Child and Adolescent Psychiatric Clinics of North America
Eating disorders in adolescents and young adults☆
Section snippets
Developmental epidemiology of eating disorders
Anorexia nervosa (AN) and bulimia nervosa (BN) exact their toll primarily during adolescence and young adulthood—a period of life marked by enormous biologic and social change for young women. Overall, lifetime prevalence estimates of AN from female general population samples range from 0.1% to 1% [52], [74], [86], [149], [150]. In the Virginia Twin Registry, the lifetime prevalence of AN in female twins was 0.51% [145]. Some studies have suggested that the incidence of AN is increasing [23],
Gender, development, and eating disorders
The female-to-male ratio for AN and BN has been estimated consistently to be approximately 10:1 in clinical and epidemiologic samples [33], [100], [114], [149]. The principles of developmental psychopathology have not been applied adequately to the study of eating disorders, especially as a means of understanding the uneven gender distribution and the peak ages of onset around and after puberty. Few studies have explored the relation between disturbances in eating and weight-related behaviors
Developmental trajectory of eating disorders
Anorexia and BN have profound medical and psychologic consequences that can impact adversely the developmental tasks of adolescence and young adulthood. Correlates of the eating disorder, such as depression, anxiety, social withdrawal, difficulty eating in social situations, heightened self-consciousness, fatigue, and medical complications of the eating disorder, can isolate an individual from the tide of normal development that his or her peers are experiencing. Many young women who recover
Developmental relation between anorexia and bulimia nervosa
Anorexia nervosa and BN, and their associated symptoms, are neither completely independent nor completely overlapping conditions. Despite the observable contrasts in feeding behavior and approaches to weight regulation, there are parallels in exaggerated concern with fatness, dietary restraint, body dissatisfaction, and body image distortion [126]. Outcome studies of AN with follow-up intervals of between 4 and 22 years indicate that between 8% and 41% of individuals developed BN during the
How can genetic epidemiology help us understand the role of adolescence and puberty on the development of eating disorders?
We have reviewed recently all extant family and twin studies of eating disorders [10], [128]. There have been no adoption studies of AN or BN.
Dimensional measures of personality
Psychometric studies consistently have linked eating disorders to a cluster of personality and temperamental traits, specifically obsessionality, perfectionism, and harm avoidance [7], [14], [76], [117], [125], [142], [143]. These findings continue to characterize individuals with AN even after recovery [19], [66], [117]. The general personality profile that has emerged of women with BN during the acute phase of the illness includes high harm avoidance, low self-esteem, neuroticism, impulsivity
Summary
Adolescence and young adulthood mark the convergence of substantial biologic and social change. Individuals differ in their innate capacity to tolerate change. Research suggests that some of the personality characteristics that are fundamental to individuals with eating disorders may render them particularly vulnerable to the impact of a changing body and changing social demands. The fact that eating disorders emerge primarily during adolescence and often run a protracted course can deprive the
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Preliminary evidence of sex differences in behavioral and neural responses to palatable food reward in rats
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Developmental trajectories of compensatory exercise and fasting behavior across the middle school years
2016, AppetiteCitation Excerpt :Wade and O'Shea (2015) identified adolescent girls engaging in driven exercise and fasting but not binge eating and purging; they found that those girls experienced significant distress that was comparable to that of girls diagnosed with typical or atypical AN. Because eating disorder symptoms often emerge during the middle school years (grades 6–8 in the current sample; Bulik, 2002; Pearson, Zapolski, & Smith, 2015a), it is important to understand the presence and developmental course of nonpurging compensatory behaviors in girls this age. We therefore investigated if these behaviors occur in girls during the middle school years, whether engagement in the behaviors follows different developmental courses for different girls across those years, and whether it was possible to predict the behaviors from the presence of elementary school risk factors.
Puberty as a critical risk period for eating disorders: A review of human and animal studies
2013, Hormones and BehaviorCitation Excerpt :The first indirectly examined the influence of puberty by exploring rates of eating disorders in children versus adolescents. These studies consistently show a significantly increased prevalence of all forms of eating disorders in individuals in mid-late adolescence as compared to pre-adolescence (Bulik, 2002). Indeed, pre-pubertal onset of eating disorders is rare (Bulik, 2002), and mean ages of onset for the disorders (i.e., 15–19 years for AN and BN) (American Psychiatric Association, 2000; Favaro et al., 2003, 2009) reflect a post-pubertal bias in onset.
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2016, Cambridge Quarterly of Healthcare Ethics
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Preparation of this article was supported by a grant from the National Institutes of Health (MH-01553).