Distinct personality profiles associated with disease risk and diagnostic status in eating disorders.

Penny Gowland, Andreas Heinz, Tomáš Paus, Henrik Walter, Iain Campbell, Tobias Banaschewski, Julia Sinclair, Lauren Robinson, Ulrike Schmidt, Gunter Schumann, Zuo Zhang, Madeleine Irish, Marina Bobou, Jeanne Winterer, Sinead King, M John Broulidakis, Betteke Maria van Noort, Sylvane Desrivières, Michael N Smolka, Sarah Hohmann, Nilakshi Vaidya, Arun L W Bokde, Rüdiger Brühl, Antoine Grigis, Marie-Laure Paillère Martinot, Juliane H Fröhner, Argyris Stringaris, Yuning Zhang, Hugh Garavan, Jean-Luc Martinot, Frauke Nees, Dimitri Papadopoulos Orfanos, Luise Poustka, Robert Whelan

Journal: Journal of affective disorders 2024;360():146-155

PMID: 38810783

Abstract

BACKGROUND

Personality traits have been associated with eating disorders (EDs) and comorbidities. However, it is unclear which personality profiles are premorbid risk rather than diagnostic markers.

METHODS

We explored associations between personality and ED-related mental health symptoms using canonical correlation analyses. We investigated personality risk profiles in a longitudinal sample, associating personality at age 14 with onset of mental health symptoms at ages 16 or 19. Diagnostic markers were identified in a sample of young adults with anorexia nervosa (AN, n = 58) or bulimia nervosa (BN, n = 63) and healthy controls (n = 47).

RESULTS

Two significant premorbid risk profiles were identified, successively explaining 7.93 % and 5.60 % of shared variance (R). The first combined neuroticism (canonical loading, r = 0.68), openness (r = 0.32), impulsivity (r = 0.29), and conscientiousness (r = 0.27), with future onset of anxiety symptoms (r = 0.87) and dieting (r = 0.58). The other, combined lower agreeableness (r = -0.60) and lower anxiety sensitivity (r = -0.47), with future deliberate self-harm (r = 0.76) and purging (r = 0.55). Personality profiles associated with "core psychopathology" in both AN (R = 80.56 %) and BN diagnoses (R = 64.38 %) comprised hopelessness (r = 0.95, 0.87) and neuroticism (r = 0.93, 0.94). For BN, this profile also included impulsivity (r = 0.60). Additionally, extraversion (r = 0.41) was associated with lower depressive risk in BN.

LIMITATIONS

The samples were not ethnically diverse. The clinical cohort included only females. There was non-random attrition in the longitudinal sample.

CONCLUSIONS

The results suggest neuroticism and impulsivity as risk and diagnostic markers for EDs, with neuroticism and hopelessness as shared diagnostic markers. They may inform the design of more personalised prevention and intervention strategies.

Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.

Address: Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom.; Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.; Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, United Kingdom.; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom; School of Medicine, Center for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI) Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland.; Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany.; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA.; Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany.; Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, United Kingdom.; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany.; Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.; Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.; Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.; NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.; Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA.; Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom.; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany.; Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France.; Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, and AP-HP, Sorbonne University, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France.; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany.; Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada.; Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany.; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.; School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland.; Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China.; Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom.; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom. Electronic address: [email protected].
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