More threads by David Baxter PhD

David Baxter PhD

Late Founder
Eating disorders often follow childhood anxiety disorders
December 24, 2004

A history of childhood-onset anxiety disorders appears to be common among people with eating disorders, report researchers who suggest that they may be a risk factor for anorexia and bulimia nervosa.

It has previously been indicated that eating disorders often co-exist with other psychological problems, such as anxiety and depression, observe Walter Kaye (University of Pittsburgh Medical Center in Pennsylvania, USA) and colleagues.

To investigate the relationship further, they determined the frequency of anxiety disorders in 97 individuals with anorexia, 282 with bulimia, and 293 with both conditions, and compared it with that for a group of women of the same age without any eating disorders.

The participants completed the Structured Clinical Interview for DSM-IV Axis I Disorders, along with standardized measures of anxiety, perfectionism, and obsessionality.

About two thirds of the individuals with eating disorders had one or more lifetime anxiety disorders, with obsessive-compulsive disorder (OCD) and social phobia the most common, at 41% and 20%, respectively.

The high rate of OCD, compared with the typical population rate of 2% to 3% was "most striking," the researchers write in the American Journal of Psychiatry.

They note that in the majority of cases, the onset of anxiety disorders occurred in childhood before the participants had developed their eating disorder.

Even people with an eating disorder who had never been diagnosed with an anxiety disorder tended to be anxious, perfectionistic, and harm avoidant.

Based on their findings, the researchers suggest that anxiety disorders, particularly OCD, are "a vulnerability factor for developing anorexia nervosa or bulimia nervosa."

Am J Psychiatry 2004; 161: 2215-2221

David Baxter PhD

Late Founder
Harm avoidance resembles the uptightness and separation-induced fearfulness we have seen in rhesus monkeys. "Severely high" harm avoidance entails: inhibition in the face of unfamiliar people or situations, fear and anticipation of harm even in the presence of reassurance and support, pessimism, and easy fatigability. Those with very low harm avoidance are laid-back--confident, carefree, optimistic, energetic, quick to recuperate, and calm in the face of unfamiliar or threatening circumstances.

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