Article

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.

Download full-text

Full-text

Available from: Blake Woodside, Aug 26, 2015
0 Followers
 · 
255 Views
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Although low weight is a key factor contributing to the high mortality in anorexia nervosa (AN), it is unclear how AN patients sustain low weight compared with bulimia nervosa (BN) patients with similar psychopathology. Studies of genes involved in appetite and weight regulation in eating disorders have yielded variable findings, in part due to small sample size and clinical heterogeneity. This study: (1) assessed the role of leptin, melanocortin, and neurotrophin genetic variants in conferring risk for AN and BN; and (2) explored the involvement of these genes in body mass index (BMI) variations within AN and BN. Our sample consisted of 745 individuals with AN without a history of BN, 245 individuals with BN without a history of AN, and 321 controls. We genotyped 20 markers with known or putative function among genes selected from leptin, melanocortin, and neurotrophin systems. There were no significant differences in allele frequencies among individuals with AN, BN, and controls. AGRP rs13338499 polymorphism was associated with lowest illness-related BMI in those with AN (p = 0.0013), and NTRK2 rs1042571 was associated with highest BMI in those with BN (p = 0.0018). To our knowledge, this is the first study to address the issue of clinical heterogeneity in eating disorder genetic research and to explore the role of known or putatively functional markers in genes regulating appetite and weight in individuals with AN and BN. If replicated, our results may serve as an important first step toward gaining a better understanding of weight regulation in eating disorders.
    Journal of Psychiatric Research 04/2014; 55. DOI:10.1016/j.jpsychires.2014.04.005 · 4.09 Impact Factor
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Functional brain imaging studies have shown abnormal neural activity in individuals recovered from anorexia nervosa (AN) during both cognitive and emotional task paradigms. It has been suggested that this abnormal activity which persists into recovery might underpin the neurobiology of the disorder and constitute a neural biomarker for AN. However, no study to date has assessed functional changes in neural networks in the absence of task-induced activity in those recovered from AN. Therefore, the aim of this study was to investigate whole brain resting state functional connectivity in nonmedicated women recovered from anorexia nervosa. Functional magnetic resonance imaging scans were obtained from 16 nonmedicated participants recovered from anorexia nervosa and 15 healthy control participants. Independent component analysis revealed functionally relevant resting state networks. Dual regression analysis revealed increased temporal correlation (coherence) in the default mode network (DMN) which is thought to be involved in self-referential processing. Specifically, compared to healthy control participants the recovered anorexia nervosa participants showed increased temporal coherence between the DMN and the precuneus and the dorsolateral prefrontal cortex/inferior frontal gyrus. The findings support the view that dysfunction in resting state functional connectivity in regions involved in self-referential processing and cognitive control might be a vulnerability marker for the development of anorexia nervosa. Hum Brain Mapp, 2012. © 2012 Wiley Periodicals, Inc.
    Human Brain Mapping 02/2014; 35(2). DOI:10.1002/hbm.22202 · 6.92 Impact Factor
  • Source
    • "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. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Using a sister-pair design, we aimed to investigate the role of maternal anxiety in pregnancy and parental overprotection as risk factors for anorexia nervosa (AN) and bulimia nervosa (BN). We were also interested in investigating anxious personality traits in patients with AN and BN compared to their healthy sisters, and their possible association to overprotection. One-hundred-and-fifty-seven females (AN = 94; BN = 63) and their healthy sisters from four European centres were recruited. Data on temperament and childhood characteristics were obtained from cases and their sisters using the Temperament and Character Interview Revised (TCI-R) and the Oxford Risk Factor Interview (ORFI); maternal anxiety and overprotection were obtained from retrospective parental report. Both AN and BN women displayed significantly higher levels of separation anxiety in childhood in comparison to their sisters, but only women with AN showed anxious temperamental traits. Mothers of women with AN reported higher levels of anxiety during the index pregnancy (p < .01), compared to when pregnant with the healthy daughter. The age in months at which women with AN were first left with another adult for a night was also higher compared to their sisters (respectively medians: 12 (range 1–120), 9 (range 1–96), p < .05). This was not the case for women with BN. Maternal overprotection was not associated with index daughter temperament. This finding is suggestive of an association between AN and maternal stress and anxiety in utero and later overprotective care, whilst BN was not associated with maternal anxiety or overprotection.
    Cognitive Therapy and Research 08/2013; 37(4). DOI:10.1007/s10608-012-9518-8 · 1.70 Impact Factor
Show more