title: Internalizing and externalizing behaviour problems in childhood contribute to the development of anorexia and bulimia nervosa-a study comparing sister pairs.
abstract: OBJECTIVE
  We wanted to clarify whether there is any clinically relevant behavioural psychopathology in patients before onset of an eating disorder (ED) compared with their healthy sisters and if there are differences in behavioural problems between the ED subtypes anorexia nervosa-restricting type (AN-R) and EDs with bulimic behaviour.
  
  
  METHODS
  Behavioural psychopathology was examined by parental report using the Child Behaviour Checklist retrospectively in 83 sister pairs discordant for an ED (37 with AN-R and 46 with bulimic EDs) by means of conditional logistic regression.
  
  
  RESULTS
  Participants who later developed an ED had significantly higher internalizing and externalizing behavioural abnormality scores before onset of the ED than their unaffected sisters. Conditional logistic regression revealed significantly higher internalizing behaviour scores in AN-R and significantly higher internalizing and externalizing scores in the bulimic disorders.
  
  
  CONCLUSIONS
  Internalizing problems (anxiety, depression and somatization) preceded the development of AN, whereas both internalizing and externalizing behaviour problems (aggressive and delinquent behaviour) preceded bulimic disorders.
authors.affiliation: Eating Disorders Unit at the Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria.
authors.forename: Mandana
authors.initials: M
authors.lastname: Adambegan
authors.forename: Gudrun
authors.initials: G
authors.lastname: Wagner
authors.forename: Ingo W
authors.initials: IW
authors.lastname: Nader
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernandez-Aranda
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.forename: Andreas
authors.initials: A
authors.lastname: Karwautz
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000523:psychology*; D052018:Bulimia Nervosa / Q000150:complications / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D012307:Risk Factors; D035781:Siblings / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult