Anxiety and Social-Emotional Processing in Eating Disorders: Examination of Family Trios
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ORIGINAL ARTICLE
Anxiety and Social-Emotional Processing in Eating Disorders: Examination of Family Trios E. Goddard • J. Treasure
Published online: 30 March 2013 Ó Springer Science+Business Media New York 2013
Abstract Anxiety, altered attention for social stimuli and poor recognition of emotions were examined as putative intermediate phenotypes of eating disorders (EDs). Three hundred and forty two participants (65 ED offspring; 52 healthy offspring; 124 parents of ED offspring; 101 parents of healthy offspring) completed self report and behavioural measures of anxiety, attention for social stimuli and emotion recognition. ED offspring and their parents had higher trait anxiety in comparison to healthy controls. Social anxiety co-segregated with the illness in parents. ED offspring did not show Stroop interference for social stimuli. Subtle alterations in response to social stimuli were observed in ED fathers. ED groups did not have difficulties recognising complex emotions. In conclusion, trait and social anxiety fulfil some of the criteria for intermediate phenotypes in EDs. There was less evidence for behavioural measures of anxiety and social processing. This may be a consequence of sample characteristics, low power or task sensitivity. Keywords Eating disorders Anxiety Attentional bias Emotion Relatives Intermediate phenotypes
Introduction Eating disorders (EDs) are moderately heritable, severe psychiatric illnesses associated with poor outcomes (Berkman et al. 2007; Bulik et al. 2006; Hudson et al. 2007; Klump
E. Goddard (&) J. Treasure Section of Eating Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, 103 Denmark Hill, London SE5 8AF, UK e-mail: [email protected]
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et al. 2009). The identification of genetic factors involved in the pathogenesis of the disorder may inform diagnosis, treatment and prevention (Pinheiro et al. 2011). Intermediate phenotypes are objective, quantitative traits that lie on the pathway from genotype to the complex phenotype and are presumed to be associated with a simpler genotype than the diagnostic phenotype. Therefore, intermediate phenotypes improve the power of studies seeking to identify genes associated with the illness (Rasetti and Weinberger 2011). Intermediate phenotypes, like endophenotypes, need to (1) be associated with the illness; (2) be independent of the acute state; (3) co-segregate with the illness in families; (4) be present in never-ill family members at an increased rate compared to the general population; (5) be heritable (Gottesman and Gould 2003).
Social-Emotional Difficulties Central to ED Phenotype A number of theoretical models of EDs emphasise socialemotional difficulties in the aetiology and maintenance of the illness (Connan et al. 2003; Hatch et al. 2010; Kaye 2008; Treasure et al. 2012). Two areas of social-emotional processing that have received attention in the ED literature are anxiety (emotional response to threat stimuli) and social cognition, specifically, the rec
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