An investigation of indirect effects of personality features on anorexia nervosa severity through interoceptive dysfunction in individuals with lifetime anorexia nervosa diagnoses

Mary E. Duffy, Megan L. Rogers, Thomas E. Joiner, Andrew W. Bergen, Wade Berrettini, Cynthia M. Bulik, Harry Brandt, Steven Crawford, Scott Crow, Manfred Fichter, Katherine Halmi, Allan S. Kaplan, Kelly L. Klump, Lisa Lilenfeld, Pierre J. Magistretti, James Mitchell, Nicholas J. Schork, Michael Strober, Laura M. Thornton, Janet TreasureBlake Woodside, Walter H. Kaye, Pamela K. Keel

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective: This study examined a hypothesized pathway by which interoceptive dysfunction accounted for associations between personality features (harm avoidance, self-directedness, and perfectionism) and anorexia nervosa (AN) severity (indicated by drive for thinness, eating disorder-related preoccupations and rituals, and body mass index). Method: The study sample (n = 270, mean age = 28.47, 95.2% female, 98% White/Caucasian) consisted of probands and biological relatives who met DSM-IV criteria for lifetime diagnoses of AN (omitting criterion D, amenorrhea) drawn from the Price Foundation Anorexia Nervosa Affected Relative Pairs Study (AN-ARP). Participants completed measures assessing personality, interoceptive dysfunction, and eating pathology. Results: Associations between personality features of low self-directedness and high perfectionism and indicators of AN severity (drive for thinness and eating disorder-related preoccupations and rituals) were significant, as were the hypothesized indirect pathways through interoceptive dysfunction. Neither harm avoidance nor body mass index was significantly related to other study variables, and the proposed indirect pathways involving these variables were not significant. Discussion: Findings suggest that certain personality features may relate to AN severity, in part, through their associations with interoceptive dysfunction. Future research should examine prospective associations and the value of interventions targeting interoceptive dysfunction for interrupting the link between personality and AN severity.

Original languageEnglish (US)
Pages (from-to)200-205
Number of pages6
JournalInternational Journal of Eating Disorders
Issue number2
StatePublished - Feb 1 2019

Bibliographical note

Funding Information:
National Science Foundation, Grant/Award Number: NSF 1449440; Price Foundation of Geneva, Switzerland; Military Suicide Research Consortium, U.S. Department of Defense, Grant/Award Numbers: W81XWH-10-2-0181, W81XWH-16-2-0003; Vetenskapsrådet, Grant/Award Number: VR Dnr: 538-2013-8864; Swedish Research Council, Grant/Award Number: VR Dnr: 538-2013-8864

Funding Information:
This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. NSF 1449440. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. This project was also in part supported by the Military Suicide Research Consortium (MSRC), an effort supported by the Department of Defense (W81XWH-10-2-0181; W81XWH-16-2-0003). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Military Suicide Research Consortium or the Department of Defense. This work was also financially supported by the Price Foundation of Geneva, Switzerland. Dr. Bulik acknowledges funding from the Swedish Research Council (VR Dnr: 538-2013-8864). The funding sources had no role in the conduct of the current research or preparation of the manuscript.


  • anorexia nervosa
  • body mass index
  • feeding and eating disorders
  • perfectionism
  • personality
  • thinness

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