Factors Associated with Suicide Attempts in Women with Eating Disorders

The primary aim of this study was to evaluate whether the prevalence of lifetime suicide attempts/completions (SACs) is greater in women with anorexia nervosa (AN) and women bulimia nervosa (BN) than women with no eating disorder (no ED). Additional aims included identifying eating disorder features, comorbid psychopathology, and temperament features associated with SACs separately in the women with AN and with BN. Women in the Swedish Twin study of Adults: Gene and Environment (STAGE; n = 12,981) and the Screening Across the Lifespan of Twins (SALT; n = 16,281) cohorts completed questionnaires assessing eating disorder behaviors, lifetime history of psychiatric disorders, and temperament. Lifetime SACs were identified using diagnoses from the Swedish National Patient Register and the Cause of Death Register. STAGE and SALT were analyzed separately. General linear models were used to evaluate whether ED category (AN, BN, or no ED) was associated with SACs, and to identify factors associated with SACs. The prevalence of SAC was higher for women in both the AN or BN categories compared with women with no ED in both STAGE and SALT. In STAGE, depression and panic disorder were associated with SACs in women with AN, and vomiting, depression, substance use and panic disorder were associated with SACs in women with BN. In SALT, alcohol abuse/dependence was associated with SACs in women with AN; no factors were identified as associated with SACs in women with BN. All identified factors acted in an additive manner and did not interact with eating disorder status to differentially increase risk. Results of this investigation may assist with identification of individuals with eating disorders at highest risk for SAC and directly inform treatment and prevention efforts.Doctor of Philosoph

Eating Disorders, Psychopathology, and Temperament in Opposite Sex and Same Sex Twins

The purpose of this study was to examine the hypothesis that prenatal exposure to sex hormones affects the risk for developing eating disorder symptoms, full syndrome eating disorders, other psychiatric disorders with known sex differences, and temperament traits in members of opposite sex (OS) versus same sex (SS) twin pairs. Female (N=9433) and male (N=7025) twins from the Swedish Twin Registry with known co-twin sex and zygosity completed questionnaires assessing eating disorder attitudes and behaviors, lifetime history of other psychiatric disorders (including alcohol abuse, substance use, mood disorders, anxiety disorders, and autism/Aspergers), and temperament traits. Females were analyzed separately using logistic regressions and analysis of variance with generalized estimating equations applied to control for the correlated nature of the data. All comparisons were across monozygotic SS twins, dizygotic SS twins, and dizygotic OS twins. Additional analyses were conducted with the full sample to assess whether a linear trend existed across female and male OS and SS twins. After controlling for multiple comparisons, no significant differences were found. Presumed prenatal exposure to sex hormones was not associated with risk or protection for developing eating disorder behaviors, full syndromes, other psychiatric disorders, or temperament traits in this sample

Uniting couples (in the treatment of) anorexia nervosa (UCAN)

To describe the development of a novel couple-based cognitive-behavioral intervention for adult anorexia nervosa (AN) called Uniting Couples (in the treatment of) Anorexia Nervosa (UCAN)

Self-image and suicide in a Swedish national eating disorders clinical register

Using a prospective design, to examine the relation between self-image (assessed using the Structural Analysis of Social Behavior) and suicide attempts/completions in women with anorexia nervosa-restricting type (ANR), anorexia nervosa-binge/purge type (ANBP), bulimia nervosa (BN), binge eating disorder, and eating disorder not otherwise specified (EDNOS); and to assess whether these self-image variables add unique predictive value to suicide when considering other baseline predictors

Understanding the Relation Between Anorexia Nervosa and Bulimia Nervosa in a Swedish National Twin Sample

We present a bivariate twin analysis of anorexia nervosa (AN) and bulimia nervosa (BN) to determine the extent to which shared genetic and environmental factors contribute to liability to these disorders

Is childhood trauma associated with lifetime suicide attempts in women with bulimia nervosa?

The purpose of this study was to explore the association between specific forms of childhood abuse and neglect with lifetime suicide attempts in women with bulimia nervosa (BN)

Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self-Esteem among Treatment-Seeking Adolescents with Bulimia Nervosa: Subjective and Objective Binge Eating

This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa (BN). We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology while SBEs may indicate restrictive/depressive symptomatology

Association between co-twin sex and eating disorders in opposite sex twin pairs: Evaluations in North American, Norwegian, and Swedish samples

These three studies examined the hypothesis that prenatal exposure to sex hormones influences twins’ risk for eating disorders based on co-twin sex, such that individuals with a female co-twin would be more likely than individuals with a male co-twin to meet diagnostic criteria for an eating disorder

NURTURE: Development and pilot testing of a novel parenting intervention for mothers with histories of an eating disorder: Nurture Pilot Testing

To describe the treatment development and pilot testing of a group parenting intervention, NURTURE (Networking, Uniting, and Reaching out To Upgrade Relationships and Eating), for mothers with histories of eating disorders