Unser Vortrag in Orlando an der AED-Conference im April 2004 mit Inhalten des Projektes wurde in Eating Disorders Review 15/4 im July/August 2004 besprochen:

Psychosocial and Genetic Risk Factors
Andreas Karwautz, MD, Professor at the University Clinic of Neuropsychiatry, Vienna, Austria, described the value of the concept of non-shared environment for development of anorexia nervosa (AN) and the opportunities to use a discordant sister-pair design for clarifying risk for developing anorexia nervosa.

Discordant sister-pairs have several advantages for study over nonrelated case-control studies. These include similar socioeconomic status, living region, family structure, parental socio-academic status, and religious orientation of parents, for example. He added that this structure allows researchers to replicate and investigate found associations in between family studies using a within-family design. Genetic markers can also be included in the same samples and then researchers can focus at the end on gene environment interaction to help clarify the etiology and pathogenesis of these disorders.

Dr. Karwautz shared recent unpublished data on 120 sister-pairs discordant for anorexia nervosa studied in Vienna, London, and Barcelona. Fifty-five of the pairs had restricting type AN and 70 had binge-purge type AN. The two groups were similar in age and the age of onset of AN was around 16 years of age.

Among the 58 sister-pairs with restricting AN, researchers found that personal environment was significant and enhances the risk of developing AN. Some common features in this group included negative self-evaluation, perfectionism, no male friends, parental control, rivalry with the unaffected sister, and a need to compete with the sister's appearance and shape. Minor but still significant factors included shyness and premorbid anxiety disorders.

Among the 62 sister-pairs with binge-purge type AN, personal environment and dieting contributed to the development of their disorder. Girls with this subtype of AN had a number of the same characteristics as those with the restricting type of AN, but were also distressed by parental arguments, and life events the year before their illness developed. Two main items emerged in the dieting domain: repeated critical comments by family members about weight, shape, and eating, and teasing about shape and weight and appearance,

Vulnerability factors have a significant influence on the development of AN of both subtypes, while dieting vulnerability factors contributed to the development of binge-purge type AN. Data from the multicenter study adds new information about personal vulnerability in the two AN subtypes. Dr. Karwautz reported that personal vulnerability (for example, negative self-evaluation and perfectionism) is highly relevant to restricting AN. Internalizing behavior problems in childhood influence the development of restricting AN, and internalizing and externalizing problems contribute to the development of binge-purge AN.

The next step, said Dr. Karwautz, will be handling candidate gene data together with psychological and psychosocial risk factors in order to develop a gene environment interaction model of development of AN.


Source: http://www.gurze.net/site12_5_00/newsletter25.htm


Univ.-Prof. Dr. Andreas Karwautz

Presse — Eating Disorders Review - 15/4 July/August 2004