title: Childhood anxiety associated with low BMI in women with anorexia nervosa.
abstract: OBJECTIVE
  Extremely low body mass index (BMI) values are associated with increased risk for death and poor long-term prognosis in individuals with anorexia nervosa (AN). The present study explores childhood personality characteristics that could be associated with the ability to attain an extremely low BMI.
  
  
  METHODS
  Participants were 326 women from the Genetics of Anorexia Nervosa (GAN) Study who completed the Structured Interview for Anorexia Nervosa and Bulimic Syndromes and whose mother completed the Child Behavioral Checklist and/or Revised Dimensions of Temperament Survey.
  
  
  RESULTS
  Children who were described as having greater fear or anxiety by their mothers attained lower BMIs during AN (p < 0.02). Path analysis in the GAN and a validation sample, Price Foundation Anorexia Nervosa Trios Study, confirmed the relation between early childhood anxiety, caloric restriction, qualitative food item restriction, excessive exercise, and low BMI. Path analysis also confirmed a relation between childhood anxiety and caloric restriction, which mediated the relation between childhood anxiety and low BMI in the GAN sample only.
  
  
  CONCLUSIONS
  Fearful or anxious behavior as a child was associated with the attainment of low BMI in AN and childhood anxiety was associated with caloric restriction. Measures of anxiety and factors associated with anxiety-proneness in childhood may index children at risk for restrictive behaviors and extremely low BMIs in AN.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, USA.
authors.forename: Jocilyn E
authors.initials: JE
authors.lastname: Dellava
authors.forename: Laura M
authors.initials: LM
authors.lastname: Thornton
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hamer
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.forename: Katherine
authors.initials: K
authors.lastname: Plotnicov
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Klump
authors.forename: Harry
authors.initials: H
authors.lastname: Brandt
authors.forename: Steve
authors.initials: S
authors.lastname: Crawford
authors.forename: Manfred M
authors.initials: MM
authors.lastname: Fichter
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Halmi
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.forename: Craig
authors.initials: C
authors.lastname: Johnson
authors.forename: Allan S
authors.initials: AS
authors.lastname: Kaplan
authors.forename: Maria
authors.initials: M
authors.lastname: Lavia
authors.forename: James
authors.initials: J
authors.lastname: Mitchell
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rotondo
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.forename: D Blake
authors.initials: DB
authors.lastname: Woodside
authors.forename: Wade H
authors.initials: WH
authors.lastname: Berrettini
authors.forename: Walter H
authors.initials: WH
authors.lastname: Kaye
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000328:Adult; D000367:Age Factors; D000856:Anorexia Nervosa / Q000523:psychology*; D001007:Anxiety; D015992:Body Mass Index; D002648:Child; D002149:Energy Intake; D015444:Exercise / Q000523:psychology; D005239:Fear; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D010551:Personality