Psychological Medicine

Original Articles

Anorexia nervosa trios: behavioral profiles of individuals with anorexia nervosa and their parents

M. J. Jacobsa1 c1, S. Roescha1, S. A. Wonderlicha1, R. Crosbya1, L. Thorntona1, D. E. Wilfleya1, W. H. Berrettinia1, H. Brandta1, S. Crawforda1, M. M. Fichtera1, K. A. Halmia1, C. Johnsona1, A. S. Kaplana1, M. LaViaa1, J. E. Mitchella1, A. Rotondoa1, M. Strobera1, D. B. Woodsidea1, W. H. Kayea1 and C. M. Bulika1

a1 University of California, San Diego (UCSD) Eating Disorders Treatment and Research Center, La Jolla, CA, USA


Background Anorexia nervosa (AN) is associated with behavioral traits that predate the onset of AN and persist after recovery. We identified patterns of behavioral traits in AN trios (proband plus two biological parents).

Method A total of 433 complete trios were collected in the Price Foundation Genetic Study of AN using standardized instruments for eating disorder (ED) symptoms, anxiety, perfectionism, and temperament. We used latent profile analysis and ANOVA to identify and validate patterns of behavioral traits.

Results We distinguished three classes with medium to large effect sizes by mothers' and probands' drive for thinness, body dissatisfaction, perfectionism, neuroticism, trait anxiety, and harm avoidance. Fathers did not differ significantly across classes. Classes were distinguished by degree of symptomatology rather than qualitative differences. Class 1 (~33%) comprised low symptom probands and mothers with scores in the healthy range. Class 2 (~43%) included probands with marked elevations in drive for thinness, body dissatisfaction, neuroticism, trait anxiety, and harm avoidance and mothers with mild anxious/perfectionistic traits. Class 3 (~24%) included probands and mothers with elevations on ED and anxious/perfectionistic traits. Mother–daughter symptom severity was related in classes 1 and 3 only. Trio profiles did not differ significantly by proband clinical status or subtype.

Conclusions A key finding is the importance of mother and daughter traits in the identification of temperament and personality patterns in families affected by AN. Mother–daughter pairs with severe ED and anxious/perfectionistic traits may represent a more homogeneous and familial variant of AN that could be of value in genetic studies.

(Received July 11 2007)

(Revised May 09 2008)

(Accepted May 14 2008)

(Online publication June 26 2008)


c1 Address for correspondence: M. J. Jacobs, Ph.D., UCSD Eating Disorders Treatment and Research Center, 8950 Villa La Jolla, C-207, La Jolla, CA 92037, USA. (Email:


Portions of this paper were presented at the annual meeting of the Eating Disorders Research Society, Toronto, Canada, 29 September–2 October 2005.