The relationship of biogenetic predisposition, personality and familial characteristics to adolescent anorexia nervosa: A risk model
This study examined the relative risk of family history of affective disorder, family history of eating disorder, perceptions of family environment as low in independence and the personality variables of feelings of ineffectiveness, model child and interoceptive awareness in predicting whether adolescents had anorexia nervosa, restricting type. Loglinear analyses were used to identify a model that best fit the data. This method permits a multivariate view of the data as well as identification of interactions among variables. Univariate analyses were also calculated. The sample consists of 49 patients with anorexia nervosa, restricting type, and their parents, as well as 259 noneating disordered adolescents and 109 of their parents. Controls were junior high and high school students from public and private schools. Subjects were administered the EAT, EDI, FES, Perfect Child Questionnaire and Family History Questionnaire. The model that best fit the data was family history of depression, feelings of ineffectiveness, poor interoceptive awareness, and the interaction between feelings of ineffectiveness and poor interoceptive awareness. The relative risk for anorexia nervosa was four times more likely for adolescents with a family history of depression and three times more likely for adolescents with poor interoceptive awareness. A feeling of ineffectiveness was a relatively weak variable contributing little to the relative risk of anorexia nervosa. The risks between the factors interoceptive awareness and feelings of ineffectiveness may not be well distinguished. These results failed to support a model with the variables "model child", family history of eating disorders, or family with low independence. Thus, the model which best fit the data was a simple one, confirming Bruch's theory that one important risk factor for anorexia nervosa was poor interoceptive. The mechanism of relative risk for anorexia nervosa in families with a history of depression remains to be explicated. The multidimensional nature of anorexia nervosa was confirmed empirically.