Anxiety and Interoception Risk for Eating Disorders in Childhood

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ABSTRACT Out of 100,000 children and adolescents, 120 will have Down Syndrome, 56 will die from sudden infant death syndrome, 15 will be diagnosed with cancer, 12 will develop Type II diabetes, and 2,900 will have an eating disorder (ED). Although the age of onset for EDs was traditionally observed in adolescence, onset is occurring younger, with many children developing EDs by age 12. Estimates suggest there will be 1.9 million new cases of youth EDs by 2024. Despite the high prevalence, costs, impairment, and deaths from EDs, there is very little knowledge on what predisposes children to develop EDs. Importantly, early detection and intervention is crucial: problematic eating behaviors can damage developing brains and bodies, and untreated EDs carry significant risk for becoming lifelong chronic health conditions, associated with high mortality rates, societal and personal burden. Our scientific premise, developed from our past work, is that anxiety and interoceptive deficits (inaccuracy identifying bodily sensations, heightened or blunted sensitivity to these sensations), as well as deficits in fear learning underlying anxiety and interoceptive deficits, will predict common, problematic eating behaviors and cognitions (e.g., restriction, body dissatisfaction, cognitive restraint), as well as clinical EDs. Our study goals are to (1) test if childhood anxiety and interoceptive deficits are risk factors for problematic eating behaviors and cognitions and EDs and (2) test if deficits in fear learning are a mechanism by which anxiety and interoceptive deficits contribute to risk. These goals will ultimately lead to (a) tools that can better detect childhood risk factors for EDs and (b) prevention efforts directly targeting mechanisms predictive of ED onset. The proposed research uses innovative parent-report momentary assessment combined with well-established diagnostic, behavioral, observational, and physiological assessment. We will recruit a sample of 400 girls across two age cohorts (6-8; 10-12 years old) enriched for interoceptive deficits, anxiety, and EDs; 75% (n=300) will be recruited based on maternal history of EDs or anxiety, and 25% (n=100) will make up the control group. This study will, for the first time, allow us to begin to quantify how early symptoms of ED develop. The specific aims are to test (1) multi- modal aspects of anxiety and (2) characteristics of interoceptive deficits that may prospectively predict problematic eating behaviors and cognitions and EDs, and (3) mechanisms of prediction among anxiety and interoceptive deficits. The proposed research has clinical impact: ultimately, this study will lead to early detection and prevention of EDs in childhood and beyond, averting the large personal and societal costs associated with both childhood onset and chronic EDs.