Get access

Risk Factors and Antecedent Life Events in the Development of Anorexia Nervosa: A Portuguese Case-Control Study

Authors

  • Bárbara C. Machado,

    1. CEDH—Centre for Studies in Human Development, Faculty of Education and Psychology, Catholic University of Portugal, Porto, Portugal
    2. Psychotherapy and Psychopathology Research Unit–CIPsi, School of Psychology, University of Minho, Braga, Portugal
    Search for more papers by this author
  • Sónia F. Gonçalves,

    1. Psychotherapy and Psychopathology Research Unit–CIPsi, School of Psychology, University of Minho, Braga, Portugal
    Search for more papers by this author
  • Carla Martins,

    1. Psychotherapy and Psychopathology Research Unit–CIPsi, School of Psychology, University of Minho, Braga, Portugal
    Search for more papers by this author
  • Hans W. Hoek,

    1. Parnassia Bavo Academy, Parnassia Psychiatric Institute, The Hague, The Netherlands
    2. Department of Epidemiology, Columbia University, New York, NY, USA
    3. Department of Psychiatry, University of Groningen, Groningen, The Netherlands
    Search for more papers by this author
  • Paulo P. Machado

    1. Psychotherapy and Psychopathology Research Unit–CIPsi, School of Psychology, University of Minho, Braga, Portugal
    Search for more papers by this author

Correspondence: Bárbara C. Machado, PhD, Faculty of Education and Psychology, Catholic University of Portugal, Rua Diogo Botelho, 1327, 4169-005 Porto, Portugal.

Email: bcmachado@porto.ucp.pt

Abstract

Objective

The aetiology of anorexia nervosa (AN) is considered to be multifactorial. This study aims to identify potential risk factors for AN and whether these factors are specific to AN or precede the development of psychiatric disorders in general and to identify specific life events in the 12 months immediately preceding the onset of eating disorder (ED) symptoms.

Method

A case-control design was used to compare a group of women who meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 86) with healthy controls (N = 86) and with a group of controls with other psychiatric disorders (N = 68), each group matched to the AN patients by age and parental socioeconomic status bands. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview.

Results

Women with AN reported significantly higher rates of perfectionism, negative attitudes toward parents' shape and weight, significant concern about feeling fat and a family history of AN or bulimia nervosa. Critical comments about weight, shape or eating was the most notable event in the year preceding AN onset.

Discussion

Perfectionism and a family history of ED emerged as the most convergent findings in the development of AN, along with being critical toward parents' shape and weight, and feeling fat. Critical comments about appearance and eating seem to be an important precipitating factor in AN onset. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Ancillary