Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-18T23:44:47.577Z Has data issue: false hasContentIssue false

13 - Comorbid anxiety and depression and the role of trauma in children and adolescents with eating disorders

from Part III - Abnormal states

Published online by Cambridge University Press:  02 December 2009

Brett McDermott
By
Timothy D. Brewerton
Edited by
Tony Jaffa
Brett McDermott
Affiliation:
University of Queensland
Timothy D. Brewerton
Affiliation:
Medical University of South Carolina, Charleston, SC, USA
Tony Jaffa
Affiliation:
Phoenix Centre, Cambridge
Get access

Summary

Introduction

In many cases it is not the eating disorder (ED) symptom or sign per se that brings the child or adolescent with an ED into treatment, but instead it is a related yet serious comorbid problem or condition which merits medical and/or psychiatric attention, e.g. suicide attempt, depression and/or anxiety. Even when the ED is established at presentation the recognition of comorbid anxious and depressive symptoms in children and adolescents is of paramount importance for successful treatment and outcome. The presence or absence of comorbidity may affect long-term prognosis.

Anxiety

In a study of 2525 Australian teenagers Patton et al. (1997) found psychiatric comorbidity to be the clearest factor associated with extreme dieting with 62% of extreme dieters reporting high levels of both anxiety and depression.

Bulik et al. (1997) looked at the prevalence and age of onset of anxiety disorders in 68 women with anorexia nervosa (AN), 116 women with bulimia nervosa (BN), 56 women with major depression (MD) with no ED and 98 randomly selected controls (RC). Comorbid anxiety disorders were common in all three patient groups (AN, 60%; BN, 57%; MD, 48%). In those cases with comorbid anxiety, 90% of AN women, 94% of BN women and 71% of MD women had anxiety disorders preceding the current primary condition (P ≤ 0.01). It is of note, however, that panic disorder tended to develop after the onset of AN, BN or MD rather than preceding these conditions.

Keywords

adolescentschildhood sexual abusedisorder comorbidityeating disordersseparation anxiety disordertraumapost-traumatic stress disorderpsychiatric comorbidity
Type
Chapter
Information
Eating Disorders in Children and Adolescents , pp. 158 - 168
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ackard, D. M. & Neumark-Sztainer, D. (2002). Date violence and date rape among adolescents: associations with disordered eating behaviors and psychological health. Child Abuse and Neglect, 26, 455–73.Google Scholar
Ackard, D. M. & Neumark-Sztainer, D. (2003). Multiple sexual victimizations among adolescent boys and girls: Prevalence and associations with eating behaviors and psychological health. Journal of Child Sexual Abuse, 12, 17–37.Google Scholar
Ackard, D. M., Neumark-Sztainer, D., Hannan, P. J., French, S. & Story, M. (2001). Binge and purge behavior among adolescents: associations with sexual and physical abuse in a nationally representative sample: the Commonwealth Fund survey. Child Abuse and Neglect, 25, 771–85.Google Scholar
Ackard, D. M., Neumark-Sztainer, D. & Hannan, P. (2003). Dating violence among a nationally representative sample of adolescent girls and boys: associations with behavioral and mental health. Journal of Gender-Specific Medicine, 6, 39–48.Google Scholar
Andrews, B. (1997). Bodily shame in relation to abuse in childhood and bulimia: a preliminary investigation. British Journal of Clinical Psychology, 36, 41–9.Google Scholar
Bailly-Lambin, I. & Bailly, D. (1999). Separation anxiety disorder and eating disorders. Encephale, 25, 226–31.Google Scholar
Brady, K., Killeen, T. K., Brewerton, T. D. & Sylverini, S. (2000). Comorbidity of psychiatric disorders and posttraumatic stress disorder. Journal of Clinical Psychiatry, 61 Suppl. 7, 22–32.Google Scholar
Brewerton, T. D. (2002). Bulimia in children and adolescents. Child Adolescent Psychiatry Clinics of North America, 11, 237–56.Google Scholar
Brewerton, T. D. (2004). Treatment principles of eating disorder patients with comorbidity: relationship to victimization and PTSD. In Clinical Handbook of Eating Disorders: An Integrated Approach, ed. Brewerton, T. D.New York: Marcel Dekker, pp. 509–45.
Brewerton, T. D., Dansky, B. S., Kilpatrick, D. G. & O'Neil, P. M. (1999). Bulimia nervosa, PTSD and “forgetting”: Results from the National Women's Study. In Trauma and Memory, ed. Williams, L. M. & Banyard, V. L. Durham, UK: Sage Publications, pp. 127–38.
Bulik, C. M., Sullivan, P. F., Fear, J. L. & Joyce, P. R. (1997). Eating disorders and antecedent anxiety disorders: a controlled study. Acta Psychiatrica Scandinavica, 96, 101–7.Google Scholar
Dansky, B. S., Brewerton, T. D., O'Neil, P. M. & Kilpatrick, D. G. (1997). The National Women's Study: Relationship of crime victimization and PTSD to bulimia nervosa. International Journal of Eating Disorders, 21, 213–28.Google Scholar
Devaud, C., Jeannin, A., Narring, F., Ferron, C. & Michaud, P. A. (1998). Eating disorders among female adolescents in Switzerland: prevalence and associations with mental and behavioral disorders. International Journal of Eating Disorders, 24, 207–16.Google Scholar
Edgardh, K. & Ormstad, K. (2000). Prevalence and characteristics of sexual abuse in a national sample of Swedish seventeen-year-old boys and girls. Acta Paediatrica, 89, 310–19.Google Scholar
Favaro, A., Rodella, F. C. & Santonastaso, P. (2000). Binge eating and eating attitudes among Nazi concentration camp survivors. Psychological Medicine, 30, 463–6.Google Scholar
Flament, M. F., Godart, N. T., Fermanian, J. & Jeammet, P. (2001). Predictive factors of social disability in patients with eating disorders. Eating and Weight Disorders, 6, 99–106.Google Scholar
Fonseca, H., Ireland, M. & Resnick, M. D. (2002). Familial correlates of extreme weight control behaviors among adolescents. International Journal of Eating Disorders, 32, 441–8.Google Scholar
Gati, A., Tenyi, T., Tury, F. & Wildmann, M. (2002). Anorexia nervosa following sexual harassment on the internet: a case report. International Journal of Eating Disorders, 31, 474–7.Google Scholar
Godart, N. T., Flament, M. F., Lecrubier, Y. & Jeammet, P. (2000). Anxiety disorders in anorexia nervosa and bulimia nervosa: co-morbidity and chronology of appearance. European Psychiatry: the Journal of the Association of European Psychiatrists, 15, 38–45.Google Scholar
Grilo, C. M. & Masheb, R. M. (2001). Childhood psychological, physical, and sexual maltreatment in outpatients with binge eating disorder: frequency and associations with gender, obesity, and eating-related psychopathology. Obesity Research, 9, 320–5.Google Scholar
Herpertz-Dahlmann, B., Muller, B., Herpertz, S., Heussen, N., Hebebrand, J. & Remschmidt, H. (2001). Prospective 10-year follow-up in adolescent anorexia nervosa–course, outcome, psychiatric comorbidity, and psychosocial adaptation. Journal of Child Psychology, Psychiatry and Allied Disciplines, 42, 603–12.Google Scholar
Johnson, J. G., Cohen, P., Kasen, S. & Brook, J. S. (2002). Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood. Archives of General Psychiatry, 59, 545–52.Google Scholar
Kendler, K. S., Bulik, C. M., Silberg, J.et al. (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Archives of General Psychiatry, 57, 953–9.Google Scholar
Kent, A. & Waller, G. (2000). Childhood emotional abuse and eating psychopathology. Clinical Psychology Review, 20, 887–903.Google Scholar
Kent, A., Waller, G. & Dagnan, D. (1999). A greater role of emotional than physical or sexual abuse in predicting disordered eating attitudes: the role of mediating variables. International Journal of Eating Disorders, 25, 159–67.Google Scholar
Keys, A., Brozek, J., Henschel, A., Mickelsen, O. & Taylor, H. L. (1950). The Biology of Human Starvation. Minneapolis, MN: University of Minnesota Press.
Kinzl, J. F., Mangweth, B., Traweger, C. M. & Biebl, W. (1997). Eating-disordered behavior in males: the impact of adverse childhood experiences. International Journal of Eating Disorders, 22, 131–8.Google Scholar
Lilenfeld, L. R. R. (2004). Psychiatric comorbidity associated with anorexia nervosa, bulimia nervosa, and binge eating disorder. In Clinical Handbook of Eating Disorders: An Integrated Approach, ed. Brewerton, T. D.New York: Marcel Dekker, pp. 183–207.
Lipschitz, D. S., Winegar, R. K., Hartnick, E., Foote, B. & Southwick, S. M. (1999). Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 385–92.Google Scholar
Miotto, P., Coppi, M., Frezza, M. & Preti, A. (2003). Eating disorders and suicide risk factors in adolescents: an Italian community-based study. Journal of Nervous and Mental Disease, 191, 437–43.Google Scholar
Molinari, E. (2001). Eating disorders and sexual abuse. Eating and Weight Disorders, 6, 68–80.Google Scholar
Moorhead, D. J., Stashwick, C. K., Reinherz, H. Z., Giaconia, R. M., Streigel-Moore, R. M. & Paradis, A. D. (2003). Child and adolescent predictors for eating disorders in a community population of young adult women. International Journal of Eating Disorders, 33, 1–9.Google Scholar
Murray, C. & Waller, G. (2002). Reported sexual abuse and bulimic psychopathology among nonclinical women: the mediating role of shame. International Journal of Eating Disorders, 32, 186–91.Google Scholar
Neumark-Sztainer, D., Story, M., Hannan, P. J., Beuhring, T. & Resnick, M. D. (2000). Disordered eating among adolescents: associations with sexual/physical abuse and other familial/psychosocial factors. International Journal of Eating Disorders, 28, 249–58.Google Scholar
Patton, G. C., Carlin, J. B., Shao, Q.et al. (1997). Adolescent dieting: healthy weight control or borderline eating disorder?Journal of Child Psychology, Psychiatry and Allied Disciplines, 38, 299–306.Google Scholar
Perez, M., Joiner, T. E. Jr. & Lewinsohn, P. M. (2004). Is major depressive disorder or dysthymia more strongly associated with bulimia nervosa?International Journal of Eating Disorders, 36, 55–61.Google Scholar
Perkins, D. F. & Luster, T. (1999). The relationship between sexual abuse and purging: findings from community-wide surveys of female adolescents. Child Abuse and Neglect, 23, 371–82.Google Scholar
Rabe-Jablonska, J. J. & Sobow, T. M. (2000). The links between body dysmorphic disorder and eating disorders. European Psychiatry: the Journal of the Association of European Psychiatrists, 15, 302–5.Google Scholar
Sherwood, N. E., Neumark-Sztainer, D., Story, M., Beuhring, T. & Resnick, M. D. (2002). Weight-related sports involvement in girls: who is at risk for disordered eating?American Journal of Health Promotion, 16, 341–4.Google Scholar
Smolak, L. & Murnen, S. K. (2002). A meta-analytic examination of the relationship between child sexual abuse and eating disorders. International Journal of Eating Disorders, 31, 136–50.Google Scholar
Striegel-Moore, R. H., Dohm, F. A., Pike, K. M., Wilfley, D. E. & Fairburn, C. G. (2002). Abuse, bullying, and discrimination as risk factors for binge eating disorder. American Journal of Psychiatry, 159, 1902–7.Google Scholar
Swanston, H. Y., Tebbutt, J. S., O'Toole, B. I. & Oates, R. K. (1997). Sexually abused children 5 years after presentation: a case-control study. Pediatrics, 100, 600–8.Google Scholar
Thompson, K. M., Wonderlich, S. A., Crosby, R. D. & Mitchell, J. E. (2001). Sexual victimization and adolescent weight regulation practices: a test across three community based samples. Child Abuse and Neglect, 25, 291–305.Google Scholar
Vanelli, M. (2002). Munchausen's syndrome by proxy web-mediated in a child with factitious hyperglycemia. Journal of Pediatrics, 141, 839.Google Scholar
Waller, G., Meyer, C., Ohanian, V., Elliott, P., Dickson, C. & Sellings, J. (2001). The psychopathology of bulimic women who report childhood sexual abuse: the mediating role of core beliefs. Journal of Nervous and Mental Disease, 189, 700–8.Google Scholar
Waller, G. (1998). Perceived control in eating disorders: relationship with reported sexual abuse. International Journal of Eating Disorders, 23, 213–16.Google Scholar
Wonderlich, S. A., Brewerton, T. D., Jocic, Z., Dansky, B. S. & Abbott, D. W. (1997). The relationship of childhood sexual abuse and eating disorders: a review. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1107–15.Google Scholar
Wonderlich, S., Crosby, R., Mitchell, J.et al. (2001). Pathways mediating sexual abuse and eating disturbance in children. International Journal of Eating Disorders, 29, 270–9.Google Scholar
Wonderlich, S. A., Crosby, R. D., Mitchell, J. E.et al. (2000). Relationship of childhood sexual abuse and eating disturbance in children. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1277–83.Google Scholar
Wonderlich, S. A., Crosby, R. D., Mitchell, J. E.et al. (2001). Eating disturbance and sexual trauma in childhood and adulthood. International Journal of Eating Disorders, 30, 401–12.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×