Risk Factor For Psychiatric Disorders Research Articles

Heritability of anxiety sensitivity: a twin study.

In attempting to explain the familial predisposition to panic disorder, most studies have focused on the heritability of physiologic characteristics (e.g., CO2 sensitivity). A heretofore unexplored possibility is that a psychological characteristic that predisposes to panic-anxiety sensitivity-might be inherited. In this study, the authors examined the heritability of anxiety sensitivity through use of a twin group. Scores on the Anxiety Sensitivity Index were examined in a group of 179 monozygotic and 158 dizygotic twin pairs. Biometrical model fitting was conducted through use of standard statistical methods. Broad heritability estimate of the Anxiety Sensitivity Index as a unifactorial construct was 45%. Additive genetic effects and unique environmental effects emerged as the primary influences on anxiety sensitivity. There was no evidence of genetic discontinuity between normal and extreme scores on the Anxiety Sensitivity Index. This study suggests that one psychological risk factor for the development of panic disorder-anxiety sensitivity-may have a heritable component. As such, anxiety sensitivity should be considered in future research on the heritability of panic disorder.

Risk factors for binge eating disorder: a community-based, case-control study.

Many risk factors have been implicated for eating disorders, although little is known about those for binge eating disorder. A community-based, case-control design was used to compare 52 women with binge eating disorder, 104 without an eating disorder, 102 with other psychiatric disorders, and 102 with bulimia nervosa. The main risk factors identified from the comparison of subjects with binge eating disorder with healthy control subjects were certain adverse childhood experiences, parental depression, vulnerability to obesity, and repeated exposure to negative comments about shape, weight, and eating. Compared with the subjects with other psychiatric disorders, those with binge eating disorder reported more childhood obesity and more exposure to negative comments about shape, weight, and eating. Certain childhood traits and pronounced vulnerability to obesity distinguished the subjects with bulimia nervosa from those with binge eating disorder. Binge eating disorder appears to be associated with exposure to risk factors for psychiatric disorder and for obesity. When compared with the wide range of risk factors for bulimia nervosa, the risk factors for binge eating disorder are weaker and more circumscribed. Pre-morbid perfectionism, negative self-evaluation, and vulnerability to obesity appear especially to characterize those in whom bulimia nervosa subsequently develops.

Childhood sexual and physical abuse as risk factors for the development of bulimia nervosa: A community-based case control study

Objective. There were two aims: First, to determine whether sexual or physical abuse in childhood or adolescence increases the risk of developing bulimia nervosa, and second, to see whether any increase in risk is specific to bulimia nervosa rather than being common to psychiatric disorders in general. Method. A case control design with individual matching was used. There were two related case control comparisons based on community samples. One hundred and two young adult women with bulimia nervosa were compared with 204 control subjects without an eating disorder, and with 102 control subjects with other psychiatric disorders, all recruited from the same community source. An investigator-based interview was used to assess sexual and physical abuse. Results. Sexual abuse involving physical contact was reported by 35% of the cases of bulimia nervosa. It was more common among this group than among the normal controls. Physical abuse was also reported by a minority of the cases of bulimia nervosa, and was more common among this group than among the normal controls. However, there were no significant differences between the cases of bulimia nervosa and the controls with general psychiatric disorder, except in the category of repeated severe sexual abuse: this was more common among the cases of bulimia nervosa although present only in small numbers within these two groups. Conclusions. The findings indicate that sexual and physical abuse are both risk factors for the development of bulimia nervosa. However, they are not present in the majority of cases. This indicates that other risk factors must operate in these cases. Sexual and physical abuse do not appear to be risk factors specific to bulimia nervosa; rather, they appear to be risk factors for psychiatric disorder in general in young adult women.

Lifetime Traumas and Mental Health: The Significance of Cumulative Adversity

This paper reports the community prevalence of 20 life traumas and considers their individual relevance as risk factors for psychiatric disorder. Also presented is the first evidence on the mental health significance of cumulative adversity as indexed by a count of lifetime exposure to a wide array of potentially traumatic events. The question of the importance of considering such events within efforts to assess variations in life stress is also examined. Our results demonstrate clear relationships between many traumatic events and, especially, accumulated lifetime trauma experience and both psychological distress and psychiatric disorder. That these relationships persist with temporal priority controlled - and net of the effects of parental psychopathology - suggest the causal relevance of major lifetime events and the conclusion that they represent on important dimension of increased mental health risk. From these findings and from evidence for the significance of traumas in disorder recurrence, it is contended that failure to take account of such events has resulted in the systematic underestimation of the role of stress exposure in accounting for variations in emotional distress and disorder.

Family psychiatric screening instrument for epidemiologic studies: pilot testing and validation

Family history, a risk factor for psychiatric disorders, is infrequently assessed in epidemiologic studies due to time and cost constraints. We designed a brief computer-scorable instrument, the Family History Screen for Epidemiologic Studies (FHE), which collects a pedigree and screens for 15 DSM-III diagnoses in an informant and in his family members. The FHE was administered to one informant in 77 families in which we had collected pedigrees, interviewed 77 informants and 239 relatives using the Lifetime Anxiety version of the Schedule for Affective Disorders and Schizophrenia or the Epidemiologic version of the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, and performed best-estimate diagnoses. We evaluated the accuracy with which the FHE predicted bestestimate diagnoses. For adults reporting on themselves, the FHE demonstrated high levels of sensitivity and specificity for depression (67.4, 75.0) and panic (92.5, 89.2), and low sensitivity and high specificity for substance abuse (33.3, 93.6). For informants reporting on adult relatives, sensitivity was low and specificity was high for depression (35.2, 84.9), panic (20.0, 91.7), and substance abuse (42.1, 93.4). For informants reporting on children, perhaps due to lower prevalence, sensitivity and specificity were poor. The FHE is a good screen for psychiatric disorders in adult informants, but it is not useful for family history. It may be useful in primary care medical settings as a screen for psychiatric history.

Dr. Shukla and Associates Reply

Back to table of contents Previous article Next article ArticleNo AccessDr. Shukla and Associates ReplySASHI SHUKLA, BRIAN COOK, SUKDEB MUKHERJEE, CHARLES GODWIN, and MORTON MILLERSASHI SHUKLASearch for more papers by this author, BRIAN COOKSearch for more papers by this author, SUKDEB MUKHERJEESearch for more papers by this author, CHARLES GODWINSearch for more papers by this author, and MORTON MILLERSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.144.10.1379AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Dr. Shukla and Associates Reply." American Journal of Psychiatry, 144(10), p. 1379 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByDifferences in course of illness between patients with bipolar II disorder with and without epileptiform discharges or other sharp activity on electroencephalograms: a cross-sectional study7 December 2020 | BMC Psychiatry, Vol. 20, No. 1Clinical characteristics of patients with bipolar disorder and premorbid traumatic brain injury: a cross-sectional study10 September 2018 | International Journal of Bipolar Disorders, Vol. 6, No. 1Head Injury as Risk Factor for Psychiatric Disorders: A Nationwide Register-Based Follow-Up Study of 113,906 Persons With Head InjurySonja Orlovska, M.D., Michael Skaarup Pedersen, M.Sc., Michael Eriksen Benros, M.D., Ph.D., Preben Bo Mortensen, Dr.Med.Sc., Esben Agerbo, Dr.Med.Sc., and Merete Nordentoft, Dr.Med.Sc.1 April 2014 | American Journal of Psychiatry, Vol. 171, No. 4Neuropsychiatric Disorders in Persons With Severe Traumatic Brain InjuryJournal of Head Trauma Rehabilitation, Vol. 26, No. 2Current Psychiatry Reports, Vol. 9, No. 3Brain Injury, Vol. 21, No. 11Primary Mania Versus Secondary Mania of HIV/AIDS in UgandaRobert G. Robinson, M.D.1 August 2006 | American Journal of Psychiatry, Vol. 163, No. 8Secondary Mania in Older AdultsJohn O. BrooksIII, Ph.D., M.D., and Jennifer C. Hoblyn, M.D., M.P.H.1 November 2005 | American Journal of Psychiatry, Vol. 162, No. 11Current Treatment Options in Neurology, Vol. 4, No. 1Current Treatment Options in Neurology, Vol. 4, No. 6Current Psychiatry Reports, Vol. 2, No. 5NEUROPSYCHIATRIC CONSEQUENCES OF STROKEAnnual Review of Medicine, Vol. 48, No. 1Journal of the History of the Neurosciences, Vol. 6, No. 1Neurocase, Vol. 3, No. 2Neurocase, Vol. 3, No. 2International Journal of Geriatric Psychiatry, Vol. 11, No. 9Brain Injury, Vol. 10, No. 5Depression, Vol. 2, No. 4Secondary mania following traumatic brain injury1 April 2006 | American Journal of Psychiatry, Vol. 150, No. 6Brain Injury, Vol. 7, No. 2Contested boundaries of bipolar disorder and the limits of categorical diagnosis in psychiatry1 April 2006 | American Journal of Psychiatry, Vol. 149, No. 11Behavioral Interventions, Vol. 7, No. 2, Vol. 4MANIAActa Psychiatrica Scandinavica, Vol. 84, No. 6Comparison of mania and depression after brain injury: causal factors1 April 2006 | American Journal of Psychiatry, Vol. 145, No. 2Acta Psychiatrica Scandinavica, Vol. 77, No. 3Acta Psychiatrica Scandinavica, Vol. 76, No. 6 Volume 144Issue 10 October 1987Pages 1379-1379 Metrics PDF download History Published online 1 April 2006 Published in print 1 October 1987

Unravelling the relationship between genetic and environmental risk factors in psychiatric disorders.

Murray et al (1985) have proposed a method for using biological markers and information about family history to reduce the heterogeneity in a disease such as schizophrenia. They propose that families which are heavily loaded with illness are most likely to be segregating for a major locus and therefore should be used for studies of genetic marker or other biological traits that are thought to be related to a genetic etiology. They propose that patients without a family history (sporadics) of an illness should be investigated for hypothesised environmental components since they are the cases where environmental factors are most likely to play a large role. They give an example from their own data on Ventricular Brain Ratios (VBR) in a sample of schizophrenic twins (Reveley et al, 1984) where schizophrenic twins without any family history (FH-) of a major psychosis had significantly larger ventricles than did schizophrenic twins with a family history (FH+). They conclude that while there is a genetic determinant to ventricular size within the normal range, large ventricles reflect an environmental aetiology that is more important in sporadic cases than in those with a familial pattern to the illness. Subsequently, Reveley & Chitkara (1985) found that singleton schizophrenic patients who were FH-had a significantly larger VBR than did controls while FH+ patients had a mean midway between FH-patients and controls. While this is an attractive hypothesis for the structural brain changes seen in some schizophrenic patients, results of other studies are not consistent with these findings (Nasrallah et al, 1983; Schulsinger et al, 1984; Owens et al, 1985; DeLisi et al, 1986). For example, in our own data (DeLisi et al, 1986), ‘familial’ schizophrenics had larger ventricles than did controls and risk factors thought to be environmental (head injuries and birth complications) were found to be present in that sample.