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1. Dehydroepiandrosterone mediates associations between trauma‐related symptoms and anterior pituitary volume in children and adolescents

   https://doi.org/10.1002/hbm.26516  

   Picci, Giorgia ; Casagrande, Chloe C. ; Ott, Lauren R. ; Petro, Nathan M. ; Christopher‐Hayes, Nicholas J. ; Johnson, Hallie J. ; Willett, Madelyn P. ; Okelberry, Hannah J. ; Wang, Yu‐Ping ; Stephen, Julia M. ; et al ( October 2023 , Human Brain Mapping)

   The anterior pituitary gland (PG) is a potential locus of hypothalamic–pituitary–adrenal (HPA) axis responsivity to early life stress, with documented associations between dehydroepiandrosterone (DHEA) levels and anterior PG volumes. In adults, elevated anxiety/depressive symptoms are related to diminished DHEA levels, and studies have shown a positive relationship between DHEA and anterior pituitary volumes. However, specific links between responses to stress, DHEA levels, and anterior pituitary volume have not been established in developmental samples.

   High‐resolution T1‐weighted MRI scans were collected from 137 healthy youth (9–17 years;M_age = 12.99 (SD = 1.87); 49% female; 85% White, 4% Indigenous, 1% Asian, 4% Black, 4% multiracial, 2% not reported). The anterior and posterior PGs were manually traced by trained raters. We examined the mediating effects of salivary DHEA on trauma‐related symptoms (i.e., anxiety, depression, and posttraumatic) and PG volumes as well as an alternative model examining mediating effects of PG volume on DHEA and trauma‐related symptoms.

   DHEA mediated the association between anxiety symptoms and anterior PG volume. Specifically, higher anxiety symptoms related to lower DHEA levels, which in turn were related to smaller anterior PG.

   These results shed light on the neurobiological sequelae of elevated anxiety in youth and are consistent with adult findings showing suppressed levels of DHEA in those with greater comorbid anxiety and depression. Specifically, adolescents with greater subclinical anxiety may exhibit diminished levels of DHEA during the pubertal window, which may be associated with disruptions in anterior PG growth.

    

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2. Associations between household income and disordered eating differ across sex and racial identity in a population‐based sample of adults

   https://doi.org/10.1002/eat.23948  

   Mikhail, Megan E. ; Ackerman, Lindsay S. ; Anaya, Carolina ; Culbert, Kristen M. ; Burt, S. Alexandra ; Klump, Kelly L. ( March 2023 , International Journal of Eating Disorders)

   Most research on socioeconomic status (SES) and eating disorders (EDs) has focused on young White women. Consequently, little is known regarding how SES may relate to EDs/disordered eating in older adults, men, or people with different racial identities. We examined whether associations between SES and EDs/disordered eating differed across age, sex, and racial identity in a large, population‐based sample spanning early‐to‐later adulthood.

   Analyses included 2797 women and 2781 men ages 18–65 (M_age = 37.41, SD = 7.38) from the population‐based Michigan State University Twin Registry. We first examined associations between SES and dimensional ED symptoms, binge eating (BE), and self‐reported ED diagnoses across age and sex in the full sample. We then examined the impact of racial identity on associations by conducting within‐ and between‐group analyses among Black and White participants.

   In the full sample, lower SES was associated with significantly greater odds of BE and lifetime EDs in men, but not women, across adulthood. The association between lower SES and greater BE risk was stronger for Black men than for White men, though significant in both groups. Conversely, Black women showed apositiveassociation between SES and dimensional ED symptoms that significantly differed from effects for Black men and White women.

   Associations between socioeconomic disadvantage and EDs/disordered eating may be particularly robust for men in adulthood, especially men with a marginalized racial identity. Oppositely, Black women may encounter social pressures and minority stress in higher SES environments that could contribute to somewhat heightened ED risk.

   Little is known regarding how associations between socioeconomic status (SES) and eating disorders (EDs) may differ across age/sex or racial identity. We found lower SES was associated with greater odds of a lifetime ED or binge eating in men only, with a particularly strong association between lower SES and binge eating for Black men. Results highlight the importance of examining how SES‐ED associations may differ across other aspects of identity.

    

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3. Depression in 3/6‐year‐old children: clinical and psychosocial outcomes in later childhood and adolescence

   https://doi.org/10.1111/jcpp.13553  

   Silver, Jamilah ; Olino, Thomas M. ; Carlson, Gabrielle A. ; Dougherty, Lea R. ; Bufferd, Sara J. ; Klein, Daniel N. ( December 2021 , Journal of Child Psychology and Psychiatry)

   In recent years, epidemiological and clinical studies have revealed that depressive disorders can present in early childhood. To clarify the validity and prognostic significance of early childhood‐onset depression, we investigated diagnostic and functional outcomes in later childhood and adolescence.

   A community sample (N = 516) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. When participants were 9, 12, and 15 years old, children and parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia and measures of symptoms and functioning.

   In models adjusting for covariates, depressed 3/6‐year‐old children were more likely to experience subsequent episodes of depressive disorders and exhibited significantly higher rates of later anxiety disorder, attention deficit hyperactivity disorder, and suicidality compared to children without depressive disorders at age 3/6. Early childhood depression was also associated with higher levels of mother, but not child, reported depressive symptoms at age 15 compared to children without depressive disorders at age 3/6. Finally, depression at age 3/6 predicted lower levels of global and interpersonal functioning and higher rates of treatment at age 15 compared to children without depressive disorders at age 3/6.

   Results support the clinical significance of depression in 3/6‐year‐old children, although further studies with larger samples are needed.

    

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4. Restrictive eating, but not binge eating or purging, predicts suicidal ideation in adolescents and young adults with low‐weight eating disorders

   https://doi.org/10.1002/eat.23210  

   Wang, Shirley B. ; Mancuso, Christopher J. ; Jo, Jenny ; Keshishian, Ani C. ; Becker, Kendra R. ; Plessow, Franziska ; Izquierdo, Alyssa M. ; Slattery, Meghan ; Franko, Debra L. ; Misra, Madhusmita ; et al ( December 2019 , International Journal of Eating Disorders)

   This study examined the relationship between eating‐disorder behaviors—including restrictive eating, binge eating, and purging—and suicidal ideation. We hypothesized that restrictive eating would significantly predict suicidal ideation, beyond the effects of binge eating/purging.

   Participants were 82 adolescents and young adults with low‐weight eating disorders. We conducted a hierarchical logistic regression, with binge eating and purging in Step 1 and restrictive eating in Step 2, to predict suicidal ideation.

   Step 1 was significant (p= .01) and explained 20% variance in suicidal ideation; neither binge eating nor purging significantly predicted suicidal ideation. Adding restrictive eating in Step 2 significantly improved the model (ΔR²= .07,p= .009). This final model explained 27% of the variance, and restrictive eating (but not binge eating/purging) significantly predicted suicidal ideation (p= .02).

   Restrictive eating is associated with suicidal ideation in youth with low‐weight eating disorders, beyond the effects of other eating‐disorder behaviors. Although healthcare providers may be more likely to screen for suicidality in patients with binge eating and purging, our findings indicate clinicians should regularly assess suicide and self‐injury in patients with restrictive eating. Future research examining how individuals progress from suicidal ideation to suicidal attempts can further enhance our understanding of suicide in eating disorders.

    

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5. Impact of expanded diagnostic criteria for avoidant/restrictive food intake disorder on clinical comparisons with anorexia nervosa

   https://doi.org/10.1002/eat.22988  

   Becker, Kendra R. ; Keshishian, Ani C. ; Liebman, Rachel E. ; Coniglio, Kathryn A. ; Wang, Shirley B. ; Franko, Debra L. ; Eddy, Kamryn T. ; Thomas, Jennifer J. ( December 2018 , International Journal of Eating Disorders)

   Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are restrictive eating disorders. There is a proposal before the American Psychiatric Association to broaden the currentDSM‐5criteria for ARFID, which currently require dietary intake that is inadequate to support energy or nutritional needs. We compared the clinical presentations of ARFID and AN in an outpatient sample to determine how a more inclusive definition of ARFID, heterogeneous for age and weight status, is distinct from AN.

   As part of standard care, 138 individuals with AN or ARFID completed an online assessment battery and agreed to include their responses in research.

   Individuals with ARFID were younger, reported earlier age of onset, and had higher percent median BMI (%mBMI) than those with AN (allps < .001). Individuals with ARFID scored lower on measures of eating pathology, depression, anxiety, and clinical impairment (allps < .05), butdid notdiffer from those with AN on restrictive eating (p = .52), and scored higher on food neophobia (p < .001).

   Allowing psychosocial impairment to be sufficient for an ARFID diagnosis resulted in a clinical picture of ARFID such that %mBMI was higher (and in the normal range) compared with AN. Differences in gender distribution, age, and age of onset remained consistent with previous research. Both groups reported similar levels of dietary restriction, although ARFID can be distinguished by relatively higher levels of food neophobia. Currently available measures of eating pathology may capture certain ARFID symptoms, but highlight the need for measures of impairment relative to ARFID.

    

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