Parental high concern and adolescent-onset anorexia nervosa. A case-control study to investigate direction of causality

Br J Psychiatry. 2000 Feb:176:132-7. doi: 10.1192/bjp.176.2.132.

Abstract

Background: Robust evidence that anorexia nervosa is preceded rather than accompanied by high-concern (overprotective) parenting is limited.

Aims: To look for evidence of parental high concern occurring before any onset of disorder.

Method: Forty consecutive referrals of adolescent girls with DSM-III-R anorexia nervosa were compared with matched controls using obstetric records and maternal interviews.

Results: Index mothers reported higher rates of: near-exclusive child care (P = 0.02), infant sleep difficulties (P = 0.018), severe distress at first regular separation (P = 0.048), high maternal trait anxiety levels (P = 0.008) and later age for first sleeping away from home (P = 0.009). More index families had experienced a severe obstetric loss prior to their daughter's birth (P = 0.066).

Conclusions: This study lends evidence to the clinical contention that high-concern parenting in infancy is associated with the later development of anorexia nervosa. This may derive, in part, from aspects of unresolved grief.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Spontaneous / psychology
  • Adolescent
  • Anorexia Nervosa / etiology
  • Anorexia Nervosa / psychology*
  • Anxiety / complications
  • Case-Control Studies
  • Female
  • Humans
  • Mother-Child Relations
  • Parent-Child Relations*
  • Parenting
  • Pregnancy
  • Pregnancy Complications / psychology