Category: Eating Disorders
There are several risk factors to developing an eating disorder, many of which are displayed within child temperament. Research demonstrates that personality traits, including anxiety, perfectionism, obsessiveness, emotional dysregulation, and altered sensitivity to reward precede the onset of an eating disorder. Personality traits also differ across diagnoses; for example, impulsivity is more common in individuals diagnosed with anorexia nervosa, binge-purge subtype (AN-b/p) compared to those diagnosed with restricting subtype (AN-r), while harm avoidance and perfectionism are common traits across all eating disorders. The Childhood Retrospective Perfectionism Questionnaire (CHIRP) was developed to retrospectively assess self-report of premorbid obsessive-compulsive personality traits (OCPT) before the onset of an eating disorder. We created a new measure, the Childhood Retrospective Questionnaire (PCT-Q), which expands the CHIRP from solely OCPT traits to include domains of harm avoidance, reward sensitivity, alexithymia, interoceptive awareness, social phobia, drive for achievement, food-related obsessions, worry about the future, and sleep. The purpose of this study was to examine differences in self-report of childhood traits between AN subgroups using this recently validated measure. We hypothesized that there would be significant differences between restricting and binge-purge subtypes, particularly for reward sensitivity, interceptive awareness, drive for achievement, and food-related obsessions. Participants were 222 patients diagnosed with AN [AN-r (n = 161) and AN-b/p (n = 61), (Mage = 18.9, SDage = 8.08; MBMI = 17.8, SDBMI = 2.29)] who were enrolled in treatment in a partial hospitalization program. The PCT-Q was administered to all consenting adult patients within the first two weeks of admission. Diagnoses were determined by psychiatrist upon admission. Independent samples t-tests compared PCT-Q scores across AN subtypes. AN-b/p patients self-reported higher pre-morbid reward sensitivity scores than patients with AN-r (p = .02). AN-r patients self-reported higher interoceptive awareness scores (p = .02), higher social phobia scores, (p = .04) and higher food-related obsessions scores than AN-b/p patients (p = .005). Given that harm avoidance, perfectionism, and anxiety are common traits among all eating disorders, it is unsurprising that there were no significant differences in drive for achievement, harm avoidance, or worry about the future between the AN subgroups. These findings confirm childhood personality differences in patients diagnosed with AN-r and AN-b/p. Results from this study will help inform directed treatment approaches for diagnostic subtypes of AN and associated personality traits.
Laura Greathouse– Research Coordinator, UC San Diego, San Diego, California
Michelle Jones– Post-Doctoral Fellow, University of California, San Diego
Tiffany Brown– Postdoctoral Research Fellow, University of California, San Diego
Christina Wierenga– Associate Professor, University of California, San Diego
Enrica Marzola– Department of Neuroscience, University of Turin, Italy
Walter Kaye– Professor, University of California, San Diego