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Plateau CR, Arcelus J, Meyer C. Detecting Eating Psychopathology in Female Athletes by Asking About Exercise: Use of the Compulsive Exercise Test. EUROPEAN EATING DISORDERS REVIEW 2018; 25:618-624. [PMID: 29057602 DOI: 10.1002/erv.2561] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/18/2017] [Accepted: 09/13/2017] [Indexed: 12/19/2022]
Abstract
The present study assessed the suitability of the Compulsive Exercise Test (athlete version; CET-A) for identifying female athletes with clinically significant features related to or comparable with eating psychopathology. Three hundred and sixty-one female athletes (including 12 with a clinically diagnosed eating disorder) completed the Eating Disorders Examination Questionnaire and the CET-A. Receiver operating curve analysis was employed to identify a cut-off value on the CET-A, which could indicate clinically significant features related to or comparable with eating psychopathology among female athletes. The analysis demonstrated that a CET-A score of 10 successfully discriminated female athletes with a current eating disorder. The results suggest that the CET-A may be a suitable tool for detecting eating psychopathology in female athletes. Additional longitudinal research is needed to evaluate the predictive value of the CET-A. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Carolyn R Plateau
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jon Arcelus
- Leicestershire Adult Eating Disorders Service, Leicestershire Partnership NHS Trust, Bennion Centre, Leicester, UK.,Institute of Mental Health, Jubilee Campus, University of Nottingham, Nottingham, UK.,Nottingham Centre for Transgender Health, 3 Oxford Street, Nottingham, UK
| | - Caroline Meyer
- WMG, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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Schmidt U, Sharpe H, Bartholdy S, Bonin EM, Davies H, Easter A, Goddard E, Hibbs R, House J, Keyes A, Knightsmith P, Koskina A, Magill N, McClelland J, Micali N, Raenker S, Renwick B, Rhind C, Simic M, Sternheim L, Woerwag-Mehta S, Beecham J, Campbell IC, Eisler I, Landau S, Ringwood S, Startup H, Tchanturia K, Treasure J. Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BackgroundAnorexia nervosa (AN) is a severe psychiatric condition and evidence on how to best treat it is limited.ObjectivesThis programme consists of seven integrated work packages (WPs) and aims to develop and test disseminable and cost-effective treatments to optimise management for people with AN across all stages of illness.MethodsWP1a used surveys, focus groups and a pre–post trial to develop and evaluate a training programme for school staff on eating disorders (EDs). WP1b used a randomised controlled trial (RCT) [International Standard Randomised Controlled Trial Number (ISRCTN) 42594993] to evaluate a prevention programme for EDs in schools. WP2a evaluated an inpatient treatment for AN using case reports, interviews and a quasi-experimental trial. WP2b used a RCT (ISRCTN67720902) to evaluate two outpatient psychological therapies for AN. WP3 used a RCT (ISRCTN06149665) to evaluate an intervention for carers of inpatients with AN. WP4 used actimetry, self-report and endocrine assessment to examine physical activity (PA) in AN. WP5 conducted a RCT (ISRCTN18274621) of an e-mail-guided relapse prevention programme for inpatients with AN. WP6 analysed cohort data to examine the effects of maternal EDs on fertility and their children’s diet and growth. WP7a examined clinical case notes to explore how access to specialist ED services affects care pathways and user experiences. Finally, WP7b used data from this programme and the British Cohort Study (1970) to identify the costs of services used by people with AN and to estimate annual costs of AN for England.ResultsWP1a: a brief training programme improved knowledge, attitudes and confidence of school staff in managing EDs in school. WP1b: a teacher-delivered intervention was feasible and improved risk factors for EDs in adolescent girls. WP2a: both psychological therapies improved outcomes in outpatients with AN similarly, but patients preferred one of the treatments. WP2b: the inpatient treatment (Cognitive Remediation and Emotional Skills Training) was acceptable with perceived benefits by patients, but showed no benefits compared with treatment as usual (TAU). WP3: compared with TAU, the carer intervention improved a range of patient and carer outcomes, including carer burden and patient ED symptomatology. WP4: drive to exercise is tied to ED pathology and a desire to improve mood in AN patients. PA was not increased in these patients. WP5: compared with TAU, the e-mail-guided relapse prevention programme resulted in higher body mass index and lower distress in patients at 12 months after discharge. WP6: women with an ED had impaired fertility and their children had altered dietary and growth patterns compared with the children of women without an ED. WP7a: direct access to specialist ED services was associated with higher referral rates, lower admission rates, greater consistency of care and user satisfaction. WP7b: the annual costs of AN in England are estimated at between £45M and £230M for 2011.ConclusionsThis programme has produced evidence to inform future intervention development and has developed interventions that can be disseminated to improve outcomes for individuals with AN. Directions for future research include RCTs with longer-term outcomes and sufficient power to examine mediators and moderators of change.Trial registrationCurrent Controlled Trials ISRCTN42594993, ISRCTN67720902, ISRCTN06149665 and ISRCTN18274621.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 16. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Helen Sharpe
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Savani Bartholdy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Eva-Maria Bonin
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Helen Davies
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Abigail Easter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Institute of Child Health, University College London, London, UK
| | - Elizabeth Goddard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rebecca Hibbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jennifer House
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Alexandra Keyes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Pooky Knightsmith
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Antonia Koskina
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nicholas Magill
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jessica McClelland
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nadia Micali
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Institute of Child Health, University College London, London, UK
| | - Simone Raenker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Bethany Renwick
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Charlotte Rhind
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mima Simic
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Lot Sternheim
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sabine Woerwag-Mehta
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jennifer Beecham
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
- Personal Social Services Research Unit, University of Kent, Canterbury, UK
| | - Iain C Campbell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ivan Eisler
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sabine Landau
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Helen Startup
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Lichtenstein MB, Hemmingsen SD, Støving RK. Identification of eating disorder symptoms in Danish adolescents with the SCOFF questionnaire. Nord J Psychiatry 2017; 71:340-347. [PMID: 28290749 DOI: 10.1080/08039488.2017.1300322] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Eating disorders often develop in adolescence and, therefore, instruments are needed that are useful to detect risk behaviour in young people. The SCOFF is a 5-item screening instrument, named SCOFF as an acronym of keywords from the questions. It has been used widely in adult samples, but studies that evaluate the scale in adolescents are missing. AIMS The aim of this study was to test the psychometric properties of the SCOFF in adolescents aged 11-20 years and for the first time validate the questionnaire in Danish. METHODS A total of 184 adolescents completed the Danish version of the SCOFF and sub-scales from the Eating Disorder Inventory (EDI-3). The sample consisted of 87 patients (mean age = 16) from a specialized eating disorder department in the Region of Southern Denmark and 97 healthy adolescents (mean age = 17) from Danish primary and high schools. RESULTS It was found that the reliability of the SCOFF was acceptable, and that cut-off 2 is useful to detect those with potential eating disorder pathology. Item 3 (weight loss) correlated poorly with EDI-3 sub-scales and might be reformulated by addressing the intentionality behind weight loss (due to unhappiness with body) rather than a specific amount of weight loss (1 stone), because this could have somatic reasons. CONCLUSIONS The SCOFF is a very easily applicable questionnaire, which may fulfil the necessary psychometric properties for detection of ED symptoms in Danish adolescents. Before general screening can be recommended, conditions regarding benefits and potential adverse effects still remain to be addressed.
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Affiliation(s)
- Mia Beck Lichtenstein
- a Centre for Telepsychiatry, Odense, Region of Southern Denmark, Department of Psychology , University of Southern Denmark , Denmark
| | - Simone Daugaard Hemmingsen
- b Nutrition Clinic, Centre for Eating Disorders, Odense University Hospital, Psychiatric Services in the Region of Southern Denmark, Research Unit of Medical Endocrinology, Department of Clinical Research , University of Southern Denmark , Denmark
| | - René Klinkby Støving
- c Nutrition Clinic, Centre for Eating Disorders, Odense University Hospital, Psychiatric Services in the Region of Southern Denmark, Research Unit of Medical Endocrinology, Department of Clinical Research , University of Southern Denmark , Denmark
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104
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Identification and Management of Eating Disorders in Integrated Primary Care: Recommendations for Psychologists in Integrated Care Settings. J Clin Psychol Med Settings 2017; 24:163-177. [DOI: 10.1007/s10880-017-9497-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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105
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Sanchez-Armass O, Raffaelli M, Andrade FCD, Wiley AR, Noyola ANM, Arguelles AC, Aradillas-Garcia C. Validation of the SCOFF questionnaire for screening of eating disorders among Mexican university students. Eat Weight Disord 2017; 22:153-160. [PMID: 26928282 DOI: 10.1007/s40519-016-0259-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/05/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To evaluate the criterion validity and diagnostic utility of the SCOFF, a brief eating disorder (ED) screening instrument, in a Mexican sample. METHODS The study was conducted in two phases in 2012. Phase I involved the administration of self-report measures [the SCOFF and the Eating Disorder Inventory-2, (EDI-2)] to 1057 students aged 17-56 years (M age = 21.0, SD = 3.4; 67 % female) from three colleges at the Universidad Autónoma de San Luis Potosí, Mexico. In Phase II, a random subsample of these students (n = 104) participated in the eating disorder examination, a structured interview that yields ED diagnoses. Analyses were conducted to evaluate the SCOFF's criterion validity by examining (a) correlations between scores on the SCOFF and the EDI-2 and (b) the SCOFF's ability to differentiate diagnosed ED cases and non-cases. RESULTS EDI-2 subscales showed high correlations with the SCOFF scores proving initial evidence of criterion validity. A score of two points on the SCOFF optimized the sensitivity (78 %) and specificity (84 %). With this cutoff, the SCOFF correctly classified over half the cases (PPV = 58 %) and screened out the majority of non-cases (NPV = 93 %) providing further evidence of criterion validity. Analyses were repeated separately for men and women, yielding gender-specific information on the SCOFF's performance. CONCLUSIONS Taken as a whole, results indicated that the SCOFF can be a useful tool for identifying Mexican university students who are at risk of eating disorders.
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Affiliation(s)
- Omar Sanchez-Armass
- School of Psychology, Universidad Autónoma de San Luis Potosí, Carretera Central Km. 424.5, 78494, San Luis Potosí, Mexico.
| | - Marcela Raffaelli
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2003 Doris Kelley Christopher Hall, Urbana, IL, 61801, USA
| | - Flavia Cristina Drumond Andrade
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 2011 Huff Hall, 1206 S. Fourth St., Champaign, IL, 6182, USA
| | - Angela R Wiley
- Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, 2003 Doris Kelley Christopher Hall, Urbana, IL, 61801, USA
| | - Aida Nacielli Morales Noyola
- School of Psychology, Universidad Autónoma de San Luis Potosí, Carretera Central Km. 424.5, 78494, San Luis Potosí, Mexico
| | - Alejandra Cepeda Arguelles
- School of Psychology, Universidad Autónoma de San Luis Potosí, Carretera Central Km. 424.5, 78494, San Luis Potosí, Mexico
| | - Celia Aradillas-Garcia
- School of Medicine, Universidad Autónoma de San Luis Potosí, Avenida Venustiano Carranza No 2405., Col. Los filtros, 7821, San Luis Potosí, Mexico
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106
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Kleiman SC, Bulik-Sullivan EC, Glenny EM, Zerwas SC, Huh EY, Tsilimigras MCB, Fodor AA, Bulik CM, Carroll IM. The Gut-Brain Axis in Healthy Females: Lack of Significant Association between Microbial Composition and Diversity with Psychiatric Measures. PLoS One 2017; 12:e0170208. [PMID: 28103291 PMCID: PMC5245801 DOI: 10.1371/journal.pone.0170208] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/02/2017] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study examined associations between the composition and diversity of the intestinal microbiota and measures of depression, anxiety, eating disorder psychopathology, stress, and personality in a group of healthy adult females. METHODS Female participants (n = 91) ages 19-50 years with BMI 18.5-25 kg/m2 were recruited from central North Carolina between July 2014 and March 2015. Participants provided a single fecal sample and completed an online psychiatric questionnaire that included five measures: (i) Beck Anxiety Inventory; (ii) Beck Depression Inventory-II; (iii) Eating Disorder Examination-Questionnaire; (iv) Perceived Stress Scale; and (v) Mini International Personality Item Pool. Bacterial composition and diversity were characterized by Illumina sequencing of the 16S rRNA gene, and associations were examined using Kendall's tau-b correlation coefficient, in conjunction with Benjamini and Hochberg's False Discovery Rate procedure. RESULTS We found no significant associations between microbial markers of gut composition and diversity and scores on psychiatric measures of anxiety, depression, eating-related thoughts and behaviors, stress, or personality in a large cohort of healthy adult females. DISCUSSION This study was the first specifically to examine associations between the intestinal microbiota and psychiatric measures in healthy females, and based on 16S rRNA taxonomic abundances and diversity measures, our results do not suggest a strong role for the enteric microbe-gut-brain axis in normal variation on responses to psychiatric measures in this population. However, the role of the intestinal microbiota in the pathophysiology of psychiatric illness may be limited to more severe psychopathology.
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Affiliation(s)
- Susan C. Kleiman
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Emily C. Bulik-Sullivan
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Elaine M. Glenny
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Stephanie C. Zerwas
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Eun Young Huh
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Matthew C. B. Tsilimigras
- Department of Bioinformatics and Genomics, The University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
| | - Anthony A. Fodor
- Department of Bioinformatics and Genomics, The University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
| | - Cynthia M. Bulik
- Department of Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ian M. Carroll
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Center for Gastrointestinal Biology and Disease, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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107
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Burns BD, Zhang Y, Wieth M, Touyz S. An exploratory study of creativity and eating disorders. J Eat Disord 2017; 5:45. [PMID: 29075495 PMCID: PMC5649089 DOI: 10.1186/s40337-017-0176-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 10/02/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND We examined whether cognitive rigidity associated with having an eating disorder generalized to creativity. METHOD One hundred twelve participants from the participant pool of an Australian university were given a measure of disordered eating (EDE-Q), asked if they had ever had a diagnosis of an eating disorder (16 reported yes), and given 3 min to generate alternative uses for a paper-clip. The alternative uses task yielded measures of creative fluency, originality, elaboration and flexibility. RESULTS A logistic regression found that only lower flexibility predicted a self-reported ED diagnosis. Across the spectrum of disordered eating behaviour there was no association between creativity measures and EDE-Q global scores. CONCLUSION Our results were consistent with previous findings of an association between cognitive inflexibility and having an ED. However we found no evidence that cognitive inflexibility generalized to creativity more broadly. Our results may lend support to Cognitive Remediation Therapy, but further study is required.
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Affiliation(s)
- Bruce D Burns
- University of Sydney, Sydney, New South Wales Australia
| | | | | | - Stephen Touyz
- University of Sydney, Sydney, New South Wales Australia
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108
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Dovey TM, Aldridge VK, Martin CI, Wilken M, Meyer C. Screening Avoidant/Restrictive Food Intake Disorder (ARFID) in children: Outcomes from utilitarian versus specialist psychometrics. Eat Behav 2016; 23:162-167. [PMID: 27794273 DOI: 10.1016/j.eatbeh.2016.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/16/2016] [Accepted: 10/18/2016] [Indexed: 11/27/2022]
Abstract
This study assessed the specificity and sensitivity of two commonly used psychometric methods to assess ARFID in children. To achieve this, a sample of 329 mothers and one father completed the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and the Child Food Neophobia Scale (CFNS). A Receiver Operating Characteristic (ROC) analysis indicated that both measures were able to successfully differentiate a known clinical sample from those of typically developing population. Although the BPFAS was more accurate at differentiating ARFID from the general population, the CFNS was acceptable and on some metrics better than its longer counterpart. The ability of a food neophobia scale to differentiate clinical and population samples, and detect gradation of food avoidance within the population sample, suggests that the multitude of psychometric measures available may be measuring similar constructs. Therefore, confidence can be expected in cross-site comparisons despite each using different psychometric measures of food avoidance in children.
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Affiliation(s)
- Terence M Dovey
- Institute of Environment, Health & Societies, Department of Life Sciences, Marie Jahoda Building, Brunel University London, Uxbridge UB8 3PH, United Kingdom.
| | - Victoria K Aldridge
- UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Clarissa I Martin
- Midlands Psychology, Midland House, 19 Newport Road, Stafford, Staffordshire ST16 1BA, United Kingdom
| | - Markus Wilken
- Institute for Pediatric Feeding Tube Management and Weaning, Siegburg, Germany
| | - Caroline Meyer
- WMG, University of Warwick, Coventry, Warwickshire CV4 7AL, United Kingdom; Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
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109
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Preston C, Ehrsson HH. Illusory Obesity Triggers Body Dissatisfaction Responses in the Insula and Anterior Cingulate Cortex. Cereb Cortex 2016; 26:4450-4460. [PMID: 27733537 PMCID: PMC5193143 DOI: 10.1093/cercor/bhw313] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022] Open
Abstract
In today's Western society, concerns regarding body size and negative feelings toward one's body are all too common. However, little is known about the neural mechanisms underlying negative feelings toward the body and how they relate to body perception and eating-disorder pathology. Here, we used multisensory illusions to elicit illusory ownership of obese and slim bodies during functional magnetic resonance imaging. The results implicate the anterior insula and the anterior cingulate cortex in the development of negative feelings toward the body through functional interactions with the posterior parietal cortex, which mediates perceived obesity. Moreover, cingulate neural responses were modulated by nonclinical eating-disorder psychopathology and were attenuated in females. These results reveal how perceptual and affective body representations interact in the human brain and may help explain the neurobiological underpinnings of eating-disorder vulnerability in women.
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Affiliation(s)
- Catherine Preston
- Department of Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden .,Psychology Department, University of York, York YO10 5DD, UK
| | - H Henrik Ehrsson
- Department of Neuroscience, Karolinska Institutet, Stockholm 17177, Sweden
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110
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Isomaa R, Lukkarila IL, Ollila T, Nenonen H, Charpentier P, Sinikallio S, Karhunen L. Development and preliminary validation of a Finnish version of the Eating Disorder Examination Questionnaire (EDE-Q). Nord J Psychiatry 2016; 70:542-6. [PMID: 27152496 DOI: 10.1080/08039488.2016.1179340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Eating behaviour can be viewed as a continuum, ranging from extremely restrictive to extremely disinhibited eating. Valid and reliable instruments are needed to ensure detection of individuals with risk for eating disorders (ED). Self-report methods are the most feasible, cost, and time efficient. One of the most widely used self-reports is the Eating Disorder Examination Questionnaire (EDE-Q). AIM The aim of this study was to develop a Finnish version of the EDE-Q version 6.0 and to assess its psychometric properties in adolescents, adults, and ED patients. METHODS The present study utilized data from three different samples: adolescents (n = 242), adults (n = 133), and ED patients (n = 52). The patient group comprised different EDs, but individual ED diagnoses were not studied separately. Data was collected January 2014 through June 2015. RESULTS The Finnish version of the EDE-Q showed acceptable-to-excellent internal consistency on all sub-scales in all three samples and discriminated patients from healthy individuals. Female participants generally scored higher than male and sex differences were more pronounced among the younger age group. CONCLUSIONS The Finnish version of the EDE-Q can, based on this study, be regarded as reliable, valid, and functional. Further studies are needed to evaluate the population norms and to test the validity in individual ED diagnoses.
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Affiliation(s)
- Rasmus Isomaa
- a Department of Social Services and Health Care , Jakobstad , Finland ;,b Faculty of Education and Welfare Studies , Åbo Akademi University , Vaasa , Finland
| | - Ida-Lina Lukkarila
- a Department of Social Services and Health Care , Jakobstad , Finland ;,c Department of Clinical Nutrition , University of Eastern Finland , Kuopio , Finland
| | - Teresa Ollila
- c Department of Clinical Nutrition , University of Eastern Finland , Kuopio , Finland
| | | | | | - Sanna Sinikallio
- e School of Educational Sciences and Psychology , University of Eastern Finland , Joensuu , Finland
| | - Leila Karhunen
- c Department of Clinical Nutrition , University of Eastern Finland , Kuopio , Finland
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111
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Cadwallader JS, Godart N, Chastang J, Falissard B, Huas C. Detecting eating disorder patients in a general practice setting: a systematic review of heterogeneous data on clinical outcomes and care trajectories. Eat Weight Disord 2016; 21:365-381. [PMID: 27043947 DOI: 10.1007/s40519-016-0273-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/16/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The incidence and prevalence of eating disorders (ED) is low in general practice (GP) settings. Studies in secondary care suggest that the general practitioner has an important role to play in the early detection of patients with EDs. The aim of this study was to describe the effect (clinical outcomes and care trajectory) of screening for EDs among patients in general practice settings. METHODS A systematic review was conducted on Medline, PsycINFO, CINAHL, Embase and WOS. The studies included were to have been carried out in a primary care setting, with screening explicitly performed in GP practices and follow-up information. RESULTS Ten studies met the inclusion criteria. For all ED patients, there was an increase in the frequency of consultations in GP setting, referrals to psychiatric resources and drug prescriptions such as antidepressants, following screening procedures. Clinical outcomes remained unclear and heterogeneous. One study focused on the course and outcome of ED patients identified by screening in the GP setting and reported recovery for anorexia nervosa (AN) and BN in more than half of the cases, after 4.8 years of mean follow-up. In this study, early age at detection predicted better recovery. CONCLUSION Most of the literature on the role of the GP in screening for and managing EDs consists of opinion papers and original studies designed in a secondary care perspective. The impact of systematically screening for EDs in a primary care setting is not clarified and requires further investigation in collaborative cohort studies with a patient-centered approach, and outcomes focused on symptoms.
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Affiliation(s)
- Jean Sébastien Cadwallader
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Villejuif, France.
- Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
| | - Nathalie Godart
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Villejuif, France
- Department of Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Julie Chastang
- Department of General Practice, Faculty of Medicine Pierre and Marie Curie, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Bruno Falissard
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Villejuif, France
| | - Caroline Huas
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM U1178, Villejuif, France
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112
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Pettersson CB, Zandian M, Clinton D. Eating disorder symptoms pre- and postpartum. Arch Womens Ment Health 2016; 19:675-80. [PMID: 26961005 DOI: 10.1007/s00737-016-0619-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 02/29/2016] [Indexed: 11/28/2022]
Abstract
The study aimed to investigate symptoms of disordered eating pre- and postpartum using a standardised and widely used measure of eating disorder (ED) psychopathology. A consecutive series of women attending either prenatal (N = 426) or postnatal (N = 345) clinics in metropolitan Stockholm were assessed using the Eating Disorder Examination Questionnaire (EDE-Q). Assessments were conducted at either the first visit to prenatal clinics (10-12 weeks of pregnancy) or 6 to 8 months postpartum. An optimised shortened version of the EDE-Q was best suited for studying eating disorders pre- and postpartum. Using the optimised version of the instrument with 14 items and a cut-off score of ≥2.8, it was estimated that 5.3 % of prepartum and 12.8 % of postpartum mothers were suffering from clinical eating disorders. Seriously disordered eating behaviour during, and especially after, pregnancy may be more common than previously thought. It is imperative that health services focus increased attention on these problems by raising awareness, developing and extending specialist services, as well as through implementing educational programmes and training directed toward frontline healthcare services.
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Affiliation(s)
- Cecilia Brundin Pettersson
- Resource Centre for Eating Disorders (KÄTS), Centre for Psychiatry Research (CPF, SLL), Karolinska Institutet, Norra Stationsgatan 69, 7 Tr, 113 64, Stockholm, Sweden
| | | | - David Clinton
- Resource Centre for Eating Disorders (KÄTS), Centre for Psychiatry Research (CPF, SLL), Karolinska Institutet, Norra Stationsgatan 69, 7 Tr, 113 64, Stockholm, Sweden. .,Institute for Eating Disorders, Kruses Gate 8, 0263, Oslo, Norway.
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113
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Chao AM, Grilo CM, Sinha R. Food cravings, binge eating, and eating disorder psychopathology: Exploring the moderating roles of gender and race. Eat Behav 2016; 21:41-7. [PMID: 26741258 PMCID: PMC4851566 DOI: 10.1016/j.eatbeh.2015.12.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/05/2015] [Accepted: 12/16/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the moderating effects of gender and race on the relationships among food cravings, binge eating, and eating disorder psychopathology in a community sample. METHODS Data were collected from a convenience sample of 320 adults (53% male; mean age 28.5±8.2years; mean BMI 27.1±5.2kg/m(2); mean education 15.1±2.2years; 64% white, 24% black, and 13% other race) participating in a cross-sectional study examining the interactions between stress, self-control and addiction. Participants completed a comprehensive assessment panel including a demographic questionnaire, the Food Craving Inventory, and Eating Disorder Examination Questionnaire. Data were analyzed using multiple logistic regression for binge eating behavior and multiple linear regression for eating disorder psychopathology. RESULTS Overall, food cravings demonstrated significant main effects for binge eating behavior (adjusted OR=2.65, p<.001) and global eating disorder psychopathology (B=.47±.09, p<.001). Females had a stronger relationship between food cravings and eating disorder psychopathology than males; there were no statistically significant differences by race. CONCLUSION These findings, based on a diverse sample recruited from the community, suggest that food cravings are associated with binge eating and eating disorder psychopathology and may represent an important target for interventions.
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Affiliation(s)
- Ariana M Chao
- University of Pennsylvania School of Nursing, Philadelphia, PA, United States; Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; CASAColumbia, Yale University School of Medicine, New Haven, CT, United States
| | - Rajita Sinha
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; CASAColumbia, Yale University School of Medicine, New Haven, CT, United States; Yale Stress Center, New Haven, CT, United States
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114
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Burton AL, Abbott MJ, Modini M, Touyz S. Psychometric evaluation of self-report measures of binge-eating symptoms and related psychopathology: A systematic review of the literature. Int J Eat Disord 2016; 49:123-40. [PMID: 26311621 DOI: 10.1002/eat.22453] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Binge eating is a symptom common to bulimia nervosa, anorexia nervosa (binge/purge subtype), and binge eating disorder. There are many self-report measures available to aid the assessment of eating disorders symptoms, but there has not yet been a systematic review of the literature to identify the most valid and reliable measures for use in assessment and treatment of binge eating. METHOD A systematic review of the psychometric properties of self-report measures that assess binge eating symptoms and psychopathology was conducted. Two independent raters assessed the psychometric properties of each measure using a standardized quality analysis tool. RESULTS Of the 2,927 studies identified, 72 studies met the inclusion criteria and described the psychometric properties of 29 different self-report measures, and nine specific subscales within these. Results from the quality analysis tool utilized in this study indicated that none of the included measures currently meet all nine criteria of adequate psychometric properties. DISCUSSION Most of the included measures had evidence for some adequate psychometric properties. Two measures received six out of nine positive ratings for the assessed psychometric properties, the BITE and the BULIT-R, and thus appear to be the measures with the most evidence of their validity and reliability. Overall, our findings implicate a need for further investigation of the psychometric properties of the available self-report questionnaires in this field.
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Affiliation(s)
- Amy L Burton
- School of Psychology, The University of Sydney, New South Wales, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, New South Wales, Australia
| | - Matthew Modini
- School of Psychology, The University of Sydney, New South Wales, Australia
| | - Stephen Touyz
- School of Psychology, The University of Sydney, New South Wales, Australia
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The Compulsive Exercise Test: confirmatory factor analysis and links with eating psychopathology among women with clinical eating disorders. J Eat Disord 2016; 4:22. [PMID: 27547403 PMCID: PMC4992271 DOI: 10.1186/s40337-016-0113-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/27/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study aimed to determine the psychometric properties of the Compulsive Exercise Test (CET) among an adult sample of patients with eating disorders. METHOD Three hundred and fifty six patients and 360 non-clinical control women completed the CET and the Eating Disorders Examination questionnaire (EDE-Q). RESULTS A confirmatory factor analysis revealed that the clinical data showed a moderate fit to the previously published five factor model derived from a community sample (Taranis L, Touyz S, Meyer C, Eur Eat Disord Rev 19:256-268, 2011). The clinical group scored significantly higher than the non-clinical group on four of the five CET subscales, and logistic regression analysis revealed that the CET could successfully discriminate between the two groups. A Receiver Operating Curve analysis revealed that a cut-off score of 15 on the CET resulted in acceptable values of both sensitivity and specificity. CONCLUSIONS The CET appears to have a factor structure that is acceptable for use with an adult sample of patients with eating disorders. It can identify compulsive exercise among patients with eating disorders and a cut-off score of 15 is acceptable as indicating an appropriate cut-off point.
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Zakhem E, El Hage R, Pezé T, Hurdiel R, Zunquin G, Theunynck D. [Factors associated with eating disorders in students of the University of Littoral Côte d'Opale]. Rev Epidemiol Sante Publique 2015; 63:259-65. [PMID: 26143089 DOI: 10.1016/j.respe.2015.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 02/16/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022] Open
Abstract
AIMS Our study aimed to observe the rate of eating disorders in first year public health students (allied medical and sports) of the University of the Littoral Opal Coast (ULCO) using the SCOFF-F (Sick, Control, One, stone, Fat, Food; French version) questionnaire and to compare morphological characteristics, level of physical condition, level of physical activity and sleep quality. METHODS Overall 642 subjects (459 women and 183 men) aged 22years (20.9±4.9years) participated in this study (Universanté-CEMHaVi). Weight, height, and fat mass were measured, and waist-to-hip ratio and body mass index (BMI) were calculated. The level of physical condition was evaluated using several physical tests: Leger and Boucher (20m) and shuttle run (4×10m), Sargent-test and handgrip strength. The SCOFF-F questionnaire followed by a clinical maintenance conducted by a professional was used to detect eating disorders. Several other questionnaires were used to evaluate the physical activity level; General Practice Assessment Questionnaire (GPAQ) and wellness. Sleep quality index was evaluated using Pittsburgh Sleep Quality Index (PSQI). RESULTS SCOFF-F was positive in 24.2% of women and 10.2% of men. In women, there were no significant differences between those who had a positive SCOFF-F screening and those who had a negative SCOFF-F screening regarding age, height, waist-to-hip ratio, level of physical condition measured and level of physical activity evaluated. However, significant differences were found between women who had a positive SCOFF-F screening and women who had a negative SCOFF-F screening regarding sleep quality, well-being score, BMI and fat mass. In men, significant differences were found between those who had a positive SCOFF-F screening and those who had a negative SCOFF-F screening regarding BMI and fat mass. CONCLUSION This study suggests that in both sexes, having a positive SCOFF-F screening is associated with higher BMI. In women, the increase in BMI and the perturbations in sleep quality and well-being score may indicate bulimia nervosa. The definition of a panel of possible factors associated with eating disorders can help in screening and early detection of eating disorders.
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Affiliation(s)
- E Zakhem
- Département d'éducation physique, faculté des lettres et des sciences humaines, université de Balamand, El-Koura, P.O. Box 100, Tripoli, Liban; URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - R El Hage
- Département d'éducation physique, faculté des lettres et des sciences humaines, université de Balamand, El-Koura, P.O. Box 100, Tripoli, Liban.
| | - T Pezé
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - R Hurdiel
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - G Zunquin
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
| | - D Theunynck
- URePSSS-EA 4488_E1 ULCO, COMUE Lille Nord-de-France, 59383 Dunkerque cedex 01, France
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Rø Ø, Reas DL, Stedal K. Eating Disorder Examination Questionnaire (EDE-Q) in Norwegian Adults: Discrimination between Female Controls and Eating Disorder Patients. EUROPEAN EATING DISORDERS REVIEW 2015; 23:408-12. [DOI: 10.1002/erv.2372] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 03/04/2015] [Accepted: 05/01/2015] [Indexed: 01/01/2023]
Affiliation(s)
- Øyvind Rø
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital; Oslo Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - Deborah L. Reas
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital; Oslo Norway
| | - Kristin Stedal
- Regional Department of Eating Disorders, Division of Mental Health and Addiction; Oslo University Hospital; Oslo Norway
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Herpertz-Dahlmann B, Dempfle A, Konrad K, Klasen F, Ravens-Sieberer U. Eating disorder symptoms do not just disappear: the implications of adolescent eating-disordered behaviour for body weight and mental health in young adulthood. Eur Child Adolesc Psychiatry 2015; 24:675-84. [PMID: 25209691 DOI: 10.1007/s00787-014-0610-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/22/2014] [Indexed: 10/24/2022]
Abstract
This study reports the outcomes of childhood and adolescent eating-disordered behaviour on the development of body mass index (BMI) and psychological functioning in young adulthood in a population-based sample in Germany (the BELLA study). Information at baseline and follow-up was obtained through a telephone interview and mailed self-report questionnaires. At both measurement points, BMI, eating disorder symptoms (SCOFF questionnaire), and symptoms of depression and anxiety were assessed in the same cohort of 771 participants (n = 420 females, n = 351 males). The age range at baseline was 11-17 years, and the age range at follow-up was 17-23 years. High scores for eating-disordered behaviour in childhood or adolescence significantly predicted eating-disordered behaviour in young adulthood (multiplicative effect estimate: 1.31; 95 % CI: 1.2-1.42, p < 0.0001), although there was a decline in prevalence (from 19.3 to 13.8 %, p = 0.002) and severity (mean decrease in SCOFF 0.07, 95 % CI: -0.01-0.14, p = 0.06). After accounting for potentially confounding variables at baseline (SES, probands' BMI, parental BMI, depressive symptoms), participants with more eating disorder symptoms at baseline had a higher risk of developing overweight (odds ratio (OR): 1.58; 95 % CI: 1.19-2.09, p = 0.001), obesity (OR = 1.67; 95 % CI: 1.03-2.66, p = 0.03), and depressive symptoms at follow-up (additive effect estimate: 0.45; 95 %CI: 0.19-0.7, p = 0.0006). Early symptoms of depression showed a significant relationship with extreme underweight in young adulthood (OR = 1.13; 95 %CI: 1.01-1.25, p = 0.02). The high stability of eating disorder symptoms and the significant association with overweight and worse mental health in adulthood underscore the need for early detection and intervention during childhood and adolescence. Youth with depression should be monitored for the development of restrictive eating disorders.
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Affiliation(s)
- Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics, RWTH Aachen, Neuenhofer Weg 21, 52074, Aachen, Germany,
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Zeiler M, Waldherr K, Philipp J, Nitsch M, Dür W, Karwautz A, Wagner G. Prevalence of Eating Disorder Risk and Associations with Health-related Quality of Life: Results from a Large School-based Population Screening. EUROPEAN EATING DISORDERS REVIEW 2015; 24:9-18. [PMID: 26010077 DOI: 10.1002/erv.2368] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/13/2015] [Accepted: 04/20/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the prevalence of eating disorder (ED) risk as well as associated psychopathology and health-related quality of life (HrQoL) in a large population sample of Austrian adolescents. METHOD A sample of 3610 adolescents aged 10-18 years was recruited from 261 schools representative for the Austrian population. The SCOFF questionnaire was used to identify participants at risk for EDs, and the Youth Self-Report and KIDSCREEN were used to assess general psychopathology and HrQoL. RESULTS In total, 30.9% of girls and 14.6% of boys were screened at risk for EDs. SCOFF scores were significantly associated with internalising and externalising behavioural problems as well as HrQoL after controlling for sex, age and body mass index. The SCOFF score further turned out to be an independent predictor of HrQoL. DISCUSSION The high prevalence of ED risk among Austrian adolescents points out the need for prevention in this field. Variables indicating eating pathology should be included in general mental health screenings.
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Affiliation(s)
- Michael Zeiler
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Karin Waldherr
- Ludwig Boltzmann Institute Health Promotion Research, Austria.,Ferdinand Porsche Distance University of Applied Sciences (FernFH), Austria
| | - Julia Philipp
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Martina Nitsch
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Wolfgang Dür
- Ludwig Boltzmann Institute Health Promotion Research, Austria
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Medical University of Vienna, Austria
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Paul L, van Rongen S, van Hoeken D, Deen M, Klaassen R, Biter LU, Hoek HW, van der Heiden C. Does cognitive behavioral therapy strengthen the effect of bariatric surgery for obesity? Design and methods of a randomized and controlled study. Contemp Clin Trials 2015; 42:252-6. [DOI: 10.1016/j.cct.2015.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 12/28/2022]
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Solmi F, Hatch SL, Hotopf M, Treasure J, Micali N. Validation of the SCOFF questionnaire for eating disorders in a multiethnic general population sample. Int J Eat Disord 2015; 48:312-6. [PMID: 25504212 PMCID: PMC4407952 DOI: 10.1002/eat.22373] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to validate the SCOFF, an eating disorders (ED) screening questionnaire, in a multiethnic general population sample of adults. METHOD A two-stage design was employed using the South East London Community Health Study phases I and II data. A total of 1,669 participants were screened using the SCOFF in SELCoHI, and 145 were administrated an ED clinical interview in SELCoHII. We explored the diagnostic validity of the questionnaire restricting to the 145 individuals with the clinical questionnaire. RESULTS Sensitivity and specificity of the SCOFF were 53.7 and 93.5%, respectively. CONCLUSION The SCOFF showed good levels of specificity but low sensitivity, resulting in a high percentage of false negatives. Given the low sensitivity found in our sample the SCOFF is likely to be a suboptimal measure for the identification of ED in the community.
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Affiliation(s)
- Francesca Solmi
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College LondonLondon, United Kingdom,* Correspondence to: Francesca Solmi, Ph.D.; Behavioural and Brain Science Unit, Institute of Child Health, 30 Guildford St, London WC1N 1EH, United Kingdom E-mail:
| | - Stephani L Hatch
- Psychological Medicine, Institute of Psychiatry, King's College LondonLondon, United Kingdom
| | - Matthew Hotopf
- Psychological Medicine, Institute of Psychiatry, King's College LondonLondon, United Kingdom
| | - Janet Treasure
- Eating Disorders Unit, Institute of Psychiatry, King's College LondonLondon, United Kingdom
| | - Nadia Micali
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College LondonLondon, United Kingdom
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Perry L, Lamont S, Brunero S, Gallagher R, Duffield C. The mental health of nurses in acute teaching hospital settings: a cross-sectional survey. BMC Nurs 2015; 14:15. [PMID: 25904820 PMCID: PMC4405850 DOI: 10.1186/s12912-015-0068-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/17/2015] [Indexed: 12/01/2022] Open
Abstract
Background Nursing is an emotionally demanding profession and deficiencies in nurses’ mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses’ health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. Methods A cross sectional survey design was used. The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected. Results A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month. Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating. Conclusion Nurses and their managers should strive to create workplaces where working practices promote nurses’ health and wellbeing, or at least are configured to minimise deleterious effects; where both nurses and their managers are aware of the potential for negative effects on the mental health of the workforce; where cultures are such that this can be discussed openly without fear of stigma or denigration.
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Affiliation(s)
- Lin Perry
- Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007 Australia
| | - Scott Lamont
- Mental Health Liaison, Prince of Wales Hospital and Community Health Services, Randwick, NSW 2031 Australia
| | - Scott Brunero
- Mental Health Liaison, Prince of Wales Hospital and Community Health Services, Randwick, NSW 2031 Australia
| | - Robyn Gallagher
- Charles Perkins Centre and Sydney Nursing School, University of Sydney, Sydney, NSW 2006 Australia
| | - Christine Duffield
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007 Australia ; Edith Cowan University, Perth, WA Australia
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Shanmugam V, Davies B. Clinical perfectionism and eating psychopathology in athletes: The role of gender. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2014.09.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liu CY, Tseng MCM, Chen KY, Chang CH, Liao SC, Chen HC. Sex difference in using the SCOFF questionnaire to identify eating disorder patients at a psychiatric outpatient clinic. Compr Psychiatry 2015; 57:160-6. [PMID: 25542817 DOI: 10.1016/j.comppsych.2014.11.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/09/2014] [Accepted: 11/11/2014] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Patients with eating disorder (ED) often remain unrecognized in many settings. Few studies have explored the use of eating measures in an adult male population. This study aimed to examine the comparative validity of the SCOFF questionnaire for detecting ED cases in men and women in the psychiatric outpatient setting. METHOD Psychiatric outpatients, including 605 men and 936 women, aged 18-45years, completed the paper form SCOFF and were interviewed using the ED Module of the Structured Clinical Interview for the DSM-IV-TR. A subgroup of patients completed several additional self-reported questionnaires concerning eating and general psychopathology. RESULTS Scores of 2 and 3 on the SCOFF were the optimal cutoff values for determining ED among men (sensitivity 86% and specificity 74%) and women (sensitivity 80% and specificity 86%), respectively. While age did not significantly affect the validity indices, the SCOFF as a screening tool for ED in obese men was underperformed. CONCLUSIONS The Mandarin Chinese version of the SCOFF is a potentially valid tool to detect ED in both genders in the psychiatric outpatient settings. By helping to detect hidden ED morbidity, the SCOFF can enhance diagnostic accuracy and facilitate comprehensive treatment among psychiatric outpatients.
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Affiliation(s)
- Chao-Yu Liu
- Department of Psychiatry, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin 64041, Taiwan
| | - Mei-Chih Meg Tseng
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan.
| | - Kuan-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei 11080, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei 10055, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10002, Taiwan
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Keyes A, Woerwag-Mehta S, Bartholdy S, Koskina A, Middleton B, Connan F, Webster P, Schmidt U, Campbell IC. Physical activity and the drive to exercise in anorexia nervosa. Int J Eat Disord 2015; 48:46-54. [PMID: 25196139 DOI: 10.1002/eat.22354] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To investigate physical activity (PA) and drive for exercise in anorexia nervosa (AN) in relation to eating disorder (ED) pathology and anxiety. METHOD Female participants were recruited into four groups: AN outpatients (n = 37), AN inpatients (n = 18), an anxiety group (n = 34), and healthy controls (HCs; n = 30). PA was measured by actigraphy and self-report together with drive/reasons for exercise, ED pathology, anxiety, depression, stress, BMI, and body composition. RESULTS ED psychopathology, general psychopathology, and physiological measures were consistent with diagnosis. All groups showed a wide range in activity, especially on self-report. No significant group differences were observed in objective PA levels, yet AN groups reported 57-92% higher total activity than HCs. Outpatients reported more walking and moderate exercise than HCs, and inpatients reported more walking but less moderate and vigorous activity than all other groups. AN groups had significantly higher drive to exercise and valued "improving tone" as important and health and enjoyment as less important reasons to exercise. DISCUSSION Self-perceived activity rather than objective data may partly explain the increased activity reported in AN. Drive to exercise in AN appears to be more related to ED pathology than to anxiety.
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Affiliation(s)
- Alexandra Keyes
- Section of Eating Disorders, Institute of Psychiatry, Kings College London, Decrespigny Park, London, United Kingdom
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Khan S, Petróczi A. Stimulus-response compatibility tests of implicit preference for food and body image to identify people at risk for disordered eating: a validation study. Eat Behav 2015; 16:54-63. [PMID: 25464068 DOI: 10.1016/j.eatbeh.2014.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 07/31/2014] [Accepted: 10/24/2014] [Indexed: 12/01/2022]
Abstract
The aim of this study was to incorporate implicit measures of relevant social cognition into eating disorder research. Fifty-three females diagnosed with an eating disorder (ED), and 41 at-risk females were recruited via ED support websites, along with 23 healthy females for comparison. Computerised online tests assessing subconscious normative ideal body image (IBI-BIAT) and personalised self-identification body image (PBI-BIAT) associations and food preferences (FP-AAT) were administered, followed by the modified version of the Eating Disorder Examination Questionnaire (EDE-Q). Anthropometric data, age, need for social approval, self-reported measures of self-esteem, normative perception and body image satisfaction were recorded. Self-reported diagnosed ED status was corroborated with BMI and EDE-Q. Diagnostic performance of the implicit measures was assessed with ROC analysis. Those diagnosed with ED showed significantly stronger automatic preferences for and self-identification with thin body image, compared to healthy females, but no differences were found in food preferences. The IBI-BIAT showed better diagnostic power than PBI-BIAT, correctly classifying 87% of the diagnosed participants. No correlation was found between IBI-BIAT and the explicit measures. The results suggest that the underlying subconscious social cognitive factors of pathological eating are linked to body image, not to food items per se.
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Affiliation(s)
- Saira Khan
- School of Life Sciences, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, United Kingdom
| | - Andrea Petróczi
- School of Life Sciences, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, United Kingdom.
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127
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Hansson E, Daukantaité D, Johnsson P. SCOFF in a general swedish adolescent population. J Eat Disord 2015; 3:48. [PMID: 26677411 PMCID: PMC4681051 DOI: 10.1186/s40337-015-0087-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/11/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although Disordered Eating Behaviors (DEB) is an ill-defined concept, multiple studies have examined prevalence of DEB and its relations to other variables in various populations. DEB have been shown to predict more serious eating disorders which in turn can lead to death. Mostly girls seem to suffer from DEB, but the question has been raised whether this, at least, partially is due to the methods used for screening. The SCOFF-questionnaire has been suggested as a quick and easily administered tool to assess DEB. However, the psychometric results regarding SCOFF suggest some inconsistencies, and more research is needed in various countries and age samples. METHOD To validate SCOFF, a total of 1265 Swedish adolescents (51.6 % girls) completed self-report questionnaires using the Eating Disorder Examination Questionnaire (EDE-Q) as a reference standard. RESULTS The factor analyses show inconclusive results as to whether SCOFF should be regarded as a comprehensive scale; furthermore, the results indicate a correlation between SCOFF and the EDE-Q in both girl and boy samples. Girls scored significantly higher on SCOFF and also had a higher total score, indicating more severe problems than boys. CONCLUSIONS The results raised questions as to whether the SCOFF might be interpreted and responded to in different ways by girls and boys, risking overlooking boys' DEB and also whether one "yes" answer, instead of the stipulated two, could be sufficient when using SCOFF for screening purposes. In sum, the results challenge the use of SCOFF in a general adolescent population.
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Affiliation(s)
- Erika Hansson
- Kristianstad University, Kristianstad, Sweden ; Lund University, Lund, Sweden
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128
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Monell E, Högdahl L, Mantilla EF, Birgegård A. Emotion dysregulation, self-image and eating disorder symptoms in University Women. J Eat Disord 2015; 3:44. [PMID: 26629343 PMCID: PMC4666164 DOI: 10.1186/s40337-015-0083-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 11/24/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND We studied associations between emotion dysregulation, self-image and eating disorder (ED) symptoms in university women, and contrasted two indirect effect models to examine possible intervening mechanisms to produce ED symptoms. METHODS 252 female Swedish university students completed the Difficulties in Emotion Regulation Scale (DERS), the Structural Analysis of Social Behavior (SASB) self-image measure, and the Eating Disorder Examination Questionnaire (EDE-Q). Correlations between scales were followed by five simple mediation analysis pairs with two possible pathways using five ED symptom variables as outcome. The models posited either self-image or emotion dysregulation as mediator or independent variable, respectively. ED symptoms were EDE-Q Global score, objective binge eating episodes (OBE), subjective binge eating episodes (SBE), and two variants of EDE-Q excessive exercise. RESULTS Emotion dysregulation and self-image were strongly correlated, and both correlated moderately with EDE-Q Global score. There were distinct indirect effects through self-image on the relationship between emotion dysregulation and ED symptoms, but not vice versa. These indirect effects were evident in relation to cognitive ED symptoms and both OBE and SBE, but not in relation to excessive exercise. CONCLUSIONS Results suggest that even if closely related, emotion dysregulation and self-image both contribute unique knowledge in relation to ED symptoms. Self-image as an intervening mechanism between emotion dysregulation and ED symptoms is relevant for models of the development, maintenance and treatment of ED, as well as treatment focus.
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Affiliation(s)
- Elin Monell
- Department of Clinical Neuroscience, Karolinska Institute, Norra Stationsgatan 69 7th floor, 113 64 Stockholm, Sweden ; Centre for Research & Development, Uppsala University/Region Gävleborg, Uppsala, Sweden
| | - Louise Högdahl
- Department of Clinical Neuroscience, Karolinska Institute, Norra Stationsgatan 69 7th floor, 113 64 Stockholm, Sweden
| | - Emma Forsén Mantilla
- Department of Clinical Neuroscience, Karolinska Institute, Norra Stationsgatan 69 7th floor, 113 64 Stockholm, Sweden
| | - Andreas Birgegård
- Department of Clinical Neuroscience, Karolinska Institute, Norra Stationsgatan 69 7th floor, 113 64 Stockholm, Sweden
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129
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Eating Psychopathology in Athletes and Nonathletes: The Effect of Situational and Dispositional Interpersonal Difficulties. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2014. [DOI: 10.1123/jcsp.2014-0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the current study, we had two aims. First, we investigated the associations between eating psychopathology, situational interpersonal difficulties, and dispositional interpersonal difficulties among athletes and nonathletes. Second, we examined the mediating role of self-critical perfectionism, self-esteem, and depression in these associations. A total of 152 athletes and 147 nonathletes completed self-report instruments pertaining to relationship quality with significant others, as well as social anxiety, loneliness, self-critical perfectionism, self-esteem, depression, and eating psychopathology. Social anxiety and loneliness were found to be the only significant independent predictors of eating psychopathology among both athletes and nonathletes. However, such associations were indirectly mediated through depression for athletes and through self-critical perfectionism, self-esteem, and depression for nonathletes. The findings of this study suggest that the psychosocial mechanisms involved in the eating psychopathology of athletes are relatively similar to that of nonathletes. Thus, it can be tentatively proposed that treatments and interventions that target reducing interpersonal conflicts currently available for the general population should also be offered to athletes.
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130
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Machado PPP, Martins C, Vaz AR, Conceição E, Bastos AP, Gonçalves S. Eating Disorder Examination Questionnaire: Psychometric Properties and Norms for the Portuguese Population. EUROPEAN EATING DISORDERS REVIEW 2014; 22:448-53. [DOI: 10.1002/erv.2318] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/21/2014] [Accepted: 06/19/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Carla Martins
- Human Cognition Lab, CIPsi, School of Psychology; University of Minho; Portugal
| | - Ana R. Vaz
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Ana Pinto Bastos
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
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131
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McKenna G, Fox JRE, Haddock G. Investigating the 'jumping to conclusions' bias in people with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 22:352-9. [PMID: 25103274 DOI: 10.1002/erv.2310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/03/2014] [Accepted: 07/06/2014] [Indexed: 11/06/2022]
Abstract
'Jumping to conclusions' (JTC) is an established reasoning bias in people with psychosis and delusion proneness. Research investigating the JTC bias in other clinical populations remains in its infancy. This study investigated whether individuals with anorexia (AN) displayed the JTC bias compared with healthy controls and, if so, whether the bias was greater in relation to emotionally salient information. The study also investigated whether delusionality was correlated with the JTC bias. JTC was measured using the 'beads task'. Three versions were employed: the standard version and two emotionally salient tasks. Results indicated that a majority (55.6%) of people with AN (n=26) displayed poor insight into their eating disorder beliefs but did not display an elevated JTC compared with healthy controls (n=33) on any task. The level of delusionality in the AN group was not correlated with JTC bias. Findings suggest that although a majority of people with AN demonstrated limited insight, they did not display the JTC bias. This may suggest that poor insight in eating disorders has different characteristics to that found in psychotic disorders, which may suggest that differences are needed in relation to how they are treated using psychological means. However, this was a small study, and study replication is required.
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Affiliation(s)
- Gráinne McKenna
- School of Psychological Sciences, University of Manchester, UK
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132
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Coughlin JW, Guarda AS, Clark JM, Furtado MM, Steele KE, Heinberg LJ. A screening tool to assess and manage behavioral risk in the postoperative bariatric surgery patient: The WATCH. J Clin Psychol Med Settings 2014; 20:456-63. [PMID: 23712596 DOI: 10.1007/s10880-012-9358-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Bariatric surgery is increasingly recognized as a highly effective treatment for individuals who are severely obese. Amount of weight loss and resolution of comorbidities surpass those of nonsurgical approaches; however, suboptimal weight loss and weight regain are not uncommon. These outcomes, though not fully understood, are likely at least partially explained by failure to make long-term behavioral and/or cognitive changes. We are unaware of any established clinical tools to guide providers in assessing postoperative behaviors and identifying those who may require specialized treatment. The goal of this paper is to introduce a brief screening tool, The WATCH, to help clinicians assess and identify patients who may be at risk for poor or untoward outcomes post bariatric surgery. We first review the literature on postoperative outcomes, including weight loss, resolution of comorbidities, suboptimal outcomes, and development of problematic eating behaviors. We then provide an easily-recalled, five-item tool that assesses outcomes, and discuss patient responses that may necessitate further intervention or referral.
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Affiliation(s)
- Janelle W Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street. Meyer 101, Baltimore, MD, 21287, USA,
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133
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Shanmugam V, Jowett S, Meyer C. Eating psychopathology as a risk factor for depressive symptoms in a sample of British athletes. J Sports Sci 2014; 32:1587-95. [DOI: 10.1080/02640414.2014.912758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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134
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Fursland A, Watson HJ. Eating disorders: a hidden phenomenon in outpatient mental health? Int J Eat Disord 2014; 47:422-5. [PMID: 24136246 DOI: 10.1002/eat.22205] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 08/13/2013] [Accepted: 09/14/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Eating disorders are common but underdiagnosed illnesses. Help-seeking for co-occurring issues, such as anxiety and depression, are common. OBJECTIVES To identify the prevalence of eating problems, using the SCOFF, and eating disorders when screening positive on the SCOFF (i.e., ≥2), among patients seeking help for anxiety and depression at a community-based mental health service. METHOD Patients (N = 260) consecutively referred and assessed for anxiety and depression treatment were administered the SCOFF screening questionnaire and a semi-structured standardized diagnostic interview during routine intake. RESULTS 18.5% (48/260) scored ≥2 on the SCOFF, indicating eating problems. Of these, 41% (19/48) met criteria for an eating disorder. Thus, overall, 7.3% (19/260) of the sample met criteria for a DSM-IV eating disorder. Those scoring ≥2 on the SCOFF were more likely to: be female (p = 0.001), younger (p = 0.003), and have a history of self-harm (p < 0.001). DISCUSSION This study confirms that eating disorders are a hidden phenomenon in general outpatient mental health. By using a standardized diagnostic interview to establish diagnosis rather than self- or staff-report, the study builds on limited previous findings. The naturalistic study setting shows that screening for eating disorders can be easily built into routine intake practice, and successfully identifies treatment need.
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Affiliation(s)
- Anthea Fursland
- Department of Health in Western Australia, Centre for Clinical Interventions, Perth, Australia
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135
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The moderating role of negative urgency on the associations between affect, dietary restraint, and calorie intake: An experimental study. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014; 59:38-43. [DOI: 10.1016/j.paid.2013.10.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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136
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Preston C, Ehrsson HH. Illusory changes in body size modulate body satisfaction in a way that is related to non-clinical eating disorder psychopathology. PLoS One 2014; 9:e85773. [PMID: 24465698 PMCID: PMC3897512 DOI: 10.1371/journal.pone.0085773] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 12/05/2013] [Indexed: 01/20/2023] Open
Abstract
Historically, body size overestimation has been linked to abnormal levels of body dissatisfaction found in eating disorders. However, recently this relationship has been called into question. Indeed, despite a link between how we perceive and how we feel about our body seeming intuitive, until now lack of an experimental method to manipulate body size has meant that a causal link, even in healthy participants, has remained elusive. Recent developments in body perception research demonstrate that the perceptual experience of the body can be readily manipulated using multisensory illusions. The current study exploits such illusions to modulate perceived body size in an attempt to influence body satisfaction. Participants were presented with stereoscopic video images of slimmer and wider mannequin bodies viewed through head-mounted displays from first person perspective. Illusory ownership was induced by synchronously stroking the seen mannequin body with the unseen real body. Pre and post-illusion affective and perceptual measures captured changes in perceived body size and body satisfaction. Illusory ownership of a slimmer body resulted in participants perceiving their actual body as slimmer and giving higher ratings of body satisfaction demonstrating a direct link between perceptual and affective body representations. Change in body satisfaction following illusory ownership of a wider body, however, was related to degree of (non-clinical) eating disorder psychopathology, which can be linked to fluctuating body representations found in clinical samples. The results suggest that body perception is linked to body satisfaction and may be of importance for eating disorder symptomology.
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Affiliation(s)
- Catherine Preston
- Brain, Body and Self Laboratory, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - H. Henrik Ehrsson
- Brain, Body and Self Laboratory, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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137
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Waller G, Micali N, James A. General Practitioners are poor at identifying the eating disorders. ACTA ACUST UNITED AC 2014; 2:146-157. [PMID: 24955292 PMCID: PMC4047629 DOI: 10.1080/21662630.2013.859437] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Nadia Micali
- Behavioural and Brain Sciences Unit, Institute of Child health, University College London, London, UK
| | - Alison James
- University Health Service, University of Sheffield, Sheffield, UK
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138
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Solmi F, Hatch SL, Hotopf M, Treasure J, Micali N. Prevalence and correlates of disordered eating in a general population sample: the South East London Community Health (SELCoH) study. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1335-46. [PMID: 24441522 PMCID: PMC4108843 DOI: 10.1007/s00127-014-0822-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/05/2014] [Indexed: 10/27/2022]
Abstract
PURPOSE Disordered eating has been shown to be more prevalent than full eating disorders diagnoses. However, research on its prevalence, socio-demographic, psychological correlates, and patterns of service use in multi-ethnic samples is still limited. This paper explores these associations in a South London-based (UK) sample. METHODS The South East London Community Health (SELCoH) study is a general population survey (N = 1,698) of individuals aged 16+. Disordered eating was defined as ≥2 positive answers at the SCOFF questionnaire. Crude and adjusted logistic and multinomial logistic regression models were fit to investigate associations between socio-demographic characteristics, disordered eating, psychiatric comorbidity, and service use. RESULTS A total of 164 (10 %) participants reported disordered eating and the majority were from ethnic minorities. In adjusted models, Asian ethnicity was associated with purging, loss of control eating and preoccupation with food. Individuals with disordered eating had higher odds of screening positive for post-traumatic stress disorder and personality disorders and of having anxiety/mood disorders, suicidal ideation/attempts, hazardous levels of drinking, and used drugs in the previous year. Only 36 % of individuals with disordered eating had sought professional help in the previous 12 months mostly through their general practitioner (27.4 %), followed by psychotherapists (12.8 %) and mental health specialists (5.5 %). CONCLUSION This study found a high prevalence of disordered eating, especially amongst ethnic minorities, and associations with a number of psychiatric conditions. Overall few participants accessed specialist services. These findings suggest that both disordered eating manifestations amongst ethnic minorities and access to care need better investigation.
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Affiliation(s)
- F. Solmi
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 30 Guilford Street, WC1N 1EH, London, UK
| | - S. L. Hatch
- Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - M. Hotopf
- Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - J. Treasure
- Eating Disorders Department, Institute of Psychiatry, King’s College London, London, UK
| | - N. Micali
- Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, 30 Guilford Street, WC1N 1EH, London, UK
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139
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Van den Eynde F, Giampietro V, Simmons A, Uher R, Andrew CM, Harvey PO, Campbell IC, Schmidt U. Brain responses to body image stimuli but not food are altered in women with bulimia nervosa. BMC Psychiatry 2013; 13:302. [PMID: 24238299 PMCID: PMC4225677 DOI: 10.1186/1471-244x-13-302] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 09/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research into the neural correlates of bulimia nervosa (BN) psychopathology remains limited. METHODS In this functional magnetic resonance imaging study, 21 BN patients and 23 healthy controls (HCs) completed two paradigms: (1) processing of visual food stimuli and (2) comparing their own appearance with that of slim women. Participants also rated food craving and anxiety levels. RESULTS Brain activation patterns in response to food cues did not differ between women with and without BN. However, when evaluating themselves against images of slim women, BN patients engaged the insula more and the fusiform gyrus less, compared to HCs, suggesting increased self-focus among women with BN whilst comparing themselves to a 'slim ideal'. In these BN patients, exposure to food and body image stimuli increased self-reported levels of anxiety, but not craving. CONCLUSIONS Our findings suggest that women with BN differ from HCs in the way they process body image, but not in the way they process food stimuli.
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Affiliation(s)
- Frederique Van den Eynde
- Department of Psychological Medicine, Section of Eating Disorders Institute of Psychiatry, King’s College London, London, UK
- Eating Disorders Program, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada
- Institute of Psychiatry, King’s College London, PO Box 59, De Crespigny Park, SE5 8AF, London, UK
| | - Vincent Giampietro
- Institute of Psychiatry, Department of Neuroimaging, King’s College London, London, UK
| | - Andrew Simmons
- Institute of Psychiatry, Department of Neuroimaging, King’s College London, London, UK
- NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London, London, UK
| | - Rudolf Uher
- Department of Psychological Medicine, Section of Eating Disorders Institute of Psychiatry, King’s College London, London, UK
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Chris M Andrew
- Institute of Psychiatry, Department of Neuroimaging, King’s College London, London, UK
| | | | - Iain C Campbell
- Department of Psychological Medicine, Section of Eating Disorders Institute of Psychiatry, King’s College London, London, UK
| | - Ulrike Schmidt
- Department of Psychological Medicine, Section of Eating Disorders Institute of Psychiatry, King’s College London, London, UK
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140
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A Meta-Analysis of the Diagnostic Accuracy of the SCOFF. SPANISH JOURNAL OF PSYCHOLOGY 2013; 16:E92. [DOI: 10.1017/sjp.2013.92] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractA meta-analysis was conducted to reach a pooled estimate of the diagnostic accuracy of the SCOFF. The 15 selected studies represented a total of 882 cases and 4350 controls. The main criterion for inclusion was that the primary study had provided diagnostic classification with both a diagnostic reference and with the SCOFF (with five items and a cut-off point of two). The pooled estimates were .80 (sensitivity) and .93 (specificity). The moderator variables gender and type of measure for the diagnostic reference (interview versus psychometric tests) account for part of the observed variability. For diagnostic references based on interviews the estimate of the efficacy improves significantly. For the studies that match this criterion the sensitivity is .882 and the specificity .925 (diagnostic odds ratio, 92.19). The main conclusion was that the five questions of the SCOFF constitute a very useful screening tool, in several languages; it is highly recommended for screening purposes.
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141
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Friborg O, Clausen L, Rosenvinge JH. A five-item screening version of the Eating Disorder Inventory (EDI-3). Compr Psychiatry 2013; 54:1222-8. [PMID: 23756110 DOI: 10.1016/j.comppsych.2013.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 04/15/2013] [Accepted: 05/01/2013] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The Eating Disorder Inventory (EDI) is used worldwide in research and treatment of eating disorders (EDs). Using the latest version (EDI-3: 91 items), we extracted the best screening items for a diagnosis of anorexia (AN) and bulimia (BN) nervosa. METHOD A patient sample of 561 women was recruited from an ED treatment centre in Denmark, and a comparison group of 878 women was randomly selected from the general population. An ED diagnosis was determined according to the Eating Disorder Examination Interview, yielding 84 AN and 202 BN patients. RESULTS Only two EDI items (Cronbach's α = .79) were needed to achieve a superior screening capability of BN (sensitivity = .94, specificity = .94). An adequate screening of AN was possible by using three items (α = .71; sensitivity = .91, specificity = .86). DISCUSSION The present study provides an even more economical and reliable screening of AN and BN compared with existing screening instruments. Implications for DSM-5 are also discussed.
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Affiliation(s)
- Oddgeir Friborg
- Department of Psychology, University of Tromsø, Norway; Department of Psychiatric Research, University Hospital of North Norway, Tromsø, Norway.
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142
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McClelland J, Bozhilova N, Nestler S, Campbell IC, Jacob S, Johnson-Sabine E, Schmidt U. Improvements in Symptoms Following Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Severe and Enduring Anorexia Nervosa: Findings from two Case Studies. EUROPEAN EATING DISORDERS REVIEW 2013; 21:500-6. [DOI: 10.1002/erv.2266] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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143
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Screening for feeding disorders. Creating critical values using the behavioural pediatrics feeding assessment scale. Appetite 2013; 69:108-13. [DOI: 10.1016/j.appet.2013.05.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 05/24/2013] [Accepted: 05/26/2013] [Indexed: 11/18/2022]
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144
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Friborg O, Reas DL, Rosenvinge JH, Rø Ø. Core pathology of eating disorders as measured by the Eating Disorder Examination Questionnaire (EDE-Q): the predictive role of a nested general (g) and primary factors. Int J Methods Psychiatr Res 2013; 22:195-203. [PMID: 24038315 PMCID: PMC6878513 DOI: 10.1002/mpr.1389] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The present study examined several factor models of the Eating Disorder Examination Questionnaire (EDE-Q), and in particular, whether a nested general factor ('g') was present, hence supporting a common pathology factor. A total of 1094 women were randomly selected by Statistics Norway and mailed a questionnaire packet. The sample was randomly split, using the first half for exploratory analyses and the second for confirmatory validation purposes. A four-factor solution received the best support, but the structure deviated from the original model of Fairburn. The internal consistency was high for the first three factors (.93, .82 and .86) and satisfactory for the fourth (.78). The additional specification of a general (g) factor improved model fit significantly, implying that the EDE-Q scores are indicators of both a general core and four primary symptom patterns. Furthermore, the g was more strongly related to predictors like age and body mass index (BMI) than the four primary factors in a full structural equation model. The validity of interpreting the global EDE-Q score as indicative of g was supported. A brief Shape and Weight Concern subscale of 11 items was strongly related to the g-factor, and may provide an abbreviated measure of overall eating disorder pathology.
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Affiliation(s)
- Oddgeir Friborg
- Department of Psychology, University of Tromsø, Tromsø, Norway; Psychiatric Research Centre of Northern Norway, University Hospital of Northern Norway, Tromsø, Norway
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145
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Renwick B, Dejong H, Kenyon M, Samarawickrema N, Loomes R, Watson C, Ghelani S, Schmidt U. Social perception in people with eating disorders. Eur Psychiatry 2013; 28:436-41. [PMID: 23769324 DOI: 10.1016/j.eurpsy.2013.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/20/2013] [Accepted: 03/22/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Social perception is a key aspect of social cognition which has so far not been investigated in eating disorders (ED). This study aimed to investigate social perception in individuals with anorexia nervosa (AN) and bulimia nervosa (BN). METHODS Outpatients with AN (restricting subtype [AN-R]: n=51; binge-purge subtype [AN-BP]: n=26) or BN (n=57) and 50 healthy control (HC) participants completed the Interpersonal Perception Task (IPT-15). This is an ecologically valid task, which consists of 15 video clips, depicting complex social situations relating to intimacy, status, kinship, competition and deception. The participants have to assess relationships between protagonists' based on non-verbal cues. RESULTS Overall, there was no difference between groups on the IPT total score and subscale scores. Group differences on the Intimacy subscale approached significance so post hoc comparisons were carried out. HCs performed significantly better than AN-R participants in determining the degree of intimacy between others. CONCLUSIONS Social perception is largely preserved in ED patients. Individuals with AN-R show impairments in identifying intimacy in social situations, this may be due to the lack of relationship experience. Further research into different aspects of social cognition is required to establish the link between interpersonal difficulties and ED psychopathology.
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Affiliation(s)
- B Renwick
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom.
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146
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Dooley-Hash S, Lipson SK, Walton MA, Cunningham RM. Increased emergency department use by adolescents and young adults with eating disorders. Int J Eat Disord 2013; 46:308-15. [PMID: 23044650 DOI: 10.1002/eat.22070] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study describes patterns of emergency department (ED) utilization by patients who screen positive for eating disorders. METHOD ED patients aged 14-20 years (n = 1,920) completed a computerized questionnaire. The analyses compared the rates of ED use between patients who screened positive for an eating disorder and those who did not and examined the reasons for ED use amongst patients with eating disorders. RESULTS ED patients who screened positive for eating disorders were significantly more likely to have previously visited the ED and, on average, utilized the ED at a rate 1.6 times higher than patients who screen negative for eating disorders. The most common chief complaints among patients who screen positive for eating disorders were abdominal pain and other gastrointestinal-related problems. DISCUSSION Patients with eating disorders utilize the ED more frequently than those without and commonly present for complaints seemingly unrelated to their eating disorder.
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Affiliation(s)
- Suzanne Dooley-Hash
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
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147
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ED management of patients with eating disorders. Am J Emerg Med 2013; 31:859-65. [PMID: 23623238 DOI: 10.1016/j.ajem.2013.02.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 02/21/2013] [Accepted: 02/25/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Eating disorders are one of the "great masqueraders" of the twenty-first century. Seemingly healthy young men and women with underlying eating disorders present to emergency departments with a myriad of complaints that are not unique to patients with eating disorders. The challenge for the Emergency Medicine physician is in recognizing that these complaints result from an eating disorder and then understanding the unique pathophysiologic changes inherent to these disorders that should shape management in the emergency department. OBJECTIVE In this article, we will review, from the perspective of the Emergency Medicine physician, how to recognize patients with anorexia and bulimia nervosa, the medical complications and psychiatric comorbidities, and their appropriate management. CONCLUSIONS Anorexia and bulimia nervosa are complex psychiatric disorders with significant medical complications. Recognizing patients with eating disorders in the ED is difficult, but failure to recognize these disorders, or failure to manage their symptoms with an understanding of their unique underlying pathophysiology and psychopathology, can be detrimental to the patient. Screening tools, such as the SCOFF questionnaire, are available for use by the EM physician. Once identified, the medical complications described in this article can help the EM physician tailor management of the patient to their underlying pathophysiology and effectuate a successful therapeutic intervention.
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148
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Readability and comprehension of self-report binge eating measures. Eat Behav 2013; 14:167-70. [PMID: 23557814 PMCID: PMC3618665 DOI: 10.1016/j.eatbeh.2013.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 01/04/2013] [Accepted: 02/14/2013] [Indexed: 11/20/2022]
Abstract
UNLABELLED The validity of self-report binge eating instruments among individuals with limited literacy is uncertain. This study aims to evaluate reading grade level and multiple domains of comprehension of 13 commonly used self-report assessments of binge eating for use in low-literacy populations. We evaluated self-report binge eating measures with respect to reading grade levels, measure length, formatting and linguistic problems. RESULTS All measures were written at a reading grade level higher than is recommended for patient materials (above the 5th to 6th grade level), and contained several challenging elements related to comprehension. Correlational analyses suggested that readability and comprehension elements were distinct contributors to measure difficulty. Individuals with binge eating who have low levels of educational attainment or limited literacy are often underrepresented in measure validation studies. Validity of measures and accurate assessment of symptoms depend on an individual's ability to read and comprehend instructions and items, and these may be compromised in populations with lower levels of literacy.
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149
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Mitchison D, Crino R, Hay P. The presence, predictive utility, and clinical significance of body dysmorphic symptoms in women with eating disorders. J Eat Disord 2013; 1:20. [PMID: 24999401 PMCID: PMC4081769 DOI: 10.1186/2050-2974-1-20] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 05/01/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Both eating disorders (EDs) and body dysmorphic disorder (BDD) are disorders of body image. This study aimed to assess the presence, predictive utility, and impact of clinical features commonly associated with BDD in women with EDs. METHODS Participants recruited from two non-clinical cohorts of women, symptomatic and asymptomatic of EDs, completed a survey on ED (EDE-Q) and BDD (BDDE-SR) psychopathology, psychological distress (K-10), and quality of life (SF-12). RESULTS A strong correlation was observed between the total BDDE-SR and the global EDE-Q scores (r = 0.79, p < 0.001). Multivariate analyses demonstrated that participants with probable EDs (n = 61) and BDD (n = 23) scored higher on 28 of the 30 BDDE-SR items compared to healthy controls (n = 173; all p < 0.05), indicating greater severity of BDD symptoms. BDD participants also scored higher than ED participants on 15 of the 30 BDDE-SR items (all p < 0.05). The remaining 15 items that ED and BDD participants scored similarly on (all p > 0.05) measured appearance checking, reassurance-seeking, camouflaging, comparison-making, and social avoidance. In addition to these behaviors, inspection of sensitivity (Se) and specificity (Sp) revealed that BDDE-SR items measuring preoccupation and dissatisfaction with appearance were most predictive of ED cases (Se and Sp > 0.60). Higher total BDDE-SR scores were associated with greater distress on the K-10 and poorer quality of life on the SF-12 (all p < 0.01). CONCLUSIONS Clinical features central to the model of BDD are common in, predictive of, and associated with impairment in women with EDs. Practice implications are that these features be included in the assessment and treatment of EDs.
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Affiliation(s)
- Deborah Mitchison
- School of Psychology and Social Science, University of Western Sydney, Sydney, NSW, Australia
| | - Rocco Crino
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia
| | - Phillipa Hay
- School of Medicine and Centre for Health Research, University of Western Sydney, Sydney, NSW, Australia ; School of Medicine, James Cook University, Townsville, QLD, Australia
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Waldman A, Loomes R, Mountford VA, Tchanturia K. Attitudinal and perceptual factors in body image distortion: an exploratory study in patients with anorexia nervosa. J Eat Disord 2013; 1:17. [PMID: 24999398 PMCID: PMC4081805 DOI: 10.1186/2050-2974-1-17] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 03/09/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Body image disturbance is a core feature of anorexia nervosa (AN). Attitudinal and cognitive biases as well as fundamental perceptual differences have been hypothesized to play a role in this disturbance. METHOD This study investigated body image dissatisfaction and distortion, haptic perception and perfectionism in 30 patients with AN and 31 age-matched healthy controls. Participants completed perceptual tasks and self-report measures. RESULTS As predicted, participants with AN scored significantly higher on body dissatisfaction, perfectionism measures and had greater body distortion (as assessed by a body size estimation task). Cognitive-affective factors and perfectionism were highly correlated with body image distortion in AN. No significant differences were found between groups on the generic perception task. CONCLUSIONS Findings did not confirm the hypothesis of fundamental perceptual inefficiencies in body image disturbance in individuals with AN. Despite renewed interest in fundamental perceptual factors implicated in body image disturbance, these findings suggest that it continues to be important to focus treatment on cognitive affective biases versus fundamental perceptual inefficiencies.
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Affiliation(s)
- Amanda Waldman
- King's College London, Division of Psychological Medicine, Institute of Psychiatry, London, UK ; South London and Maudsley NHS Foundation Trust, London, UK
| | - Rachel Loomes
- King's College London, Division of Psychological Medicine, Institute of Psychiatry, London, UK
| | | | - Kate Tchanturia
- King's College London, Division of Psychological Medicine, Institute of Psychiatry, London, UK ; South London and Maudsley NHS Foundation Trust, London, UK
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