title: Risk for self-reported anorexia or bulimia nervosa based on drive for thinness and negative affect clusters/dimensions during adolescence: A three-year prospective study of the TChAD cohort.
abstract: OBJECTIVE
  This study explored the cross-sectional and predictive effect of drive for thinness and/or negative affect scores on the development of self-reported anorexia nervosa (AN) and bulimia nervosa (BN).
  
  
  METHODS
  K-means were used to cluster the Eating Disorder Inventory-Drive for Thinness (DT) and Child Behavior Checklist Anxious/Depressed (A/D) scores from 615 unrelated female twins at age 16-17. Logistic regressions were used to assess the effect of these clusters on self-reported eating disorder diagnosis at ages 16-17 (n = 565) and 19-20 (n = 451).
  
  
  RESULTS
  DT and A/D scores were grouped into four clusters: Mild (scores lower than 90th percentile on both scales), DT (higher scores only on DT), A/D (higher scores only on A/D), and DT-A/D (higher scores on both the DT and A/D scales). DT and DT-A/D clusters at age 16-17 were associated cross-sectionally with AN and both cross-sectionally and longitudinally with BN. The DT-A/D cluster had the highest prevalence of AN at follow-up compared with all other clusters. Similarly, an interaction was observed between DT and A/D that predicted risk for AN.
  
  
  CONCLUSIONS
  Having elevated DT and A/D scores may increase risk for eating disorder symptomatology above and beyond a high score on either alone. Findings suggest that cluster modeling based on DT and A/D may be useful to inform novel and useful intervention strategies for AN and BN in adolescents.
authors.affiliation: University of Extremadura Medical School, Badajoz, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Peñas-Lledó
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Paul
authors.initials: P
authors.lastname: Lichtenstein
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Larsson
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology*; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D057566:Self Report; D013851:Thinness / Q000150:complications*
keywords: anorexia; anxiety; bulimia; depression; drive for thinness; eating disorders; negative affect; risk; subtyping