It is therefore difficult to determine from these studies whether abnormalities in brain activations are state factors or whether they represent biomarkers. An alternative research design is to examine individuals recovered from AN, as they continue to display not only temperamental and personality traits but neural aberrancies that may have predisposed them to the illness [Cowdrey et al., 2011; Jacobs et al., 2009; Wagner et al., 2006a]. For example , Wagner et al. [2007] showed that women recovered from AN had greater neural response to both positive and negative feedback in the caudate and dorsolateral prefrontal cortex; regions of the brain thought to be involved in higher level cognitive processes. "
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    • "In terms of chronology, anxiety problems have been found to precede ED onset (Deep et al. 1995; Bulik et al. 1997; Godart et al. 2002, 2006; Hildebrandt et al. 2012; Swinbourne et al. 2012) and to predict later development of ED (Kaye et al. 2004; Lilenfeld et al. 2006; Jacobs et al. 2009; Mazzeo and Bulik 2009; Micali et al. 2011). Contributions from longitudinal studies also seem to confirm that child ''emotional'' characteristics are associated with eating behaviours (Martin et al. 2000; Haycraft et al. 2011) indicating that internalizing characteristics in childhood could predispose to eating disorder later on in life. "
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