Rayworth BB, Wise LA, Harlow BL. Childhood abuse and risk of eating disorders in women

Obstetrics and Gynecology Epidemiology Center, Brigham & Women's Hospital & Harvard Medical School, Boston, Massachusetts 02115, USA.
Epidemiology (Impact Factor: 6.2). 06/2004; 15(3):271-8. DOI: 10.1097/01.ede.0000120047.07140.9d
Source: PubMed


Eating disorders are one of the most common psychiatric disorders among women. Little is known about underlying causes.
To assess the association between childhood violence victimization and eating disorders, we performed a case-control study of women participating in the Harvard Study of Moods and Cycles, a population-based sample of women 36 to 44 years of age. Cases were women who met the diagnostic criteria for anorexia nervosa, bulimia nervosa, or binge-eating disorder after a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). A self-administered questionnaire was used to assess a history of abuse as a child.
Compared with women who reported no abuse, women who reported childhood physical abuse had twice the odds of suffering from subclinical eating disorder symptoms (odds ratio [OR] = 2.0; 95% confidence interval [CI] = 1.3-3.3) or meeting DSM-IV criteria for an eating disorder (2.1; 1.1-4.2). Women who reported both physical and sexual abuse during childhood had 3 times the odds of developing eating disorder symptoms (3.0; 1.3-6.8) and nearly 4 times the odds of meeting DSM-IV criteria for an eating disorder (3.9; 1.3-11.5). These associations persisted within the subgroup of women with no depression antecedent to first onset of an eating disorder.
The present study provides additional evidence of an association between preadolescent trauma and psychiatric morbidity.

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    • "However, this may not be unexpected given the relationship between anxiety and eating disorders aside from the context of bipolar disorder (Kaye, 2008). Finally, childhood trauma has been implicated as a precursor to both bipolar disorder and eating disorders, with a particular emphasis on physical abuse as a trigger (Jen et al., 2013; Leverich et al., 2002; Post and Leverich, 2006; Rayworth et al., 2004; Rodriguez et al., 2005). Our data provides further evidence to support this connection, with an increased incidence of traumatic events in childhood for bipolar patients with eating disorder comorbidity, an effect that seems to be driven primarily by experiences of physical abuse and violence. "
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    ABSTRACT: Background: Bipolar disorder is a heterogeneous mood disorder associated with several important clinical comorbidities, such as eating disorders. This clinical heterogeneity complicates the identification of genetic variants contributing to bipolar susceptibility. Here we investigate comorbidity of eating disorders as a subphenotype of bipolar disorder to identify genetic variation that is common and unique to both disorders. Methods: We performed a genome-wide association analysis contrasting 184 bipolar subjects with eating disorder comorbidity against both 1370 controls and 2006 subjects with bipolar disorder only from the Bipolar Genome Study (BiGS). Results: The most significant genome-wide finding was observed bipolar with comorbid eating disorder vs. controls within SOX2-OT (p=8.9×10(-8) for rs4854912) with a secondary peak in the adjacent FXR1 gene (p=1.2×10(-6) for rs1805576) on chromosome 3q26.33. This region was also the most prominent finding in the case-only analysis (p=3.5×10(-7) and 4.3×10(-6), respectively). Several regions of interest containing genes involved in neurodevelopment and neuroprotection processes were also identified. Limitations: While our primary finding did not quite reach genome-wide significance, likely due to the relatively limited sample size, these results can be viewed as a replication of a recent study of eating disorders in a large cohort. Conclusions: These findings replicate the prior association of SOX2-OT with eating disorders and broadly support the involvement of neurodevelopmental/neuroprotective mechanisms in the pathophysiology of both disorders. They further suggest that different clinical manifestations of bipolar disorder may reflect differential genetic contributions and argue for the utility of clinical subphenotypes in identifying additional molecular pathways leading to illness.
    Journal of Affective Disorders 09/2015; 189. DOI:10.1016/j.jad.2015.09.029 · 3.38 Impact Factor
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    • "Within the civilian literature, childhood trauma exposure has been related to the development of obsessive–compulsive disorder (OCD; Lochner et al., 2002; Matthews et al., 2008; Grisham et al., 2011), social anxiety disorder (SAD) (Cougle et al., 2010; Simon et al., 2009), panic disorder (Friedman et al., 2002; Cougle et al., 2010), generalized anxiety disorder (GAD) (Cougle et al., 2010), specific phobia (Cougle et al., 2010), eating disorders (Wonderlich et al., 1997; Rayworth et al., 2004; Jonas et al., 2011) drug-use disorders (Wilsnack et al., 1997), psychosis (Read et al., 2005; Fisher et al., 2010; Alvarez et al., 2011), hypochondriasis (Barsky et al., 1994), and somatization (Sansone et al., 2001; Paras et al., 2009). To date, however, far less research has examined whether critical warzone experiences might also be broadly associated with psychiatric symptomatology. "
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    ABSTRACT: The objective of the present research was to test the hypotheses that: (1) Iraq/Afghanistan war veterans experience a wide range of psychiatric symptomatology (e.g., obsessive-compulsive symptoms, hypochondriasis, somatization); and (2) General psychiatric symptomatology among Iraq/Afghanistan war veterans is associated with their warzone experiences. To achieve this objective, Iraq/Afghanistan war veterans (N = 155) completed a screening questionnaire that assessed a wide range of psychiatric symptoms along with a measure of warzone experiences. As expected, returning veterans reported significant elevations across a wide range of clinical scales. Approximately three-fourths screened positive on at least one clinical subscale, and a third screened positive on five or more. In addition, nearly all of these conditions were associated with veterans’ warzone experiences (average r = 0.36); however, this association was much stronger among veterans with PTSD (average r = 0.33) than among veterans without PTSD (average r = 0.15). We also observed that approximately 18% of the variance in total psychiatric symptomatology was attributable to warzone experiences above and beyond the effects of childhood trauma and demographic factors. Taken together, these findings suggest that returning veterans experience a broad array of psychiatric symptoms that are strongly associated with their warzone experiences.
    Psychiatry Research 12/2014; in press. DOI:10.1016/j.psychres.2014.12.007 · 2.47 Impact Factor
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    • "The direct medical and mental healthcare costs associated with domestic violence are estimated to exceed $4 billion each year in the USA alone (Centers for Disease Control and Prevention & National Center for Injury Prevention and Control, 2003). Little is known about the relationship between IPV and eating disorders, despite evidence that psychiatric patients experience a high prevalence of IPV (Oram et al., 2013) and substantial literature on the association between eating disorder and childhood abuse (Rayworth et al., 2004; Wonderlich et al., 1997). "
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    ABSTRACT: Objectives: To estimate the prevalence and risk of lifetime and past year intimate partner violence (IPV) among males and females with eating disorders. Methods: Systematic review. We searched 15 electronic databases, supplemented by hand searching, citation tracking, updating a review on victimisation and mental disorder and expert recommendations. Results: Eight papers were included, involving 6775 females and 4857 males. Individual studies reported that eating disorders are associated with a high prevalence and increased odds of lifetime IPV among both males and females. Evidence is lacking on eating disorder and past year IPV, on whether associations between eating disorder and IPV vary by type of IPV, and temporality. Discussion: More research is needed to investigate the strength and nature of the association between eating disorders and IPV, including with regards to the direction of causality between eating disorders and IPV, and whether associations are mediated by childhood abuse.
    Journal of Psychiatric Research 05/2013; 47(9). DOI:10.1016/j.jpsychires.2013.04.014 · 3.96 Impact Factor
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