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Getting closer to personalised treatments for eating disorders

A new study reveals further insight into the links between personality traits and the onset of eating disorder symptoms

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Eating disorders, including anorexia nervosa and bulimia nervosa, are serious mental illnesses that affect around 1.25 million people in the UK. Anorexia alone has the highest death rate of any psychiatric disorder, but little is known about what causes it, meaning treatment options are limited and not always effective.

A new study from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, funded in part by the Foundation, reveals further insight into the links between personality traits and the onset of eating disorder symptoms. These findings could help to design more personalised treatments.

The study, published at the end of last month in the Journal of Affective Disorders, uses a comprehensive approach to look at how combinations of different personality traits are linked with the co-development and co-occurrence of eating disorders, depression, anxiety, and suicidal risk.

According to study findings, interventions and therapies that focus on personality traits like neuroticism could be key to preventing the development of eating disorders among those at risk.

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“[Our findings] suggest that interventions targeting hopelessness and introversion may improve clinical outcomes.”
Dr Zuo Zhang
Social, Genetic and Developmental Psychiatry Centre, IoPPN, King's College London
Dr Zuo Zhang

Characterised by intense fears surrounding eating, weight and body shape, eating disorders are serious and potentially life-threatening illnesses. People with eating disorders severely restrict their diet or engage in compensatory behaviours like purging to prevent weight gain. These disorders can cause a significant amount of psychological distress and lead to other medical complications for those living with them, and often co-occur alongside other conditions such as anxiety and addiction – all of which makes them particularly difficult to treat.

Dr Zuo Zhang at the Social, Genetic and Developmental Psychiatry Centre, IoPPN – the lead author of this study – has identified personality profiles that could indicate both the future risk and current diagnoses of eating disorders and several co-occurring conditions.

The team has analysed data from both a longitudinal adolescent sample, involving repeated observations over a prolonged period of time, and a young adult clinical sample – with overlapping measures of psychopathology (i.e. symptoms) and personality.

Dr Zhang’s study shows that neuroticism and impulsivity are two key personality traits that could serve as early risk factors for future anxiety and dieting behaviours.

Here, neuroticism is a personality trait describing an individual's tendency to experience negative emotions.

Dr Zhang explains, "Imagine experiences of negative emotions as if you were driving on a bumpy road. People high in neuroticism might find themselves encountering those bumps more frequently and feeling them more intensely. They often exhibit heightened sensitivity to stressors, and perceive them as more threatening or challenging. This may lead to avoidance or maladaptive coping strategies. Therefore, neuroticism has a strong link to mental health."

Neuroticism was found to be a diagnostic marker for both anorexia and bulimia, while impulsivity had specific links to bulimia. As well as this, findings suggest that hopelessness is a key diagnostic marker of depression, anxiety and suicidal risk occurring alongside eating disorders, while extraversion was found to have potential protective factors linked with lower depressive risks in patients with bulimia.

"[Our findings] suggest that interventions targeting hopelessness and introversion may improve clinical outcomes," says Dr Zhang.

The study could play a key role in informing the design of new eating disorder treatments that target specific personality traits. Dr Zhang adds, "For people who are feeling hopeless, therapies can focus on challenging negative beliefs and thoughts, teaching coping skills to manage stress and setbacks, and setting achievable goals to foster a sense of hope and agency. For more introverted people, therapies can include strategies to improve social skills, increase assertiveness, and build confidence in social interactions."

By understanding the mechanisms and risk factors of eating disorders and co-occurring mental health conditions, we can get closer to developing more personalised intervention and prevention strategies - improving outcomes for both at-risk individuals and those already living with these devastating illnesses.

Read the full paper in the Journal of Affective Disorders

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