Childhood anxiety associated with low BMI in women with anorexia nervosa.
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.
Dellava
Jocilyn E
JE
Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, USA.
Thornton
Laura M
LM
Hamer
Robert M
RM
Strober
Michael
M
Plotnicov
Katherine
K
Klump
Kelly L
KL
Brandt
Harry
H
Crawford
Steve
S
Fichter
Manfred M
MM
Halmi
Katherine A
KA
Jones
Ian
I
Johnson
Craig
C
Kaplan
Allan S
AS
Lavia
Maria
M
Mitchell
James
J
Rotondo
Alessandro
A
Treasure
Janet
J
Woodside
D Blake
DB
Berrettini
Wade H
WH
Kaye
Walter H
WH
Bulik
Cynthia M
CM
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