Anorexia nervosa and anorexic-like syndromes in a population-based female twin sample.
Abstract
OBJECTIVE: The authors explored the epidemiologic characteristics and risk factors of anorexia nervosa and examined the relationship between narrowly defined anorexia nervosa and anorexia-like syndromes. METHOD: Structured interviews were administered to a population-based sample of 2,163 female twins. Anorexia nervosa was diagnosed by computer algorithm ("computer narrow") and by narrow and broad clinical definitions. RESULTS: Lifetime prevalence estimates of 0.51%, 1.62%, and 3.70% were obtained for the computer narrow, clinical narrow, and clinical broad diagnoses, respectively. Dieting status, greater number of years of parental education, low self-esteem, high levels of neuroticism, and maternal overprotectiveness were significantly associated with anorexia nervosa. Both the pattern of comorbidity and the relationship to epidemiologic risk factors suggested an etiologic continuity between narrowly and broadly defined anorexic syndromes. Co-twins of twins with anorexia nervosa were at significantly higher risk for lifetime anorexia nervosa, bulimia nervosa, major depression, and current low body mass index. Significant comorbidity was found between anorexia nervosa and major depression, bulimia nervosa, generalized anxiety disorder, alcoholism, phobias, and panic disorder. CONCLUSIONS: The authors' analyses support the hypothesis of a spectrum of anorexic-like syndromes in women. These syndromes are familial and share familial etiologic factors with major depression and bulimia nervosa.
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The observed prevalence estimates were generally similar to those of previous studies.
“The observed prevalence estimates were generally similar to those of previous studies,1–8,22,23 and salient differences in sociodemographic and clinical correlates were observed between eating disorder subtypes.”
From Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement (2011) · cites this paper as [4]
Cites
Society and the Adolescent Self-Image
Rosenberg, M. (1965) · doi:10.1515/9781400876136 · Cited by 30,126 · see citing works
The Statistical Analysis of Failure Time Data.
Aitkin, M. A., Kalbfleisch, J. D., & Prentice, R. L. (1981) · Biometrics · doi:10.2307/2530581 · Cited by 9,875 · see citing works
A revised version of the Psychoticism scale
Eysenck, S. B. G., Eysenck, H. J., & Barrett, P. (1985) · Personality and Individual Differences · doi:10.1016/0191-8869(85)90026-1 · Cited by 3,094 · see citing works
Use of the Danish Adoption Register for the study of obesity and thinness.
Stunkard, A. J., Sørensen, T. I. A., & D, F. S. M. (1983) · PubMed · Cited by 1,773 · see citing works
Depressive attributional style.
Seligman, M. E. P., Abramson, L. Y., Semmel, A., & von Baeyer, C. L. (1979) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.88.3.242 · Cited by 1,099 · see citing works
(1982) · Medical Entomology and Zoology · Cited by 764 · see citing works
Genes, culture, and personality : an empirical approach
Eaves, L. J., Eysenck, H. J., & Martin, N. G. (1989) · Cited by 637 · see citing works
The genetic epidemiology of bulimia nervosa.
(1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.12.1627 · Cited by 631 · see citing works
Inference from Complex Samples
Kish, L., & Frankel, M. R. (1974) · Journal of the Royal Statistical Society Series B (Methodological) · doi:10.1111/j.2517-6161.1974.tb00981.x · Cited by 530 · see citing works
Parental Characteristics in Relation to Depressive Disorders
Parker, G. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.2.138 · Cited by 509 · see citing works
A Population-Based Twin Study of Major Depression in Women
Kendler, K. S. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820040009001 · Cited by 451 · see citing works
Self-citationBody Image in Anorexia Nervosa: Measurement, Theory and Clinical Implications
Garner, D. M., & Garfinkel, P. E. (1982) · The International Journal of Psychiatry in Medicine · doi:10.2190/r55q-2u6t-lam7-rqr7 · Cited by 356 · see citing works
Body Image in Anorexia Nervosa and Bulimia Nervosa
Cash, T. F., & Brown, T. A. (1987) · Behavior Modification · doi:10.1177/01454455870114005 · Cited by 283 · see citing works
Anorexia nervosa: Evidence for a genetic basis
Holland, A. J., Sicotte, N. L., & Treasure, J. L. (1988) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(88)90004-9 · Cited by 251 · see citing works
MANN, A. H., Wakeling, A., Wood, K., Monck, E., Dobbs, R., & SZMUKLER, G. I. (1983) · Psychological Medicine · doi:10.1017/s0033291700047991 · Cited by 222 · see citing works
King, M. (1989) · Psychological Medicine Monograph Supplement · doi:10.1017/s0264180100000515 · Cited by 206 · see citing works
Whitaker, A. H., Davies, M., Shaffer, D., Johnson, J., Abrams, S., Walsh, B. T., & Kalikow, K. T. (1989) · Psychological Medicine · doi:10.1017/s0033291700011107 · Cited by 199 · see citing works
Rand, C. S. W., & Kuldau, J. M. (1990) · International Journal of Eating Disorders · doi:10.1002/1098-108x(199005)9:3 · Cited by 199 · see citing works
Anorexia nervosa: a study of 34 twin pairs and one set of triplets
Holland, A. J., Hall, A., Murray, R., Russell, G. F. M., & Crisp, A. H. (1984) · British Journal of Psychiatry · doi:10.1192/bjp.145.4.414 · Cited by 174 · see citing works
The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care
Hoek, H. W. (1991) · Psychological Medicine · doi:10.1017/s0033291700020560 · Cited by 162 · see citing works
Clinical findings in patients with anorexia nervosa and affective illness in their relatives
Gershon, E. S., Schreiber, J. L., Hamovit, J. R., Dibble, E. D., Kaye, W., Nürnberger, J. I., Andersen, A. E., & Ebert, M. H. (1984) · American Journal of Psychiatry · doi:10.1176/ajp.141.11.1419 · Cited by 161 · see citing works
Norris, D. L. (1984) · Psychological Medicine · doi:10.1017/s0033291700019802 · Cited by 146 · see citing works
Whitehouse, A. M., Cooper, P., Vize, C. E., Hill, C., & Vogel, L. (1992) · Europe PMC (PubMed Central) · Cited by 105 · see citing works
Garfinkel, P. E., Garner, D. M., Rose, J., Darby, P. L., Brandes, J. S., O'hanlon, J., & Walsh, N. (1983) · Psychological Medicine · doi:10.1017/s0033291700051539 · Cited by 104 · see citing works
Affective and Anxiety Disorders in the Long-Term Follow-up of Anorexia Nervosa
Toner, B. B., Garfinkel, P. E., & Garner, D. M. (1989) · The International Journal of Psychiatry in Medicine · doi:10.2190/934q-eppl-keyg-nn0u · Cited by 88 · see citing works
Family Issues in the Pathogenesis of Anorexia Nervosa
Yager, J. (1982) · Psychosomatic Medicine · doi:10.1097/00006842-198203000-00007 · Cited by 81 · see citing works
Eating attitudes and disorder in young women: a general practice based survey
Meadows, G. N., Palmer, R. L., Newball, E. U. M., & Kenrick, J. M. T. (1986) · Psychological Medicine · doi:10.1017/s003329170000917x · Cited by 68 · see citing works
Biederman, J., Rivinus, T. M., Kemper, K. J., Hamilton, D., MacFadyen, J., & Harmatz, J. S. (1985) · American Journal of Psychiatry · doi:10.1176/ajp.142.12.1495 · Cited by 58 · see citing works
Prevalence and incidence of eating disorders in a suburban area
Cullberg, J., & Engström‐Lindberg, M. (1988) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1988.tb06342.x · Cited by 49 · see citing works
Low Self-Esteem in Eating Disordered Patients in the Absence of Depression
Silverstone, P. H. (1990) · Psychological Reports · doi:10.2466/pr0.1990.67.1.276 · Cited by 47 · see citing works
Eating disorder and affective disorder: Relatives or merely chance acquaintances?
Katz, J. L. (1987) · Comprehensive Psychiatry · doi:10.1016/0010-440x(87)90028-9 · Cited by 28 · see citing works
A Family Systems Orientation to the Treatment of Anorexia Nervosa
Liebman, R., SARGENT, J. A., & SILVER, M. (1983) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)62325-6 · Cited by 23 · see citing works
LOW SELF-ESTEEM IN EATING DISORDERED PATIENTS IN THE ABSENCE OF DEPRESSION
Silverstone, P. H. (1990) · Psychological Reports · doi:10.2466/pr0.67.5.276-278 · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.040 · Cited by 4,973 · see citing works
Swanson, S. A., Crow, S. J., Le Grange, D., Swendsen, J., & Merikangas, K. R. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.22 · Cited by 1,611 · see citing works
Comorbidity of Anxiety Disorders With Anorexia and Bulimia Nervosa
Kaye, W. H., Bulik, C. M., Thornton, L., Barbarich, N., Masters, K., & the Price Foundation Collaborative Group (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.12.2215 · Cited by 1,162 · see citing works
Risk factors for eating disorders.
Striegel-Moore, R. H., & Bulik, C. M. (2007) · American Psychologist · doi:10.1037/0003-066x.62.3.181 · Cited by 999 · see citing works
New insights into symptoms and neurocircuit function of anorexia nervosa
Kaye, W. H., Fudge, J. L., & Paulus, M. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2682 · Cited by 843 · see citing works
Neurobiology of anorexia and bulimia nervosa
Kaye, W. (2008) · Physiology & Behavior · doi:10.1016/j.physbeh.2007.11.037 · Cited by 625 · see citing works
The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project.
Preti, A., Girolamo, G. D., Vilagut, G., Alonso, J., Graaf, R. D., Bruffaerts, R., Demyttenaere, K., Pinto-Meza, A., Haro, J. M., & Morosini, P. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.04.003 · Cited by 456 · see citing works
The co‐morbidity of eating disorders and anxiety disorders: a review
Swinbourne, J. M., & Touyz, S. W. (2007) · European Eating Disorders Review · doi:10.1002/erv.784 · Cited by 448 · see citing works
Anorexia Nervosa and Major Depression: Shared Genetic and Environmental Risk Factors
Wade, T. D., Bulik, C. M., Neale, M., & Kendler, K. S. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.3.469 · Cited by 375 · see citing works
Self-citationEating disorders in White and Black women
Striegel-Moore, R. H., Dohm, F. A., Kraemer, H. C., Taylor, C. B., Daniels, S., Crawford, P. B., & Schreiber, G. B. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.7.1326 · Cited by 302 · see citing works
Anxiety disorders in subjects seeking treatment for eating disorders: A DSM-IV controlled study
Godart, N. T., Flament, M. F., Curt, F., Perdereau, F., Lang, F., Venisse, J. L., Halfon, O., Bizouard, P., Loas, G., Corcos, M., et al. (2003) · Psychiatry Research · doi:10.1016/s0165-1781(03)00038-6 · Cited by 207 · see citing works
Wierenga, C. E., Ely, A., Bischoff-Grethe, A., Bailer, U. F., Simmons, A. N., & Kaye, W. H. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00410 · Cited by 195 · see citing works
Garfinkel, P. E., Lin, E., Goering, P., Spegg, C., Goldbloom, D., Kennedy, S., Kaplan, A. S., & Woodside, D. B. (1996) · British Journal of Psychiatry · doi:10.1192/bjp.168.4.500 · Cited by 175 · see citing works
Eating disorders: clinical features and pathophysiology
Klein, D. A., & Walsh, B. T. (2004) · Physiology & Behavior · doi:10.1016/j.physbeh.2004.02.009 · Cited by 164 · see citing works
Shared transmission of eating disorders and anxiety disorders
Keel, P. K., Klump, K. L., Miller, K. B., McGue, M., & Iacono, W. G. (2005) · International Journal of Eating Disorders · doi:10.1002/eat.20168 · Cited by 147 · see citing works
A search for susceptibility loci for anorexia nervosa: methods and sample description
Kaye, W. H., Lilenfeld, L. R., Berrettini, W. H., Strober, M., Devlin, B., Klump, K. L., Goldman, D., Bulik, C. M., Halmi, K. A., Fichter, M. M., et al. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00240-1 · Cited by 116 · see citing works
Delineation of differential temporal relations between specific eating and anxiety disorders
Buckner, J. D., Silgado, J., & Lewinsohn, P. M. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.01.014 · Cited by 75 · see citing works
Boraska, V., Davis, O. S. P., Cherkas, L. F., Helder, S. G., Harris, J., Krug, I., Pei‐Chi Liao, T., Treasure, J., Ntalla, I., Karhunen, L., et al. (2012) · American Journal of Medical Genetics Part B: Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32087 · Cited by 61 · see citing works
A practice guideline for treatment of eating disorders in children and adolescents
Ebeling, H., Tapanainen, P., Joutsenoja, A., Koskinen, M., Morin‐Papunen, L., Järvi, L., Hassinen, R., Keski‐Rahkonen, A., Rissanen, A., & Wahlbeck, K. (2003) · Annals of Medicine · doi:10.1080/07853890310000727 · Cited by 44 · see citing works
Pharmacotherapy of Eating Disorders
Jackson, C. W., Cates, M., & Lorenz, R. (2010) · Nutrition in Clinical Practice · doi:10.1177/0884533610362239 · Cited by 28 · see citing works
- Authors
- Walters, E. E., & Kendler, K. S.
- Affiliations
- Virginia Commonwealth University (US)
- Venue
- American Journal of Psychiatry
- Published
- 1995-01-01
- Volume
- 152
- Issue
- 1
- Pages
- 64-71
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2414900583
- Cited by
- 332
- References
- 33
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 8 · 2016: 3 · 2015: 4 · 2014: 14 · 2013: 12 · 2012: 17
- FWCI
- 12.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hd026746-05)
- National Institute on Alcohol Abuse and Alcoholism (R01AA009095, AA-09095)
- National Institute of Mental Health (R01MH040828, MH 40828)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 26746)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- anorexia nervosa, bulimia nervosa, comorbidities, risk factors, prevalence, family transmission, twin studies, dieting, self-esteem, neuroticism, major depressive disorder, generalized anxiety disorder, alcoholism, phobia, panic disorder, body mass index
- MeSH terms
- Adolescent, Adult, Anorexia Nervosa, Mental Disorders, Bulimia, Depressive Disorder, Diseases in Twins, Family, Female, Humans, Risk Factors, Sex Factors, Twins, Dizygotic, Twins, Monozygotic, Comorbidity, Prevalence, Confidence Intervals, Odds Ratio, Age of Onset
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