Emotion dysregulation in childhood may increase risk of anorexia nervosa as a teen

Although children in general have difficulty managing the wide range of emotions that may well up inside them, some may experience more frequent emotional dysregulation than others. A report in JAMA Psychiatry examines whether a history of this dysregulation is tied to an increased risk of broad anorexia nervosa at adolescence.¹

Investigators included every child with complete exposure data who was in the Millennium Cohort Study, which was a UK general population birth cohort. Mothers were asked via the Children’s Social Behavior Questionnaire about their child’s skills at regulating emotions at 3, 5, and 7 years of age. The main outcome included symptoms that aligned with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis of anorexia nervosa or atypical anorexia nervosa at 14 years of age, which were described through a series of questions about body image, weight perception, and dieting behaviors, which the investigators termed broad anorexia nervosa.

There were 15,896 participants who had complete available data and were included in the analysis. In those who had both outcome data and complete exposure (9912 of the analytical sample [62.4%]), 97 participants who were mostly girls and White had symptoms that were consistent with a diagnosis of broad anorexia when they were aged 14 years. There was no evidence that indicated that a child with lower ability to regulate emotion at 3 years of age had increase odds of reporting symptoms of broad anorexia nervosa later in life (odds ratio [OR], 1.21; 95% CI, 0.91-1.63). Yet, a child who did not see improvement in his or her emotion regulation skills and who also had increased difficulties regulating his or her emotions at 7 years of age did have greater odds of a broad anorexia nervosa diagnosis at 14 years of age (OR, 1.45; 95% CI, 1.16-1.83).

The investigators concluded that there does appear to be a link between a diagnosis of broad anorexia nervosa in adolescence and a child’s inability to develop the ability to regulate emotion, particularly when the inability is continual. Working with young patients to support the development of the necessary skills to appropriately manage emotion could be a way to reduce the incidence of anorexia nervosa.

Reference

1. Henderson M, Bould H, Flouri E, et al. Association of emotion regulation trajectories in childhood with anorexia nervosa and atypical anorexia nervosa in early adolescence. JAMA Psychiatry. July 7, 2021. Epub ahead of print. doi:10.1001/jamapsychiatry.2021.1599