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- Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control studyPublication . 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 studyPublication . 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
- Eating disorders and non-suicidal self-injury: Structural equation modelling of a conceptual modelPublication . Vieira, Ana Isabel; Machado, Bárbara C.; Moreira, Célia S.; Machado, Paulo P.P.; Brandão, Isabel; Roma‐Torres, António; Gonçalves, SóniaEvidence suggests several risk factors for both eating disorders (ED) and nonsuicidal self‐injury (NSSI), but the relationships between these factors are not well understood. Considering our previous work and a conceptual model, this cross‐sectional study aimed to assess the relationships among distal and proximal factors for the presence of NSSI in ED. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. Structural equation modelling revealed that both distal and proximal factors were related to the presence of NSSI in ED, disclosing a mediating role of the proximal factors. Stressful life events mediated the relationship between childhood sexual abuse, peer aggres-sion, and both ED and NSSI. Childhood physical abuse was related to ED and NSSI via substance use, negative self‐evaluation, and suicide attempts. Find- ings provided support for the conceptual model and highlight the possible mechanisms by which psychoso cial factors may lead to ED and NSSI.
- Putative risk factors for non-suicidal self-injury in eating disordersPublication . Vieira, Ana Isabel; Machado, Bárbara C.; Machado, Paulo P. P.; Brandão, Isabel; Roma-Torres, António; Gonçalves, SóniaEvidence suggests a common association between eating disorders (EDs) and non-suicidal self-injury (NSSI). The present study aimed to investigate the potential risk factors for NSSI among ED patients. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. The results showed that 33% of ED patients reported NSSI in their lifetime. NSSI appeared to occur more frequently among binge eating/purging type ED patients than among patients with other ED and to be related to a more severe eating pathology. A younger age at the onset of eating problems, more negative self-evaluation, suicide attempts, substance abuse, parents’ low weight, family tension at mealtime, parental alcohol problems, childhood abuse, peer aggression, and negative antecedent life events were more common among patients with co-occurring EDs and NSSI than among patients without NSSI. The results may inform the risk assessment and treatment of NSSI in EDs in the early detection period.