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Early Onset Binge Eating and Purging Eating Disorders: Course and Outcome in a Population-Based Study of Adolescents

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Abstract

This study aimed to describe the course of early onset eating disorders in a population-based sample followed from 14 to 20 years; identify variables that could account for the persistence of eating disorders from 14 to 20 years; and describe outcome of early onset eating disorders with reference to general and psychological functioning at age 20. Participants (N = 1,383; 49 % male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, which has followed children from pre-birth to young adulthood. Eating disorder symptoms were assessed using an adapted version of the Eating Disorder Examination-Questionnaire, at ages 14, 17 and 20. At age 14, 70 participants met DSM-IV criteria for a binge eating or purging eating disorder. Nearly half (44 %) of these adolescents ceased to meet criteria for an eating disorders at ages 17 and 20, whilst one-quarter still met criteria for an eating disorder at age 20 and one-fifth met criteria for an eating disorder at all three time points. Purging at age 17 and externalising behaviour problems at age 14 were the strongest predictors of eating disorder persistence to age 20. Participants who experienced a persistent eating disorder were less likely to complete high school than other participants, and reported pronounced depressive and anxiety symptoms at age 20. This study provides new data the course and outcome of early onset eating disorders at a population level. Behavioural difficulties in early adolescence and purging in middle adolescence may predict persistent eating pathology to young adulthood.

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Acknowledgments

We are extremely grateful to the Raine Study participants and their families who took part in this study and to the Raine Study team for cohort management and data collection.

Financial Support

The first author is supported by an early career research fellowship from the National Health and Medical Research Council (NHMRC) of Australia. Core funding for the Western Australian Pregnancy Cohort (Raine) Study is provided by the Raine Medical Research Foundation; The University of Western Australia (UWA); the Faculty of Medicine, Dentistry and Health Sciences at UWA; the Telethon Institute for Child Health Research; the Women’s and Infant’s Research Foundation; and Curtin University. Funding for the 14-year Raine Study follow-up was provided by the Raine Medical Research Foundation and NHMRC project grants. Funding for the 17-year follow-up was provided by NHMRC programme grant 35314. Funding for the 20-year follow-up was provided by the Canadian Institutes of Health Research and NHMRC project grants.

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Authors and Affiliations

  1. Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Australia, 6872

    Karina L. Allen & Wendy H. Oddy

  2. School of Psychology, The University of Western Australia, Crawley, Western Australia

    Karina L. Allen & Susan M. Byrne

  3. Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA

    Ross D. Crosby

  4. Department of Biostatistics, Neuropsychiatric Research Institute, Fargo, ND, USA

    Ross D. Crosby

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  1. Karina L. Allen
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  2. Susan M. Byrne
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  3. Wendy H. Oddy
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  4. Ross D. Crosby
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Correspondence to Karina L. Allen.

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Allen, K.L., Byrne, S.M., Oddy, W.H. et al. Early Onset Binge Eating and Purging Eating Disorders: Course and Outcome in a Population-Based Study of Adolescents. J Abnorm Child Psychol 41, 1083–1096 (2013). https://doi.org/10.1007/s10802-013-9747-7

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  • DOI: https://doi.org/10.1007/s10802-013-9747-7

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