title: Parental high concern and adolescent-onset anorexia nervosa. A case-control study to investigate direction of causality.
abstract: BACKGROUND
  Robust evidence that anorexia nervosa is preceded rather than accompanied by high-concern (overprotective) parenting is limited.
  
  
  OBJECTIVE
  To look for evidence of parental high concern occurring before any onset of disorder.
  
  
  METHODS
  Forty consecutive referrals of adolescent girls with DSM-III-R anorexia nervosa were compared with matched controls using obstetric records and maternal interviews.
  
  
  RESULTS
  Index mothers reported higher rates of: near-exclusive child care (P = 0.02), infant sleep difficulties (P = 0.018), severe distress at first regular separation (P = 0.048), high maternal trait anxiety levels (P = 0.008) and later age for first sleeping away from home (P = 0.009). More index families had experienced a severe obstetric loss prior to their daughter's birth (P = 0.066).
  
  
  CONCLUSIONS
  This study lends evidence to the clinical contention that high-concern parenting in infancy is associated with the later development of anorexia nervosa. This may derive, in part, from aspects of unresolved grief.
authors.affiliation: North Bristol NHS Trust, Southmead Hospital, Bristol.
authors.forename: P
authors.initials: P
authors.lastname: Shoebridge
authors.forename: S G
authors.initials: SG
authors.lastname: Gowers
mesh_terms: D000022:Abortion, Spontaneous / Q000523:psychology; D000293:Adolescent; D000856:Anorexia Nervosa / Q000209:etiology / Q000523:psychology*; D001007:Anxiety / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009034:Mother-Child Relations; D010287:Parent-Child Relations; D016487:Parenting; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology