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1.
Eur Eat Disord Rev ; 28(1): 55-65, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31297906

RESUMO

OBJECTIVE: This exploratory study is the first to examine family-based treatment (FBT) adherence and association to treatment outcome in the context of a large-scale, multi-centre study for the treatment of adolescents with anorexia nervosa. METHOD: One hundred and ninety recorded FBT sessions from 68 adolescents with anorexia nervosa and their families were recruited across multiple sites (N = 6). Each site provided 1-4 tapes per family over four treatment time points, and each was independently rated for therapist adherence. RESULTS: There were differences in adherence scores within and between sites. ANOVA produced a main effect for site, F(5, 46) = 8.6, p < .001, and phase, F(3, 42) = 12.7, p < .001, with adherence decreasing in later phases. Adherence was not associated to end of treatment percent ideal body weight after controlling for baseline percent ideal body weight (r = .088, p = .48). CONCLUSIONS: Results suggest that FBT can be delivered with adherence in phase one of treatment. Adherence was not associated with treatment outcome as determined using percent ideal body weight.


Assuntos
Anorexia Nervosa/terapia , Terapia Familiar , Cooperação do Paciente/estatística & dados numéricos , Adolescente , Humanos , Resultado do Tratamento
2.
Int J Eat Disord ; 52(9): 1004-1014, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31373405

RESUMO

OBJECTIVE: The aim of this randomized controlled trial with a parallel design was to evaluate the effect of brief, cognitive remediation therapy (CRT) for anorexia nervosa (AN) on set-shifting. METHOD: Two hundred seventy-five inpatient adults and adolescents with AN (mean age = 23.1; SD = 12.7) were randomly assigned (using simple randomization procedures) to either a CRT or control condition. All participants received treatment as usual; however, the CRT condition completed five CRT group sessions in lieu of other group therapies provided on the unit. Set-shifting abilities were evaluated by: (a) neuropsychological measures and (b) experimental cognitive behavior therapy thought records. Blinding of group assignment occurred during baseline assessment and ended following group commencement. RESULTS: Data from 135 CRT and 140 control condition participants were analyzed. On all neuropsychological measures, results revealed no between group condition effects, but did show statistically significant time effects, with medium to large effect sizes. Thought record analysis revealed a significant condition by age interaction effect where adults in the CRT condition generated significantly more alternative thoughts and had stronger believability of alternative thoughts than children, a trend that was not found in the control condition. This yielded moderate to large effect sizes of.0.56 and 0.72, respectively. DISCUSSION: Based on traditional neuropsychological measures, these findings do not suggest a differential effect of CRT for AN in the format applied. However, results suggest that CRT may have some increased beneficial cognitive effect for adults, as compared to children, based on thought record analysis.


Assuntos
Anorexia Nervosa/terapia , Remediação Cognitiva/métodos , Psicoterapia de Grupo/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
3.
Int J Eat Disord ; 52(2): 200-205, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30636025

RESUMO

OBJECTIVE: This study examined a hypothesized pathway by which interoceptive dysfunction accounted for associations between personality features (harm avoidance, self-directedness, and perfectionism) and anorexia nervosa (AN) severity (indicated by drive for thinness, eating disorder-related preoccupations and rituals, and body mass index). METHOD: The study sample (n = 270, mean age = 28.47, 95.2% female, 98% White/Caucasian) consisted of probands and biological relatives who met DSM-IV criteria for lifetime diagnoses of AN (omitting criterion D, amenorrhea) drawn from the Price Foundation Anorexia Nervosa Affected Relative Pairs Study (AN-ARP). Participants completed measures assessing personality, interoceptive dysfunction, and eating pathology. RESULTS: Associations between personality features of low self-directedness and high perfectionism and indicators of AN severity (drive for thinness and eating disorder-related preoccupations and rituals) were significant, as were the hypothesized indirect pathways through interoceptive dysfunction. Neither harm avoidance nor body mass index was significantly related to other study variables, and the proposed indirect pathways involving these variables were not significant. DISCUSSION: Findings suggest that certain personality features may relate to AN severity, in part, through their associations with interoceptive dysfunction. Future research should examine prospective associations and the value of interventions targeting interoceptive dysfunction for interrupting the link between personality and AN severity.


Assuntos
Anorexia Nervosa/complicações , Anorexia Nervosa/psicologia , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Adulto , Anorexia Nervosa/patologia , Feminino , Humanos , Masculino , Transtornos da Personalidade/patologia , Estudos Prospectivos
4.
Eur Eat Disord Rev ; 27(2): 161-172, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30136346

RESUMO

OBJECTIVE: Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are highly comorbid. However, the factors that account for this comorbidity are poorly understood. We examined the core dimensions of AN and OCD and psychological and personality factors shared by both disorders. METHOD: In path analyses (N = 732 women with either current AN or recovered from AN), we examined which factors were uniquely and independently associated with the core dimensions of AN and OCD. We also examined recovery from AN as a moderator. RESULTS: When individuals with AN reported greater concern over mistakes, they endorsed more severity in both AN and OCD core dimensions. These unique associations existed above and beyond all other transdiagnostic personality and psychological factors and regardless of AN recovery status. CONCLUSIONS: Concern over mistakes partially accounts for severity in the core dimensions of both AN and OCD. Concern over mistakes may represent an important target in the aetiology of AN and OCD.


Assuntos
Anorexia Nervosa/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Adolescente , Adulto , Anorexia Nervosa/epidemiologia , Comorbidade , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/epidemiologia , Personalidade , Psicologia , Adulto Jovem
5.
Int J Eat Disord ; 51(3): 275-280, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29314160

RESUMO

OBJECTIVE: Family-based treatment (FBT) for adolescent anorexia nervosa (AN) promotes faster weight restoration when compared to other treatments. However, the mechanisms through which this occurs are not clarified. This study explored the trajectories of parental self-efficacy and perceived family flexibility during FBT and systemic family therapy (SyFT). We also explored whether parental self-efficacy mediates the effects of treatment on weight gain early in treatment. METHOD: 158 adolescents (12-18 years old; 89% girls) and their parents were randomized to FBT or SyFT. Parental self-efficacy as well as adolescents' and parental perceptions of the family's flexibility were collected at baseline and at sessions 2, 4, 6, and 8. RESULTS: Over time, only parents in FBT reported significantly greater self-efficacy. The change in maternal self-efficacy over the first 8 weeks of treatment was a significant mediator of session 10 weight gain. There were no significant group differences in perceived flexibility by session 8. DISCUSSION: Both parents in FBT and mothers in SyFT understand early the need to change their family's rules and roles. However, the specific strategies of FBT appear to mediate early weight gain in AN.


Assuntos
Anorexia Nervosa/terapia , Relações Familiares/psicologia , Pais/psicologia , Autoeficácia , Adolescente , Feminino , Humanos , Masculino , Resultado do Tratamento
6.
Int J Eat Disord ; 49(9): 891-4, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27062400

RESUMO

OBJECTIVE: We examined the timing and number of days of hospitalization during the course of treatment, hospitalization effects on outcome, and predictors and moderators of the use of hospitalization in adolescents with anorexia nervosa (AN). METHOD: Data used in this study were collected from 158 adolescents (ages 12 to 18 years of age) who met DSM-IVTR criteria for AN (exclusive of the amenorrhea criteria) randomized to receive either Family Based Treatment (FBT) or Systemic Family Therapy (SyFT) in a 7 site study. RESULTS: The trajectory of hospital day use is similar in the first 5 weeks irrespective of treatment allocation. However, days of hospitalization continued to increase throughout SyFT but leveled off in FBT after ∼5 weeks of treatment. Early hospitalization was a negative predictor for improvements in percent weight change for both treatment groups (t(1)=2.6, p = 0.011). Co-morbid psychopathology predicted early hospital use in both treatments. Higher levels of eating related obsessions and depression moderated hospitalization rates suggesting that FBT reduces early hospitalization rates compared to SyFT for these subgroups. DISCUSSION: These data support and extend findings from previous studies by identifying patterns of hospital use, and predictors and moderators of treatment effect for early hospitalization use in adolescent AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:891-894).


Assuntos
Anorexia Nervosa/terapia , Terapia Familiar/métodos , Adolescente , Anorexia Nervosa/psicologia , Peso Corporal , Criança , Transtorno Depressivo/complicações , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Comportamento Obsessivo , Indução de Remissão , Resultado do Tratamento
7.
Eur Eat Disord Rev ; 22(1): 32-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24123541

RESUMO

Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits.


Assuntos
Amenorreia/psicologia , Anorexia Nervosa/psicologia , Feminilidade , Masculinidade , Personalidade , Adolescente , Adulto , Amenorreia/etiologia , Anorexia Nervosa/complicações , Feminino , Humanos , Inventário de Personalidade
8.
Int J Eat Disord ; 45(2): 202-13, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21495052

RESUMO

OBJECTIVE: To describe obstacles in the implementation of a controlled treatment trial of adolescent anorexia nervosa (AN). METHOD: The original aim was to enter 240 participants with AN to one of four cells: Behavioral family therapy (BFT) plus fluoxetine; BFT plus placebo; systems family therapy (SFT) plus fluoxetine; SFT plus placebo. RESULTS: Recruitment was delayed pending a satisfactory resolution concerning participant safety. After 6 months of recruitment it became clear that the medication was associated with poor recruitment leading to a study redesign resulting in a comparison of two types of family therapy with a projected sample size of 160. One site was unable to recruit and was replaced. DISCUSSION: Problems with the delineation of safety procedures, recruitment, re-design of the study, and replacement of a site, were the main elements resulting in a 1-year delay. Suggestions are made for overcoming such problems in future AN trials.


Assuntos
Anorexia Nervosa/terapia , Seleção de Pacientes , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Adolescente , Anorexia Nervosa/tratamento farmacológico , Anorexia Nervosa/psicologia , Terapia Comportamental/métodos , Terapia Familiar/métodos , Feminino , Fluoxetina/uso terapêutico , Humanos , Tamanho da Amostra , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico
9.
Int J Eat Disord ; 45(6): 800-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22488115

RESUMO

OBJECTIVE: To examine childhood perfectionism in anorexia nervosa (AN) restricting (RAN), purging (PAN), and binge eating with or without purging (BAN) subtypes. METHOD: The EATATE, a retrospective assessment of childhood perfectionism, and the eating disorder inventory (EDI-2) were administered to 728 AN participants. RESULTS: EATATE responses revealed general childhood perfectionism, 22.3% of 333 with RAN, 29.2% of 220 with PAN, and 24.8% of 116 with BAN; school work perfectionism, 31.2% with RAN, 30.4% with PAN, and 24.8% with BAN; childhood order and symmetry, 18.7% with RAN, 21.7% with PAN, and 17.8% with BAN; and global childhood rigidity, 42.6% with RAN, 48.3% with PAN and 48.1% with BAN. Perfectionism preceded the onset of AN in all subtypes. Significant associations between EDI-2 drive for thinness and body dissatisfaction were present with four EATATE subscales. DISCUSSION: Global childhood rigidity was the predominate feature that preceded all AN subtypes. This may be a risk factor for AN.


Assuntos
Anorexia Nervosa/psicologia , Personalidade , Adolescente , Adulto , Criança , Comportamento Infantil , Humanos , Masculino , Inventário de Personalidade , Estudos Retrospectivos , Adulto Jovem
10.
Eur Eat Disord Rev ; 20(2): 111-5, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21830261

RESUMO

This exploratory study assessed whether maternal recall of childhood feeding and eating practices differed across anorexia nervosa (AN) subtypes. Participants were 325 women from the Genetics of Anorexia Nervosa study whose mothers completed a childhood feeding and eating questionnaire. Multinomial logistic regression analyses were used to predict AN subtype from measures related to childhood eating: (i) infant feeding (breastfed, feeding schedule, age of solid food introduction), (ii) childhood picky eating (picky eating before age 1 year and between ages one and five) and (iii) infant gastrointestinal problems (vomiting and colic). Results revealed no significant differences in retrospective maternal report of childhood feeding and eating practices among AN subtypes.


Assuntos
Anorexia Nervosa/psicologia , Comportamento Alimentar/psicologia , Mães/psicologia , Adolescente , Adulto , Anorexia Nervosa/complicações , Aleitamento Materno/psicologia , Criança , Cólica/complicações , Feminino , Humanos , Lactente , Masculino , Rememoração Mental , Estudos Retrospectivos , Inquéritos e Questionários , Vômito/complicações
11.
Eur Eat Disord Rev ; 20(3): e129-36, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22351620

RESUMO

OBJECTIVE: To further refine our understanding of impulsivity, obsessions, and compulsions in anorexia nervosa (AN) by isolating which behaviours--binge eating, purging, or both--are associated with these features. METHODS: We conducted regression analyses with binge eating, purging, and the interaction of binge eating with purging as individual predictors of scores for impulsivity, obsessions, and compulsions in two samples of women with AN (n = 1373). RESULTS: Purging, but not binge eating, was associated with higher scores on impulsivity, obsessions, and compulsions. Purging was also associated with worst eating rituals and with worst eating preoccupations. CONCLUSION: Our results suggest that purging, compared with binge eating, may be a stronger correlate of impulsivity, obsessions, and compulsions in AN.


Assuntos
Anorexia Nervosa/complicações , Bulimia/complicações , Comportamento Compulsivo/complicações , Comportamento Impulsivo/complicações , Comportamento Obsessivo/complicações , Vômito/complicações , Adolescente , Adulto , Anorexia Nervosa/psicologia , Bulimia/psicologia , Comportamento Compulsivo/psicologia , Feminino , Humanos , Comportamento Impulsivo/psicologia , Comportamento Obsessivo/psicologia , Vômito/psicologia
12.
Biol Psychiatry ; 91(3): 313-327, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34861974

RESUMO

BACKGROUND: Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. METHODS: We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. RESULTS: Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. CONCLUSIONS: Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.


Assuntos
Transtorno Depressivo Maior , Transtornos Mentais , Transtorno Depressivo Maior/genética , Estudo de Associação Genômica Ampla , Humanos , Transtornos Mentais/genética , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Tentativa de Suicídio
13.
Psychosom Med ; 73(6): 491-7, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21715295

RESUMO

OBJECTIVES: Comorbidity among eating disorders, traumatic events, and posttraumatic stress disorder (PTSD) has been reported in several studies. The main objectives of this study were to describe the nature of traumatic events experienced and to explore the relationship between PTSD and anorexia nervosa (AN) in a sample of women. METHODS: Eight hundred twenty-four participants from the National Institutes of Health-funded Genetics of Anorexia Nervosa Collaborative Study were assessed for eating disorders, PTSD, and personality characteristics. RESULTS: From a final sample of 753 women with AN, 13.7% (n = 103) met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for PTSD. The sample mean age was 29.5 (standard deviation = 11.1) years. In pairwise comparisons across AN subtypes, the odds of having a PTSD diagnosis were significantly lower in individuals with restricting AN than individuals with purging AN without binge eating (odds ratio = 0.49, 95% confidence interval = 0.30-0.80). Most participants with PTSD reported the first traumatic event before the onset of AN (64.1%, n = 66). The most common traumatic events reported by those with a PTSD diagnosis were sexually related traumas during childhood (40.8%) and during adulthood (35.0%). CONCLUSIONS: AN and PTSD do co-occur, and traumatic events tend to occur before the onset of AN. Clinically, these results underscore the importance of assessing trauma history and PTSD in individuals with AN and raise the question of whether specific modifications or augmentations to standard treatment for AN should be considered in a subgroup to address PTSD-related psychopathology.


Assuntos
Anorexia Nervosa/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adolescente , Adulto , Fatores Etários , Anorexia Nervosa/genética , Anorexia Nervosa/psicologia , Índice de Massa Corporal , Criança , Abuso Sexual na Infância/psicologia , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Epigenômica , Feminino , Predisposição Genética para Doença , Humanos , Acontecimentos que Mudam a Vida , Masculino , Menarca , Pessoa de Meia-Idade , Determinação da Personalidade , Prevalência , Transtornos de Estresse Pós-Traumáticos/genética , Transtornos de Estresse Pós-Traumáticos/psicologia
14.
Int J Eat Disord ; 44(3): 225-32, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20143323

RESUMO

OBJECTIVE: We investigated the sociodemographic characteristics in women with and without lifetime eating disorders. METHOD: Participants were from a multisite international study of eating disorders (N = 2,096). Education level, relationship status, and reproductive status were examined across eating disorder subtypes and compared with a healthy control group. RESULTS: Overall, women with eating disorders were less educated than controls, and duration of illness and age of onset were associated with educational attainment. Menstrual status was associated with both relationship and reproductive status, but eating disorder subtypes did not differ significantly from each other or from healthy controls on these dimensions. DISCUSSION: Differences in educational attainment, relationships, and reproduction do exist in individuals with eating disorders and are differentially associated with various eating disorder symptoms and characteristics. These data could assist in educating patients and family members about long-term consequences of eating disorders.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Relações Interpessoais , Reprodução , Apoio Social , Adulto , Escolaridade , Feminino , Humanos
15.
J Clin Psychol ; 67(4): 391-403, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21365638

RESUMO

We studied the relation between intrusive and repetitive hair pulling, the defining feature of trichotillomania, and compulsive and impulsive features in 1,453 individuals with anorexia nervosa and bulimia nervosa. We conducted a series of regression models examining the relative influence of compulsive features associated with obsessive-compulsive disorder, compulsive features associated with eating disorders, trait features related to harm avoidance, perfectionism, and novelty seeking, and self harm. A final model with a reduced sample (n = 928) examined the additional contribution of impulsive attributes. One of 20 individuals endorsed hair pulling. Evidence of a positive association with endorsement of compulsive behavior of the obsessive-compulsive spectrum emerged. Hair pulling may be more consonant with ritualistic compulsions than impulsive urges in those with eating disorders.


Assuntos
Comportamento Compulsivo , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Tricotilomania/psicologia , Adolescente , Adulto , Comorbidade , Europa (Continente)/epidemiologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , América do Norte/epidemiologia , Tricotilomania/epidemiologia , Adulto Jovem
16.
Eur Eat Disord Rev ; 19(6): 487-93, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21780254

RESUMO

This analysis is a follow-up to an earlier investigation of 182 genes selected as likely candidate genetic variations conferring susceptibility to anorexia nervosa (AN). As those initial case-control results revealed no statistically significant differences in single nucleotide polymorphisms, herein, we investigate alternative phenotypes associated with AN. In 1762 females, using regression analyses, we examined the following: (i) lowest illness-related attained body mass index; (ii) age at menarche; (iii) drive for thinness; (iv) body dissatisfaction; (v) trait anxiety; (vi) concern over mistakes; and (vii) the anticipatory worry and pessimism versus uninhibited optimism subscale of the harm avoidance scale. After controlling for multiple comparisons, no statistically significant results emerged. Although results must be viewed in the context of limitations of statistical power, the approach illustrates a means of potentially identifying genetic variants conferring susceptibility to AN because less complex phenotypes associated with AN are more proximal to the genotype and may be influenced by fewer genes.


Assuntos
Anorexia Nervosa/genética , Anorexia Nervosa/psicologia , Genótipo , Fenótipo , Adulto , Fatores Etários , Ansiedade/genética , Ansiedade/psicologia , Imagem Corporal , Índice de Massa Corporal , Impulso (Psicologia) , Feminino , Seguimentos , Predisposição Genética para Doença , Humanos , Menarca/psicologia , Satisfação Pessoal , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Adulto Jovem
17.
Am J Med Genet B Neuropsychiatr Genet ; 156B(4): 454-61, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21438147

RESUMO

Extensive population-based genome-wide association studies have identified an association between the FTO gene and BMI; however, the mechanism of action is still unknown. To determine whether FTO may influence weight regulation through psychological and behavioral factors, seven single-nucleotide polymorphisms (SNPs) of the FTO gene were genotyped in 1,085 individuals with anorexia nervosa (AN) and 677 healthy weight controls from the international Price Foundation Genetic Studies of Eating Disorders. Each SNP was tested in association with eating disorder phenotypes and measures that have previously been associated with eating behavior pathology: trait anxiety, harm-avoidance, novelty seeking, impulsivity, obsessionality, compulsivity, and concern over mistakes. After appropriate correction for multiple comparisons, no significant associations between individual FTO gene SNPs and eating disorder phenotypes or related eating behavior pathology were identified in cases or controls. Thus, this study found no evidence that FTO gene variants associated with weight regulation in the general population are associated with eating disorder phenotypes in AN participants or matched controls.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/genética , Variação Genética , Estudo de Associação Genômica Ampla , Obesidade/genética , Proteínas/genética , Dioxigenase FTO Dependente de alfa-Cetoglutarato , Anorexia Nervosa/genética , Estudos de Casos e Controles , Feminino , Genótipo , Humanos , Fenótipo , Polimorfismo de Nucleotídeo Único
18.
Int J Eat Disord ; 43(1): 14-21, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19260043

RESUMO

OBJECTIVE: We examined prevalence of substance use disorders (SUD) in women with: (1) anorexia nervosa (AN) restricting type (RAN); (2) AN with purging only (PAN); (3) AN with binge eating only (BAN); and (4) lifetime AN and bulimia nervosa (ANBN). Secondary analyses examined SUD related to lifetime purging behavior and lifetime binge eating. METHOD: Participants (N = 731) were drawn from the International Price Foundation Genetic Studies. RESULTS: The prevalence of SUD differed across AN subtypes, with more in the ANBN group reporting SUD than those in the RAN and PAN groups. Individuals who purged were more likely to report substance use than those who did not purge. Prevalence of SUD differed across lifetime binge eating status. DISCUSSION: SUD are common in AN and are associated with bulimic symptomatology. Results underscore the heterogeneity in AN, highlighting the importance of screening for SUD across AN subtypes.


Assuntos
Anorexia Nervosa/epidemiologia , Bulimia/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Índice de Massa Corporal , Bulimia/diagnóstico , Distribuição de Qui-Quadrado , Comorbidade , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Determinação da Personalidade , Prevalência , Escalas de Graduação Psiquiátrica , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Inquéritos e Questionários
19.
Am J Med Genet B Neuropsychiatr Genet ; 153B(5): 1070-80, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20468064

RESUMO

We performed association studies with 5,151 SNPs that were judged as likely candidate genetic variations conferring susceptibility to anorexia nervosa (AN) based on location under reported linkage peaks, previous results in the literature (182 candidate genes), brain expression, biological plausibility, and estrogen responsivity. We employed a case-control design that tested each SNP individually as well as haplotypes derived from these SNPs in 1,085 case individuals with AN diagnoses and 677 control individuals. We also performed separate association analyses using three increasingly restrictive case definitions for AN: all individuals with any subtype of AN (All AN: n = 1,085); individuals with AN with no binge eating behavior (AN with No Binge Eating: n = 687); and individuals with the restricting subtype of AN (Restricting AN: n = 421). After accounting for multiple comparisons, there were no statistically significant associations for any individual SNP or haplotype block with any definition of illness. These results underscore the importance of large samples to yield appropriate power to detect genotypic differences in individuals with AN and also motivate complementary approaches involving Genome-Wide Association (GWA) studies, Copy Number Variation (CNV) analyses, sequencing-based rare variant discovery assays, and pathway-based analysis in order to make up for deficiencies in traditional candidate gene approaches to AN.


Assuntos
Anorexia Nervosa/genética , Estudos de Associação Genética , Predisposição Genética para Doença/genética , Adolescente , Adulto , Idoso , Bulimia/genética , Feminino , Haplótipos/genética , Humanos , Pessoa de Meia-Idade , Fenótipo , Polimorfismo de Nucleotídeo Único/genética , Adulto Jovem
20.
Front Psychiatry ; 11: 609675, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33304289

RESUMO

Background: This study explores the impact of weight gain during medical stabilization hospitalization on weight outcomes between three outpatient treatments for adolescent anorexia nervosa (AN): Adolescent Focused Therapy (AFT), Systemic Family Therapy (SyFT), and Family Based Treatment (FBT). Methods: A secondary analysis of weight gain data (N = 215) of adolescents (12-18 years) meeting DSM-IV criteria for AN (exclusive of amenorrhea criteria) who participated in two randomized clinical trials (RCTs) was conducted. Main outcomes examined were changes in weight restoration (≥95% expected body weight or EBW) and differences in weight change attributable to hospital weight gain. Results: Weight gain resulting from hospitalizations did not substantially change weight recovery rates. Hospital weight gain contributed most to overall treatment weight gain in AFT compared to FBT and SyFT. Conclusion: Brief medical stabilization weight gain does not contribute substantially to weight recovery in adolescents with AN who participated in RCTs.

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