Research from Sweden reveals that girls with a family history of anorexia show increased rates of anxiety, autism spectrum traits, and other psychiatric conditions before any eating disorder diagnosis, highlighting the importance of early monitoring.
A new study of daughters of women with anorexia nervosa suggests that psychiatric difficulties may emerge well before any eating disorder diagnosis, with anxiety and autism spectrum traits appearing more often in girls at familial high risk than in a matched comparison group. Researchers in Sweden found that 32.1% of at-risk daughters met criteria for at least one psychiatric diagnosis, compared with 4.8% of daughters whose mothers had no eating disorder history, according to the paper in the Journal of Eating Disorders. The authors say the pattern points to early psychological vulnerabilities that may help set the stage for later anorexia nervosa.
The study used a family high-risk design, a method long employed in psychiatry to identify early markers of illness. Earlier family research has linked anorexia nervosa with other psychiatric conditions in relatives, including depression and pervasive developmental disorders, and family history studies have shown that eating disorders cluster across generations. The Swedish team focused on pre-adolescent girls because the risk of anorexia nervosa rises sharply around puberty and because girls with affected mothers are thought to carry the highest familial risk.
The findings add to a small but growing body of work on the children of mothers with anorexia nervosa. A previous pilot study of adolescent daughters described strained but close mother-daughter relationships and avoidant conversations about food, while still finding the girls psychologically robust. In the new study, however, the girls at higher familial risk showed more psychiatric diagnoses overall and more emotional symptoms on questionnaire measures, even though most of the continuous trait scores did not differ significantly between groups.
The researchers were careful to note the study’s limits, including the small sample size and the fact that assessments were based on parent report rather than direct interviews with the girls. Still, they say the results strengthen the case for close monitoring of children in families affected by anorexia nervosa. The authors argue that early signs of anxiety, autism-related difficulties or other psychiatric symptoms may represent the first clues to a broader vulnerability, and that following these children over time will be essential to determine whether those difficulties predict later eating disorder onset.
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