Poor social comparison and the tendency to submissive behavior in anorexia nervosa

Objective: The aim of this study was to confirm an association between low social rank (SR) and anorexia nervosa (AN), and to test the hypotheses that low SR is (a) present after recovery from the illness, (b) mediates an association between increased childhood interpersonal adversity (CIA) and AN. Method: Participants were 18 women with active AN, 13 recovered women, and 16 healthy controls. General and specific psychopathology, childhood adversity, and indices of SR were assessed using self-report measures. Results: Low SR was observed in both the active and the recovered AN groups and was a significant mediator in the relationship between CIA and AN status. Conclusion: CIA may contribute to the risk of developing AN via its impact on the development of low SR. The latter may be a shared risk factor for AN and affective disorder, and could be a useful therapeutic target. (c) 2007 by Wiley Periodicals, Inc.Peer reviewe