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- Ahrén-Moonga, Jennie
(författare)
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An eating disorder is more than just disordered eating : bio-psycho-social perspectives
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Several reports show that stress and psychiatric ill health are increasing in adolescents. Eating disorders (ED) and related conditions such as depression, self-injurious behaviour and suicide attempts are becoming more common, especially among young women. Eating disorders include two main categories: anorexia nervosa (self-starvation) and bulimia nervosa (binge eating and compensatory actions). These disorders do not only involve deviations in eating behaviour, but also include several severe physiological and psychiatric symptoms. The aetiology of eating disorders remains largely unclear, and multifactorial models that integrate biological, psychological and social perspectives are necessary in the investigation of risk factors and the natural history of these conditions. The overall aim of the present thesis was to integrate bio-psycho-social aspects in the study of the aetiology and clinical course of eating disorders. The studies included are based on two different data sets. Study I is based on the Uppsala Birth Cohort Multigenerational Study (UBCoS Multigen), a longitudinal register-based study including information about families spanning over three generations. The sample includes all men and women born at the Uppsala University Hospital between the years 1915-1929 and their descendants born up to 2002. The database is unique in enabling researchers to study intergenerational associations. The second data set is a clinical sample of severely ill, eating disorder inpatients from a specialized clinic (Study II-IV). Our results indicate that social background can be of importance in the development of eating disorders; higher education in parents and maternal grandparents was associated with higher risk of hospitalization for ED. Further we found a higher risk of ED in women with the highest marks in school. The clinical studies showed that patients with eating disorders had higher scores on somatic stress and physiological tension, as well as on cognitive-social anxiety as compared to healthy controls. The co-morbidity with self-injurious behaviour and suicide attempts was high, especially in patients with bulimia nervosa. Among the bulimia nervosa patients low social adaptation, negative childhood environment and low childhood adjustment were more common. Biological markers as measured by cytokines showed higher levels of pro-inflammatory proteins in the patient group. Personality traits indicating anxiety and aggression were associated with increased levels of cytokines. Finally neuropsychological impairments and negative self-evaluations were common in both anorexia and bulimia nervosa. Eating disorders are to be considered an increasing public health problem. Studies on the interplay between social factors, interpersonal variations in behaviour, and biological aspects of eating pathology are essential for a better understanding of eating disorders.
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| 2. |
- Ahrén-Moonga, Jennie, et al.
(författare)
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Association of Higher Parental and Grandparental Education and Higher School Grades With Risk of Hospitalization for Eating Disorders in Females : The Uppsala Birth Cohort Multigenerational Study
- 2009
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Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 170:5, s. 566-575
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Tidskriftsartikel (refereegranskat)abstract
- Eating disorders are a leading cause of disease burden amongyoung women. This study investigated associations of socialcharacteristics of parents and grandparents, sibling position,and school performance with incidence of eating disorders. Theauthors studied Swedish females born in 1952–1989 (n =13,376), third-generation descendants of a cohort born in Uppsalain 1915–1929. Data on grandparental and parental socialcharacteristics, sibling position, school grades, hospitalizations,emigrations, and deaths were obtained by register linkages.Associations with incidence of hospitalization for eating disorderswere studied with multivariable Cox regression, adjusted forage and study period. Overall incidence of hospitalization foreating disorders was 32.0/100,000 person-years. Women with morehighly educated parents and maternal grandparents were at higherrisk (hazard ratio for maternal grandmother with higher educationrelative to elementary education = 6.5, 95% confidence interval:2.2, 19.3, adjusted for parental education). Independent offamily social characteristics, women with the highest schoolgrades had a higher risk of eating disorders (hazard ratio =7.7, 95% confidence interval: 2.5, 24.1 for high compared withlow grades in Swedish, adjusted for parental education). Thus,higher parental and grandparental education and higher schoolgrades may increase risk of hospitalization for eating disordersin female offspring, possibly because of high internal and externaldemands.
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| 4. |
- Ahrén-Moonga, Jennie, et al.
(författare)
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Levels of tumour necrosis factor-alpha and interleukin-6 in severely ill patients with eating disorders
- 2011
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Ingår i: Neuropsychobiology. - : S. Karger AG. - 0302-282X .- 1423-0224. ; 63:1, s. 8-14
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Tidskriftsartikel (refereegranskat)abstract
- Background: The underlying pathophysiology of eating disorders (ED) is dependent on complex interactions between psychological, biological and social factors. The purpose of the present study was to examine a possible increase in cytokines indicating inflammation, as measured by tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in ED patients, and to explore possible relationships between cytokines and self-reported personality traits. Methods: Female patients with severe ED (n = 26) were recruited consecutively from an inpatient clinic and were compared to age-matched healthy females (n = 12). Commercial ELISA tests developed for the measurement of serum levels of TNF-α and IL-6 were employed. Personality traits were measured using Karolinska Scales of Personality. Results: The patient group displayed increased levels of the cytokine TNF-α and a tendency towards increased IL-6 levels. Spearman's rank correlation coefficient was used to examine possible relationships between levels of cytokines and personality traits. The results showed that IL-6 levels were positively related to both somatic and psychic anxiety and to aggression scales, such as irritability and suspicion. Increased levels of TNF-α, in turn, were significantly correlated with high scores on the depression-related anxiety scale Inhibition of Aggression. However, increased levels of cytokines in the ED group did not seem to be mainly associated with symptoms of depression. Conclusion: We cannot rule out the possibility that comorbid conditions in the group contribute to the higher cytokine values. Further studies need to explore the possible influence of cytokines on the severity of ED and whether this might be mediated or moderated by specific personality traits.
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| 7. |
- Ahren-Moonga, Jennie, et al.
(författare)
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Personality traits and self-injurious behaviour in patients with eating disorders
- 2008
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Ingår i: European eating disorders review. - : Wiley. - 1072-4133 .- 1099-0968. ; 16:4, s. 268-275
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Tidskriftsartikel (refereegranskat)abstract
- The interest in different aspects of personality and the neuropsychological basis for behaviour in eating disorder patients has increased over the last decade. The present study aims at exploring personality traits, self-injurious behaviour (SIB) and suicide attempts in a group of severely ill eating disorder patients. Patients with eating disorders (N = 38) and age-matched controls (N = 67) were examined concerning self-reported personality traits by means of the Karolinska scales of personality (KSP). Psychosocial history and SIB was collected from medical records. Depression was rated by means of the Beck Depression Inventory (BDI). Results indicated significantly higher anxiety-related and detachment traits in both anorexia nervosa (AN) and bulimia nervosa (BN) patients and higher hostility in BN patients than controls. No specific personality traits could be defined as typical for self-injurious or suicidal behaviour. The AN group was lower than the BN group on scales measuring impulsivity, guilt and anxiety. Furthermore, presence of SIB and suicide attempts was more frequent among the BN patients.
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| 8. |
- Ahrén-Moonga, Jennie, et al.
(författare)
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Personality traits and self-injury behaviour in patients with eating disorders
- 2008
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Ingår i: European eating disorders review. - : Wiley. - 1072-4133 .- 1099-0968. ; 16:4, s. 268-275
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Tidskriftsartikel (refereegranskat)abstract
- The interest in different aspects of personality and the neuropsychological basis for behaviour in eating disorder patients has increased over the last decade. The present study aims at exploring personality traits, self-injurious behaviour (SIB) and suicide attempts in a group of severely ill eating disorder patients. Patients with eating disorders (N = 38) and age-matched controls (N = 67) were examined concerning self-reported personality traits by means of the Karolinska scales of personality (KSP). Psychosocial history and SIB was collected from medical records. Depression was rated by means of the Beck Depression Inventory (BDI). Results indicated significantly higher anxiety-related and detachment traits in both anorexia nervosa (AN) and bulimia nervosa (BN) patients and higher hostility in BN patients than controls. No specific personality traits could be defined as typical for self-injurious or suicidal behaviour. The AN group was lower than the BN group on scales measuring impulsivity, guilt and anxiety. Furthermore, presence of SIB and suicide attempts was more frequent among the BN patients.
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