Andrea Joensen, Leonie K Elsenburg, Else Marie Olsen, Claus Thorn Ekstrøm, Naja Hulvej Rod, Katrine Strandberg-Larsen
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引用次数: 0
Abstract
Objective: Childhood adversities are linked to eating disorders (EDs), but their cumulative and evolving nature is often overlooked. This study employs a comprehensive measure of adversities, captured through trajectories across ages 0-9, to examine associations with (1) clinically diagnosed EDs at ages 10-18 and (2) a composite outcome of diagnosed and self-reported ED symptoms at age 18. Differences between diagnosed and non-diagnosed EDs were also assessed.
Methods: Data from children born in Denmark between 1996 and 2003 (total population; N = 500,240) and participants in the 18-year follow-up of the Danish National Birth Cohort (DNBC-18; N = 43,687, 50% of those eligible for invitation) were used. Diagnosed EDs were identified through national registers, and non-diagnosed EDs through the DNBC-18. Adversities were grouped into three predefined dimensions: material deprivation, loss or threat of loss, and family dynamics. A group-based multi-trajectory model identified trajectories from ages 0-9. Associations were analyzed using quasi-Poisson and multinomial logistic regression.
Results: Four trajectory groups were identified: low adversity (72.1%), material deprivation (18.0%), loss or threat of loss (5.5%), and high adversity (4.4%). < 1% had a diagnosed ED, while 2.5% had a non-diagnosed ED, both more common in females. While no overall associations were found in the total population, the high adversity group had a higher risk of eating disorders not otherwise specified (EDNOS) compared to the low adversity group (IRR = 1.58, 95% CI: 1.16-2.12). In the DNBC-18 analyses, a higher risk in the high adversity group compared to the low adversity group, was entirely driven by non-diagnosed EDs (RRR = 1.73, 95% CI: 1.37-2.20).
Conclusion: Individuals exposed to high adversity had a higher risk of EDs, particularly non-diagnosed cases, highlighting a diagnostic gap shaped by differences in symptom recognition, help-seeking, and access to care.
期刊介绍：
Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.
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