Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence
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Background: Cross‐sectional associations between anxiety disorders and eating disorders ( ED s) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with ED s. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent‐reported anxiety in mid‐childhood (age 10) and child‐reported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population‐based sample. Methods: Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children ( ALSPAC ), a population‐based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14. Results: Parent‐reported anxiety symptoms at age 10 yielded 5 factors: obsessive‐compulsive disorder ( OCD ) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 ( OR = 1.11, p = .007), whereas Factor 4 predicted diagnoses of anorexia nervosa ( OR = 1.10, p = .01) and disordered eating by age 16 ( OR = 1.08, p = .001). Conclusions: Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescent‐onset ED symptoms and ED diagnoses.
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Anxiety is a transdiagnostic factor involved in the development and maintenance of anorexia nervosa and is predictive for its course and treatment outcomes.
“A transdiagnostic factor that is involved in the development, maintenance of, and is predictive for the course and treatment outcomes of anorexia nervosa is anxiety [10–20].”
From Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa (2024) · cites this paper as [15]
The Results (Eating Disorder Diagnosis; page not provided) report that worries at age 10 predicted an anorexia nervosa diagnosis by age 16, supporting a link to development. The paper does not establish that anxiety maintains anorexia nervosa or predicts its course or treatment outcomes; its prospective analysis concerns onset in adolescence. (LLM, conf=0.88)
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- Authors
- Schaumberg, K., Zerwas, S., Goodman, E., Yilmaz, Z., Bulik, C. M., & Micali, N.
- Affiliations
- University of Wisconsin–Madison (US)
- University of North Carolina at Chapel Hill (US)
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill NC
- University of Geneva (CH)
- Corresponding author
- Micali, Nadia
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2018-10-24
- Volume
- 60
- Issue
- 6
- Pages
- 686-696
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC6482103
- OpenAlex
- W2898199308
- Cited by
- 80
- References
- 70
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 13 · 2023: 11 · 2022: 10 · 2021: 13 · 2020: 10 · 2019: 3
- FWCI
- 7.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- UNC Libraries
- Funders
- National Institute of Mental Health (5R01MH073842, R21MH109917, T32MH076694)
- Medical Research Council
- Wellcome Trust (102215/2/13/2)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- anxiety disorders, eating disorders, anorexia nervosa, bulimia nervosa, disordered eating, generalized anxiety disorder, childhood anxiety, adolescence, developmental psychopathology, prospective associations, obsessive-compulsive disorder, social anxiety disorder, somatic anxiety, worry, Avon Longitudinal Study of Parents and Children
- MeSH terms
- Phobia, Social, Adolescent, Anorexia Nervosa, Anxiety Disorders, Feeding and Eating Disorders, Child, Female, United Kingdom, Humans, Longitudinal Studies, Male, Obsessive-Compulsive Disorder, Comorbidity, Bulimia Nervosa
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