Skip to main content
×
×
Home

A twin study of specific bulimia nervosa symptoms

  • S. E. Mazzeo (a1) (a2) (a3), K. S. Mitchell (a1) (a3), C. M. Bulik (a4), S. H. Aggen (a3) (a5), K. S. Kendler (a3) (a5) and M. C. Neale (a3) (a5) (a6)...
Abstract
Background

Twin studies have suggested that additive genetic factors significantly contribute to liability to bulimia nervosa (BN). However, the diagnostic criteria for BN remain controversial. In this study, an item-factor model was used to examine the BN diagnostic criteria and the genetic and environmental contributions to BN in a population-based twin sample. The validity of the equal environment assumption (EEA) for BN was also tested.

Method

Participants were 1024 female twins (MZ n=614, DZ n=410) from the population-based Mid-Atlantic Twin Registry. BN was assessed using symptom-level (self-report) items consistent with DSM-IV and ICD-10 diagnostic criteria. Items assessing BN were included in an item-factor model. The EEA was measured by items assessing similarity of childhood and adolescent environment, which have demonstrated construct validity. Scores on the EEA factor were used to specify the degree to which twins shared environmental experiences in this model.

Results

The EEA was not violated for BN. Modeling results indicated that the majority of the variance in BN was due to additive genetic factors. There was substantial variability in additive genetic and environmental contributions to specific BN symptoms. Most notably, vomiting was very strongly influenced by additive genetic factors, while other symptoms were much less heritable, including the influence of weight on self-evaluation. These results highlight the importance of assessing eating disorders at the symptom level.

Conclusions

Refinement of eating disorder phenotypes could ultimately lead to improvements in treatment and targeted prevention, by clarifying sources of variation for specific components of symptomatology.

Copyright
Corresponding author
*Address for correspondence: Dr S. E. Mazzeo, Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA 23284–2018, USA. (Email: semazzeo@vcu.edu)
References
Hide All
Akaike, H (1987). Factor analysis and AIC. Psychometrika 52, 317332.
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychiatric Association: Washington, DC.
Becker, AE, Fay, K (2006). Sociocultural issues and eating disorders. In Eating Disorders Review Part II (ed. Wonderlich, S., Mitchell, J. E., de Zwaan, M. and Steiger, H.), pp. 3563. Radcliffe Publishing: Oxford.
Becker, AE, Grinspoon, SK, Klibanski, A, Herzog, DB (1999). Eating disorders. New England Journal of Medicine 340, 10921098.
Bulik, CM (2005). Exploring the gene-environment nexus in eating disorders. Journal of Psychiatry and Neuroscience 30, 335338.
Bulik, CM, Hebebrand, J, Keski-Rahkonen, A, Klump, KL, Reichborn-Kjennerud, T, Mazzeo, SE, Wade, TD (2007). Genetic epidemiology, endophenotypes, and eating disorder classification. International Journal of Eating Disorders 40, S52S60.
Bulik, CM, Sullivan, PF, Kendler, KS (1998). Heritability of binge-eating and broadly defined bulimia nervosa. Biological Psychiatry 44, 12101218.
Bulik, CM, Sullivan, PF, Wade, TD, Kendler, KS (2000). Twin studies of eating disorders: a review. International Journal of Eating Disorders 27, 120.
Cachelin, FM, Veisel, C, Barzegarnazari, E, Striegel-Moore, RH (2000). Disordered eating, acculturation, and treatment-seeking in a community sample of Hispanic, Asian, Black, and White women. Psychology of Women Quarterly 24, 244253.
Crocker, L, Algina, J (1986). Introduction to Classical and Modern Test Theory. Wadsworth Group: Belmont, CA.
Fairburn, CG, Cowen, PJ, Harrison, PJ (1999). Twin studies and the etiology of eating disorders. International Journal of Eating Disorders 26, 349358.
Fairburn, CG, Cooper, Z (2007). Thinking afresh about the classification of eating disorders. International Journal of Eating Disorders 40, S107S110.
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinician Version. American Psychiatric Press: Washington, DC.
Hettema, JM, Neale, MC, Kendler, KS (1995). Physical similarity and the equal-environment assumption in twin studies of psychiatric disorders. Behavior Genetics 25, 327335.
Hudson, JI, Hiripi, E, Pope, HG, Kessler, RC (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348358.
Kato, T, Iwamoto, K, Kakiuchi, C, Kuratomi, G, Okazaki, Y. (2005). Genetic or epigenetic difference causing discordance between monozygotic twins as a clue to molecular basis of mental disorders. Molecular Psychiatry 10, 622630.
Kendler, KS, Gardner, CO (1998). Twin studies of adult psychiatric and substance dependence disorders: Are they biased by differences in the environmental experiences of monozygotic and dizygotic twins in childhood and adolescence? Psychological Medicine 28, 625633.
Kendler, KS, MacLean, CJ, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1991). The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry 148, 16271637.
Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1993). A test of the equal environment assumption in twin studies of psychiatric illness. Behavior Genetics 23, 2127.
Kendler, KS, Prescott, C (1999). A population-based twin study of lifetime major depression in men and women. Archives of General Psychiatry 56, 3944.
Kendler, KS, Prescott, C (2006). Genes, Environment, and Psychopathology: Understanding the Causes of Psychiatric and Substance Use Disorders. The Guilford Press: New York, NY.
Kendler, KS, Walters, EE, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1995). The structure of the genetic and environmental risk factors for six major psychiatric disorders in women: phobia, generalized anxiety disorder, panic disorder, bulimia, major depression and alcoholism. Archives of General Psychiatry 52, 374383.
Keski-Rahkonen, 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.
Klump, KL, Burt, SA, McGue, M, Iacono, WG (2007). Changes in genetic and environmental influences on disordered eating across adolescence: a longitudinal twin study. Archives of General Psychiatry 64, 14091415.
Klump, KL, Holly, A, Iacono, WG, McGue, M, Willson, LE (2000 a). Physical similarity and twin resemblance for eating attitudes and behaviors: a test of the equal environments assumption. Behavior Genetics 30, 5158.
Klump, KL, McGue, M, Iacono, WG (2000 b). Age differences in genetic and environmental influences on eating attitudes and behaviors in preadolescent and adolescent female twins. Journal of Abnormal Psychology 109, 239251.
le Grange, D (2005). Family issues and eating disorders. In Eating Disorders Review Part I (ed. Wonderlich, S., Mitchell, J. E., De Zwaan, M., and Steiger, H.), pp. 1525. Radcliffe Publishing: Oxford.
Loehlin, JC, Nichols, RC (1976). Heredity, Environment, and Personality: A Study of 850 Sets of Twins. University of Texas Press: Austin, TX.
Lykken, DT, McGue, M, Tellegen, A (1987). Recruitment bias in twin research: The rule of two-thirds reconsidered. Behavior Genetics 17, 343362.
Mazzeo, SE, Mitchell, KS, Bulik, CM, Reichborn-Kjennerud, T, Kendler, KS, Neale, MC (2009). Assessing the heritability of anorexia nervosa symptoms using a marginal maximal likelihood approach. Psychological Medicine 39, 463473.
Mitchell, KS, Mazzeo, SE, Bulik, CM, Aggen, SH, Kendler, KS, Neale, MC (2007). An investigation of a measure of twins' equal environments. Twin Research and Human Genetics 10, 840847.
Muthén, LK, Muthén, BO (1998–2006). Mplus User's Guide, 4th edn. Muthén & Muthén: Los Angeles, CA.
Neale, MC, Aggen, SH, Maes, HH, Kubarych, TS, Schmitt, JE (2006 a). Methodological issues in the assessment of substance use phenotypes. Addictive Behaviors 31, 10101034.
Neale, MC, Boker, S, Xie, G, Maes, H (2003). Mx: Statistical modeling, 6th edn. Department of Psychiatry, Virginia Commonwealth University: Richmond, VA.
Neale, MC, Harvey, E, Maes, H, Sullivan, PF, Kendler, KS (2006 b). Extensions to the modeling of initiation and progression: Applications to substance use and abuse. Behavior Genetics 36, 507524.
Neale, MC, Lubke, G, Aggen, SH, Dolan, CV (2005). Problems with using sum scores for estimating variance components: Contamination and measurement noninvariance. Twin Research and Human Genetics 8, 553568.
Reichborn-Kjennerud, T, Bulik, CM, Kendler, KS, Røysamb, E, Maes, H, Tambs, K, Harris, J (2003). Gender differences in binge-eating: a population-based twin study. Acta Psychiatrica Scandinavica 108, 196202.
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.
Silberg, JL, Bulik, CM (2005). The developmental association between eating disorders symptoms and symptoms of depression and anxiety in juvenile twin girls. Journal of Child Psychology and Psychiatry 46, 13171326.
Simon, S, Schmidt, U, Pilling, S (2005). The health service use and cost of eating disorders. Psychological Medicine 35, 15431551.
Spoor, STP, Stice, E, Burton, E, Bohon, C (2007). Relations of bulimic symptom frequency and intensity to psychosocial impairment and health care utilization: Results from a community-recruited sample. International Journal of Eating Disorders 40, 505514.
Sullivan, PF, Bulik, CM, Kendler, KS (1998). Genetic epidemiology of binging and vomiting. British Journal of Psychiatry 173, 7579.
Sullivan, PF, Eaves, LJ (2002). Evaluation of analyses of univariate discrete twin data. Behavior Genetics 32, 221227.
Wade, TD, Bergin, JL, Martin, NG, Gillespie, NA, Fairburn, CG (2006). A transdiagnostic approach to understanding eating disorders. The Journal of Nervous and Mental Disease 194, 510517.
Wade, TD, Martin, NG, Tiggemann, M (1998). Genetic and environmental risk factors for the weight and shape concerns characteristic of bulimia nervosa. Psychological Medicine 28, 761771.
Wilfley, DE, Bishop, ME, Wilson, GT, Agras, WS (2007). Classification of eating disorders: Toward DSM-V. International Journal of Eating Disorders 40, S123S129.
Winn, S, Perkins, S, Walwyn, R, Schmidt, U, Eisler, I, Treasure, J, Berelowitz, M, Dodge, L, Frost, S, Jenkins, M, Johnson-Sabine, E, Keville, S, Murphy, R, Robinson, P, Yi, I (2007). Predictors of mental health problems and negative caregiving experiences in carers of adolescents with bulimia nervosa. International Journal of Eating Disorders 40, 171178.
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? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 21
Total number of PDF views: 68 *
Loading metrics...

Abstract views

Total abstract views: 424 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 14th August 2018. This data will be updated every 24 hours.