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Muley A, Deshmane A, Mahajan A, Shah J. Eating Disorders: Assessing Its Prevalence and Pattern Among Adults With Type 2 Diabetes. Cureus 2024; 16:e52425. [PMID: 38371141 PMCID: PMC10870338 DOI: 10.7759/cureus.52425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Eating disorders (EDs) are severe and multifaceted mental health issues that affect a person's perception of their body weight in relationship with food. Existing evidence shows that EDs significantly affect the physical and emotional health of individuals with Type-2 Diabetes (T2D) and are associated with impaired metabolic control and a high risk of medical complications, including higher mortality rates. However, there is a paucity of research looking into the prevalence of EDs. OBJECTIVE A cross-sectional study was conducted to map the prevalence of EDs and to assess its pattern among adults with T2D from Ahmedabad City, Gujarat, India. METHODOLOGY Two hundred fifty-four T2D individuals aged 30-60 were enrolled in the study. A questionnaire was developed using the Sick, Control, One, Fat, Food (SCOFF) questionnaire and a five-question screening tool intended to identify the possibility of EDs as well as the Eating Disorder Examination-Questionnaire (EDEQ), which is used to identify the pattern of EDs with subscales like Restraint, Eating Concern, Shape Concern, and Weight Concern. Written informed consent was obtained from all participants. Descriptive statistics, Pearson's Correlation, and Logistic Regression analysis were used. A p-value of < 0.05 was considered significant. RESULTS The results revealed that 90 (35%) of the total participants were at a high risk of EDs. Among these, 54 (21% of the total population) were males, and 36 (14% of total participants) were females. There was a mild statistically significant negative correlation between age and exercise with the presence of ED (r = -0.151, p = 0.016 and r = -0.186, p = 0.003, respectively), while education showed a significant positive correlation (r = 0.150, p = 0.017). Males had significantly higher scores for eating concerns than females (19.75±4.88 vs 17.88±5.92; p = 0.008). The logistic regression model revealed that education was a significant predictor of EDs (OD = 1.47, 95% CI 1.00-2.16 and p = 0.04). CONCLUSION The study identified that people with T2D are at risk of EDs, and eating concerns worry them the most. Thus, counseling sessions should focus on identifying the determinants of EDs and educating the patients regarding quality eating. This will have implications in addressing the other morbidities as well as health risks related to BMI; especially obesity as it is more prevalent in the T2D population.
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Affiliation(s)
- Arti Muley
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Aditi Deshmane
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Anu Mahajan
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Jeel Shah
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
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Terävä-Utti E, Nurmi M, Laitinen L, Rissanen T, Polo-Kantola P. Hyperemesis gravidarum and eating disorders before and after pregnancy: A register-based study. Int J Eat Disord 2024; 57:70-80. [PMID: 37873998 DOI: 10.1002/eat.24082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE Hyperemesis gravidarum (HG) is a severe form of excessive vomiting during pregnancy. The connection between psychiatric morbidity and HG has been debated, but only a few studies have focused on eating disorders (EDs). The objective of this study was to evaluate the association between HG and both pre-pregnancy and new post-pregnancy EDs. METHODS A register-based controlled study. HG diagnoses were retrieved from healthcare registers between 2005 and 2017. Women with HG in their first pregnancy resulting in delivery were chosen as cases (n = 4265; the HG group) and women with no HG as controls (n = 302,663; the non-HG group). The associations between EDs and HG were analyzed by binary logistic regression, adjusted with age, body mass index, smoking, socioeconomic status, and pre-pregnancy psychiatric diagnoses. RESULTS In the HG group, 1.6% and in the non-HG group, 0.2% had a pre-pregnancy ED. Women with ED were more likely to have HG in their first pregnancy compared with women with no history of EDs (adjusted odds ratio [AOR] 9.4, 95% CI 6.52-13.66, p < .0001). Moreover, 0.4% of the women in the HG group and 0.1% of the women in the non-HG group had a new ED diagnosis after pregnancy, and thus the women in the HG group were more likely to have an ED diagnosis after pregnancy (AOR I 3.5, 95% CI 1.71-7.15, p < .001, AOR II 2.7, 95% CI 1.30-5.69, p = .008). DISCUSSION We found a bidirectional association between ED and HG, suggesting a shared etiology or risk factors between these disorders. This finding emphasizes the importance of collaboration across various specialties when treating these patients. PUBLIC SIGNIFICANCE Our findings suggest a bidirectional association between HG and EDs before and after pregnancy. This finding provides essential information for healthcare professionals working with pregnant women. As both of these disorders are known to have far-reaching effects on the lives of both the mother and her offspring, our results help clinicians to target special attention and interventions to the patients suffering from these disorders.
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Affiliation(s)
- Eeva Terävä-Utti
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
| | - Miina Nurmi
- Department of Public Health, University of Turku, Turku, Finland
| | - Linda Laitinen
- University of Turku, Turku, Finland
- Department of Obstetrics and Gynecology, Hospital Nova of Central Finland, The Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Tiia Rissanen
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
- University of Turku, Turku, Finland
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103
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Hatoum AH, Burton AL, Berry SL, Abbott MJ. Psychometric properties of self-report measures of eating disorder cognitions: a systematic review. J Eat Disord 2023; 11:233. [PMID: 38124134 PMCID: PMC10734145 DOI: 10.1186/s40337-023-00947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Although eating disorder (ED) models display some differences in theory and treatment approach, cognitive-behavioural, schema-focused, and disorder-specific models all highlight the fundamental nature of cognitions as key factors in ED development and maintenance processes. As such, it is vital that ED cognitions continue to be assessed and monitored as therapeutic targets and treatment outcomes as well as being examined as constructs in empirical research. This review aimed to systematically identify and evaluate the psychometric properties of existing self-report measures of ED cognitions. METHODS A systematic review protocol was registered using the international prospective register of systematic reviews (PROSPERO; CRD42023440840). Included studies described the development, validation and/or the psychometric evaluation of a measure (or subscale) that was specifically developed to solely assess ED cognitions (that is thoughts, expectations, assumptions, or beliefs), in English-speaking, adult populations. The search was conducted using three electronic databases: PsycINFO, MedLine, and Embase. Two independent reviewers conducted screening, selection and evaluation of the psychometric properties of relevant measures using a standardised, well-established quality appraisal tool. RESULTS Of the initial search of 7581 potential studies, 59 met inclusion criteria and described the psychometric evaluation of 31 measures (or subscales) of ED cognitions. The findings from the current review indicate that of the included measures, none currently meet all nine criteria of adequate psychometric properties. The Eating Beliefs Questionnaire (EBQ; and EBQ-18), and the Eating Disorder Inventory Body Dissatisfaction subscale (EDI [BD]) currently possess the most evidence supporting their validity, reliability, and clinical utility. CONCLUSIONS The findings of the current systematic review provide guidance for future researchers to focus efforts on improving evidence for the validity, reliability and utility of self-report measures of ED cognitions. Overall, the present study has provided a detailed and systematic evaluation to support researchers and clinicians in future selection of measures of ED cognitions dependent on the specific aims of their research and treatment.
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Affiliation(s)
- Amaani H Hatoum
- School of Psychology, The University of Sydney, Level 2, 94 Mallet Street, Camperdown, Sydney, NSW, 2006, Australia.
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Amy L Burton
- School of Psychology, The University of Sydney, Level 2, 94 Mallet Street, Camperdown, Sydney, NSW, 2006, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Sophie L Berry
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Level 2, 94 Mallet Street, Camperdown, Sydney, NSW, 2006, Australia
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Hamulka J, Czarniecka-Skubina E, Gutkowska K, Drywień ME, Jeruszka-Bielak M. Nutrition-Related Knowledge, Diet Quality, Lifestyle, and Body Composition of 7-12-Years-Old Polish Students: Study Protocol of National Educational Project Junior-Edu-Żywienie (JEŻ). Nutrients 2023; 16:4. [PMID: 38201834 PMCID: PMC10780563 DOI: 10.3390/nu16010004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Increasing students' nutrition knowledge is an important goal of school education which may improve their lifestyle and consequently reduce the incidence of non-communicable chronic diseases, including obesity. This research aimed at assessing the dietary habits, nutrition-related knowledge and attitudes, and nutritional status of Polish students aged 7-12 years. Additional objectives included recognizing nutrition-related knowledge among their parents and teachers as well as the school food and nutrition environment. The final goal was to develop a nutrition education program. This study protocol presents a general and detailed approach for realizing the above-mentioned issues, including conducting quantitative and qualitative research. The study was designed as cross-sectional, covering primary school students from all over Poland, including rural, town, and metropolitan areas. Data on eating habits, lifestyle, nutrition-related knowledge, and attitudes were collected with questionnaires. Measurements of body weight, height, waist and hip circumferences, and handgrip strength were performed in accordance with the International Standards for Anthropometric Assessment (ISAK) recommendations. Body composition was assessed with bioelectrical impedance analysis. Ultimately, 2218 schools from all 16 voivodeships in Poland registered for the project. In total, quantitative data were collected among 27,295 students, 17,070 parents, and 2616 teachers. Anthropometric measurements were taken among 18,521 students. The results allow us to develop a multifaceted educational program based on knowledge and adapted to the perception of students. Our research may contribute to the identification of subpopulations of children and adolescents at risk of excessive body weight and define the predictors of obesity risk in Poland.
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Affiliation(s)
- Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland; (J.H.); (M.E.D.)
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland;
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland;
| | - Małgorzata Ewa Drywień
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland; (J.H.); (M.E.D.)
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska St., 02-787 Warsaw, Poland; (J.H.); (M.E.D.)
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105
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Rometsch C, Guthoff M, Zipfel S, Stengel A. Renal failure following insulin purging in atypical anorexia nervosa and type 1 diabetes mellitus. Front Psychiatry 2023; 14:1325021. [PMID: 38152359 PMCID: PMC10752605 DOI: 10.3389/fpsyt.2023.1325021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
Objective Anorexia nervosa (AN) and atypical anorexia nervosa (AAN) are severe and complex eating disorders that can be prevalent among individuals with type 1 diabetes mellitus (T1DM). Insulin purging, characterized by the intentional underuse / omission of insulin to control weight, is under-recognized in medicine and is a purging strategy of patients with AN or AAN and comorbid T1DM. Often, this can lead to renal failure, necessitating a (pancreas-) kidney transplantation. This article presents a comprehensive overview of the interplay between AN/AAN and T1DM and summarizes the evidence in literature. Methods A narrative review is presented on basis of a detailed case study of a 32-year-old female with end-stage renal failure seeking (pancreas-) kidney transplantation displaying etiology, diagnosis, comorbidities, complications, and treatment of AN and AAN with emphasis on those patients with T1DM. Results Insulin purging in patients with AN/AAN and coexisting T1DM can exacerbate T1DM complications, including accelerating the onset of end-stage renal failure. A multidisciplinary approach including nutrition treatment and psychotherapeutic techniques was considered necessary for treatment, focusing on psychosomatic in-patient care before and after organ transplantation. Conclusion Insulin purging in patients with AAN and T1DM poses severe health risks, including accelerated renal complications. For those considering transplantation, insulin purging has explicitly to be diagnosed and a holistic treatment addressing both the renal condition and psychosomatic symptoms/disorders is crucial for successful post-transplant outcomes.
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Affiliation(s)
- Caroline Rometsch
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Martina Guthoff
- Department of Internal Medicine IV, Diabetology, Endocrinology, Nephrology, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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106
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Graybeal AJ, Brandner CF, Henderson A, Aultman RA, Vallecillo-Bustos A, Newsome TA, Stanfield D, Stavres J. Associations between eating behaviors and metabolic syndrome severity in young adults. Eat Behav 2023; 51:101821. [PMID: 37866123 DOI: 10.1016/j.eatbeh.2023.101821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
Metabolic syndrome (MetS), a precursor to cardiovascular disease and type II diabetes, is rapidly increasing in young adults. Accordingly, earlier interventions aimed at combating the onset of MetS in young adults are required. However, current behavioral interventions have failed to consider the eating behaviors that precede disease development, likely contributing to the consistently high failure rates of these interventions. The purpose of this cross-sectional study was to evaluate the associations between eating behaviors and MetS severity (MetSindex) in a sample of young adults. A sample of 104 (non-Hispanic White: 45; non-Hispanic Black: 49; Hispanic White: 5; Asian: 5) young adult (age: 23.1 ± 4.4) males and females (F:61, M:43) completed anthropometric, blood pressure, blood glucose, and blood lipid assessments; each of which were used to calculate a continuous MetSindex score. Participants also completed the revised version of the 18-item Three-factor Eating Questionnaire to measure emotional eating (EmE), uncontrolled eating (UE), and cognitive restraint (CR). EmE was positively associated with MetSindex for young adult females (p = 0.033) and non-Hispanic Black participants (p = 0.050), but not male (p = 0.506) or non-Hispanic White participants (p = 0.558). Additionally, MetSindex was greater in the highest EmE tertile compared to the lowest EmE tertile for the total sample (p = 0.037) and young adult females (p = 0.015). UE and CR were not associated with MetSindex. These data suggest a potential link between EmE and MetS severity in young adults, and that behavioral interventions aimed at MetS prevention should focus on treating the underlying EmE behaviors common in young adults, particularly for young female and Black adults at the greatest risk.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Caleb F Brandner
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Alex Henderson
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Ryan A Aultman
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Ta'Quoris A Newsome
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Diavion Stanfield
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Jon Stavres
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, USA
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107
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Stiegler N, Bouchard JP. [Anorexia nervosa: demographic, socio-economic and cultural data still too limited]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2023; 68:24-26. [PMID: 38070977 DOI: 10.1016/j.soin.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Although eating disorders are a public health issue, treating anorexia nervosa from a demographic and socio-economic perspective remains a challenge. Data are scarce, patchy and often of questionable quality. Such a lack of data on a somatopsychic illness with serious repercussions is a real problem, since reliable, longitudinal and detailed information could provide additional answers in understanding the illness, both in terms of age, sex and gender structure, and in terms of family, social and environmental factors.
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Affiliation(s)
- Nancy Stiegler
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, Robert Sobukwe road, Bellville, 7535, Cape-Town, South Africa
| | - Jean-Pierre Bouchard
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, Robert Sobukwe road, Bellville, 7535, Cape-Town, South Africa; Psychologie-criminologie-victimologie (PCV), Cours de Gourgue, 33000 Bordeaux, France.
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108
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Landini L, Dadson P, Gallo F, Honka MJ, Cena H. Microbiota in anorexia nervosa: potential for treatment. Nutr Res Rev 2023; 36:372-391. [PMID: 35875979 DOI: 10.1017/s0954422422000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Anorexia nervosa (AN) is characterised by the restriction of energy intake in relation to energy needs and a significantly lowered body weight than normally expected, coupled with an intense fear of gaining weight. Treatment of AN is currently based on psychological and refeeding approaches, but their efficacy remains limited since 40% of patients after 10 years of medical care still present symptoms of AN. The intestine hosts a large community of microorganisms, called the "microbiota", which live in symbiosis with the human host. The gut microbiota of a healthy human is dominated by bacteria from two phyla: Firmicutes and, majorly, Bacteroidetes. However, the proportion in their representation differs on an individual basis and depends on many external factors including medical treatment, geographical location and hereditary, immunological and lifestyle factors. Drastic changes in dietary intake may profoundly impact the composition of the gut microbiota, and the resulting dysbiosis may play a part in the onset and/or maintenance of comorbidities associated with AN, such as gastrointestinal disorders, anxiety and depression, as well as appetite dysregulation. Furthermore, studies have reported the presence of atypical intestinal microbial composition in patients with AN compared with healthy normal-weight controls. This review addresses the current knowledge about the role of the gut microbiota in the pathogenesis and treatment of AN. The review also focuses on the bidirectional interaction between the gastrointestinal tract and the central nervous system (microbiota-gut-brain axis), considering the potential use of the gut microbiota manipulation in the prevention and treatment of AN.
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Affiliation(s)
- Linda Landini
- S.S.D. Dietetics and Clinical Nutrition ASL 4 Chiavarese Liguria-Sestri Levante Hospital, Sestri Levante, Italy
| | - Prince Dadson
- Turku PET Centre, University of Turku, Turku, Finland
| | - Fabrizio Gallo
- S.S.D. Dietetics and Clinical Nutrition ASL 4 Chiavarese Liguria-Sestri Levante Hospital, Sestri Levante, Italy
| | | | - Hellas Cena
- Dietetics and Clinical Nutrition Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy
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109
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Jordan E. "If You Don't Lose Weight, the Government Will Take You Away": An Analysis of Memorable Messages and Eating Disorders in the LGBTQ+ Community. HEALTH COMMUNICATION 2023; 38:2925-2935. [PMID: 36127805 DOI: 10.1080/10410236.2022.2126695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Family communication plays a key role in children's body image, disordered eating, and full-blown eating disorders;. However, much existing communication research on eating disorders has focused on general populations. As the LGBTQ+ community is disproportionately affected by eating disorders , more work is needed to better understand how family communication may be perceived as influencing eating disorders in the LGBTQ+ community. Thus, the current study aimed to further this understanding by examining familial memorable messages reported by LGBTQ+ individuals which they perceived to have influenced their eating disorders. In a Qualtrics survey, participants (n = 73) provided memorable messages received from family members and explained their significance. Results of a thematic analysis indicate five themes among the memorable messages: Problematic Body Size/Weight, Pathologized Eating, Emphasizing Appearance Ideals, Emotion Origins, and Other Focus. Findings support the theory of memorable messages and reveal the ways in which diet culture and LGBTQ+ identity stigma intersect within parent-child communication toward a perceived influence on LGBTQ+ eating disorders. Implications for future communication research on LGBTQ+ eating disorders, as well as practical applications, are discussed.
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Affiliation(s)
- Ellen Jordan
- Department of Communication, University of Missouri
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110
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Yan WS, Liu MM, Liu SJ. A Behavioral and Event-Related Potentials Study of Food-Related Inhibitory Control in Probable Binge Eating Disorder. Psychol Res Behav Manag 2023; 16:4737-4748. [PMID: 38024662 PMCID: PMC10676687 DOI: 10.2147/prbm.s441949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Background Similar to addictive disorders, deficits on cognitive control might be involved in the onset and development of Binge Eating Disorder (BED). However, it remains unclear whether general or food-related inhibitory control impairments would be basically linked to overeating and binge eating behaviors. This study thus aimed to investigate behavioral performance and electrophysiological correlates of food-related inhibitory control among individuals with binge eating behavior. Methods Sixty individuals with probable BED (pBED) and 60 well-matched healthy controls (HCs) were assessed using the typical Stop-Signal Task, a revised Go/No Go Task, and a food-related Go/No Go Task. Besides, another separate sample, including 35 individuals with pBED and 35 HCs, completed the food-related Go/No Go Task when EEG signals were recorded with the event-related potentials (ERPs). Results The data revealed that the pBED group performed worse with a longer SSRT on the Stop-Signal Task compared with HCs (Cohen's d = 0.58, p = 0.002). Moreover, on the food-related Go/No Go Task, the pBED group had a lower success rate of inhibition in no-go trials (Cohen's d = 0.47, p = 0.012). The ERPs data showed that in comparison with HCs, the pBED group exhibited increased P300 latency (FC1, FC2, F3, F4, FZ) in the no-go trials of the food-related Go/No Go Task (Cohen's d 0.56-0.73, all p < 0.05). Conclusion These findings suggested that individuals with binge eating could be impaired in both non-specific and food-related inhibitory control aspects, and the impairments in food-related inhibitory control might be linked to P300 abnormalities, implying a behavioral-neurobiological dysfunction mechanism implicated in BED.
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Affiliation(s)
- Wan-Sen Yan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China
- Guizhou Research Institute for Health Development, Guizhou Medical University, Guiyang, People’s Republic of China
| | - Meng-Meng Liu
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China
| | - Su-Jiao Liu
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, People’s Republic of China
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111
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Loria-Kohen V, Montiel Fernández N, López-Plaza B, Aparicio A. [Anorexia nervosa, microbiota and brain]. NUTR HOSP 2023; 40:46-50. [PMID: 37929904 DOI: 10.20960/nh.04955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Introduction Anorexia nervosa (AN) is a psychiatric disease with a high prevalence and comorbidities, characterized by a low response rate to treatment. It is considered as a multifactorial disease. In recent years, the focus has been placed on the presence of intestinal dysbiosis and its possible involvement as a causal factor as well as an alternative treatment. The objective of this work has been to review the current state of knowledge of alterations in the intestinal microbiota identified in patients with AN and the possibility of using probiotics as a therapeutic alternative. Significant changes in the diversity of species associated with weight loss have been described that could favor the perpetuation of the disorder, and that would explain many of the nutritional, gastrointestinal, psychological, and cognitive alterations present in these patients. The use of probiotics, still little studied in patients with AN, sheds some light on this matter to improve the treatment response, always hand in hand with conventional treatments.
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Affiliation(s)
- Viviana Loria-Kohen
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030)
| | - Natalia Montiel Fernández
- Máster Universitario en Nutrición Clínica. Universidad Europea. Facultad de Ciencias Biomédicas y de la Salud
| | - Bricia López-Plaza
- Instituto de Investigación Sanitaria La Paz (IdiPAZ). Hospital Universitario La Paz
| | - Aránzazu Aparicio
- Departamento de Nutrición y Ciencia de los Alimentos. Facultad de Farmacia. Universidad Complutense de Madrid. Grupo de Investigación VALORNUT-UCM (920030). IdISSC
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Azmi MB, Jawed A, Ahmed SDH, Naeem U, Feroz N, Saleem A, Sardar K, Qureshi SA, Azim MK. Understanding the impact of structural modifications at the NNAT gene's post-translational acetylation site: in silico approach for predicting its drug-interaction role in anorexia nervosa. Eat Weight Disord 2023; 28:97. [PMID: 37987927 PMCID: PMC10663277 DOI: 10.1007/s40519-023-01618-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/18/2023] [Indexed: 11/22/2023] Open
Abstract
PURPOSE Anorexia nervosa (AN) is a neuropsychological public health concern with a socially disabling routine and affects a person's healthy relationship with food. The role of the NNAT (Neuronatin) gene in AN is well established. The impact of mutation at the protein's post-translational modification (PTM) site has been exclusively associated with the worsening of the protein's biochemical dynamics. METHODS To understand the relationship between genotype and phenotype, it is essential to investigate the appropriate molecular stability of protein required for proper biological functioning. In this regard, we investigated the PTM-acetylation site of the NNAT gene in terms of 19 other specific amino acid probabilities in place of wild type (WT) through various in silico algorithms. Based on the highest pathogenic impact computed through the consensus classifier tool, we generated 3 residue-specific (K59D, P, W) structurally modified 3D models of NNAT. These models were further tested through the AutoDock Vina tool to compute the molecular drug binding affinities and inhibition constant (Ki) of structural variants and WT 3D models. RESULTS With trained in silico machine learning algorithms and consensus classifier; the three structural modifications (K59D, P, W), which were also the most deleterious substitution at the acetylation site of the NNAT gene, showed the highest structural destabilization and decreased molecular flexibility. The validation and quality assessment of the 3D model of these structural modifications and WT were performed. They were further docked with drugs used to manage AN, it was found that the ΔGbind (kcal/mol) values and the inhibition constants (Ki) were relatively lower in structurally modified models as compared to WT. CONCLUSION We concluded that any future structural variation(s) at the PTM-acetylation site of the NNAT gene due to possible mutational consequences, will serve as a basis to explore its relationship with the propensity of developing AN. LEVEL OF EVIDENCE No level of evidence-open access bioinformatics research.
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Affiliation(s)
- Muhammad Bilal Azmi
- Department of Biochemistry, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Areesha Jawed
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Danish Haseen Ahmed
- Department of Biochemistry, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Unaiza Naeem
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Nazia Feroz
- Department of Biochemistry, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Arisha Saleem
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Kainat Sardar
- Department of Biochemistry, University of Karachi, Karachi, Pakistan
- Department of Chemistry, Bahria College NORE-1, Karachi, Pakistan
| | | | - M Kamran Azim
- Department of Biosciences, Mohammad Ali Jinnah University, Karachi, Pakistan
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Franco L, Nakano EY, Raposo A, Alturki HA, Alarifi SN, Chaves C, Teixeira-Lemos E, Romão B. Eating Attitudes of Patients with Celiac Disease in Brazil: A Nationwide Assessment with the EAT-26 Instrument. Nutrients 2023; 15:4796. [PMID: 38004190 PMCID: PMC10674570 DOI: 10.3390/nu15224796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. In this sense, a gluten-free diet is the only safe treatment available. Due to the restrictions resulting from this eating pattern, this treatment may impair the relationship of the people with CD with food, increasing the risk of a disordered eating attitude, which is associated with eating disorders. The EAT-26 is a validated instrument already applied worldwide in different populations, and higher scores are suggestive of eating attitudes prone to evolve into eating disorders. Studies carried out in other countries have already shown that people with CD are prone to developing eating disorders; however, no study has been carried out with this theme in the population with CD in Brazil. We carried out a nationwide cross-sectional study in three steps: (i) study design and instrument; (ii) recruitment of participants and ethics; (iii) statistical analysis. A total of 385 participants were included in our sample, 96.36% of them being women. The internal consistency of the applied self-administered Brazilian version of the EAT-26 online questionnaire presented a satisfactory Cronbach's alpha of 0.812, and in total, 36.1% of the respondents were classified with a disordered eating attitude. No differences were found among the scores of participants when divided by categories regarding gender, average monthly income, age, and educational level. However, scores classified as a disordered eating attitude were found in respondents with a body mass index classified as overweight and obese. Our study highlights that disordered eating attitudes are present in overweight and obese women with celiac disease; thus, public health politics are needed to prevent and treat these attitudes.
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Affiliation(s)
- Luiza Franco
- Instituto de Educação Superior de Brasilia, IESB University Center, Brasília 70200-730, Brazil;
| | | | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Hmidan A. Alturki
- General Directorate for Funds & Grants, King Abdulaziz City for Science & Technology, Riyadh 11442, Saudi Arabia;
| | - Sehad N. Alarifi
- Department of Food and Nutrition Science, Al-Quwayiyah College of Sciences and Humanities, Shaqra University, Shaqraa 11971, Saudi Arabia;
| | - Cláudia Chaves
- ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Edite Teixeira-Lemos
- CERNAS Research Centre, Polytechnic University of Viseu, 3504-510 Viseu, Portugal;
| | - Bernardo Romão
- Instituto de Educação Superior de Brasilia, IESB University Center, Brasília 70200-730, Brazil;
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Mahon C, Hamburger D, Webb JB, Yager Z, Howard E, Booth A, Fitzgerald A. Protocol of a cluster randomised trial of BodyKind: a school-based body image programme for adolescents. BMC Public Health 2023; 23:2246. [PMID: 37964252 PMCID: PMC10647142 DOI: 10.1186/s12889-023-17002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Poor body image is prevalent among adolescents and associated with several negative outcomes for their physical and psychological health. There is a pressing need to address this growing public health concern, yet there are few evidence-informed universal programmes for older adolescents that address contemporary body image concerns (i.e., social media). BodyKind is a four lesson, school-based, teacher led, universal body image programme that incorporates empirically supported principles of cognitive dissonance, self-compassion, compassion for others and social activism, to support positive body image development. Building on previous pilot trials in the USA, this paper outlines the protocol for a cluster randomised control trial (cRCT) and implementation evaluation of the BodyKind programme which was culturally adapted for the Irish cultural context. METHODS We aim to recruit 600 students aged 15-17 years in Transition Year (4th year) across 26 second-level schools in Ireland. Using minimisation, schools will be randomly assigned to receive BodyKind (intervention condition, n=300) or classes as usual (waitlist control, n=300). Teachers in intervention groups will receive training and deliver the programme to students over four weeks, at a rate of one lesson per week. Primary outcomes of body appreciation, body dissatisfaction and psychological wellbeing and secondary outcomes of self-compassion, compassion for others, body ideal internalisation, social justice motives and appearance-based social media use will be assessed at pre-, post- and 2 month follow up. Mediation and moderation analyses will be conducted to identify how and for whom the intervention works best. An implementation evaluation will assess the quality of programme implementation across schools and how this may influence intervention outcomes. Waitlist control schools will receive the programme after the 2-month follow up. CONCLUSION This study will be the first to implement a cRCT and an implementation evaluation to assess the impact of this multicomponent school-based body image programme designed to support healthy body image development. If shown to be effective, BodyKind will have the potential to improve adolescent body image and wellbeing and inform efforts to implement sustainable and scalable programmes in schools. TRIAL REGISTRATION The trial was retrospectively registered on 10/10/2023 on ClinicalTrials.gov NCT06076993 .
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Affiliation(s)
- Ciara Mahon
- School of Psychology, University College Dublin (UCD), Newman Building, Belfield, Dublin 4, Ireland.
| | | | - Jennifer B Webb
- Department of Psychological Science, Health Psychology Ph.D. Program, University of North Carolina at Charlotte (UNC Charlotte), Charlotte, USA
| | - Zali Yager
- Embrace Collective NFP, Adelaide, Australia
| | - Emma Howard
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Ailbhe Booth
- School of Psychology, University College Dublin (UCD), Newman Building, Belfield, Dublin 4, Ireland
- Jigsaw, The National Centre for Youth Mental Health, Dublin, Ireland
| | - Amanda Fitzgerald
- School of Psychology, University College Dublin (UCD), Newman Building, Belfield, Dublin 4, Ireland
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115
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Varela C, Hoyo Á, Tapia-Sanz ME, Jiménez-González AI, Moral BJ, Rodríguez-Fernández P, Vargas-Hernández Y, Ruiz-Sánchez LJ. An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review. Front Psychol 2023; 14:1221679. [PMID: 38023032 PMCID: PMC10663237 DOI: 10.3389/fpsyg.2023.1221679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Eating disorders (EDs) are serious psychological problems that affect not only the individual, but also their entire environment. The prevalence rates of EDs are higher among the adolescent population. A better understanding of ED risk factors is essential to design effective prevention and intervention programs that focus beyond the areas of weight and appearance. Methods The main objective of this systematic review was to identify the risk factors of EDs and provide a comprehensive approach, analyzing the interplay between individuals, their inner circle, and the society characteristics. The Web of Science, Scopus, CENTRAL and PsycInfo databases were searched. Results The initial search produced 8,178 references. After removing duplicates and performing the selection process by three independent reviewers, 42 articles were included in the systematic review according to the pre-specified inclusion criteria. The results suggest the relevance of society and the inner circle on the development of EDs. Discussion The internalization of the thin ideal, promoted by the current society, and living in an unsupportive, unaffectionate, non-cohesive environment were associated with the onset of EDs symptomatology. Other associated variables with this ED indicator were poor-quality relationships and feeling judged about appearance. These aspects seem to be essential for the development of individual characteristics like self-esteem or adaptative coping during adolescence. This systematic review has shown the complex etiology of EDs and the relevance of the interplay between the different areas involved. Furthermore, this information could be relevant to improve the design of innovative and more effective prevention and intervention programs. Systematic review registration PROSPERO, identifier CRD42022320881.
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Affiliation(s)
- Carmen Varela
- Universitat de Barcelona, Barcelona, Spain
- Departamento de Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad de Burgos, Burgos, Spain
- Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | - Ángela Hoyo
- Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | | | | | - Benito Javier Moral
- Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
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Mushtaq T, Ashraf S, Hameed H, Irfan A, Shahid M, Kanwal R, Aslam MA, Shahid H, Koh-E-Noor, Shazly GA, Khan MA, Jardan YAB. Prevalence of Eating Disorders and Their Association with Social Media Addiction among Youths. Nutrients 2023; 15:4687. [PMID: 37960340 PMCID: PMC10647586 DOI: 10.3390/nu15214687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/01/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders and excessive attachment to social media are a matter of great concern among youths. This study assessed the prevalence of eating disorders and their association with social media addiction among youths. A descriptive cross-sectional study was conducted on 350 participants aged 14-25 years. Two pre-validated tools were used, i.e., the Eating Attitude Test and the Social Networking Addiction Scale. SPSS was used to analyze the data. Out of the 350 students, 42% had probable eating disorders, and 41.7% had social media addictions. The findings revealed that the chances of having eating disorders were significantly higher among youths who lived in separate places, smoked, and had a family history of eating disorders (p ≤ 0.05). Furthermore, the dieting domain displayed notably higher scores for youths living separately (p ≤ 0.05) and smokers (p ≤ 0.01). Moreover, the scores for bulimia and food preoccupation were significantly higher among participants who were married (p = 0.038), were smokers (p = 0.027), and had a family history of eating disorders (p = 0.001). Higher scores in the oral control domain were reported by females (p ≤ 0.05) and severely obese youths (p ≤ 0.01). Moreover, social media addiction was significantly higher among students aged 18-21 (p ≤ 0.01). Spearman's correlation revealed that social media addiction has a weak positive relationship with eating disorders (r = 0.133, p ≤ 0.01), particularly bulimia and food preoccupation (r = 0.173, p ≤ 0.001). This reflects the need to address the harmful consequences of social media addiction that might raise the likelihood of developing eating disorders, particularly bulimia nervosa.
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Affiliation(s)
- Tehreem Mushtaq
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Seemab Ashraf
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Huma Hameed
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Ali Irfan
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan;
| | - Maria Shahid
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Rabbia Kanwal
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Muhammad Arslan Aslam
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Hijab Shahid
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Koh-E-Noor
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Gamal A. Shazly
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mahtab Ahmad Khan
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
- Institute of Clinical and Experimental Pharmacology and Toxicology, University of Lubeck, 23566 Lubeck, Germany
| | - Yousef A. Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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117
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Pike AC, Sharpley AL, Park RJ, Cowen PJ, Browning M, Pulcu E. Adaptive learning from outcome contingencies in eating-disorder risk groups. Transl Psychiatry 2023; 13:340. [PMID: 37925461 PMCID: PMC10625579 DOI: 10.1038/s41398-023-02633-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/06/2023] Open
Abstract
Eating disorders are characterised by altered eating patterns alongside overvaluation of body weight or shape, and have relatively low rates of successful treatment and recovery. Notably, cognitive inflexibility has been implicated in both the development and maintenance of eating disorders, and understanding the reasons for this inflexibility might indicate avenues for treatment development. We therefore investigate one potential cause of this inflexibility: an inability to adjust learning when outcome contingencies change. We recruited (n = 82) three groups of participants: those who had recovered from anorexia nervosa (RA), those who had high levels of eating disorder symptoms but no formal diagnosis (EA), and control participants (HC). They performed a reinforcement learning task (alongside eye-tracking) in which the volatility of wins and losses was independently manipulated. We predicted that both the RA and EA groups would adjust their learning rates less than the control participants. Unexpectedly, the RA group showed elevated adjustment of learning rates for both win and loss outcomes compared to control participants. The RA group also showed increased pupil dilation to stable wins and reduced pupil dilation to stable losses. Their learning rate adjustment was associated with the difference between their pupil dilation to volatile vs. stable wins. In conclusion, we find evidence that learning rate adjustment is unexpectedly higher in those who have recovered from anorexia nervosa, indicating that the relationship between eating disorders and cognitive inflexibility may be complex. Given our findings, investigation of noradrenergic agents may be valuable in the field of eating disorders.
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Affiliation(s)
- Alexandra C Pike
- Department of Psychology and York Biomedical Research Institute, University of York, Heslington, York, YO10 5DD, UK.
- Anxiety Laboratory, Neuroscience and Mental Health Group, Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK.
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
| | - Ann L Sharpley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Rebecca J Park
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Philip J Cowen
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Erdem Pulcu
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Tokatly Latzer I, Richmond TK, Zhang B, Pearl PL. Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality. Epilepsia 2023; 64:2982-2992. [PMID: 37611929 DOI: 10.1111/epi.17759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To assess the occurrence rate, characteristics, and impact of eating disorders (EDs) in adolescents with epilepsy. METHODS In this observational study, adolescents with epilepsy seen in a single center between 2013 and 2022 who had comorbid EDs were compared to two control groups of adolescents with only epilepsy and only EDs. Patients with intellectual disability or autism spectrum disorder were excluded. Data retrieved included demographic and anthropometric details and clinical variables relating to seizure types, EDs, and psychiatric disorders and behaviors. RESULTS A total of 376 subjects were included in the study: 84 adolescents with both epilepsy and eating disorders, 135 with only epilepsy, and 157 with only EDs. The rate of EDs in adolescents with epilepsy was 7.0% (95% confidence interval [CI] 5.6%-8.5%) overall, 11.3% (95% CI 8.8%-14.3%) in females, and 3.1% (95% CI 1.9%-4.8%) in males. The median (interquartile range [IQR]) time difference between the onset of epilepsy to an ED was 1.6 (.5-3.6) years. Among adolescents with epilepsy, those with an ED were more likely to be female (p = .001) and have a lower body mass index z-score (zBMI) percentile (p < .001). Epilepsy type, seizure frequency, or seizure duration were not specific for having or not having EDs. Among adolescents with EDs, those with epilepsy had a younger onset of their EDs (p < .001), included relatively more males (p = .007), and consisted of more cases of anorexia-nervosa-restrictive type (p < .001), and fewer cases of bulimia nervosa (p = .04) and binge eating disorder (p = .003). Adolescents with epilepsy and a comorbid ED were more likely to have psychiatric comorbidities such as depression, anxiety, and suicidality than adolescents with only epilepsy or EDs. SIGNIFICANCE EDs should be suspected and screened for in intellectually intact female and male adolescents with epilepsy, irrespective of their epilepsy type. If disturbed eating behaviors or EDs are identified, further evaluation should be directed at detecting other psychopathologies, including suicidality.
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Bo Zhang
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Phillip L Pearl
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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119
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Dahlgren CL, Reneflot A, Brunborg C, Wennersberg AL, Wisting L. Estimated prevalence of DSM-5 eating disorders in Norwegian adolescents: A community based two-phase study. Int J Eat Disord 2023; 56:2062-2073. [PMID: 37530417 DOI: 10.1002/eat.24032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE Little is known about the prevalence of DSM-5 eating disorders (EDs) in adolescents. In Norway, the most recent community-based prevalence study in adolescents was published more than 20 years ago. The aim of this study was to assess the prevalence of DSM-5 EDs in Norwegian adolescents using a two-phase design. METHOD A total of 1558 upper secondary school students (827 girls and 730 boys) (ages 16-19) were screened for at-risk ED pathology using the Eating Disorder Examination-Questionnaire short version (EDE-QS). A sub-sample of 99 adolescents (87 girls and 12 boys) subsequently participated in a clinical interview using the Eating Disorder Assessment for DSM-5 (EDA-5). RESULTS Eating pathology was common, with 19.9% of participants scoring at or above the applied EDE-QS cut-off. The estimated prevalence of any ED was 9.4% in the total sample, and 16.4% in girls. The number of boys who took part in the diagnostic interview was low, thus, diagnostic data from boys were not analyzed separately. Prevalence estimates of AN, BN, BED, and OSFED in girls were 2.7%, 1.1%, 1.9%, and 10.7%. Atypical AN was the most frequently assigned diagnosis in girls. DISCUSSION Sampling biases limit generalizability of results. Additional population-based studies are warranted to assess the prevalence of EDs in Norwegian youth. PUBLIC SIGNIFICANCE STATEMENT In this study, 1558 adolescents, aged 16-19, were screened for ED pathology. A subsample completed a diagnostic interview using DSM-5 criteria. Results showed that one in five adolescents displayed problematic eating behaviors and cognitions. The estimated prevalence rate of any ED was 9.4%. Sampling biases limit generalizability of results. Additional population-based studies are warranted to assess the prevalence of EDs in Norwegian youth.
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Affiliation(s)
- Camilla Lindvall Dahlgren
- Department of Psychology, Oslo New University College, Oslo, Norway
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål HF, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Anne-Louise Wennersberg
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål HF, Oslo, Norway
| | - Line Wisting
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål HF, Oslo, Norway
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Ferrero EM, Yunker AG, Cuffe S, Gautam S, Mendoza K, Bhupathiraju SN, Mattei J. Nutrition and Health in the Lesbian, Gay, Bisexual, Transgender, Queer/Questioning Community: A Narrative Review. Adv Nutr 2023; 14:1297-1306. [PMID: 37536566 PMCID: PMC10721458 DOI: 10.1016/j.advnut.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/16/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023] Open
Abstract
Sexual and gender minorities have a higher risk for health and nutrition-related disparities across the life course compared to the heterosexual or cisgender population. Experiences of stigmatization and discrimination are associated with diminished mental health quality and psychological distress, which are risk factors for developing various eating disorders. Other nutrition disparities include increased risk for food insecurity, body dissatisfaction, and weight complications, such as those experienced by the transgender population in association with gender-affirming hormone therapies. Despite the need for tailored nutrition recommendations that address the unique needs of the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) community, there are currently no such guidelines in North America. The purpose of this review is to summarize major LGBTQ+ nutrition disparities and highlight the need for tailored recommendations. We examine the evidence on mental health and social disparities in this group, including vulnerabilities to disordered eating, food insecurity, and healthcare provider discrimination. Importantly, we identify a scarcity of literature on dietary concerns and nutrition care guidelines for LGBTQ+ groups, including studies that address intersectionality and differences among specific gender and sexual orientations. These gaps underline the urgency of prioritizing nutrition for LGBTQ+ health needs and for developing tailored public health nutrition recommendations for this underserved population. Our review suggests that future LGBTQ+ health and nutrition research agendas should include personalized and precision nutrition, social determinants of health, diet quality, body image, and healthcare provider cultural competency and responsiveness. Moreover, the current evidence on LGBTQ+ nutrition and health will be strengthened when research studies (including clinical trials) with robust methodologies amplify inclusion and representation of this community to elucidate health and nutrition disparities in sexual and gender minorities.
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Affiliation(s)
- Elisabetta M Ferrero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Alexandra G Yunker
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sherri Cuffe
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Saloni Gautam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Kenny Mendoza
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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Breiner CE, Miller ML, Sanzari CM, Perry TR, Hormes JM. Peer Ethnicity as a Mediator in the Relationship Between Ethnic Identity and Body Appreciation in Black College-Aged Women. JOURNAL OF BLACK PSYCHOLOGY 2023; 49:814-834. [PMID: 38500608 PMCID: PMC10948201 DOI: 10.1177/00957984231192285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Strong ethnic identity is recognized as a protective factor against body image concern and eating pathology in Black women as they tend to hold cultural values in line with an acceptance of a variety of body shapes and sizes. Reinforcement of these cultural ideals may occur via same-race peer relationships. The current study examined the mediating role of same-race versus other-race peers in the relationship between ethnic identity and body appreciation in Black women. Participants were 139 Black undergraduate women (Mage = 18.94 years, MBMI = 25.33) who completed validated measures of ethnic identity and body appreciation and reported on the ethnic makeup of their friends. We conducted mediation analysis examining the role of same-race peers on the relationship between ethnic identity and body appreciation. Same-race peers mediated the relationship between ethnic identity and body appreciation, where having a greater percentage of friends increased both ethnic identity and body appreciation in Black women. The influence of same-race peers should be considered in the development of culturally informed prevention and intervention efforts for eating pathology in Black women.
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Abid MT, Banna MHA, Akter S, Brazendale K, Spence C, Begum MUH, Rashid R, Bari FS, Rifat MA, Sultana MS, Khaleduzzaman M, Debnath SC, Mahjabin N, Khan MSI, Hassan MN. Prevalence and predictors of binge eating disorder symptoms among a sample of university students in Bangladesh: A cross-sectional survey. Health Sci Rep 2023; 6:e1668. [PMID: 37920659 PMCID: PMC10618435 DOI: 10.1002/hsr2.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/25/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
Background and Aims There is a dearth of information about binge eating disorder (BED) among Bangladeshi university students, who may be more susceptible to BED due to the rise in unhealthy lifestyles and food habits. Therefore, the purpose of this study was to assess the prevalence and associated factors of BED symptoms among Bangladeshi university students. Methods Students (N = 525) from three public universities in Bangladesh participated in this cross-sectional study between November 2022 and March 2023. Face-to-face interviews were conducted using a structured paper-based questionnaire that included two validated survey tools; the binge eating disorder screener and the patient health questionnaire-9. To identify the factors associated with BED symptoms, multiple logistic regression analysis was conducted, with sociodemographic and behavioral information (e.g., age, sex, smoking status, etc.) considered as covariates. Results The prevalence of BED symptoms among participants (mean age 21.28 years, 50.3% male and 49.7% female) was 20.6%. Male students had a 2.28 times higher likelihood of having BED symptoms compared to female counterparts (adjusted odds ratio [AOR] = 2.28; 95% CI: 1.33-3.89). Older students (AOR = 3.56, 95% CI: 1.80-7.05), students who were overweight or obese (AOR = 3.32, 95% CI: 1.87-5.89), and students reporting higher depressive symptoms (AOR = 2.69, 95% CI: 1.66-4.35) were at greater risk for developing BED compared to their respective counterparts. Conclusions This study provides new insights into the prevalence of BED symptoms and its contributing factors among Bangladeshi students. Approximately 1-in-5 university students reported having BED symptoms. University students who are older, overweight, or obese, and who report depressive symptoms may be at greatest risk. Future longitudinal studies are needed to determine the causal factors underlying BED. Findings from this study can assist policymakers and public health professionals in developing effective and targeted strategies to mitigate the risks associated with BED among Bangladeshi university students.
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Affiliation(s)
- Mohammad Tazrian Abid
- Faculty of Nutrition and Food SciencePatuakhali Science and Technology UniversityPatuakhaliBangladesh
| | - Md. Hasan Al Banna
- Department of Food MicrobiologyFaculty of Nutrition and Food Science, Patuakhali Science and Technology UniversityPatuakhaliBangladesh
- Nutrition InitiativeKushtiaBangladesh
| | - Shammy Akter
- Department of Applied Nutrition and Food TechnologyFaculty of Biological Sciences, Islamic UniversityKushtiaBangladesh
| | - Keith Brazendale
- Department of Health SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Charles Spence
- Department of Experimental PsychologyUniversity of OxfordOxfordUK
| | | | - Rumana Rashid
- Department of Public Health NutritionPrimeasia UniversityDhakaBangladesh
| | | | - M. A. Rifat
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Mst. Sadia Sultana
- Department of Public Health and InformaticsJahangirnagar UniversityDhakaBangladesh
| | - Md. Khaleduzzaman
- Faculty of Nutrition and Food SciencePatuakhali Science and Technology UniversityPatuakhaliBangladesh
| | - Sourav Chandra Debnath
- Faculty of Nutrition and Food SciencePatuakhali Science and Technology UniversityPatuakhaliBangladesh
| | - Nushrat Mahjabin
- Faculty of Nutrition and Food SciencePatuakhali Science and Technology UniversityPatuakhaliBangladesh
| | - Md. Shafiqul Islam Khan
- Department of Food MicrobiologyFaculty of Nutrition and Food Science, Patuakhali Science and Technology UniversityPatuakhaliBangladesh
| | - Md. Nazmul Hassan
- Department of Environmental SanitationFaculty of Nutrition and Food Science, Patuakhali Science and Technology UniversityPatuakhaliBangladesh
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Wimmer J, Rösch SA, Schmidt R, Hilbert A. Neurofeedback strategies in binge-eating disorder as predictors of EEG-neurofeedback regulation success. Front Hum Neurosci 2023; 17:1234085. [PMID: 38021247 PMCID: PMC10645064 DOI: 10.3389/fnhum.2023.1234085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Treatment options such as neurofeedback (NF) that directly target the link between aberrant brain activity patterns and dysfunctional eating behaviors in binge-eating disorder (BED) are emerging. However, virtually nothing is known about mental strategies used to modulate food-specific brain activity and the associated brain-based or subjective success of specific strategies. This study firstly investigated the use of mental strategies in response to individually appetitive food cues in adults with BED and overweight or obesity based on a randomized-controlled trial providing electroencephalography (EEG)- or real-time functional near-infrared spectroscopy (rtfNIRS)-NF to BED. Methods Strategy reports written by participants were classified with qualitative content analysis. Additionally, the mental strategies employed by the N = 23 patients who received EEG-NF targeting the reduction of fronto-central high beta activity were analyzed quantitatively through their link with subjective and EEG-NF regulation success. Results The following eight categories, ordered by frequency in descending order, were found: "Behavior," "Imagination," "Emotion," "Distraction," "Thought," "Concentration," "Self-Talk" and "No Strategy." Linear mixed models revealed "Imagination," "Behavior," and "Thought" strategies as positive predictors of EEG-NF regulation success (defined as high beta activity during regulation beneath the baseline), and "Concentration" as a negative predictor of subjective (i.e., self-reported) NF regulation success. Discussion In conclusion, our study offers a classification system that may be used in future studies assessing strategy use for regulating food-related responses in patients with BED and associated overweight/obesity, providing valuable information on potential benefits of specific strategies and transferability to situations outside the NF treatment.
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Affiliation(s)
- Jytte Wimmer
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
| | - Sarah Alica Rösch
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
- International Max Planck Research School NeuroCom, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
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Mutti C, Malagutti G, Maraglino V, Misirocchi F, Zilioli A, Rausa F, Pizzarotti S, Spallazzi M, Rosenzweig I, Parrino L. Sleep Pathologies and Eating Disorders: A Crossroad for Neurology, Psychiatry and Nutrition. Nutrients 2023; 15:4488. [PMID: 37892563 PMCID: PMC10610508 DOI: 10.3390/nu15204488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
The intricate connection between eating behaviors and sleep habits is often overlooked in clinical practice, despite their profound interdependence. Sleep plays a key role in modulating psychological, hormonal and metabolic balance and exerting an influence on food choices. Conversely, various eating disorders may affect sleep continuity, sometimes promoting the development of sleep pathologies. Neurologists, nutritionists and psychiatrists tend to focus on these issues separately, resulting in a failure to recognize the full extent of the clinical conditions. This detrimental separation can lead to underestimation, misdiagnosis and inappropriate therapeutic interventions. In this review, we aim to provide a comprehensive understanding of the tangled relationship between sleep, sleep pathologies and eating disorders, by incorporating the perspective of sleep experts, psychologists and psychiatrists. Our goal is to identify a practical crossroad integrating the expertise of all the involved specialists.
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Affiliation(s)
- Carlotta Mutti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, 43125 Parma, Italy
| | - Giulia Malagutti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, 43125 Parma, Italy
| | - Valentina Maraglino
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, 43125 Parma, Italy
| | - Francesco Misirocchi
- Neurology Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy (A.Z.)
| | - Alessandro Zilioli
- Neurology Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy (A.Z.)
| | - Francesco Rausa
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, 43125 Parma, Italy
| | - Silvia Pizzarotti
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, 43125 Parma, Italy
| | - Marco Spallazzi
- Neurology Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy (A.Z.)
| | - Ivana Rosenzweig
- Plasticity Centre, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London WC2R 2LS, UK
| | - Liborio Parrino
- Sleep Disorders Center, Department of General and Specialized Medicine, University Hospital of Parma, 43125 Parma, Italy
- Neurology Unit, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy (A.Z.)
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125
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Fernández-Aranda F, Granero R, Jiménez-Murcia S. Editorial: Neurological, psychological and endocrine markers of eating disorders and obesity. Front Nutr 2023; 10:1289370. [PMID: 37899820 PMCID: PMC10613052 DOI: 10.3389/fnut.2023.1289370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Fernando Fernández-Aranda
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Roser Granero
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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Gezelius CME, Wahlund BA, Wiberg BM. Relation between increasing attachment security and weight gain: a clinical study of adolescents and their parents at an outpatient ward. Eat Weight Disord 2023; 28:82. [PMID: 37816948 PMCID: PMC10564661 DOI: 10.1007/s40519-023-01611-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023] Open
Abstract
PURPOSE We wanted to evaluate the impact of a relational focus in the treatment of adolescent ED-patients and their parents at an intensive outpatient ward, based on attachment theory, combined with a family approach and psychodynamic principles. Our aim was to investigate the distribution of different attachment styles among the adolescent ED-patients and their parents, and to find out if they could change by the treatment. METHODS Swedish adolescents (n = 33; 3 boys, 30 girls) and their parents (n = 60; 34 mothers, 26 fathers) participated. MEASURES Attachment Style Questionnaire (ASQ), Body Mass Index (BMI) and Children's Global Assessment Scale (CGAS) before and after treatment. RESULTS The adolescents were high on Need for Approval (ASQ4) of the Insecure/Anxious scale before treatment (in contrast to the parents). The patients had a significant decrease in ASQ4 after treatment, which correlated inversely to the increase in BMI but not to CGAS. The mothers showed features of the Secure/Confident style, fathers of the Insecure/Avoidant with elevated Relationships as Secondary (ASQ2). CONCLUSIONS Treatment with a relational and a family focus has impact on attachment insecurity in adolescent ED-patients and outcomes in terms of BMI. It is important to engage the parents, who need to help the adolescents to separate at that developmental stage. A secure therapeutic context, which enables mentalizations and allows new relational experiences, is essential. The ASQ-instrument is useful in indicating how the treatment of ED-adolescents is proceeding. LEVEL OF EVIDENCE Level IV: evidence obtained from multiple time series with the intervention.
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Affiliation(s)
- Christina M E Gezelius
- Department of Children and Youth Psychiatry, Center for Clinical Research, Falun Hospital, Falun, Sweden
| | - Björn A Wahlund
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- California Institute of Technology, Pasadena, USA
| | - Britt M Wiberg
- Department of Psychology, Umeå University, 90187, Umeå, Sweden.
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127
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Bazo Perez M, Hayes TB, Frazier LD. Beyond generalized anxiety: the association of anxiety sensitivity with disordered eating. J Eat Disord 2023; 11:173. [PMID: 37784155 PMCID: PMC10544544 DOI: 10.1186/s40337-023-00890-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Anxiety and eating disorders (EDs) are rising at alarming rates. These mental health disorders are often comorbid, yet the factors associated with their comorbidity are not well understood. The present study examined a theoretical model of the pathways and relative associations of anxiety sensitivity (AS) with different dimensions of ED risk, controlling for generalized anxiety. METHODS Participants (N = 795) were undergraduate students with an average age of 21 (SD = 4.02), predominantly female (71%), and Hispanic (71.8%). Participants completed an online survey with established measures of AS (i.e., Anxiety Sensitivity Index-3; ASI-3), general anxiety (i.e., Beck Anxiety Inventory; BAI), and eating behaviors (i.e., Eating Attitudes Test-26; EAT-26). RESULTS The results of our structural equation models indicated that AS subscales were significantly associated with dimensions of the EAT-26, even when controlling for generalized anxiety. Specifically, the ASI-3 factors reflecting cognitive and social concerns provided the most consistent significant associations with EDs. Whereas reporting higher cognitive concerns was associated with higher ED symptoms (e.g., reporting the urge to vomit after a meal), reporting higher social concerns was associated with fewer ED symptoms. These differential results may suggest risk and resilience pathways and potential protective or buffering effects of social concerns on ED risk. DISCUSSION Findings advance understanding of the role of AS in the comorbidity of anxiety and EDs, demonstrating the strong association of AS with ED pathology. These findings provide cognitive indicators for transdiagnostic therapeutic intervention in order to reduce the risk of EDs.
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Affiliation(s)
- Maria Bazo Perez
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Timothy B Hayes
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
| | - Leslie D Frazier
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
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Liang G, Cheng Y, Barnhart WR, Song J, Lu T, He J. A network analysis of disordered eating symptoms, big-five personality traits, and psychological distress in Chinese adults. Int J Eat Disord 2023; 56:1842-1853. [PMID: 37337937 DOI: 10.1002/eat.24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/07/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE Previous studies have revealed associations between disordered eating symptoms, big-five personality traits, and psychological distress. However, limited research has explored these relationships as a network, including their interconnections, and even less has done so in non-Western populations. We employed network analysis to investigate the co-occurrence of disordered eating symptoms, big-five personality traits, and psychological distress in Chinese adults. METHOD A sample of 500 Chinese adults (256 men) completed measures assessing big-five personality traits, psychological distress, and disordered eating symptoms. The network of personality traits, psychological distress, and disordered eating symptoms was estimated, including its central and bridge nodes. RESULTS The central nodes in the network were the facets of openness (like adventure), extraversion (like going to social and recreational parties), and disordered eating symptoms (dissatisfaction with body weight or shape). Moreover, certain facets of neuroticism (always worrying something bad will happen), psychological distress (feeling worthless), and an inverse facet of extraversion (bored by parties with lots of people) were identified as essential bridge nodes in maintaining the structure of the network. CONCLUSION Our findings suggest that personality traits (e.g., openness and extraversion) and body dissatisfaction are important in maintaining the network in a community sample of Chinese adults. While future replication is needed, findings from this study suggest that individuals with negative self-thinking, predisposed neuroticism, and extraversion may be at risk of developing disordered eating symptoms. PUBLIC SIGNIFICANCE The present study contributes to existing knowledge by employing a network perspective to examine the associations between disordered eating symptoms, big-five personality traits, and psychological distress in a Chinese adult community sample. The identified facets of neuroticism and extraversion and symptoms of psychological distress may be worthy of targeting in the prevention and treatment of disordered eating in the Chinese context.
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Affiliation(s)
- Guangsheng Liang
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Yawei Cheng
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, Texas, USA
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Jianwen Song
- Department of Educational Psychology, Baylor University, Waco, Texas, USA
| | - Tom Lu
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, Texas, USA
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, People's Republic of China
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Zelkowitz RL, Kehle-Forbes SM, Smith BN, Vogt DS, Mitchell KS. Associations between DSM-5 posttraumatic stress disorder Criterion E2 endorsement and selected self-destructive behaviors in recent-era veterans: A focus on disordered eating. J Trauma Stress 2023; 36:1001-1009. [PMID: 37485630 DOI: 10.1002/jts.22960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 07/25/2023]
Abstract
Revisions to the posttraumatic stress disorder (PTSD) criteria in the DSM-5 included a new criterion in the alterations in arousal and reactivity cluster (i.e., engagement in reckless and self-destructive behaviors; Criterion E2). Despite its clinical significance, little is known about how this symptom corresponds to engagement in specific direct and indirect self-harm behaviors. We examined associations between E2 and self-reported recent engagement in direct and indirect self-harm behaviors, including disordered eating, which is not included in the prototypical E2 symptom scope, in a trauma-exposed sample of 1,010 recent-era veterans (61.5% self-identified women, 38.5% self-identified men). We also tested whether gender moderated these associations. We repeated analyses in a subsample of participants with clinically elevated PTSD symptoms. Participants self-reported past-month PTSD symptoms (PCL-5) as well as past-month nonsuicidal self-injury, suicidal ideation, suicide planning, fasting, purging, binge eating, compulsive exercise, and problematic alcohol and drug use. We found no evidence for moderation by gender for any of the behaviors examined in the main sample. However, after controlling for gender and demographic covariates, weighted logistic regressions showed small, significant associations between E2 score and direct self-harm behaviors, substance use, purging, and binge eating, aORs = 1.30-1.91. Criterion E2 was linked to behaviors included in the typical symptom scope (self-directed violence, substance use) and those that are not (disordered eating behaviors). Comprehensive screening for self-destructive behaviors, including disordered eating, among veteran men and women who endorse Criterion E2 is indicated.
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Affiliation(s)
- Rachel L Zelkowitz
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Shannon M Kehle-Forbes
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Brian N Smith
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Dawne S Vogt
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Karen S Mitchell
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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Candido ACR, Ferraz SD, Uggioni MLR, Zanevan IR, Colonetti L, Grande AJ, Colonetti T, Rosa MID. Omega-3 as an adjuvant in the treatment eating and psychological symptoms in patients with anorexia nervosa: a systematic review and meta-analyses. J Hum Nutr Diet 2023; 36:1970-1981. [PMID: 37226879 DOI: 10.1111/jhn.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND This study was carried out to assess the effects of omega-3 supplementation as an adjunct treatment for eating and psychological symptoms in patients with anorexia nervosa. METHODS We conducted a systematic review of the literature using the terms 'anorexia nervosa' AND 'Fatty Acids, Omega-3'. Five randomised controlled trials with a total of 144 participants, published between 2003 and 2022, were included. RESULTS The effects of supplementation of omega-3 on anxiety were standardised mean difference (SMD) 0.79, 95% confidence interval (CI) -0.08 to 1.66; p = 0.08; I² = 3%; two studies, 33 participants; moderate quality of evidence. For depression, the supplementation of omega-3 was SMD: 0.22, 95% CI: -0.50 to 0.93; p = 0.18; I² = 45%; two studies, 33 participants; moderate quality of evidence. For obsessive-compulsive disorder, the supplementation of omega-3 was SMD: -0.22, 95% CI: -0.70 to 2.25; p = 0.36; I² = 0%; three studies, 32 participants; low quality of evidence. CONCLUSION This research showed that regardless of dose, time or, if associated with other components, the use of omega-3 supplementations as an adjuvant treatment showed no evidence of effect in eating and psychological symptoms in patients with anorexia nervosa.
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Affiliation(s)
- Ana Claudia Rodrigues Candido
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Sarah Dagostin Ferraz
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Maria Laura Rodrigues Uggioni
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Ivan Rosso Zanevan
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Laura Colonetti
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Antônio José Grande
- Laboratory of Evidence-Based Practice, Universidade Estadual de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Tamy Colonetti
- Laboratory of Evidence-Based Practice, Universidade Estadual de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Maria Inês da Rosa
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Martínez de Alva P, Ghaderi A, Andersson G, Feldman I, Sampaio F. The cost-effectiveness of a virtual intervention to prevent eating disorders in young women in Sweden. Int J Eat Disord 2023; 56:1887-1897. [PMID: 37415559 DOI: 10.1002/eat.24018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To determine the cost-effectiveness of a virtual version of the Body Project (vBP), a cognitive dissonance-based program, to prevent eating disorders (ED) among young women with a subjective sense of body dissatisfaction in the Swedish context. METHOD A decision tree combined with a Markov model was developed to estimate the cost-effectiveness of the vBP in a clinical trial population of 149 young women (mean age 17 years) with body image concerns. Treatment effect was modeled using data from a trial investigating the effects of vBP compared to expressive writing (EW) and a do-nothing alternative. Population characteristics and intervention costs were sourced from the trial. Other parameters, including utilities, treatment costs for ED, and mortality were sourced from the literature. The model predicted the costs and quality-adjusted life years (QALYs) related to the prevention of incidence of ED in the modeled population until they reached 25 years of age. The study used both a cost-utility and return on investment (ROI) framework. RESULTS In total, vBP yielded lower costs and larger QALYs than the alternatives. The ROI analysis denoted a return of US $152 for every USD invested in vBP over 8 years against the do-nothing alternative and US $105 against EW. DISCUSSION vBP is likely to be cost-effective compared to both EW and a do-nothing alternative. The ROI from vBP is substantial and could be attractive information for decision makers for implementation of this intervention for young females at risk of developing ED. PUBLIC SIGNIFICANCE This study estimates that the vBP is cost-effective for the prevention of eating disorders among young women in the Swedish setting, and thus is a good investment of public resources.
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Affiliation(s)
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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132
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He J, Fu Y, Cui S, Barnhart WR, Zhang X, Han J, Wang Y, Ganson KT, Nagata JM. Screen use while eating is associated with lower intuitive eating and higher disordered eating in Chinese adult men and women. Int J Eat Disord 2023; 56:1961-1972. [PMID: 37489116 DOI: 10.1002/eat.24026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE We aimed to explore the potential associations between screen use while eating and intuitive eating and disordered (thinness-oriented and muscularity-oriented) eating behaviors. METHODS Analyses included 600 Chinese adults (50% women; Mage = 30.67, SD = 8.08) recruited online. The use of four major screen devices was captured, including cell phones, tablets, computers, and TVs. Three types of eating behaviors were examined, namely intuitive eating, thinness-oriented disordered eating, and muscularity-oriented disordered eating. Pearson correlation and hierarchical regression analyses were conducted separately for men and women to examine the sex-specific associations between screen use while eating and intuitive eating, thinness-oriented disordered eating, and muscularity-oriented disordered eating. RESULTS In both men and women, more screen use while eating was significantly associated with lower intuitive eating, higher thinness-oriented disordered eating, and higher muscularity-oriented disordered eating, above and beyond total screen time and social media use. DISCUSSION We found preliminary evidence for the significant links between screen use while eating and intuitive eating and disordered eating. Given the global increases in screen use, continued research is warranted to further explore the role of screen use while eating in the development and maintenance of intuitive eating and disordered eating. PUBLIC SIGNIFICANCE Much remains unknown regarding screen use while eating and eating behaviors. We found that in both Chinese men and women, more screen use while eating was significantly and uniquely associated with lower intuitive eating, higher thinness-oriented disordered eating, and higher muscularity-oriented disordered eating. Findings highlight the importance of incorporating screen use while eating in future research on intuitive eating and disordered eating.
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Affiliation(s)
- Jinbo He
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yuru Fu
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Shuqi Cui
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Xinyi Zhang
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Jiayi Han
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yitong Wang
- School of Economics and Management, Yan'an University, Yan'an, Shaanxi, China
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Jason M Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
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133
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de Oliveira Galvão PP, Valente JY, Cogo-Moreira H, Mari JJ, Sanchez ZM. Bullying as a Risk Factor for Eating Disorder Behaviors Among Students: Secondary Analysis for a Cluster Randomized Controlled Trial. Child Psychiatry Hum Dev 2023; 54:1404-1414. [PMID: 35325334 DOI: 10.1007/s10578-022-01343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to examine whether being a victim of bullying predicted body dissatisfaction and eating disorder behavior (EDB). In this study, we performed secondary analysis from a cluster randomized controlled trial among 5208 eight grade students from 73 public schools in three Brazilian cities. Data were collected in 2019 through an anonymous self-report questionnaire on bullying, body dissatisfaction, and EDB. We used factor analysis, multivariate linear regression, and multinomial logistic regression to verify whether being a victim of bullying during the baseline results in body dissatisfaction and EDB at the nine months follow-up for the control and intervention groups. Our results showed that being female (OR 1.41, 95% CI 1.22-1.63) is a risk factor for dissatisfaction by overweight. Bullying was not a predictor of body dissatisfaction; however, being a victim of bullying (β 0.40, 95% CI 0.35-0.46) is a predictor of having more EDB, independent of the exposure to the program. Therefore, bullying deserves attention in the school environment.
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Affiliation(s)
- Patricia Paiva de Oliveira Galvão
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, sala 404, São Paulo, SP, CEP 04.023-062, Brazil.
| | | | - Hugo Cogo-Moreira
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Jair J Mari
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, sala 404, São Paulo, SP, CEP 04.023-062, Brazil
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134
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Hamatani S, Matsumoto K, Andersson G, Tomioka Y, Numata S, Kamashita R, Sekiguchi A, Sato Y, Fukudo S, Sasaki N, Nakamura M, Otani R, Sakuta R, Hirano Y, Kosaka H, Mizuno Y. Guided Internet-Based Cognitive Behavioral Therapy for Women With Bulimia Nervosa: Protocol for a Multicenter Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49828. [PMID: 37725414 PMCID: PMC10548332 DOI: 10.2196/49828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/24/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Individual face-to-face cognitive behavioral therapy is known to be effective for bulimia nervosa (BN). Since foods vary considerably between regions and cultures in which patients live, cultural adaptation of the treatment program is particularly important in cognitive behavioral therapy for BN. Recently, an internet-based cognitive behavioral therapy (ICBT) program was developed for Japanese women with BN, adapted to the Japanese food culture. However, no previous randomized controlled trial has examined the effectiveness of ICBT. OBJECTIVE This paper presents a research protocol for strategies to examine the effects of guided ICBT. METHODS This study is designed as a multicenter, prospective, assessor-blinded randomized controlled trial. The treatment groups will be divided into treatment as usual (TAU) alone as the control group and ICBT combined with TAU as the intervention group. The primary outcome is the total of binge eating and purging behaviors assessed before and after treatment by an independent assessor. Secondary outcomes will include measures of eating disorder severity, depression, anxiety, quality of life, treatment satisfaction, and working alliances. Treatment satisfaction and working alliances will be measured post assessment only. Other measures will be assessed at baseline, post intervention, and follow-up, and the outcomes will be analyzed on an intention-to-treat basis. RESULTS This study will be conducted at 7 different medical institutions in Japan from August 2022 to October 2026. Recruitment of participants began on August 19, 2022, and recruitment is scheduled to continue until July 2024. The first participants were registered on September 8, 2022. CONCLUSIONS This is the first multicenter randomized controlled trial in Japan comparing the effectiveness of ICBT and TAU in patients with BN. TRIAL REGISTRATION University Hospital Medical Information Network UMIN000048732; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000055522. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49828.
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Affiliation(s)
- Sayo Hamatani
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Kazuki Matsumoto
- Division of Clinical Psychology, Kagoshima University Hospital, Kagishima, Japan
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Yukiko Tomioka
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Rio Kamashita
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Atsushi Sekiguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yasuhiro Sato
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | - Shin Fukudo
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | - Natsuki Sasaki
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masayuki Nakamura
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryoko Otani
- Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Ryoichi Sakuta
- Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
- Department of Neuropsychiatry, University of Fukui, Fukui, Japan
| | - Yoshifumi Mizuno
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Division of Developmental Higher Brain Functions, United Graduate School of Child Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
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135
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Schnepper R, Blechert J, Arend AK, Yanagida T, Reichenberger J. Emotional eating: elusive or evident? Integrating laboratory, psychometric and daily life measures. Eat Weight Disord 2023; 28:74. [PMID: 37702801 PMCID: PMC10499733 DOI: 10.1007/s40519-023-01606-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE Emotional eating (EE) refers to eating in response to (negative) emotions. Evidence for the validity of EE is mixed: some meta-analyses find EE only in eating disordered patients, others only in restrained eaters, which suggest that only certain subgroups show EE. Furthermore, EE measures from lab-based assessments, ecological momentary assessment (EMA), and psychometric measures often diverge. This paper tested whether the covariance of these three different EE methods can be modeled through a single latent variable (factorial validity), and if so, how this variable would relate to restrained eating (construct validity), Body-Mass-Index (BMI), and subclinical eating disorder symptomatology (concurrent validity). METHODS 102 non-eating disordered female participants with a wide BMI range completed EE measures from three methods: psychometric questionnaires, a laboratory experiment (craving ratings of food images in induced neutral vs. negative emotion) and EMA questionnaires (within-participant correlations of momentary negative emotions and momentary food cravings across 9 days). Two measures for each method were extracted and submitted to confirmatory factor analysis. RESULTS A one-factor model provided a good fit. The resulting EElat factor correlated positively with subclinical eating disorder symptoms and BMI but not with restrained eating. CONCLUSIONS The one-factor solution shows that the EE construct can validly be assessed with three different methods. Individual differences in EE are supported by the data and are related to eating and weight problem symptomatology but not to restrained eating. This supports learning accounts of EE and underscores the relevance of the EE construct to physical and mental health. LEVEL OF EVIDENCE II (Evidence obtained from well-designed controlled trials without randomization).
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Affiliation(s)
- Rebekka Schnepper
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
- Department of Psychosomatics, University Hospital Basel, Hebelstr. 2, 4056, Basel, Switzerland
| | - Jens Blechert
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
| | - Ann-Kathrin Arend
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria
| | - Takuya Yanagida
- Faculty of Psychology, Department of Developmental and Educational Psychology, University of Vienna, Universitaetsstr. 7, 1010, Vienna, Austria
| | - Julia Reichenberger
- Faculty of Psychology, Department of Health Psychology and Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Hellbrunner Str. 34, 5020, Salzburg, Austria.
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136
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Dziewa M, Bańka B, Herbet M, Piątkowska-Chmiel I. Eating Disorders and Diabetes: Facing the Dual Challenge. Nutrients 2023; 15:3955. [PMID: 37764739 PMCID: PMC10538145 DOI: 10.3390/nu15183955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Eating disorders and diabetes mellitus are distinct yet closely linked health conditions, presenting distinct challenges in terms of care and management. Eating disorders encompass a spectrum of mental health disorders characterized by abnormal eating behaviors and disruptions in weight regulation. Research indicates that individuals with diabetes might be at an elevated risk of developing eating disorders. The necessity to adhere to specific dietary guidelines, monitor blood sugar levels vigilantly, and manage drug administration can collectively contribute to the emergence of detrimental attitudes toward food and body image. On the other hand, incorrect eating behaviors such as binge eating and purging can disrupt blood sugar control, significantly impacting the development and management of diabetes. This intricate relationship emphasizes the crucial necessity for a comprehensive understanding and specialized care to effectively address the dual challenges faced by individuals dealing with both diabetes and eating disorders. This paper represents the inaugural comprehensive review delving into the intricate connection between eating disorders and diabetes, thereby illuminating previously under-researched areas. The insights gleaned from this review may contribute to developing integrated interventions that aim to improve the overall well-being and quality of life for individuals grappling with the complexities of eating disorders and diabetes.
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Affiliation(s)
| | | | | | - Iwona Piątkowska-Chmiel
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Jaczewskiego 8b Street, 20-090 Lublin, Poland
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137
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Rozgonjuk D, Ignell J, Mech F, Rothermund E, Gündel H, Montag C. Smartphone and Instagram use, body dissatisfaction, and eating disorders: investigating the associations using self-report and tracked data. J Eat Disord 2023; 11:149. [PMID: 37667321 PMCID: PMC10478361 DOI: 10.1186/s40337-023-00865-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/08/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Previous research has linked smartphone and Instagram use to higher body dissatisfaction (BD) as well as eating disorder (ED) symptomatology. However, these studies have typically been limited to using self-report measures for technology use which, as shown by scientific literature, might not be reliable. In the present work, we combine self-reported assessments as well as tracked smartphone and Instagram use. METHODS The effective sample comprised N = 119 women (34 with ED diagnosis history) who were queried about BD and ED symptomatology, and who provided the data about their smartphone and Instagram use duration for each day of the previous week. RESULTS The study results show that women with an ED diagnosis history scored higher on both BD as well as ED scales. Although women with an ED diagnosis history had higher smartphone screen time, there were no statistically significant differences in Instagram screen time. Tracked smartphone use duration was positively correlated with both BD and ED symptomatology, but the role of Instagram use needs to be further elucidated. CONCLUSIONS The results of this study show that while BD and ED symptomatology are correlated with smartphone use, it may be that Instagram use is not the main contributor to that relationship.
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Affiliation(s)
- Dmitri Rozgonjuk
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany.
- Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia.
- Institute of Computer Science, University of Tartu, Tartu, Estonia.
| | - Johanna Ignell
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Franziska Mech
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
| | - Eva Rothermund
- Ulm University Medical Center, Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Harald Gündel
- Ulm University Medical Center, Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany.
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138
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Stoody VB, Garber AK, Miller CA, Bravender T. Advancements in Inpatient Medical Management of Malnutrition in Children and Adolescents with Restrictive Eating Disorders. J Pediatr 2023; 260:113482. [PMID: 37196778 DOI: 10.1016/j.jpeds.2023.113482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/10/2023] [Accepted: 04/30/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Vishvanie Bernadene Stoody
- Division of Adolescent/Young Adult and Sports Medicine, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI.
| | - Andrea Kay Garber
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, CA
| | - Catherine Anne Miller
- Division of Adolescent/Young Adult and Sports Medicine, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI
| | - Terrill Bravender
- Division of Adolescent/Young Adult and Sports Medicine, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI
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139
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Hacker KS, Salwen-Deremer JK. Comment on: Re-evaluating the binge eating scale cut-off using DSM-5 criteria: analysis and replication in presurgical metabolic and bariatric surgery samples. Surg Obes Relat Dis 2023; 19:950-951. [PMID: 37137802 DOI: 10.1016/j.soard.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Katrina S Hacker
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Jessica K Salwen-Deremer
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Department of Medicine, Section of Gastroenterology & Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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140
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Overhage L, Hailu R, Busch AB, Mehrotra A, Michelson KA, Huskamp HA. Trends in Acute Care Use for Mental Health Conditions Among Youth During the COVID-19 Pandemic. JAMA Psychiatry 2023; 80:924-932. [PMID: 37436733 PMCID: PMC10339224 DOI: 10.1001/jamapsychiatry.2023.2195] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/21/2023] [Indexed: 07/13/2023]
Abstract
Importance Understanding how children's utilization of acute mental health care changed during the COVID-19 pandemic is critical for directing resources. Objective To examine youth acute mental health care use (emergency department [ED], boarding, and subsequent inpatient care) during the second year of the COVID-19 pandemic. Design, Setting, and Participants This cross-sectional analysis of national, deidentified commercial health insurance claims of youth mental health ED and hospital care took place between March 2019 and February 2022. Among 4.1 million commercial insurance enrollees aged 5 to 17 years, 17 614 and 16 815 youth had at least 1 mental health ED visit in the baseline year (March 2019-February 2020) and pandemic year 2 (March 2021-February 2022), respectively. Exposure The COVID-19 pandemic. Main outcomes and measures The relative change from baseline to pandemic year 2 was determined in (1) fraction of youth with 1 or more mental health ED visits; (2) percentage of mental health ED visits resulting in inpatient psychiatry admission; (3) mean length of inpatient psychiatric stay following ED visit; and (4) frequency of prolonged boarding (≥2 midnights) in the ED or a medical unit before admission to an inpatient psychiatric unit. Results Of 4.1 million enrollees, 51% were males and 41% were aged 13 to 17 years (vs 5-12 years) with 88 665 mental health ED visits. Comparing baseline to pandemic year 2, there was a 6.7% increase in youth with any mental health ED visits (95% CI, 4.7%-8.8%). Among adolescent females, there was a larger increase (22.1%; 95% CI, 19.2%-24.9%). The fraction of ED visits that resulted in a psychiatric admission increased by 8.4% (95% CI, 5.5%-11.2%). Mean length of inpatient psychiatric stay increased 3.8% (95% CI, 1.8%-5.7%). The fraction of episodes with prolonged boarding increased 76.4% (95% CI, 71.0%-81.0%). Conclusions and relevance Into the second year of the pandemic, mental health ED visits increased notably among adolescent females, and there was an increase in prolonged boarding of youth awaiting inpatient psychiatric care. Interventions are needed to increase inpatient child psychiatry capacity and reduce strain on the acute mental health care system.
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Affiliation(s)
- Lindsay Overhage
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Ruth Hailu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Alisa B. Busch
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- McLean Hospital, Belmont, Massachusetts
| | - Ateev Mehrotra
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
- Division of General Internal Medicine Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Kenneth A. Michelson
- Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Haiden A. Huskamp
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
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141
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Pellizzer ML, Wade TD. Developing a definition of body neutrality and strategies for an intervention. Body Image 2023; 46:434-442. [PMID: 37573765 DOI: 10.1016/j.bodyim.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/06/2023] [Accepted: 07/16/2023] [Indexed: 08/15/2023]
Abstract
The aim of this study was to provide a definition for body neutrality and understand the key strategies recommended to improve body neutrality for testing in future interventions. There is minimal academic literature on body neutrality and thus this study focused on examining websites where the concept has been discussed for some time. This was achieved using a realist synthesis of websites and a common elements approach to extract the key definition elements of body neutrality, strategies to improve body neutrality, in addition to the common critiques of both the body positivity and body neutrality movements. The initial search found 175 websites, of which 107 were included in the final synthesis, and common elements analysis followed after removal of duplicates and ineligible websites. Three elements, with several sub-elements, best operationalised the definition of body neutrality. Six strategies were found for development of a body neutrality intervention. This innovative study paves the way for rigorous evaluation of body neutrality. Recommendations for future work are provided, including the use of current measures, creating a new measure, and evaluating prevention and intervention programs including Single Session Interventions (SSIs).
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Affiliation(s)
- Mia L Pellizzer
- Blackbird Initiative, Flinders University, Adelaide, Australia; Flinders University Institute of Mental Health and Wellbeing, Flinders University, Adelaide, Australia.
| | - Tracey D Wade
- Blackbird Initiative, Flinders University, Adelaide, Australia; Flinders University Institute of Mental Health and Wellbeing, Flinders University, Adelaide, Australia
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142
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Merino D, Gérard AO, Destere A, Askenazy F, Dor E, Benoit M, Cherikh F, Drici MD. Iatrogenic triggers for anorexia nervosa and bulimia nervosa: A WHO safety database disproportionality analysis. Psychiatry Res 2023; 327:115415. [PMID: 37611327 DOI: 10.1016/j.psychres.2023.115415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
Eating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their potential iatrogenic triggers, using real-world data from the WHO safety database (VigiBase®). VigiBase® was queried for all AN and BN reports. The reports were classified as `pediatric' or `adult' according to age. Disproportionality analyses relied on the Information Component (IC), in which a 95% confidence interval lower-end positivity was required to suspect a signal. Our queries yielded 309 AN and 499 BN reports. Isotretinoin was disproportionately reported in pediatric AN (IC 3.6; [2.6-4.3]), adult AN (IC 3.1; [1.7-4.0]), and pediatric BN (IC 3.9; [3.0-4.7]). Lamivudine (IC 4.2; [3.2-4.9]), nevirapine (IC 3.7; [2.6-4.6]), and zidovudine (IC 3.4; [2.0-4.3]) had the highest ICs in adult AN. AN was associated with isotretinoin, anticonvulsants in minors, and antiretroviral drugs in adults. In adults, BN was related to psychotropic and hormonally active drugs. Before treatment initiation, an anamnesis should seek out mental health conditions, allowing the identification of patients at risk of developing or relapsing into AN or BN. In addition to misuse, the hypothesis of iatrogenic triggers for AN and BN should also be considered.
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Affiliation(s)
- Diane Merino
- Department of Psychiatry, University Hospital of Nice, Nice, France; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France
| | - Alexandre Olivier Gérard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur Laboratory of Molecular Physio Medicine (LP2M), UMR 7370, CNRS, Nice, France
| | - Alexandre Destere
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France
| | - Florence Askenazy
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Emmanuelle Dor
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Michel Benoit
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Faredj Cherikh
- Department of Addiction, University Hospital of Nice, Nice, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France.
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143
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Bang L, Bahrami S, Hindley G, Smeland OB, Rødevand L, Jaholkowski PP, Shadrin A, Connell KSO, Frei O, Lin A, Rahman Z, Cheng W, Parker N, Fan CC, Dale AM, Djurovic S, Bulik CM, Andreassen OA. Genome-wide analysis of anorexia nervosa and major psychiatric disorders and related traits reveals genetic overlap and identifies novel risk loci for anorexia nervosa. Transl Psychiatry 2023; 13:291. [PMID: 37658054 PMCID: PMC10474135 DOI: 10.1038/s41398-023-02585-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 07/04/2023] [Accepted: 08/10/2023] [Indexed: 09/03/2023] Open
Abstract
Anorexia nervosa (AN) is a heritable eating disorder (50-60%) with an array of commonly comorbid psychiatric disorders and related traits. Although significant genetic correlations between AN and psychiatric disorders and related traits have been reported, their shared genetic architecture is largely understudied. We investigated the shared genetic architecture of AN and schizophrenia (SCZ), bipolar disorder (BIP), major depression (MD), mood instability (Mood), neuroticism (NEUR), and intelligence (INT). We applied the conditional false discovery rate (FDR) method to identify novel risk loci for AN, and conjunctional FDR to identify loci shared between AN and related phenotypes, to summarize statistics from relevant genome-wide association studies (GWAS). Individual GWAS samples varied from 72,517 to 420,879 participants. Using conditional FDR we identified 58 novel AN loci. Furthermore, we identified 38 unique loci shared between AN and major psychiatric disorders (SCZ, BIP, and MD) and 45 between AN and psychological traits (Mood, NEUR, and INT). In line with genetic correlations, the majority of shared loci showed concordant effect directions. Functional analyses revealed that the shared loci are involved in 65 unique pathways, several of which overlapped across analyses, including the "signal by MST1" pathway involved in Hippo signaling. In conclusion, we demonstrated genetic overlap between AN and major psychiatric disorders and related traits, and identified novel risk loci for AN by leveraging this overlap. Our results indicate that some shared characteristics between AN and related disorders and traits may have genetic underpinnings.
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Affiliation(s)
- Lasse Bang
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Guy Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olav B Smeland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Linn Rødevand
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Piotr P Jaholkowski
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kevin S O' Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Aihua Lin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Zillur Rahman
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Weiqiu Cheng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Nadine Parker
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Chun C Fan
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Anders M Dale
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
- Multimodal Imaging Laboratory, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
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144
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Aouad P, Hambleton A, Marks P, Maloney D, Calvert S, Caldwell B, McLean SA, Shelton B, Cowan K, Feneley J, Pepin G, Paxton S, Williams M, Meddick T, Squire S, Hickie I, Kay Lambkin F, Touyz S, Maguire S. Setting the top 10 eating disorder research and translation priorities for Australia. Aust N Z J Psychiatry 2023; 57:1281-1291. [PMID: 36196038 DOI: 10.1177/00048674221128754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES People with eating disorders, as well as their caregivers, experience high symptom burden, reduced quality of life and increased risk of early mortality. A lack of resources, disjointed vision and limited uptake of the evidence have limited the translation and implementation of research into practice. Little is known about what stakeholders (people with a lived experience, caregivers, health care professionals, researchers and policymakers) see as the most important research priorities. This study aimed to identify Australia's top 10 consensus-derived research and translation priorities for eating disorders. METHODS Participants (n = 606) included people with a lived experience, carers, health care professionals (clinicians) and researchers working in eating disorders. The methodology aligned with the James Lind Alliance priority setting process, which involved oversight by a co-design advisory committee and utilised a national online interim priority setting survey and co-design workshops to identify the top 10 research and translation priorities. RESULTS The initial national consultations elicited 1210 issues from 480 individuals. From this, 606 participants shortlisted 59 plain language questions in order of personal priority. In total, 16 questions were consistently ranked as important. As a final step, 24 individuals (with equal representation from all 4 stakeholder groups) attended the final prioritisation workshop to co-establish the top 10 research and translation priorities. CONCLUSION The findings highlight the need for people with a lived experience, carers, health professionals and researchers to work collaboratively to develop co-designed research and translation activities that address the key areas of early intervention, prevention, understanding the aetiology of eating disorders and effective treatment of people experiencing eating disorders.
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Affiliation(s)
- Phillip Aouad
- InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ashlea Hambleton
- InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Peta Marks
- InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Danielle Maloney
- InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Local Health District, NSW Health, Sydney, NSW, Australia
| | | | | | - Siân A McLean
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Beth Shelton
- National Eating Disorders Collaboration, Sydney, NSW, Australia
| | | | | | - Genevieve Pepin
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Susan Paxton
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Michelle Williams
- Royal Hobart Hospital, Tasmanian Health Service, Hobart, TAS, Australia
| | - Thy Meddick
- Mental Health Alcohol and Other Drugs Branch, Clinical Excellence Queensland, Brisbane, QLD, Australia
| | | | - Ian Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Frances Kay Lambkin
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Stephen Touyz
- InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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145
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Chapman L, Cartwright-Hatton S, Lester KJ. "I think it is woven through me, and sadly that means it is woven through our family life": the experiences and support needs of mothers with eating disorders. J Eat Disord 2023; 11:147. [PMID: 37644486 PMCID: PMC10466810 DOI: 10.1186/s40337-023-00868-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Eating disorders may disrupt parenting, and there is evidence to suggest that the children of parents with eating disorders are at greater risk for the development of eating disorders themselves. This study sought to broaden and extend current understandings of the lived experiences of mothers who have eating disorders. METHOD A qualitative study using thematic analysis was conducted. Eighteen mothers living in the UK, USA, and Australia took part in semi-structured online interviews. Participants were mothers to at least one child aged two years or older, had received a lifetime diagnosis of one or more eating disorders, and reported experiencing symptoms since becoming a parent. RESULTS Data were analysed using an inductive approach to reflexive thematic analysis. Four major themes, each with subthemes, were identified. These were: parenthood as a double-edged sword; the eating disorder impacts on parenting; blame and burden; and seeking support. CONCLUSIONS The lived experiences of mothers indicate a complex relationship between eating disorders and parenthood. While parenting can impact eating disorders, eating disorders can also impact parenting, in a range of ways that extend beyond the domains of food, eating and the body. There is a pressing need for the development of specialised, non-judgemental support options for parents with eating disorders and their families.
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Affiliation(s)
- Laura Chapman
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
| | | | - Kathryn J Lester
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, UK.
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146
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Caldiroli A, La Tegola D, Manzo F, Scalia A, Affaticati LM, Capuzzi E, Colmegna F, Argyrides M, Giaginis C, Mendolicchio L, Buoli M, Clerici M, Dakanalis A. The Impact of the COVID-19 Pandemic on Binge Eating Disorder: A Systematic Review. Nutrients 2023; 15:3777. [PMID: 37686811 PMCID: PMC10490470 DOI: 10.3390/nu15173777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this systematic review was to synthesise the impact of the COVID-19 pandemic on binge eating disorder (BED) the new onset and course. Inclusion criteria: original articles and BED diagnosis; and the main outcomes: relationships between the COVID-19 pandemic and the new onset/clinical changes in BED, and specific results for BED. Exclusion criteria: mixed/inaccurate diagnoses and articles not written in English. We searched four databases and one registry until 5 May 2023. The quality appraisal was conducted using the Effective Public Health Practice Project (EPHPP) tool. Twelve studies with 4326 participants were included. All studies were observational with nine cross-sectional and three longitudinal. Four of the included studies investigated new-onset BED, while eight examined the BED clinical course of patients with a previous diagnosis. With the exception of one study, the available literature indicates both an increase in BED diagnoses and a clinical worsening during COVID-19. Major limitations include study quality (weak-to-moderate) and high heterogeneity in terms of pandemic phase, population, geographical areas, and psychometric tools. Our findings indicate that BED patients are particularly vulnerable to events characterised by social distancing and over-worry, and should be, therefore, carefully monitored. Further studies are needed to corroborate our findings, implement preventive strategies, and promote personalised treatments. PROSPERO registration number: CRD42023434106.
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Affiliation(s)
- Alice Caldiroli
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Davide La Tegola
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Francesca Manzo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Alberto Scalia
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Letizia Maria Affaticati
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Enrico Capuzzi
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Fabrizia Colmegna
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
| | - Marios Argyrides
- Department of Psychology, Neapolis University Pafos, Paphos 8042, Cyprus;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece;
| | - Leonardo Mendolicchio
- Istituto Auxologico Italiano IRCCS, U.O. dei Disturbi del Comportamento Alimentare, Ospedale San Giuseppe, 28824 Piancavallo, Italy;
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy;
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - Massimo Clerici
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCSS San Gerardo dei Tintori, Via G.B. Pergolesi 33, 20900 Monza, Italy; (A.C.); (D.L.T.); (E.C.); (F.C.); (M.C.)
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 38, 20900 Monza, Italy; (F.M.); (A.S.); (L.M.A.)
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147
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Nicula M, Kimber M, Boylan K, Grant C, Laliberté M, Miller K, Dimitropoulos G, Trollope K, Webb C, Couturier J. Assessing the feasibility of an intervention for adolescents and parents transitioning out of paediatric eating disorder services: A mixed methods study. EUROPEAN EATING DISORDERS REVIEW 2023. [PMID: 37632341 DOI: 10.1002/erv.3027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/28/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE To assess the feasibility of a new intervention designed to support adolescents and parents in the transition from paediatric eating disorder (ED) treatment to adult mental health services. METHOD Pre-transition adolescents with EDs, and their parents, were invited to complete up to five transition intervention components over 3 months. A mixed methods design was used to assess intervention feasibility, comprised of acceptability and preliminary effectiveness. A single-arm pre-post design was used to collect and analyse quantitative survey and feasibility data. Individual qualitative interviews and written reflections were collected and analysed using content analysis. RESULTS This study yielded a 33% (10/31) recruitment rate and 68% (13/19) retention rate. On average, participants completed 75% of the expected components in under 3 months, with varied completion of each expected intervention component (40%-100%). Participants found the intervention convenient and helpful. Parents reported a significant decrease in guilt (Z = -2.02, p = 0.04, d = -0.83). By 1-month post-transition, three adolescents transitioned to interim supports and none started specialist adult treatment. CONCLUSIONS Although this transition intervention did not demonstrate adequate feasibility, its acceptability and effectiveness should be evaluated after an update based on participant feedback. Other solutions to bridge the transition gap for adolescents with EDs should continue to be identified. CLINICAL TRIAL REGISTRATION NUMBER NCT04888273.
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Affiliation(s)
| | | | - Khrista Boylan
- McMaster University, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Christina Grant
- McMaster University, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Michele Laliberté
- St. Joseph's Healthcare Hamilton, West 5th Campus, Hamilton, Ontario, Canada
| | - Kathryn Miller
- St. Joseph's Healthcare Hamilton, West 5th Campus, Hamilton, Ontario, Canada
| | | | | | - Cheryl Webb
- McMaster University, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Jennifer Couturier
- McMaster University, Hamilton, Ontario, Canada
- McMaster Children's Hospital, Hamilton, Ontario, Canada
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148
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Fernández-Aranda F, Granero R, Jiménez-Murcia S. Eating Disorders and Addictive Behaviors: Implications for Human Health. Nutrients 2023; 15:3718. [PMID: 37686749 PMCID: PMC10490401 DOI: 10.3390/nu15173718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
Eating disorders (EDs) are mental health diseases characterized by dysfunctional eating patterns, including restrictive eating, avoidance of foods, binge eating, and compensative behaviors to avoid weight increases and promote thinness (purging, vomiting, laxative/diuretics misuse, and compulsive exercise) [...].
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Affiliation(s)
- Fernando Fernández-Aranda
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.G.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.G.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (R.G.); (S.J.-M.)
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, 08907 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
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149
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Zhu J, Hay PJ, Yang Y, Le Grange D, Lacey JH, Lujic S, Smith C, Touyz S. Specific psychological therapies versus other therapies or no treatment for severe and enduring anorexia nervosa. Cochrane Database Syst Rev 2023; 8:CD011570. [PMID: 37610143 PMCID: PMC10445422 DOI: 10.1002/14651858.cd011570.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND Anorexia nervosa is a psychological condition characterised by self-starvation and fear or wait gain or other body image disturbance. The first line of treatment is specific psychological therapy; however, there is no consensus on best practice for treating people who develop severe and enduring anorexia nervosa (SEAN). Notably, there is no universal definition of SEAN. OBJECTIVES To evaluate the benefits and harms of specific psychological therapies for severe and enduring anorexia nervosa compared with other specific therapies, non-specific therapies, no treatment/waiting list, antidepressant medication, dietary counselling alone, or treatment as usual. SEARCH METHODS We used standard, extensive Cochrane search methods. The last search date was 22 July 2022. SELECTION CRITERIA We included parallel randomised controlled trials (RCTs) of people (any age) with anorexia nervosa of at least three years' duration. Eligible experimental interventions were any specific psychological therapy for improved physical and psychological health in anorexia nervosa, conducted in any treatment setting with no restrictions in terms of number of sessions, modality, or duration of therapy. Eligible comparator interventions included any other specific psychological therapy for anorexia nervosa, non-specific psychological therapy for mental health disorders, no treatment or waiting list, antipsychotic treatment (with or without psychological therapy), antidepressant treatment (with or without psychological therapy), dietary counselling, and treatment as usual as defined by the individual trials. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Our primary outcomes were clinical improvement (weight restoration to within the normal weight range for participant sample) and treatment non-completion. Results were presented using the GRADE appraisal tool. MAIN RESULTS We found two eligible studies, but only one study provided usable data. This was a parallel-group RCT of 63 adults with SEAN who had an illness duration of at least seven years. The trial compared outpatient cognitive behaviour therapy for SEAN (CBT-SEAN) with specialist supportive clinical management for SEAN (SSCM-SE) over eight months. It is unclear if there is any difference between the effect of CBT-SEAN versus SSCM-SE on clinical improvement at 12 months (risk ratio (RR) 1.42, 95% confidence interval (CI) 0.66 to 3.05) or treatment non-completion (RR 1.72, 95% CI 0.45 to 6.59). There were no reported data on adverse effects. The trial was at high risk of performance and detection bias. We rated the GRADE level of evidence as very low-certainty for both primary outcomes, downgrading for imprecision and risk of bias concerns. AUTHORS' CONCLUSIONS This review reports evidence from one trial that evaluated CBT-SEAN versus SSCM-SE. There was very low-certainty evidence of little or no difference in clinical improvement and treatment non-completion between the two therapies. There is a need for larger high-quality trials to determine the benefits of specific psychological therapies for people with SEAN. These should take into account the duration of illness as well as participants' previous experience with evidence-based psychological therapy for anorexia nervosa.
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Affiliation(s)
- James Zhu
- Sydney Local Health District, Sydney, NSW, Australia
| | - Phillipa J Hay
- Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
- Mental Health Services, WSLHD, Campbelltown, Australia
| | - Yive Yang
- Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | | | | | - Sanja Lujic
- Centre for Big Data Research in Health, UNSW, Sydney, Australia
| | - Caroline Smith
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Stephen Touyz
- School of Psychology and InsideOut Institute, University of Sydney, Sydney, Australia
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150
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Andrade JA, Salaroli LB, Noll PRES, Noll M, Feitosa SO, Raimundo RD, de Oliveira AG, Mendonça CR, de Abreu LC. Indicators of Eating Disorders in Sexually Abused Brazilian Adolescents: Family and School Contexts. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1393. [PMID: 37628392 PMCID: PMC10453146 DOI: 10.3390/children10081393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023]
Abstract
Eating disorders, characterized by abnormal eating behaviors, are among a wide variety of psychiatric conditions that mainly affect children and adolescents. These disorders have a multifactorial origin and can be associated with restrictive diets, negative feelings, harmful family relationships, and post-traumatic stress. Thus, this study's objective was to evaluate the association between indicators of eating disorders and family and school contexts in Brazilian adolescents who previously experienced sexual abuse and examine the findings based on sex. National School Health Survey data were utilized. Among 102,301 students between 11 and 19 years of age, 4124 reported having experienced sexual abuse and were included in this study. Self-report questionnaires were used to assess participants' health status and the presence of risk behaviors, which were examined through multivariate analysis using a Poisson regression model. The results indicated positive relationships between self-induced vomiting, laxative misuse, and other purgative methods and infrequent meals with family, hunger, and the presence of violence in students' daily lives, regardless of sex (p < 0.05). In addition, body dissatisfaction and negative feelings about one's body were associated with having been bullied or teased by schoolmates for both sexes (p < 0.05). Distant relationships with parents were associated with purgative methods and body dissatisfaction among female students (p < 0.05). In conclusion, body dissatisfaction, negative feelings about one's body, laxative misuse, self-induced vomiting, and purgative methods were found to be associated with factors in family and school contexts such as hunger, infrequent meals with family, family violence, distant relationships with parents, and bullying at school in adolescents who have previously experienced sexual abuse.
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Affiliation(s)
- Julia Altoé Andrade
- Nutrition and Health Postgraduate Program, Health Sciences Center, Federal University Espirito Santo, Vitória 29075-910, Brazil; (J.A.A.); (L.B.S.)
| | - Luciane Bresciani Salaroli
- Nutrition and Health Postgraduate Program, Health Sciences Center, Federal University Espirito Santo, Vitória 29075-910, Brazil; (J.A.A.); (L.B.S.)
| | | | - Matias Noll
- Instituto Federal Goiano, Ceres 76300-000, Brazil; (P.R.e.S.N.); (M.N.); (S.O.F.)
- Health Sciences Postgraduate Program, Medical School, Universidade Federal de Goiás, Goiânia 74605-080, Brazil;
| | | | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André 09060-590, Brazil; (R.D.R.); (A.G.d.O.)
| | - Adriana Gonçalves de Oliveira
- Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário FMABC, Santo André 09060-590, Brazil; (R.D.R.); (A.G.d.O.)
| | - Carolina Rodrigues Mendonça
- Health Sciences Postgraduate Program, Medical School, Universidade Federal de Goiás, Goiânia 74605-080, Brazil;
| | - Luiz Carlos de Abreu
- Nutrition and Health Postgraduate Program, Health Sciences Center, Federal University Espirito Santo, Vitória 29075-910, Brazil; (J.A.A.); (L.B.S.)
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