Temperament and Eating Attitudes in an Adolescent Community Sample: A Brief Report

Objective. Temperament traits like high harm avoidance (HA) have been proposed as putative risk factors for the development of eating disorders (EDs). We aimed at studying the relationship between temperament and eating attitudes on a large community sample of adolescents. Method. We recruited 992 high school students aged 14–18. In addition to measuring body mass index (BMI), participants were asked to complete the temperament and character inventory and the food frequency questionnaire. Results. Sixty-two percent of the sample reported overeating, 22.8% reported normal eating, and 15.2% reported under eating. Under and normal eaters had higher BMI than that of over eaters. Harm avoidance was found to be significantly higher in those participants with lower eating intakes whilst novelty seeking was found to be higher in over eaters. Conclusion. An interesting association between temperament (high HA) and food approach (under eating) emerged. Longitudinal studies are needed to evaluate whether these traits represent a risk factor for the development of EDs

Body Mass Index Specifiers in Anorexia Nervosa: Anything below the "Extreme"?

The validity of body mass index (BMI) specifiers for anorexia nervosa (AN) has been questioned, but their applicability to inpatients with extremely low BMIs and their prognostic validity are currently unknown. Therefore, we designed this study: (a) to test current BMI specifiers in severe inpatients; (b) to explore a “very extreme” specifier (VE-AN; BMI ≤ 13.5); and (c) to verify inpatients’ hospitalization outcome according to BMI severity. We enrolled 168 inpatients with AN completing the following: Eating disorder Examination-Questionnaire, Eating Disorder Inventory-2, State-Trait Anxiety Inventory, Beck Depression Inventory, Body Shape Questionnaire, and EQ-5D-VAS. According to the current BMI classification, those with a BMI < 15 versus those with non-extreme AN (NE-AN, BMI ≥ 15) differed on all measures but the quality of life with those with NE-AN reporting more impaired scores on all measures. Adopting an exploratory classification comparing VE-AN, extreme AN (E-AN, BMI = 13.6–14.99), and NE-AN, no differences emerged between VE-AN and E-AN, while those with NE-AN reported significantly more impaired scores on all variables while the quality of life again did not differ across groups. Hospitalization outcome improved for all groups, independently of BMI. Groups differed concerning the length of stay that mirrored BMI severity and impacted also hospitalization outcomes. Taken together, our data support the lack of validity of current BMI specifiers in AN, even in the acute setting. Moreover, the exploratory subgroup of patients with BMI ≤ 13.5 did not delineate a clinically different group

Development and validation of the Premorbid Childhood Traits Questionnaire (PCT-Q) in eating disorders

PurposeSome features of eating disorders (EDs) are often present in childhood before the onset of the ED. We developed a novel questionnaire to retrospectively capture such childhood traits.MethodsFocus groups were conducted at the University of California-San Diego, USA, and at the University of Turin, Italy. Three focus groups were conducted at each site, interviewing patients and parents to identify those traits that most commonly characterize childhood of patients with EDs. A preliminary version of the Premorbid Childhood Traits Questionnaire (PCT-Q) derived from these focus groups was then administered to 94 consecutive inpatients with an ED and to 286 healthy controls (HCs) at the Turin site. Also, 208 participants' parents were enrolled as well; in fact, the PCT-Q was developed with both a proband and an informant version.ResultsA 37-item final version of the PCT-Q was generated. Reliability analyses suggested acceptability for harm avoidance (HA), social phobia, alexithymia, interoceptive awareness (IA), and food obsessions. Inter-rater reliability ranged from fair to moderate. ED sufferers scored significantly higher than HCs on HA, social phobia, alexithymia, IA, and food obsessions.ConclusionsThese findings support the possibility that premorbid traits contribute to a risk to develop an ED in some individuals.Level of evidenceIII: case-control analytic study