Risk and protection factors, concomitant disorders, and symptom evolution following clinical management
Co-Investigators: J.-Y. Frappier, J. Wilkins, D. Taddeo, O. Jamoulle, & D. Meilleur
Funding Source: Fonds Québécois de Recherche sur la Société et la Culture (FQRSC)
Anorexia nervosa is the third most frequent chronic medical condition for teenagers. Over 75% of anorexic people would develop this problem before reaching adulthood. Research conducted on young anorexic teenagers is far behind the research concerned with adults. There is limited knowledge that would enable us to understand the factors which influence the prognostic of this illness in young patients.
Recent studies, mainly carried out on adult female, have demonstrated that sexual abuse antecedents influence the emergence of this problem, especially because some sexual abuse victims could, for example, restrict their eating behaviors as a refusal to see their body develop sexually after puberty, or as a mean to regain control over their own body (Fallon, Katzman and Wooley, 1994). Nevertheless, not all sexual abuse victims become anorexic, and not all people suffering from anorexia nervosa have a history of sexual abuse. As well, this connection is still controversial, since some studies have found only a weak relationship between those factors (Smolak and Murden, 2002). In fact, a simultaneous combination of genetic and environmental variables, including sexual abuse, would play a role in the development of anorexia nervosa (Fairburn and Harrison, 2003). The distinctive role of sexual abuse in the appearance of this illness, as well as the relationships between sexual abuse antecedents and other risk factors associated with anorexia nervosa, remain yet to be specified, in particular among young teenagers.
This clinical study, extending over three years, will be conducted by McGill University in collaboration with the Sainte-Justine Hospital. Benefiting from the financial support of McGill University, in addition to the Fonds Québécois de Recherche sur la Société et la Culture, this research will seek to identify the psychiatric, psychosocial and biological factors that can help distinguish the different profiles of young female adolescents (10 to 17 years old) who obtain services at the Clinique de l’Adolescence of the Sainte-Justine Hospital after having received a diagnostic of anorexia nervosa (according to the DSM IV TR criteria), as well as to measure the evolution of their symptoms, three months after the beginning of the treatment.
Clinical variables, which will be collected as from the summer of 2008, will be compiled in a grid according to a pre-established agenda: original weight, body mass index, weight and symptoms progress, number of medical visits, consultations and psychotherapeutic follow-ups, etc. Self-administered questionnaires will be completed by the teenagers in order to cover the various psychiatric, psychosocial and biological factors under study. The parents will answer questionnaires about familial functioning and the history of psychiatric and psychological problems of the family members.
This study falls under the tread of the recommendations specified by the Society for Adolescent Medicine, such as that future studies should seek to identify the factors - psychiatric, psychosocial and biological, which are associated with anorexia nervosa, and, most specifically, in the young patient populations (Golden et al., 2003). The results will be analyzed by using well known social sciences statistical methods and will be widely distributed within the various intervention and research environments. A better understanding of the events lived by these young anorexic girls, including sexual abuse, is essential in order to target specific interventions, and thus support the healing of these endangered female adolescents.
For more information on this project, please contact Delphine Collin-Vézina.