Comparisons between atypical anorexia nervosa and anorexia nervosa: Psychological and comorbidity patterns
Corresponding Author
Hannah F. Fitterman-Harris PhD
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Correspondence
Hannah F. Fitterman-Harris, Department of Psychological and Brain Sciences, University of Louisville, 2301 S. 3rd St., Life Sciences Building, Room 317, Louisville, KY 40292, USA.
Email: [email protected]
Contribution: Conceptualization, Formal analysis, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorYuchen Han MS
Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Writing - review & editing
Search for more papers by this authorKimberly D. Osborn MSW
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Louisville, Kentucky, USA
Contribution: Conceptualization, Resources, Writing - original draft, Writing - review & editing
Search for more papers by this authorLoie M. Faulkner BA
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Formal analysis, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorBrenna M. Williams MS
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorJamie-Lee Pennesi PhD
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Methodology, Writing - review & editing
Search for more papers by this authorCheri A. Levinson PhD
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Department of Pediatrics – Division of Child and Adolescent Psychiatry, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Methodology, Project administration, Supervision, Writing - review & editing
Search for more papers by this authorCorresponding Author
Hannah F. Fitterman-Harris PhD
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Correspondence
Hannah F. Fitterman-Harris, Department of Psychological and Brain Sciences, University of Louisville, 2301 S. 3rd St., Life Sciences Building, Room 317, Louisville, KY 40292, USA.
Email: [email protected]
Contribution: Conceptualization, Formal analysis, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorYuchen Han MS
Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Data curation, Formal analysis, Methodology, Writing - review & editing
Search for more papers by this authorKimberly D. Osborn MSW
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Louisville, Kentucky, USA
Contribution: Conceptualization, Resources, Writing - original draft, Writing - review & editing
Search for more papers by this authorLoie M. Faulkner BA
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Formal analysis, Methodology, Writing - original draft, Writing - review & editing
Search for more papers by this authorBrenna M. Williams MS
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Writing - original draft, Writing - review & editing
Search for more papers by this authorJamie-Lee Pennesi PhD
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Methodology, Writing - review & editing
Search for more papers by this authorCheri A. Levinson PhD
Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
Department of Pediatrics – Division of Child and Adolescent Psychiatry, University of Louisville, Louisville, Kentucky, USA
Contribution: Conceptualization, Methodology, Project administration, Supervision, Writing - review & editing
Search for more papers by this authorAbstract
Objective
Literature comparing “atypical” anorexia nervosa (atypical AN) and anorexia nervosa (AN) suggests these diagnoses share significant similarities in eating disorder (ED) pathology and psychiatric comorbidities. This study evaluated potential differences in ED pathology, psychiatric comorbidity, associated mechanisms (i.e., ED fears and perfectionism), and demographic factors (i.e., ethnicity and age) between individuals with atypical AN and AN.
Method
Data from seven protocols were combined for a total 464 individuals diagnosed with atypical AN (n = 215) or AN (n = 249). Between-group differences in ED severity and behaviors, psychiatric comorbidities, ED fears, perfectionism, and demographic factors were assessed using t-tests, Wilcoxon rank-sum tests, and Fisher's exact test.
Results
Participants with atypical AN reported higher levels of overvaluation of weight and shape than those with AN. Participants with AN scored higher on food-related fears (anxiety about eating, food avoidance behaviors, and feared concerns) and fears of social eating, as well as obsessive-compulsive symptoms. Participants with AN were more likely to identify as Asian or Pacific Islander. No other statistically significant differences were found between groups for overall ED severity, ED behaviors, psychiatric comorbidities, general ED fears, perfectionism, or demographic factors.
Discussion
Overall, results support previous literature indicating limited differences between individuals with atypical AN and AN, though individuals with atypical AN reported more overvaluation of weight and shape and those with AN reported higher food and social eating fears and obsessive-compulsive symptoms. Relatively few overall differences between atypical AN and AN highlight the importance of exploring dimensional conceptualizations of AN as an alternative to the current categorical conceptualization.
Public Significance
This study assessed differences among individuals with atypical anorexia nervosa and anorexia nervosa in eating disorder severity and behaviors, comorbid psychiatric diagnoses, associated mechanisms, and demographic factors. Few differences emerged, though participants with atypical anorexia nervosa reported more overvaluation of weight and shape, while those with anorexia nervosa reported more food and social eating fears and higher obsessive-compulsive symptoms. Results support exploration of these diagnoses as a spectrum disorder.
CONFLICT OF INTEREST STATEMENT
CAL reports financial interests in Awaken Digital Solutions and the Behavioral Wellness Clinic, however these interests are unrelated to the submitted publication. All other authors report no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| eat24147-sup-0001-TableS1.docxWord 2007 document , 22.7 KB | Data S1: Supporting Information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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