Table 1.
Characteristics of the studies included in the review.
| Author (year); Country | N sample Mean age, SD | N control/comparison (Mean age, SD) | Variables observed | Measure | FHA versus controls [Effect size (CI 95%)] | FHA versus comparisons [Effect size (CI 95%)] |
|---|---|---|---|---|---|---|
| Marcus et al. (32); USA | 28 with FHA 26.4 ± 5.6 |
24 with organic amenorrhea 26.2 ± 4.7 25 eumenorrheic 25.9 ± 5.1 |
Depression | Beck Depression Inventory Hamilton Raing Scale for Depression |
Higher levels of depressive symptoms both in Beck Depression Inventory [d= 0.77 (0.21-1.32)] and Hamilton Raing Scale for Depression [d= 0.74 (0.19 -1.30–)] | NS |
| Disfunctional Attitude | The Disfunctional Attitude Scale | Higher dysfunctional attitudes [d= 0.83 (0.27-1.40)]. Specifically, greater need for approval [d=0.85 (0.29-1.41)] |
NS | |||
| Sefl-control | Self-Control Scale | NS | NS | |||
| Eating attitude | Eating Disorder Inventory-2 Bulimia Test |
Higher drive for thinness [d=1.17 (0.41-1.94)] Higher bulimia [d=1.12 (0.36-1.88)] Higher ineffectiveness [d = 0.77 (0.04-1.50)] Higher interoceptive awareness [d=0.90 (0.16-1.64)] Higher bulimic symptoms [d=1.42 (0.63-2.21)] |
Higher drive for thinness [d =0.89 (0.20-1.59)] Higher bulimia [d=0.04 (-0.66-0.67)] Higher ineffectiveness [d=0.91 (0.21-1.61)] Higher interoceptive awareness [d==0.73 (0.05-1.42)] Higher bulimic symptoms[d==0.91 (0.22-1.61)] |
|||
| Bomba et al. (11); Italy | 20 with FHA (10 N-FHA and 10 Hy-FHA) 16.4 ± 0.9 |
20 eumenorrheic 17.1 ± 1.2 |
Depression | Children’s Depression Inventory | NS | NA |
| Eating attitudes | Eating Disorder Inventory-2; | N-FHA: Higher drive for thinness [g = 0.30 (-0.45-1.07)] Hy-FHA: Higher Ineffectiveness [g=0.67 (-0.11-1.45)] Higher Ascetism [g =0.71 (-0.07-1.49)] Higher Impulse regulation [g=0.26 (-0.50-1.02)] Higher Social Insecurity [g= 0.71 (-0.07-1.48)] Higher EDI-2 total score [g= 0.52 (-0.24-1.29)] |
||||
| Previous trauma events and life events, psychosomatic disorders, and depressive and anxiety traits | Psychodinamic semistructured interview for girls and their parents | Mild subclinical depressive trait Subclinical eating disorders in adolescence Stressfull events were reported by parents of FHA patients; mainy, precence of psychoatric disease in famiy, postpartum depression, intrafamiliar conflicts, transferts, and chornic disease Reported life events associated with the onset of amenorrhea were common life events that these teenagers felt as highly stressful (such as change of school or breaking up with boyfriend). Eighty percent of FHA girls reported having an excessively demanding, controlling, and intrusive mother, with conflicting family relationships in 50% of cases. |
||||
| Dundon et al. (33); USA | 41 with FHA 26.1 ± 5.5 |
39 eumenorrheic 25.1 ± 4.9 |
Sexual function | McCoy Female Sexuality Questionnaire | Lower scores on sexuality [d = 1.22 (0.74-1.69)] | NA |
| Depression | Zung Self-Rating Depression Scale | Higher depression [d = 0.83 (0.37-1.29)] | ||||
| Anxiety | Zung Self-Rating Anxiety Scale | Higher anxiety [d =1.26 (0.79-1.75)] | ||||
| Bomba et al. (34); Italy | 21 with FHA 16.2 ± 0.9 |
21 with anorexia nervosa 15.9 ± 1.1 21 eumenorrheic 16.2 ± 1.1 |
Depression | Children’s Depression Inventory; | Higher scores of depression at CDI [d =1.25 (0.59-1.90)] | Lower scores at CDI [d =-0.99 (-1.63 - -0.35)]. |
| Eating attitude | Eating Disorder Inventory-2 | Higher drive for thinness [d=1.21 (0.55 – 1.87)] Higher maturity fears [d=1.30 (0.63-1.96)] Higher social insecurity [d = 0.94 (0.30-1.58)] |
Lower drive for thinness [d= -0.78 (-1.41–0.16)] Lower ineffectiveness [d= -0.65 (-1.27- -0.03)]; Lower interpersonal distrust [d=-0.87 (-1.50 - -0.24)] Lower interoceptive awareness [d=-1.08 (-1.73 - -0.44)] |
|||
| Alexithymia | Toronto Alexthymia Scale-20 | Higher scores of alexithymia [d= 1.27 (0.61-1.93)]; and the difficulties in describing feelings subscale [d = 1.38 (0.71-2-05)] | Lower scores at difficulty in identifying feelings [d= -0.94 (-1.58- -0.30)] | |||
|
Pentz and Radoš
( 35); Croatia |
25 with FHA 21 (18-24)1 |
21 with organic amenorrhea 23 (21 - 26)1 20 eumenorrheic 24 (20.5 – 26.5)1 |
Trait measurements | Multidimensional Perfectionism Scale Self-Control Scale |
Higher levels of perfectionism trait [d= 1.39 (1.06-1.72)] Higher levels of concerns over mistake [d= 1.08 (0.85-1.31)] | Higher levels of personal standards [d= 0.73 (0.61-0.85)] |
| Eating attitudes | Adolescent Dieting Scale + Eating Attitude Test | NS | NS | |||
| Parental rearing perception | Memories of upbringing | NS | NS | |||
| DSM-IV Disorders | Structured Clinical Interview for DSM-IV Disorders (SCID) | History of anorexia nervosa | History of anorexia nervosa | |||
|
Tranoulis et al.
( 36, 37); UK |
41 with FHA (17.8 ± 1.8) |
86 eumenorrheic (18.3 ± 2.7) |
Sleep disordersa | Athens Insomnia Scalea | Higher scores at the following subscales of AIS-8a [g= 0.55 (0.17-0.93)]: awakenings during the night [g== 0.71 (0.32-1.09)] final awakening [g=1.13 (0.73-1.52)] total sleep duration [g= 0.65 (0.27-1.03)] quality of sleep [g= 1.6 (1.18-2.02)]. Lower sleepiness during the daya [g=-1.0 (-1.39 - -0.61)] |
NA |
| Anxietya,b | State-Trait-Anxiety-Inventorya,b | Higher scores of STAI g=1.10 (0.70 - 1.50)] | ||||
| Eating Attitudesa,b | Eating Attitude Test-26a,b | Higher scores of EAT-26 [g= 1.36 (0.95-1.77)]a
Higher scores of EAT-26 subscalesb: specifically dieting [g= 0.90 (0.51-1.29)], bulimia and food preoccupation [g= 1.72 (1.29-2.15)]. |
||||
| Overweight preoccupationa,b | Multidimensional Body-Self-Relations Questionnairea,b | Higher scores of MBSRQ [g= 1.06 (0.67-1.45)], | ||||
| Physical Activitya,b | International Physical Activity Questionnairea,b | Higher scores of IPAQ [g= 0.57 (0.19-0.94)]. | ||||
|
Strock et al.
( 38); USA |
33 with FHA (21.2 ± 0.5) |
28 eumenorrheic (24.1 ± 0.9) |
Mood | Profile of Mood States | NS | NA |
| Depression | Beck Depression Inventory | NS | ||||
| Stress | Daily Stress Inventory Perceived Stress Scale |
NS | ||||
| Eating Attidues | Three-Factor Eating Questionnaire Eating Disorder Inventory |
Higher drive for thinness [d= 1.00 (0.47-1.54)] Higher cognitive restraint [d= -4.16 (3.26 -5.05)] |
||||
| Disfunctional Attitude | Dysfunctional Attitude Scale | Greater need for social approval [d= 2.7 (2.00 – 3.39)] |
||||
| Resilience | Brief Resilient Coping | NS |
1Data refers to median and interquartile range.
*The appropriate Effect size measure for each variable is calculated. Specifically, Cohen’s d is reported when two groups have similar standard deviations and are of the same size. While Hedges’ g is calculated when there are different sample sizes.