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Adding maintaining factors to developmental models of anorexia nervosa: An empirical examination in adolescents

Research output: Contribution to journalArticlepeer-review

Alba Moreno-Encinas, Montserrat Graell, José Ángel Martínez-Huertas, Mar Faya, Janet Treasure, Ana Rosa Sepúlveda

Original languageEnglish
Pages (from-to)548-558
Number of pages11
JournalEuropean Eating Disorders Review
Volume29
Issue number4
DOIs
Accepted/In press2021
PublishedJul 2021

Bibliographical note

Funding Information: We express our gratitude to all the families, staff hospital and psychiatrists from the mental health centres who helped us in the recruitment process. We are grateful to the headmasters and teachers from the Secondary Schools: IES La Estrella, IES Las Musas, IES Alameda de Osuna that facilitated us the recruitment stage. Finally, we would like to thank P. Andr?s, T. Alvarez, and D. Anastasiadou for their help in the recruitment and data collection process. Leptin was analyzed by Immunonutrition Research Group, Institute of Food Science, Technology and Nutrition (ICTAN) ? CSIC, coordinated by A. Marcos. This work was supported by the Spanish Ministry of Science and Innovation (RYC-2009-05092 and PSI2011-23127); and the Ministry of Education of Spain (FPU15/05783). Funding Information: We express our gratitude to all the families, staff hospital and psychiatrists from the mental health centres who helped us in the recruitment process. We are grateful to the headmasters and teachers from the Secondary Schools: IES La Estrella, IES Las Musas, IES Alameda de Osuna that facilitated us the recruitment stage. Finally, we would like to thank P. Andrés, T. Alvarez, and D. Anastasiadou for their help in the recruitment and data collection process. Leptin was analyzed by Immunonutrition Research Group, Institute of Food Science, Technology and Nutrition (ICTAN) – CSIC, coordinated by A. Marcos. This work was supported by the Spanish Ministry of Science and Innovation (RYC‐2009‐05092 and PSI2011‐23127); and the Ministry of Education of Spain (FPU15/05783). Publisher Copyright: © 2021 Eating Disorders Association and John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Objective: A biopsychosocial approach has been proposed to explain the pathogenesis of anorexia nervosa (AN), despite only a few of the existing etiological models having received empirical support. The aim of this study was to empirically investigate Herpertz-Dahlmann, Seitz, and Konrad (2011, https://doi.org/10.1007/s00406-011-0246-y)’s developmental model and to consider if interpersonal reactions to the illness might serve as maintaining factors following the model proposed by Treasure and Schmidt (2013, https://doi.org/10.1186/2050-2974-1-13). Method: One hundred adolescents and their families were participated in the study: 50 diagnosed with AN, paired by age and parents’ socio-economic status with 50 adolescents without a pathology. Biological, psychological and familial variables were assessed using ten questionnaires and a blood analysis test. Additionally, structural equation modeling was conducted to assess two hypothetical models. Results: The fit of both models was good after the addition of two covariate parameters (e.g., Comparative Fit Index > 0.96 and Tucker–Lewis Index > 0.95). Premorbid traits were linked to body dissatisfaction and to the number of stressful life events; this in turn was linked to AN symptoms. Biological and familial consequences reinforced this pathology. Conclusions: Our findings provide support for both models, suggesting that inter relationships between bio-psycho-familial variables can influence the course of AN during adolescence.

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