Longitudinal relationships between childhood, adolescent, and adult eatingdisorders

Objective: This study investigates the longitudinal course of eating proble ms from childhood though adulthood. The following questions are answered: ( 1) How stable are eating disorder symptoms and diagnoses over a 17-year int erval from childhood to adulthood? (2) Do early childhood eating problems p redict the occurrence of eating disorders in adulthood? Method: An epidemio logically selected sample of approximately 800 children and their mothers r eceived DSM-based structured psychiatric assessments in 1975, 1983, 1985, a nd 1992. The stability of full DSM diagnostic criteria for anorexia nervosa and bulimia nervosa, symptom scales derived from DSM criteria, and individ ual symptoms such as binge eating or dieting between early adolescence, lat e adolescence, and young adulthood was examined. Results: Early adolescent bulimia nervosa is associated with a 9-fold increase in risk for late adole scent bulimia nervosa and a 20-fold increase in risk for adult bulimia nerv osa. Late adolescent bulimia nervosa is associated with a 35-fold increase in risk for adult bulimia nervosa. Symptom scale scores for anorexia nervos a and bulimia nervosa correlate in the 0.3 to 0.5 range from early to late adolescence and young adulthood. For both anorexia nervosa and bulimia nerv osa, gender, as well as eating symptoms at early and late adolescence, all predict young-adult eating disorder symptoms. Risk factors for the later de velopment of eating disorders comprise eating conflicts, struggles with foo d, and unpleasant meals in early childhood. Conclusion: The presence of eat ing problems in early childhood or an eating disorder in adolescence confer s a strong risk for an eating disorder in young adulthood.