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  • Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control study
    Publication . Machado, Bárbara César; Gonçalves, Sónia F.; Martins, Carla; Brandão, Isabel; Roma-Torres, António; Hoek, Hans W.; Machado, Paulo P.
    Objective This study is the result of two Portuguese case– control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN Method A case–control design was used to compare a group of women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 98) and BN (N = 79) with healthy controls (N = 86) and with other psychiatric disorders (N = 68). Each control group was matched with AN patients regarding age and parental social categories. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Results Compared to AN, women with BN reported significantly higher rates of paternal high expectations, excessive family importance placed on fitness/keeping in shape, and negative consequences due to adolescent overweight and adolescent objective overweight. Discussion Overweight during adolescence emerged as the most relevant retrospective correlate in the distinction between BN and AN participants. Family expectations and the importance placed on keeping in shape were also significant retrospective correlates in the BN group.
  • Risk factors and antecedent life events in the development of anorexia nervosa: a portuguese case-control study
    Publication . Machado, Bárbara César; Gonçalves, Sónia; Martins, Carla; Hoek, Hans W.; Machado, Paulo P.
    Objective: The aetiology of anorexia nervosa (AN) is considered to be multifactorial. This study aims to identify potential risk factors for AN and whether these factors are specific to AN or precede the development of psychiatric disorders in general and to identify specific life events in the 12 months immediately preceding the onset of eating disorder (ED) symptoms. Method: A case-control design was used to compare a group of women who meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N= 86) with healthy controls (N= 86) and with a group of controls with other psychiatric disorders (N= 68), each group matched to the AN patients by age and parental socioeconomic status bands. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Results: Women with AN reported significantly higher rates of perfectionism, negative attitudes toward parents’ shape and weight, significant concern about feeling fat and a family history of AN or bulimia nervosa. Critical comments about weight, shape or eating was the most notable event in the year preceding AN onset. Discussion: Perfectionism and a family history of ED emerged as the most convergent findings in the development of AN, along with being critical toward parents’ shape and weight, and feeling fat. Critical comments about appearance and eating seem to be an important precipitating factor in AN onset