Adding maintaining factors to developmental models of anorexia nervosa: An empirical examination in adolescents. (23rd February 2021)

• Record Type: Journal Article
• Authors: Moreno‐Encinas, Alba; Graell, Montserrat; Martínez‐Huertas, José Ángel; Faya, Mar; Treasure, Janet; Sepúlveda, Ana Rosa
• Is Part Of: European eating disorders review. Volume 29:Number 4(2021)
• Page Start: 548
• Page End: 558
• Publication Date: 2021-02-23
• Subjects: adolescence -- anorexia nervosa -- developmental model -- etiology -- maintaining factors -- structural equation modeling; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/erv.2826
• Languages: English
• ISSNs: 1072-4133

Abstract

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. Highlights: These findings in part provide empirical support for the developmental model proposed by Herpertz‐Dahlmann et al. (2011) and the interpersonal maintenance model (Treasure & Schmidt, 2013) for AN. Premorbid traits are linked to AN symptoms through body dissatisfaction and stressful life events, and the biological, psychological and familial consequences that follow may act as maintaining mechanisms. This model suggests a temporal sequence of symptoms that might explain the course of AN and its maintenance. This has implications for early intervention as interventions into maintenance factors in the early stages of the illness can moderate the course of the disorder.