Skip to main content

An investigation of temperament endophenotype candidates for early emergence of the core cognitive component of eating disorders

  • S. M. Wilksch (a1) and T. D. Wade (a1)

This study was designed to investigate potential temperament endophenotypes for clinically significant importance of shape and weight.


Seven temperament risk factors for eating disorders and the Eating Disorder Examination were assessed in 699 female twins aged 12–15 years. Each variable was evaluated against the following endophenotype criteria: associated with illness in the general population; found in non-affected family members at a higher rate than in the general population; and, heritable.


All seven variables were significantly associated with clinically significant importance of shape and weight, while thin-ideal internalization, ineffectiveness, body dissatisfaction and sensitivity to punishment were found at significantly elevated levels in non-affected twins, when controlling for sister's temperament score. These four variables had genetic correlations with importance of shape and weight, ranging from 0.48 to 0.95.


Future research should evaluate the stability of the identified endophenotypes and their utility for predicting significant growth in importance of shape and weight, and also whether different endophenotypes emerge when the importance of weight and shape reaches its peak in adolescents, around 15 to 16 years of age.

Corresponding author
*Address for correspondence: S. M. Wilksch, Ph.D., School of Psychology, Flinders University, PO Box 2100, Adelaide, SA, 5001, Australia. (Email:
Hide All
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Publishing, Inc.: Washington, DC.
Bellodi L, Cavallini MC, Bertelli S, Chiapparino D, Riboldi C, Smeraldi E (2001). Morbidity risk for obsessive-compulsive spectrum disorders in first-degree relatives of patients with eating disorders. American Journal of Psychiatry 158, 563569.
Berrettini WH (2005). Genetic bases for endophenotypes in psychiatric disorders. Dialogues in Clinical Neuroscience 7, 95101.
Bryant-Waugh RJ, Cooper PJ, Taylor CL, Lask BD (1996). The use of the eating disorder examination with children: a pilot study. International Journal of Eating Disorders 19, 391397.
Bulik CM, Hebebrand J, Keski-Rahkonen A, Klump KL, Reichborn-Kjennerud T, Mazzeo S E, Wade TD (2007). Genetic epidemiology, endophenotypes, and eating disorder classification. International Journal of Eating Disorders 40 (Suppl.), S52S60.
Bulik CM, Tozzi F, Anderson C, Mazzeo SE, Aggen S, Sullivan PF (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry 160, 366368.
Cassin SE, von Ranson KM (2005). Personality and eating disorders: a decade in review. Clinical Psychology Review 25, 895916.
Clifford CA, Murray RM, Fulker DW (1984). Genetic and environmental influences on obsessional traits and symptoms. Psychological Medicine 14, 791800.
Cole TJ, Flegal KM, Nicholls D, Jackson AA (2007). Body mass index cut offs to define thinness in children and adolescents: international survey. British Medical Journal 335, 112.
Cooper PJ, Fairburn CG (1993). Confusion over the core psychopathology of bulimia nervosa. International Journal of Eating Disorders 13, 385389.
Cooper PJ, Goodyer I (1997). Prevalence and significance of weight and shape concerns in girls aged 11–16 years. British Journal of Psychiatry 171, 542544.
Cusumano DL, Thompson J (2001). Media influence and body image in 8–11 year-old boys and girls: a preliminary report on Multidimensional Media Influence Scale. International Journal of Eating Disorders 29, 3744.
Eaves LJ, Eysenck HJ, Martin NG, Jardine R, Heath AC, Feingold L, Young PA, Kendler KS (1989). Genes, Culture and Personality: An Empirical Approach. Oxford University Press: Oxford.
Fairburn CG, Cooper Z (1993). The Eating Disorder Examination, 12th edn. In Binge Eating: Nature, Assessment, and Treatment (ed.Fairburn C. G. and Wilson G. T.), pp. 317360. Guilford Press: New York.
Fairburn CG, Cooper Z (2007). Thinking afresh about the classification of eating disorders. International Journal of Eating Disorders 40, S107S110.
Fairburn CG, Cooper Z, Shafran R (2003). Cognitive behaviour therapy for eating disorders: a ‘transdiagnostic’ theory and treatment. Behaviour Research and Therapy 41, 509528.
Frost RO, Marten P, Lahart C, Rosenblate R (1990). The dimensions of perfectionism. Cognitive Therapy and Research 14, 449468.
Garner DM, Olmstead MP, Polivy J (1983). Development and validation of a multidimensional Eating Disorder Inventory for anorexia nervosa and bulimia nervosa. International Journal of Eating Disorders 2, 1534.
Gershon ES, Goldin LR (1986). Clinical methods in psychiatric genetics: I. Robustness of genetic marker investigative strategies. Acta Psychiatrica Scandinavica 74, 113118.
Goldfein JA, Walsh B, Midlarsky E (2000). Influence of shape and weight on self-evaluation in bulimia nervosa. International Journal of Eating Disorders 27, 435445.
Gowers SG, Shore A (2001). Development of weight and shape concerns in the aetiology of eating disorders. British Journal of Psychiatry 179, 236242.
Gray JA (1981). A model for personality. In A Critique of Eysenck's Theory of Personality (ed.Eysenck H. J.), pp. 246276. Springer: New York.
Hollander E, Kim S, Khanna S, Pallanti S (2007). Obsessive-compulsive disorder and obsessive-compulsive spectrum disorders: diagnostic and dimensional issues. CNS Spectrums 12 (Suppl. 3), 513.
Jacobi C, Hayward C, de Zwaan M, Kraemer H C, Agras W (2004). Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin 130, 1965.
Jimerson DC, Lesem MD, Kaye WH, Brewerton TD (1992). Low serotonin and dopamine metabolite concentrations in cerebrospinal fluid from bulimic patients with frequent binge episodes. Archives of General Psychiatry 49, 132138.
Keski-Rahkonnen A, Bulik CM, Neale BM, Rose RJ, Rissanen A, Kaprio J (2005). Body dissatisfaction and drive for thinness in young adult twins. International Journal of Eating Disorders 37, 188199.
Larsson H, Lichtenstein P, Larsson J (2006). Genetic contributions to the development of ADHD subtypes from childhood to adolescence. Journal of the American Academy of Child and Adolescent Psychiatry 45, 973981.
Lilenfeld LR, Kaye WH, Greeno CG, Merikangas KR, Plotnicov K, Pollice C, Rao R, Strober M, Bulik CM, Nagy L (1997). Psychiatric disorders in women with bulimia nervosa and their first-degree relatives: effects of comorbid substance dependence. International Journal of Eating Disorders 22, 253264.
Lilenfeld LR, Kaye WH, Greeno CG, Merikangas KR, Plotnicov K, Pollice C, Rao R, Strober M, Bulik CM, Nagy L (1998). A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Archives of General Psychiatry 55, 603610.
Micali N, Holliday J, Karwautz A, Haidvogl M, Wagner G, Fernandez-Aranda F, Badia A, Gimenez L, Solano R, Brecelj-Anderluh M, Mohan R, Collier D, Treasure JL (2007). Childhood eating and weight in eating disorders: a multi-centre European study of affected women and their unaffected sisters. Psychotherapy and Psychosomatics 76, 234241.
Neale MC (1997). Mx: Statistical Modeling, 2nd edn. Medical College of Virginia, Department of Psychiatry: Richmond, VA.
Nes RB, Roysamb E, Reichborn-Kjennerud T, Harris JR, Tambs K (2007). Symptoms of anxiety and depression in young adults: genetic and environmental influences on stability. Twin Research and Human Genetics 10, 450461.
Raevuori A, Dick DM, Keski-Rahkonnen A, Pulkkinen L, Rose RJ, Rissanen A, Kaprio J, Viken RJ, Silventoinen K (2007). Genetic and environmental factors affecting self-esteem from age 14 to 17: a longitudinal study of Finnish twins. Psychological Medicine 37, 16251633.
Reichborn-Kjennerud T, Bulik CM, Kendler KS, Roysamb E, Tambs K, Torgersen S, Harris JR (2004). Undue influence of weight on self-evaluation: a population-based twin study of gender differences. International Journal of Eating Disorders 35, 123132.
Schoemaker C, van Strien T, van der Staak C (1994). Validation of the Eating Disorders Inventory in a nonclinical population using transformed and untransformed responses. International Journal of Eating Disorders 15, 387393.
Shafran R, Lee M, Fairburn CG (2004). Clinical perfectionism: a case report. Behavioural and Cognitive Psychotherapy 32, 353357.
Shafran R, Lee M, Payne E, Fairburn CG (2006). The impact of manipulating personal standards on eating attitudes and behaviour. Behaviour Research and Therapy 44, 897906.
Slade PD (1982). Towards a functional analysis of anorexia nervosa and bulimia nervosa. British Journal of Clinical Psychology 21, 167179.
Steiger H, Gauvin L, Israel M, Koerner N, Ng Ying Kin N, Paris J, Young SN (2001). Association of serotonin and cortisol indices with childhood abuse in bulimia nervosa. Archives of General Psychiatry 58, 837843.
Stice E (2001). A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology 110, 124135.
Thordarson DS, Radomsky AS, Rachman S, Shafran R, Sawchuk CN, Hakstian A (2004). The Vancouver Obsessional Compulsive Inventory (VOCI). Behaviour Research and Therapy 42, 12891314.
Torrubia R, Avila C, Molto J, Caseras X (2001). The Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) as a measure of Gray's anxiety and impulsivity dimensions. Personality and Individual Differences 31, 837862.
Treasure J, Lopez C, Roberts M (2007). Endophenotypes in eating disorders: moving toward ecologically based diagnosis and treatment focussed on pathophysiology. Pediatric Health 1, 171181.
Tyrka AR, Waldron I, Graber JA, Brooks-Gunn J (2002). Prospective predictors of the onset of anorexic and bulimic syndromes. International Journal of Eating Disorders 32, 282290.
van Strien T, Ouwens M (2003). Validation of the Dutch EDI-2 in one clinical and two nonclinical populations. European Journal of Psychological Assessment 19, 6684.
Wade T, Tiggemann M, Martin NG, Heath AC (1997). Characteristics of interview refusers: women who decline to participate in interviews relating to eating. International Journal of Eating Disorders 22, 9599.
Wade TD, Bulik CM (2007). Shared genetic and environmental risk factors between undue influence of body shape and weight on self-evaluation and dimensions of perfectionism. Psychological Medicine 37, 635644.
Wade TD, Byrne S, Bryant-Waugh R (2008). The Eating Disorder Examination: norms and construct validity with young and middle adolescent girls. International Journal of Eating Disorders. Published online: 23 April 2008. doi:10.1002/eat.20526.
Wade TD, Crosby RD, Martin NG (2006). Use of latent profile analysis to identify eating disorder phenotypes in an adult Australian twin cohort. Archives of General Psychiatry 63, 13771384.
Wade TD, Davidson S, O'Dea JA (2003). A preliminary controlled evaluation of a school-based media literacy program and self-esteem program for reducing eating disorder risk factors. International Journal of Eating Disorders 33, 371383.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 16
Total number of PDF views: 27 *
Loading metrics...

Abstract views

Total abstract views: 160 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th November 2017. This data will be updated every 24 hours.