title: Risk factors and antecedent life events in the development of anorexia nervosa: a Portuguese case-control study.
abstract: OBJECTIVE
  The aetiology of anorexia nervosa (AN) is considered to be multifactorial. This study aims to identify potential risk factors for AN and whether these factors are specific to AN or precede the development of psychiatric disorders in general and to identify specific life events in the 12 months immediately preceding the onset of eating disorder (ED) symptoms.
  
  
  METHODS
  A case-control design was used to compare a group of women who meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 86) with healthy controls (N = 86) and with a group of controls with other psychiatric disorders (N = 68), each group matched to the AN patients by age and parental socioeconomic status bands. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview.
  
  
  RESULTS
  Women with AN reported significantly higher rates of perfectionism, negative attitudes toward parents' shape and weight, significant concern about feeling fat and a family history of AN or bulimia nervosa. Critical comments about weight, shape or eating was the most notable event in the year preceding AN onset.
  
  
  CONCLUSIONS
  Perfectionism and a family history of ED emerged as the most convergent findings in the development of AN, along with being critical toward parents' shape and weight, and feeling fat. Critical comments about appearance and eating seem to be an important precipitating factor in AN onset.
authors.affiliation: CEDH-Centre for Studies in Human Development, Faculty of Education and Psychology, Catholic University of Portugal, Porto, Portugal; Psychotherapy and Psychopathology Research Unit-CIPsi, School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Bárbara C
authors.initials: BC
authors.lastname: Machado
authors.forename: Sónia F
authors.initials: SF
authors.lastname: Gonçalves
authors.forename: Carla
authors.initials: C
authors.lastname: Martins
authors.forename: Hans W
authors.initials: HW
authors.lastname: Hoek
authors.forename: Paulo P
authors.initials: PP
authors.lastname: Machado
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000209:etiology*; D057215:Body Dysmorphic Disorders / Q000150:complications*; D001835:Body Weight; D016022:Case-Control Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000235:genetics; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis; D009771:Obsessive-Compulsive Disorder / Q000150:complications; D011174:Portugal; D012307:Risk Factors; D055815:Young Adult
keywords: anorexia nervosa; family history of ED; perfectionism; replication; risk factors