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Jarcho JM, Tanofsky-Kraff M, Nelson EE, Engel SG, Vannucci A, Field SE, Romer AL, Hannallah L, Brady SM, Demidowich AP, Shomaker LB, Courville AB, Pine DS, Yanovski JA. Neural activation during anticipated peer evaluation and laboratory meal intake in overweight girls with and without loss of control eating. Neuroimage 2015; 108:343-53. [PMID: 25550068 PMCID: PMC4323624 DOI: 10.1016/j.neuroimage.2014.12.054] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 12/15/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022] Open
Abstract
The interpersonal model of loss of control (LOC) eating proposes that socially distressing situations lead to anxious states that trigger excessive food consumption. Self-reports support these links, but the neurobiological underpinnings of these relationships remain unclear. We therefore examined brain regions associated with anxiety in relation to LOC eating and energy intake in the laboratory. Twenty-two overweight and obese (BMIz: 1.9±0.4) adolescent (15.8±1.6y) girls with LOC eating (LOC+, n=10) and without LOC eating (LOC-, n=12) underwent functional magnetic resonance imaging (fMRI) during a simulated peer interaction chatroom paradigm. Immediately after the fMRI scan, girls consumed lunch ad libitum from a 10,934-kcal laboratory buffet meal with the instruction to "let yourself go and eat as much as you want." Pre-specified hypotheses regarding activation of five regions of interest were tested. Analysis of fMRI data revealed a significant group by peer feedback interaction in the ventromedial prefrontal cortex (vmPFC), such that LOC+ had less activity following peer rejection (vs. acceptance), while LOC- had increased activity (p<.005). Moreover, functional coupling between vmPFC and striatum for peer rejection (vs. acceptance) interacted with LOC status: coupling was positive for LOC+, but negative in LOC- (p<.005). Activity of fusiform face area (FFA) during negative peer feedback from high-value peers also interacted with LOC status (p<.005). A positive association between FFA activation and intake during the meal was observed among only those with LOC eating. In conclusion, overweight and obese girls with LOC eating may be distinguished by a failure to engage regions of prefrontal cortex implicated in emotion regulation in response to social distress. The relationship between FFA activation and food intake supports the notion that heightened sensitivity to incoming interpersonal cues and perturbations in socio-emotional neural circuits may lead to overeating in order to cope with negative affect elicited by social discomfort in susceptible youth.
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Affiliation(s)
- Johanna M Jarcho
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA.
| | - Eric E Nelson
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Scott G Engel
- Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, 700 1st Ave S, Fargo, ND 58103, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Sara E Field
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Adrienne L Romer
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Louise Hannallah
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Andrew P Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Lauren B Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Amber B Courville
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
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202
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Lindenberg K, Kordy H. Wirksamkeit eines gestuften, Internetvermittelten Ansatzes zur Prävention von Essstörungen bei Schülern der 7. bis 10. Klasse. KINDHEIT UND ENTWICKLUNG 2015. [DOI: 10.1026/0942-5403/a000152] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Essstörungen sind schwerwiegende Erkrankungen, die vorwiegend Jugendliche und junge Erwachsene betreffen. Eine effektive Prävention ist dringend gewünscht. Das individuelle Risiko kann oft nur unscharf eingeschätzt werden. Daher bieten sich gestufte Strategien wie das Internet-vermittelte Programm YoungEs[s]prit an. In der hier vorgestellten prospektiven, randomisiert-kontrollierten Interventionsstudie wurde die Wirksamkeit von YoungEs[s]prit geprüft. In einem adaptiven Design wurde die Studie in zwei Wellen durchgeführt. Hauptzielkriterium war die kumulierte Inzidenzrate (nach DSM-IV Kriterien) in einem 12-Monatszeitraum. Die statistische Prüfung erfolgte mit Hilfe survival-analytischer Methoden. In der 1.Welle (n=896) zeigte sich die präventive Wirksamkeit von YoungEs[s]prit (Log Rank χ2=4,29, df=1, p=0,038, 2-seitig) mit einem hazard ratio von 1,67. Die kumulierte Inzidenzrate der aktiven Kontrollgruppe lag bei 9,6 % verglichen mit 5,9 % in der YoungEs[s]prit Gruppe. In der 2.Welle (n=771) konnten keine Unterschiede zwischen den Gruppen gefunden werden (4,8 % vs. 5,6 %, Logrank χ2=0,27, df=1, p=0,600, 2-seitig). In der Gesamtbewertung wurde der Nachweis für die Wirksamkeit daher nicht erbracht (p1*p2=0,0228 >cα=0,0087). Während die Rate der 1. Welle mit 9,6 % der in der Literatur berichteten Größenordnung von etwa 10 % entsprach, lag die Rate in der 2. Welle mit 4,8 % ungewöhnlich niedrig. Daher wurde exploriert, inwieweit (1) die unterschiedliche Zusammensetzung der Stichproben, z. B. der größere Anteil von Mädchen in der 2. Welle, (2) die größere Nähe zu Einrichtungen der Versorgung in der 2. Welle oder (3) die gestiegene Aufmerksamkeit für Essstörungen durch die 1. Untersuchungswelle zu dieser niedrigen kumulierten Inzidenzrate beigetragen haben könnten.
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Affiliation(s)
| | - Hans Kordy
- Forschungsstelle für Psychotherapie, Universitätsklinikum Heidelberg
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203
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Solmi F, Sonneville KR, Easter A, Horton NJ, Crosby RD, Treasure J, Rodriguez A, Jarvelin MR, Field AE, Micali N. Prevalence of purging at age 16 and associations with negative outcomes among girls in three community-based cohorts. J Child Psychol Psychiatry 2015; 56:87-96. [PMID: 24975817 PMCID: PMC4303957 DOI: 10.1111/jcpp.12283] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The comorbidity of purging behaviours, such as vomiting, inappropriate use of laxatives, diuretics or slimming medications, has been examined in literature. However, most studies do not include adolescents, individuals who purge in the absence of binge eating, or those purging at subclinical frequency. This study examines the prevalence of purging among 16-year-old girls across three countries and their association with substance use and psychological comorbidity. METHODS Data were obtained by questionnaire in 3 population-based cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), United Kingdom, n = 1,608; Growing Up Today Study (GUTS), USA, n = 3,504; North Finland Birth Cohort (NFBC85/86), Finland, n = 2,306). Multivariate logistic regressions were employed to estimate associations between purging and outcomes. Four models were fit adjusting for binge eating and potential confounders of these associations. RESULTS In ALSPAC, 9.7% of girls reported purging in the 12-months prior to assessment, 7.3% in GUTS, and 3.5% in NFBC. In all 3 cohorts, purging was associated with adverse outcomes such as binge drinking (ALSPAC: odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4-2.9; GUTS: OR = 2.5, 95% CI = 1.5-4.0; NFBC: OR = 1.7, 95% CI = 1.0-2.8), drug use (ALSPAC: OR = 2.9, 95% CI = 1.8-4.7; GUTS: OR = 4.5, 95% CI = 2.8-7.3; NFBC: OR = 4.1, 95% CI = 2.6-6.6), depressive symptoms in ALSPAC (OR = 2.2, 95% CI = 1.5-3.1) and GUTS(OR = 3.7, 95% CI = 2.2-6.3), and several psychopathology measures including clinical anxiety/depression in NFBC (OR = 11.2, 95% CI = 3.9, 31.7). CONCLUSIONS Results show a higher prevalence of purging behaviours among girls in the United Kingdom compared to those in the United States and Finland. Our findings support evidence highlighting that purging in adolescence is associated with negative outcomes, independent of its frequency and binge eating.
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Affiliation(s)
- Francesca Solmi
- Behavioural & Brain Sciences Unit, Institute of Child Health, University College LondonLondon, UK
| | - Kendrin R Sonneville
- Division of Adolescence Medicine, Boston's Children Hospital, Harvard Medical SchoolBoston, MA, USA
| | - Abigail Easter
- Behavioural & Brain Sciences Unit, Institute of Child Health, University College LondonLondon, UK
| | - Nicholas J Horton
- Department of Mathematics & Statistics, Amherst CollegeAmherst, MA, USA
| | - Ross D Crosby
- Department of Neuroscience, Neuropsychiatric Research Institute, University of North DakotaFargo, ND, USA
| | - Janet Treasure
- Eating Disorder Unit, Institute of Psychiatry, King's College LondonLondon, UK
| | - Alina Rodriguez
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College LondonLondon, UK,Mid Sweden University, Department of Psychology, Campus ÖstersundÖstersund, Sweden
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College LondonLondon, UK,Institute of Health Sciences, University of OuluOulu, Finland,Biocenter Oulu, University of OuluOulu, Finland,Unit of Primary Care, Oulu University Hospital, OYSOulu, Finland,Department of Children and Young People and Families, National Institute for Health and WelfareOulu, Finland
| | - Alison E Field
- Division of Adolescence Medicine, Boston's Children Hospital, Harvard Medical SchoolBoston, MA, USA
| | - Nadia Micali
- Behavioural & Brain Sciences Unit, Institute of Child Health, University College LondonLondon, UK
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204
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Turner BJ, Yiu A, Layden BK, Claes L, Zaitsoff S, Chapman AL. Temporal associations between disordered eating and nonsuicidal self-injury: examining symptom overlap over 1 year. Behav Ther 2015; 46:125-38. [PMID: 25526840 DOI: 10.1016/j.beth.2014.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 08/08/2014] [Accepted: 09/05/2014] [Indexed: 10/24/2022]
Abstract
Disordered eating (DE) and nonsuicidal self-injury (NSSI) commonly co-occur. This study compared several models of the longitudinal relationship between DE and NSSI, including concurrent and prospective models, and examined the possible moderating roles of self-objectification, impulsivity, and emotion dysregulation in these relationships. Individuals with NSSI (N=197) recruited from online forums completed measures of NSSI and DE every 3 months for 1 year. We tested the associations between NSSI and DE using hierarchical linear models. Results supported a concurrent relationship, wherein frequency of NSSI positively covaried with concurrent DE severity. Body surveillance moderated the concurrent relationship between NSSI and DE. Individuals who engaged in more body surveillance endorsed high levels of DE pathology, whereas those lower in body surveillance engaged in more frequent NSSI only at higher levels of DE. In addition, whereas DE did not prospectively predict NSSI, frequency of NSSI predicted more severe DE 3 months later. The prospective relationship between DE and later NSSI was moderated by emotion dysregulation, such that highly dysregulated individuals had a stronger relationship between DE and later NSSI, whereas this relationship was not significant among individuals low in emotion dysregulation. These findings add valuable information regarding the co-occurrence of self-damaging behaviors.
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205
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Flament MF, Buchholz A, Henderson K, Obeid N, Maras D, Schubert N, Paterniti S, Goldfield G. Comparative distribution and validity of DSM-IV and DSM-5 diagnoses of eating disorders in adolescents from the community. EUROPEAN EATING DISORDERS REVIEW 2014; 23:100-10. [PMID: 25524758 DOI: 10.1002/erv.2339] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 11/20/2014] [Accepted: 11/22/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVES DSM-5 changes for eating disorders (EDs) aimed to reduce preponderance of non-specified cases and increase validity of specific diagnoses. The objectives were to estimate the combined effect of changes on prevalence of EDs in adolescents and examine validity of diagnostic groupings. METHOD A total of 3043 adolescents (1254 boys and 1789 girls, Mage = 14.19 years, SD = 1.61) completed self-report questionnaires including the Eating Disorder Diagnostic Scale. RESULTS Prevalence of full-threshold EDs increased from 1.8% (DSM-IV) to 3.7% (DSM-5), with a higher prevalence of bulimia nervosa (1.6%) and the addition of the diagnosis of purging disorder (1.4%); prevalence of binge eating disorder was unchanged (0.5%), and non-specified cases decreased from 5.1% (DSM-IV) to 3.4% (DSM-5). Validation analyses demonstrated that DSM-5 ED subgroups better captured variance in psychopathology than DSM-IV subgroups. DISCUSSION Findings extend results from previous prevalence and validation studies into the adolescent age range. Improved diagnostic categories should facilitate identification of EDs and indicate targeted treatments.
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Affiliation(s)
- Martine F Flament
- University of Ottawa Institute of Mental Health Research, Ottawa, Canada
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206
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Hilbert A, Pike KM, Goldschmidt AB, Wilfley DE, Fairburn CG, Dohm FA, Walsh BT, Striegel Weissman R. Risk factors across the eating disorders. Psychiatry Res 2014; 220:500-6. [PMID: 25103674 PMCID: PMC4785871 DOI: 10.1016/j.psychres.2014.05.054] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 02/21/2014] [Accepted: 05/28/2014] [Indexed: 11/23/2022]
Abstract
This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, 04103 Leipzig, Germany.
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Andrea B Goldschmidt
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Faith-Anne Dohm
- Graduate School of Education & Allied Professions, Fairfield University, Fairfield, CT, USA
| | - B Timothy Walsh
- Department of Psychiatry, Columbia University, New York, NY, USA
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207
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Aspen V, Weisman H, Vannucci A, Nafiz N, Gredysa D, Kass A, Trockel M, Wilfley DE, Taylor CB. Psychiatric co-morbidity in women presenting across the continuum of disordered eating. Eat Behav 2014; 15:686-93. [PMID: 25462028 PMCID: PMC4303490 DOI: 10.1016/j.eatbeh.2014.08.023] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/13/2014] [Accepted: 08/21/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the prevalence and correlates of psychiatric co-morbidity across a large sample of college women without an eating disorder, those at high risk for an eating disorder and women diagnosed using DSM-5 criteria for an eating disorder. PARTICIPANTS 549 college women aged 18-25. METHODS Data from the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV Axis I disorders and self-report questionnaires were analyzed using logistic regression for categorical data and ANCOVA for continuous measures. RESULTS Eating disordered symptomatology was strongly associated with anxiety disorders, mood disorders and insomnia. These co-morbidities (type and severity) tend to increase with eating disorder symptom severity. CONCLUSIONS Prevention and treatment programs for eating disorders need to address the high levels of mood, anxiety and sleep problems in this population. The findings on insomnia are novel and suggest that sleep disturbance may play an integral role in eating-related difficulties.
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Affiliation(s)
- Vandana Aspen
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA USA
| | - Hannah Weisman
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Najia Nafiz
- Department of Psychology, California State University, Sacramento, CA USA
| | - Dana Gredysa
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Andrea Kass
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Mickey Trockel
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - C. Barr Taylor
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA USA
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208
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Perry RM, Hayaki J. Gender differences in the role of alexithymia and emotional expressivity in disordered eating. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2014.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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209
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Stice E, Marti CN, Rohde P, Shaw H. Young woman smokers gain significantly more weight over 2-year follow-up than non-smokers. How Virginia doesn't slim. Appetite 2014; 85:155-9. [PMID: 25433235 DOI: 10.1016/j.appet.2014.11.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/17/2014] [Accepted: 11/23/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Although young women often report smoking for weight control purposes, no prospective study has tested whether smokers subsequently gain less weight over time than non-smokers. As this is an important lacuna because smoking results in greater mortality than obesity, the present study addresses this question. METHOD Female college students (N = 398; M age = 18.4, SD =0.6; M BMI = 23.7, SD =4.3) recruited for a body acceptance intervention trial provided data on smoking behavior and had their body mass measured at baseline and at 1-mo, 6-mo, 1-yr, and 2-yr follow-ups. RESULTS Counter to the belief that smoking is an effective weight control strategy, baseline smokers (n = 29) gained significantly more weight (r = .29) than baseline non-smokers (n = 304), controlling for baseline BMI, parental obesity status, socio-economic status, and intervention condition; over 2-yr follow-up smokers gained 2.9 kg versus 0.9 kg for non-smokers. Descriptive data indicated that weight gain was greater for young women who quit smoking during follow-up (n = 13; M = 4.8 kg) than for persistent smokers (n = 16; M = 1.4 kg), though both groups gained more weight than non-smokers. CONCLUSIONS RESULTS challenge the widely held belief that smoking is an effective weight control strategy, ironically suggesting that smokers gain more weight than non-smokers during young adulthood, though non-experimental prospective studies do not establish causal relations and future research with larger representative samples is needed.
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Affiliation(s)
- Eric Stice
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon 97403, United States.
| | - C Nathan Marti
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon 97403, United States
| | - Paul Rohde
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon 97403, United States
| | - Heather Shaw
- Oregon Research Institute, 1776 Millrace Drive, Eugene, Oregon 97403, United States
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210
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Le Grange D, O'Connor M, Hughes EK, Macdonald J, Little K, Olsson CA. Developmental antecedents of abnormal eating attitudes and behaviors in adolescence. Int J Eat Disord 2014; 47:813-24. [PMID: 25046731 DOI: 10.1002/eat.22331] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study capitalizes on developmental data from an Australian population-based birth cohort to identify developmental markers of abnormal eating attitudes and behaviors in adolescence. The aims were twofold: (1) to develop a comprehensive path model identifying infant and childhood developmental correlates of Abnormal Eating Attitudes and Behaviors in adolescence, and (2) to explore potential gender differences. METHOD Data were drawn from a 30-year longitudinal study that has followed the health and development of a population based cohort across 15 waves of data collection from infancy since 1983: The Australian Temperament Project. Participants in this analysis were the 1,300 youth who completed the 11th survey at 15-16 years (1998) and who completed the eating disorder inventory at this time point. RESULTS Developmental correlates of Abnormal Eating Attitudes and Behaviors in mid-adolescence were temperamental persistence, early gestational age, persistent high weight, teen depression, stronger peer relationships, maternal dieting behavior, and pubertal timing. Overall, these factors accounted for 28% of the variance in Abnormal Eating Attitudes and Behaviors at 15-16 years of age. Depressive symptoms, maternal dieting behavior, and early puberty were more important factors for girls. Late puberty was a more important factor for boys. DISCUSSION Findings address an important gap in our understanding of the etiology of Abnormal Eating Attitudes and Behaviors in adolescence and suggest multiple targets for preventive intervention.
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Affiliation(s)
- Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
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211
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Vannucci A, Tanofsky-Kraff M, Ranzenhofer LM, Kelly NR, Hannallah LM, Pickworth CK, Grygorenko MV, Brady SM, Condarco TA, Kozlosky M, Demidowich AP, Yanovski SZ, Shomaker LB, Yanovski JA. Puberty and the manifestations of loss of control eating in children and adolescents. Int J Eat Disord 2014; 47:738-47. [PMID: 24888295 PMCID: PMC4211942 DOI: 10.1002/eat.22305] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/11/2014] [Accepted: 05/15/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We investigated the manifestations of pediatric loss of control (LOC) eating at different stages of pubertal development. METHOD Participants were a nonclinical sample of 468 youth (8-17 years). Physical examination determined pubertal stage. LOC eating and disordered eating attitudes were assessed with the Eating Disorder Examination. In a randomized crossover design, a subset (n = 244) ate ad libitum from two test meals designed to capture normal and LOC eating. RESULTS There were no differences in the prevalence rates or frequency of reported LOC eating episodes across pubertal stages (ps ≥ 0.50). There were, however, puberty by LOC eating interactions in disordered eating attitudes and palatable food consumption (ps ≤ .05), even after adjusting for age and body composition. LOC eating was associated with elevated global disordered eating attitudes, weight concern, and shape concern in post-pubertal youth (ps ≤ .001), but not pre-pubertal youth (ps ≥ .49). In late-puberty, youth with LOC eating consumed less energy from protein (p < .001) and more from carbohydrate (p = .003) and snack-type foods (p = .02) than those without LOC eating, whereas endorsement of LOC eating in pre- or early-to-mid-puberty was not associated with differences in eating behavior (ps ≥ 0.20). CONCLUSIONS Findings suggest that puberty may be a critical risk period, when LOC eating behaviors in boys and girls may become accompanied by greater weight and shape concerns and more obesogenic food consumption patterns. Interventions for LOC eating during pre-puberty should be evaluated to determine if they are particularly beneficial for the prevention of exacerbated eating disorder psychopathology and adverse weight outcomes.
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Affiliation(s)
- Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Lisa M. Ranzenhofer
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Nichole R. Kelly
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Louise M. Hannallah
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - C. Katherine Pickworth
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Mariya V. Grygorenko
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Tania A. Condarco
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Lauren B. Shomaker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20814, USA
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Stachowitz AL, Choi HS, Schweinle A. THE USE OF THE BASC-2 FOR THE IDENTIFICATION OF FEMALE ADOLESCENTS AT RISK FOR DEVELOPING AN EATING DISORDER. PSYCHOLOGY IN THE SCHOOLS 2014. [DOI: 10.1002/pits.21804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Norman K, Sodano SM, Cook-Cottone C. An Exploratory Analysis of the Role of Interpersonal Styles in Eating Disorder Prevention Outcomes. JOURNAL FOR SPECIALISTS IN GROUP WORK 2014. [DOI: 10.1080/01933922.2014.948234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rosenvinge JH, Pettersen G. Epidemiology of eating disorders part II: an update with a special reference to the DSM-5. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/21662630.2014.940549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Witcomb GL, Arcelus J, Chen J. Can cognitive dissonance methods developed in the West for combatting the 'thin ideal' help slow the rapidly increasing prevalence of eating disorders in non-Western cultures? SHANGHAI ARCHIVES OF PSYCHIATRY 2014; 25:332-40. [PMID: 24991176 PMCID: PMC4054580 DOI: 10.3969/j.issn.1002-0829.2013.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/18/2013] [Indexed: 11/18/2022]
Abstract
SUMMARY Eating disorders are common, life-threatening conditions in Western countries, but until relatively recently they were regarded as uncommon in non-Western cultures. However, the prevalence of eating disorders in many of the more affluent non-Western countries is rising rapidly as community members, particularly young women, internalize the 'thin ideal' that has been widely promoted by the international media. This review discusses the factors involved in the development of eating disorders in non-Western settings with a particular emphasis on the influences of urbanization, modernization, Westernization, and the resulting changes in women's roles. The cognitive dissonance programs developed in Western countries that have proven successful in countering the negative effects of the thin idea are described and their potential application to East Asia and other non-Western countries are discussed.
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Affiliation(s)
- Gemma L Witcomb
- Loughborough University Centre for Research into Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK ; Leicester Eating Disorder Service, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK
| | - Jon Arcelus
- Loughborough University Centre for Research into Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK ; Leicester Eating Disorder Service, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK ; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PRC
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PRC
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Ciao AC, Loth K, Neumark-Sztainer D. Preventing eating disorder pathology: common and unique features of successful eating disorders prevention programs. Curr Psychiatry Rep 2014; 16:453. [PMID: 24821099 PMCID: PMC4104660 DOI: 10.1007/s11920-014-0453-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors' descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research.
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Affiliation(s)
- Anna C. Ciao
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Katie Loth
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Jordan J, McIntosh VVW, Carter JD, Rowe S, Taylor K, Frampton CMA, McKenzie JM, Latner J, Joyce PR. Bulimia nervosa-nonpurging subtype: closer to the bulimia nervosa-purging subtype or to binge eating disorder? Int J Eat Disord 2014; 47:231-8. [PMID: 24282157 DOI: 10.1002/eat.22218] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 09/30/2013] [Accepted: 10/05/2013] [Indexed: 11/05/2022]
Abstract
OBJECTIVE DSM-5 has dropped subtyping of bulimia nervosa (BN), opting to continue inclusion of the somewhat contentious diagnosis of BN-nonpurging subtype (BN-NP) within a broad BN category. Some contend however that BN-NP is more like binge eating disorder (BED) than BN-P. This study examines clinical characteristics, eating disorder symptomatology, and Axis I comorbidity in BN-NP, BN-P, and BED groups to establish whether BN-NP more closely resembles BN-P or BED. METHOD Women with BN-P (n = 29), BN-NP (n = 29), and BED (n = 54) were assessed at baseline in an outpatient psychotherapy trial for those with binge eating. Measures included the Structured Clinical Interviews for DSM-IV, Eating Disorder Examination, and Eating Disorder Inventory-2. RESULTS The BN-NP subtype had BMIs between those with BN-P and BED. Both BN subtypes had higher Restraint and Drive for Thinness scores than BED. Body Dissatisfaction was highest in BN-NP and predicted BN-NP compared to BN-P. Higher Restraint and lower BMI predicted BN-NP relative to BED. BN-NP resembled BED with higher lifetime BMIs; and weight-loss clinic than eating disorder clinic attendances relative to the BN-P subtype. Psychiatric comorbidity was comparable except for higher lifetime cannabis use disorder in the BN-NP than BN-P subtype DISCUSSION These results suggest that BN-NP sits between BN-P and BED however the high distress driving inappropriate compensatory behaviors in BN-P requires specialist eating disorder treatment. These results support retaining the BN-NP group within the BN category. Further research is needed to determine whether there are meaningful differences in outcome over follow-up.
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Affiliation(s)
- Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Canterbury District Health Board, Christchurch, New Zealand
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Bomba M, Corbetta F, Bonini L, Gambera A, Tremolizzo L, Neri F, Nacinovich R. Psychopathological traits of adolescents with functional hypothalamic amenorrhea: a comparison with anorexia nervosa. Eat Weight Disord 2014; 19:41-8. [PMID: 23912931 DOI: 10.1007/s40519-013-0056-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 07/23/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Functional hypothalamic amenorrhea (FHA) is a form of anovulation, due to the suppression of hypothalamic-pituitary-ovarian axis, not related to identifiable organic causes. Like adolescents with anorexia nervosa (AN), subjects with FHA show dysfunctional attitudes, low self-esteem, depressive mood, anxiety and inability to cope with daily stress. The aim of the study is to examine similarities and differences between FHA and AN in terms of clinical profiles and psychological variables. METHODS 21 adolescents with FHA, 21 adolescents with anorexia nervosa, and 21 healthy adolescents were included in the study. All the teenagers completed a battery of self-administered psychological tests for the detection of behaviors and symptoms attributable to the presence of an eating disorder (EDI-2), depression (CDI), and alexithymia (TAS-20). RESULTS Different from healthy controls, subjects with FHA and with AN shared common psychopathological aspects, such as maturity issues, social insecurity and introversion, a tendency to depression, excessive concerns with dieting, and fear of gaining weight. Nevertheless, adolescents with AN presented a more profound psychopathological disorder as observed at test comparisons with subjects with FHA. CONCLUSIONS Results show a clinical spectrum that includes AN and FHA and suggest the necessity to treat FHA with a multidisciplinary approach for both organic and psychological aspects.
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Affiliation(s)
- Monica Bomba
- Clinic of Child and Adolescent Mental Health, Ospedale San Gerardo di Monza, University of Milan Bicocca, Via Pergolesi, 33, 20900, Monza (MB), Italy,
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Collins B, Fischer S, Stojek M, Becker K. The relationship of thought suppression and recent rape to disordered eating in emerging adulthood. J Adolesc 2014; 37:113-21. [DOI: 10.1016/j.adolescence.2013.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 10/29/2013] [Accepted: 11/08/2013] [Indexed: 11/29/2022]
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Litwack SD, Mitchell KS, Sloan DM, Reardon AF, Miller MW. Eating disorder symptoms and comorbid psychopathology among male and female veterans. Gen Hosp Psychiatry 2014; 36:406-10. [PMID: 24815590 PMCID: PMC4287387 DOI: 10.1016/j.genhosppsych.2014.03.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 03/13/2014] [Accepted: 03/19/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Eating disorder (ED) symptoms have gone mostly unexamined among veterans. The current study assessed rates of bulimia nervosa (BN) and binge eating disorder (BED) symptoms and diagnoses and their associations with common comorbidities among male and female veterans. METHOD Participants were US military veterans who screened positive for trauma histories and/or a probable Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) posttraumatic stress disorder (PTSD) diagnosis (n=499). Symptoms of PTSD were assessed using the Clinician-Administered PTSD Scale, and symptoms of EDs, mood, and substance use disorders were assessed using the Structured Clinical Interview for the DSM-IV. RESULTS Lifetime rates of BN and BED diagnoses were comparable to civilian populations, and a considerable range of lifetime and current BN and BED symptoms were identified. In multivariate models, PTSD and depression severity were most consistently associated with BN and BED symptom severity, with depression most strongly associated with EDs for women. CONCLUSIONS Findings highlight the importance of screening for ED symptoms among male and female veterans, particularly those that present with PTSD and depression symptomatology. Future examinations of the temporal order of such relationships and the degree to which ED symptoms and associated symptoms impact veteran functioning are warranted.
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Affiliation(s)
| | - Karen S. Mitchell
- VA Boston Healthcare System,VA National Center for PTSD,Department of Psychiatry, Boston University School of Medicine
| | - Denise M. Sloan
- VA Boston Healthcare System,VA National Center for PTSD,Department of Psychiatry, Boston University School of Medicine
| | | | - Mark W. Miller
- VA Boston Healthcare System,VA National Center for PTSD,Department of Psychiatry, Boston University School of Medicine
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Stephen EM, Rose J, Kenney L, Rosselli-Navarra F, Weissman RS. Adolescent risk factors for purging in young women: findings from the national longitudinal study of adolescent health. J Eat Disord 2014; 2:1. [PMID: 24999424 PMCID: PMC4081801 DOI: 10.1186/2050-2974-2-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 12/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There exists a dearth of prospective adolescent eating disorder studies with samples that are large enough to detect small or medium sized effects for risk factors, that are generalizable to the broader population, and that follow adolescents long enough to fully capture the period of development when the risk of eating disorder symptoms occurring is highest. As a result, the purpose of this study was to examine psychosocial risk factors for purging for weight control in a nationally representative sample of adolescents. Data were extracted from the restricted-use data sets of the National Longitudinal Study of Adolescent Health (Waves I-III), selecting females with valid demographic and purging information (N = 5,670). RESULTS The prevalence of purging was 0.88% at Wave II and 0.56% at Wave III. In multivariable multinomial logistic regressions, purging at Wave II was predicted by parental poverty and low levels of self-esteem at Wave I; purging at Wave III was predicted by body mass index and the frequency of delinquent behaviors at Wave I. CONCLUSIONS Individuals with high body mass index, individuals with low self-esteem, and individuals in families experiencing economic hardship appear specifically at risk for the development of purging behaviors in later years and may benefit from more targeted prevention efforts.
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Affiliation(s)
- Eric M Stephen
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459, USA
| | - Jennifer Rose
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459, USA
| | - Lindsay Kenney
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459, USA
| | | | - Ruth Striegel Weissman
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06459, USA
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Health-related quality of life among adolescents with eating disorders. J Psychosom Res 2014; 76:1-5. [PMID: 24360133 DOI: 10.1016/j.jpsychores.2013.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/05/2013] [Accepted: 11/08/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Health-related quality of life (HRQoL) is an emerging area of research in eating disorders (EDs) that has not been examined in adolescents in detail. The aim of the current study is to investigate HRQoL in an adolescent ED sample, examining the impact of ED symptoms on HRQoL. METHODS Sixty-seven treatment-seeking adolescents (57 females) with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) completed self-report measures of HRQoL and ED symptoms. RESULTS Participants reported poorer HRQoL in mental health domains than in physical health domains. Disordered attitudes, binge eating, and compensatory behaviors were associated with poorer mental health HRQoL, and body dissatisfaction was associated with poorer physical health HRQoL. CONCLUSION The current study assessed HRQoL among adolescents with EDs, finding several consistencies with the literature on adults with EDs. Future research should compare adolescents and adults with EDs on HRQoL.
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ter Huurne ED, Postel MG, de Haan HA, DeJong CAJ. Effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified: study protocol of a randomized controlled trial. BMC Psychiatry 2013; 13:310. [PMID: 24238630 PMCID: PMC3840645 DOI: 10.1186/1471-244x-13-310] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 11/11/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Disordered eating behavior and body dissatisfaction affect a large proportion of the Dutch population and account for severe psychological, physical and social morbidity. Yet, the threshold for seeking professional care is still high. In the Netherlands, only 7.5% of patients with bulimia nervosa and 33% of patients with anorexia nervosa are treated within the mental health care system. Easily accessible and low-threshold interventions, therefore, are needed urgently. The internet has great potential to offer such interventions. The aim of this study is to determine whether a web-based treatment program for patients with eating disorders can improve eating disorder psychopathology among female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. METHODS/DESIGN This randomized controlled trial will compare the outcomes of an experimental treatment group to a waiting list control group. In the web-based treatment program, participants will communicate personally and asynchronously with their therapists exclusively via the internet. The first part of the program will focus on analyzing eating attitudes and behaviors. In the second part of the program participants will learn how to change their attitudes and behaviors. Participants assigned to the waiting list control group will receive no-reply email messages once every two weeks during the waiting period of 15 weeks, after which they can start the program. The primary outcome measure is an improvement in eating disorder psychopathology as determined by the Eating Disorder Examination Questionnaire. Secondary outcomes include improvements in body image, physical and mental health, body weight, self-esteem, quality of life, and social contacts. In addition, the participants' motivation for treatment and their acceptability of the program and the therapeutic alliance will be measured. The study will follow the recommendations in the CONSORT statement relating to designing and reporting on RCTs. DISCUSSION This study protocol presents the design of a RCT for evaluating the effectiveness of a web-based treatment program using intensive therapeutic support for female patients with bulimia nervosa, binge eating disorder and eating disorders not otherwise specified. TRIAL REGISTRATION The protocol for this study is registered with the Netherlands Trial Registry NTR2415.
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Affiliation(s)
- Elke D ter Huurne
- Tactus Addiction Treatment, Institutenweg1, P,O, Box 154, Enschede, PH, 7521, The Netherlands.
| | - Marloes G Postel
- Tactus Addiction Treatment, Institutenweg1, P.O. Box 154, Enschede, PH, 7521, The Netherlands,Department of Psychology Health & Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Hein A de Haan
- Tactus Addiction Treatment, Institutenweg1, P.O. Box 154, Enschede, PH, 7521, The Netherlands,Nijmegen Institute for Scientist Practitioners in Addiction, Toernooiveld 5, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands
| | - Cor AJ DeJong
- Nijmegen Institute for Scientist Practitioners in Addiction, Toernooiveld 5, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands,Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
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Jackson T, Chen H. Risk Factors for Disordered Eating During Early and Middle Adolescence: A Two Year Longitudinal Study of Mainland Chinese Boys and Girls. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 42:791-802. [DOI: 10.1007/s10802-013-9823-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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De Pasquale C, Pistorio ML, Tornatore E, De Berardis D, Fornaro M. The relationship between drive to thinness, conscientiousness and bulimic traits during adolescence: a comparison between younger and older cases in 608 healthy volunteers. Ann Gen Psychiatry 2013; 12:34. [PMID: 24176173 PMCID: PMC3816099 DOI: 10.1186/1744-859x-12-34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 10/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence represents one of the critical transitions in the life span and is characterized by a tremendous pace in growth and change that is second only to that of infancy. Both biological and psychological changes occurring during early adolescence may also influence the definition of subsequent late adolescence or early adulthood physiological or (psycho)-pathological features, including bulimia nervosa (BN) whenever occurring. Therefore, a pre-emptive assessment of suggestive psychological traits, including bulimic ones, during early and late years of adolescence, is recommended and represents the goal of the present study. METHODS Six hundred and eight healthy volunteers attending mid- or high school, aged 14-19 years, were consecutively enrolled at multiple sites in Eastern Sicily, Italy. A systematic psychological assessment was performed, including McCrae and Costa' BigFive, the Eating Disorders Inventory (EDI), Bisantis's Assertivity test and the Liebowitz Social Anxiety Scale for Children and Adolescents. Demographic and general characteristics, including the body mass index, were also recorded. Based on hierarchical considerations, cases were then divided into 'younger' ('early' years, 14-16) and 'older' ('late' years, 17-19) adolescents. RESULTS Upon descriptive and Pearson's correlation analyses, the following EDI constructs 'drive to thinness' and 'bulimia' scored significantly higher (both p = <.001) in 'early' vs. 'late' cases. Conversely, BigFive 'conscientiousness' was higher in older subjects vs. early cases (p = <.003). As expected, 'drive to thinness' positively correlated with BN both in early (r = .31) and late (r = .50) cases. In the 'late' group, age correlated with conscientiousness (r = .206) while BN correlated with drive to thinness (r = .505); finally, a negative correlation was observed with regard to consciousness and BN (r = -.19). CONCLUSIONS Despite intrinsic methodological limits, our preliminary findings confirm that the transition between early and late years of adolescence is a critical phase of life span, with the consolidation of 'conscientiousness' eventually playing a protective role towards the onset of bulimic traits. If confirmed by replication studies, ideally providing long-term follow-ups too, an early acknowledgement of bulimic traits may play a major predictive role for subsequent BN, ultimately contributing to more effective pre-emptive interventions as well.
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Affiliation(s)
| | | | | | | | - Michele Fornaro
- Department of Education Science, University of Catania, Catania 95125, Italy.
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Tseng MCM, Fang D, Chang CH, Lee MB. Identifying high-school dance students who will develop an eating disorder: a 1-year prospective study. Psychiatry Res 2013; 209:611-8. [PMID: 23664298 DOI: 10.1016/j.psychres.2013.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 12/24/2012] [Accepted: 04/09/2013] [Indexed: 10/26/2022]
Abstract
This study examined the changes in eating disorder (ED) status over 1 year and identified risk factors for EDs among female dance students. In 2003, all students enrolled in each of the nation's 12 high schools with gifted dance programs participated in a two-phase survey. The same participants were invited to take part in a follow-up survey 1 year later. In all, 583 persons completed the phase 1 questionnaire survey, and 245 persons completed interviews twice at baseline and follow-up. Thirty-five females had a newly developed ED, and less than half of the ED cases found at baseline had recovered at follow-up. Being a grade 12 student carried a reduced risk of EDs, whereas higher baseline scores on the Bulimic Investigatory Test Edinburgh (BITE) increased risks of developing an ED after 1 year. A 10-item BITE questionnaire validly identified girl dance students who would develop EDs later in high school. EDs were more commonly developed during middle adolescence, and we suggest that prevention work against EDs begin in this period among the dance student population. The brief screening questionnaire might help detect intervention targets of a prevention program among adolescent dance students.
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Affiliation(s)
- Mei-Chih Meg Tseng
- Department of Psychiatry, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei 10002, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei 10055, Taiwan; Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei 10051, Taiwan.
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Sánchez-Carracedo D, López-Guimerà G, Fauquet J, Barrada JR, Pàmias M, Puntí J, Querol M, Trepat E. A school-based program implemented by community providers previously trained for the prevention of eating and weight-related problems in secondary-school adolescents: the MABIC study protocol. BMC Public Health 2013; 13:955. [PMID: 24118981 PMCID: PMC3852520 DOI: 10.1186/1471-2458-13-955] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 09/30/2013] [Indexed: 11/16/2022] Open
Abstract
Background The prevention of eating disorders and disordered eating are increasingly recognized as public health priorities. Challenges in this field included moving from efficacy to effectiveness and developing an integrated approach to the prevention of a broad spectrum of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. The main aim of this effectiveness trial protocol is to test whether this program has effects when incorporating an integrated approach to prevention and when previously-trained community providers implement the intervention. Methods/design The research design involved a multi-center non-randomized controlled trial with baseline, post and 1-year follow-up measures. Six schools from the city of Sabadell (close to Barcelona) participated in the intervention group, and eleven schools from four towns neighboring Sabadell participated in the control group. A total of 174 girls and 180 boys in the intervention group, and 484 girls and 490 boys in the control group were registered in class lists prior to baseline. A total of 18 community providers, secondary-school class tutors, nurses from the Catalan Government’s Health and School Program, and health promotion technicians from Sabadell City Council were trained and delivered the program. Shared risk factors of eating and weight-related problems were assessed as main measures. Discussion It will be vital for progress in disordered eating prevention to conduct effectiveness trials, which test whether interventions are effective when delivered by community providers under ecologically valid conditions, as opposed to tightly controlled research trials. The MABIC project will provide new contributions in this transition from efficacy to effectiveness and new data about progress in the integrated approach to prevention. Pending the results, the effectiveness trial meets the effectiveness standards set down by the Society for Prevention Research. This study will provide new evidence to improve and enhance disordered eating prevention programs. Trial registration Current Controlled Trials ISRCTN47682626
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Affiliation(s)
- David Sánchez-Carracedo
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès) Barcelona, Spain.
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Peer similarity and influence for weight-related outcomes in adolescence: a meta-analytic review. Clin Psychol Rev 2013; 33:1218-36. [PMID: 24252520 DOI: 10.1016/j.cpr.2013.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 09/16/2013] [Accepted: 09/19/2013] [Indexed: 11/22/2022]
Abstract
Weight-related problems, including obesity and disordered eating, have emerged as major public health concerns for adolescents. To address these deviations from healthy eating and weight regulation, prevention and intervention efforts have targeted the influence of peers. Yet, evidence that peers influence weight-related outcomes, often inferred from similarity among peers, is inconsistent. This meta-analytic review evaluated peer similarity and influence not only for body size and symptoms of disordered eating, but also for key determinants of obesity (food intake and physical activity levels) and eating pathology (body dissatisfaction and weight control strategies). For each of the six outcomes, data was summarized from 9 to 24 independent studies. Results revealed significant, non-trivial similarity among peers across outcome variables, with the exception of disordered eating. Findings indicated that resemblances among peers were unlikely to be solely the reflection of cognitive biases or the selection of alike friends, but may be partially due to influence. To better understand the influence of peers, further longitudinal research is needed, particularly focusing on the factors that moderate susceptibility to conformity.
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229
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Hilbert A. Cognitive-behavioral therapy for binge eating disorder in adolescents: study protocol for a randomized controlled trial. Trials 2013; 14:312. [PMID: 24066704 PMCID: PMC3850645 DOI: 10.1186/1745-6215-14-312] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 09/11/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Binge eating disorder is a prevalent adolescent disorder, associated with increased eating disorder and general psychopathology as well as an increased risk for overweight and obesity. As opposed to binge eating disorder in adults, there is a lack of validated psychological treatments for this condition in adolescents. The goal of this research project is therefore to determine the efficacy of age-adapted cognitive-behavioral therapy in adolescents with binge eating disorder - the gold standard treatment for adults with binge eating disorder. METHODS/DESIGN In a single-center efficacy trial, 60 12- to 20-year-old adolescents meeting diagnostic criteria of binge eating disorder (full-syndrome or subthreshold) according to the Diagnostic and Statistical Manual of Mental Disorders 4th or 5th Edition, will be centrally randomized to 4 months of cognitive-behavioral therapy (n = 30) or a waiting-list control condition (n = 30). Using an observer-blind design, patients are assessed at baseline, mid-treatment, post-treatment, and at 6- and 12-month follow-ups after the end of treatment. In 20 individual outpatient sessions, cognitive-behavioral therapy for adolescents focuses on eating behavior, body image, and stress; parents receive psychoeducation on these topics. Primary endpoint is the number of episodes with binge eating over the previous 28 days at post-treatment using a state-of-the art clinical interview. Secondary outcome measures address the specific eating disorder psychopathology, general psychopathology, mental comorbidity, self-esteem, quality of life, and body weight. DISCUSSION This trial will allow us to determine the short- and long-term efficacy of cognitive-behavioral therapy in adolescent binge eating disorder, to determine cost-effectiveness, and to identify predictors of treatment outcome. Evidence will be gathered regarding whether this treatment will help to prevent excessive weight gain. If efficacy can be demonstrated, the results from this trial will enhance availability of evidence-based treatment of adolescent binge eating disorder. TRIAL REGISTRATION German Clinical Trials Register: DRKS00000542.
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Affiliation(s)
- Anja Hilbert
- Department of Medical Psychology and Medical Sociology, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig, 04103 Germany.
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230
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Goldschmidt AB, Wall MM, Loth KA, Bucchianeri MM, Neumark-Sztainer D. The course of binge eating from adolescence to young adulthood. Health Psychol 2013; 33:457-60. [PMID: 23977873 DOI: 10.1037/a0033508] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The course of binge eating in adolescence is variable, and little is known about factors maintaining binge eating behaviors. The current study sought to characterize the course of binge eating and identify psychosocial factors associated with its maintenance. METHOD A population-based sample reported on binge eating, depression symptoms, self-esteem, and body satisfaction at 5-year intervals spanning early/middle adolescence (Time 1 [T1]), late adolescence/early young adulthood (Time 2 [T2]), and early/middle young adulthood (Time 3 [T3]). Logistic regression examined factors predicting maintenance or cessation of binge eating. RESULTS A total of 15.8% of participants with binge eating at T1 continued to report binge eating at T2, and 42.0% of participants with binge eating at T2 continued to report binge eating at T3. From T1 to T2, improvements in self-esteem predicted cessation of binge eating. From T2 to T3, cessation of binge eating was predicted by improved body satisfaction, greater decreases in depression symptoms, and greater improvements in self-esteem. CONCLUSIONS Binge eating is relatively stable from late adolescence/early young adulthood to early/middle young adulthood, but less so from middle/late adolescence to late adolescence/early young adulthood. Improvements in psychosocial functioning during this timeframe may improve the outcome of binge eating, although mechanisms responsible for psychosocial changes (e.g., treatment involvement) require further investigation. Self-esteem appears to be a particularly salient factor involved in binge eating cessation and should be targeted in prevention and treatment programs.
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Affiliation(s)
| | | | - Katie A Loth
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Michaela M Bucchianeri
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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231
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Katsikitis M, Sharman R. A psychological overview of counselling adolescents in healthy eating behaviours. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2013. [DOI: 10.1080/21507686.2013.779930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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232
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Emery RL, King KM, Fischer SF, Davis KR. The moderating role of negative urgency on the prospective association between dietary restraint and binge eating. Appetite 2013; 71:113-9. [PMID: 23938953 DOI: 10.1016/j.appet.2013.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 06/24/2013] [Accepted: 08/01/2013] [Indexed: 11/27/2022]
Abstract
It is well documented that negative urgency, a personality trait characterized by a tendency to act impulsively in the face of negative emotions, and dietary restraint independently increase risk to binge eat; however, it is unclear how these factors interact to alter risk for such behavior. It may be that individuals high on negative urgency, who also engage in dietary restraint, are at a greater risk to binge eat than individuals low on negative urgency. Accordingly, we sought to investigate whether negative urgency moderated the prospective association between dietary restraint and binge eating frequency among a sample of college women. We hypothesized that women who engaged in dietary restraint would report higher binge eating frequencies across the first semester of college and that this effect would be strengthened among individuals higher on negative urgency. Results indicated that negative urgency moderated the prospective association between dietary restraint and binge eating frequency. This effect was found to be "protective but reactive," such that low levels of dietary restraint protected against binge eating frequency at low to moderate levels of negative urgency, but this buffering effect was lost at high levels of negative urgency where binge eating frequency was equal across all levels of dietary restraint. These findings demonstrate that negative urgency and dietary restraint interact to differentially alter risk for binge eating frequency, and individuals high on negative urgency are at the greatest risk to engage in more frequent binge eating regardless of level of dietary restraint.
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Affiliation(s)
- Rebecca L Emery
- University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA 98195, United States; University of Pittsburgh, 210 South Bouquet Street, 3129 Sennott Square, Pittsburgh, PA 15260, United States.
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233
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Dennard EE, Richards CS. Depression and coping in subthreshold eating disorders. Eat Behav 2013; 14:325-9. [PMID: 23910775 DOI: 10.1016/j.eatbeh.2013.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/09/2013] [Accepted: 05/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The eating disorder literature has sought to understand the role of comorbid psychiatric diagnoses and coping in relation to eating disorders. The present research extends these findings by studying the relationships among depression, coping, and the entire continuum of disordered eating behaviors, with an emphasis on subthreshold eating disorders. METHOD 109 undergraduate females completed questionnaires to assess disordered eating symptoms, depressive symptoms, and the use of active and avoidant coping mechanisms. Hypotheses were tested using bivariate linear regression and multivariate linear regression. RESULTS Results indicated that depression was a significant predictor of disordered eating symptoms after controlling for relationships between depression and coping. Although avoidant coping was positively associated with disordered eating, it was not a significant predictor after controlling for depression and coping. DISCUSSION Previous research has found associations between depression and diagnosable eating disorders, and this research extends those findings to the entire continuum of disordered eating. Future research should continue to investigate the predictors and correlates of the disordered eating continuum using more diverse samples. Testing for mediation and moderation among these variables may also be a fruitful area of investigation.
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Affiliation(s)
- E Eliot Dennard
- Texas Tech University, Department of Psychology, Lubbock, TX 79409, USA.
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234
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Stice E, Becker CB, Yokum S. Eating disorder prevention: current evidence-base and future directions. Int J Eat Disord 2013; 46:478-85. [PMID: 23658095 PMCID: PMC3926692 DOI: 10.1002/eat.22105] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This narrative review sought to (a) characterize prevention programs that have produced reliable, reproducible, and clinically meaningful effects in efficacy trials, (b) discuss effectiveness trials that have tested whether prevention programs produce intervention effects under ecologically valid real-world conditions, (c) discuss dissemination efforts and research on dissemination, and (d) offer suggestions regarding directions for future research in this field. CONCLUSION A literature revealed that 6 prevention programs have produced significant reductions in eating disorder symptoms through at least 6-month follow-up and that 2 have significantly reduced future eating disorder onset. Effectiveness trials indicate that 2 prevention programs have produced effects under ecologically valid conditions that are only slightly attenuated. Although there have been few dissemination efforts, evidence suggests that a community participatory approach is most effective. Lastly, it would be useful to develop programs that produce larger and more persistent reductions in eating disorder symptoms and eating disorder onset, focus more on effectiveness trials that confirm that prevention programs produce clinically meaningful effects under real-world conditions, conduct meditational, mechanisms of action, and moderator research that provides stronger support for the intervention theory of prevention programs, and investigate the optimal methods of disseminating and implementing evidence-based prevention programs.
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Affiliation(s)
- Eric Stice
- Oregon Research Institute, Eugene, Oregon 97403, USA.
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235
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What are adolescents' experiences of body dissatisfaction and dieting, and what do they recommend for prevention? A qualitative study. Eat Weight Disord 2013; 18:133-41. [PMID: 23760841 DOI: 10.1007/s40519-013-0023-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 06/27/2012] [Indexed: 10/27/2022] Open
Abstract
Body dissatisfaction and dieting are risk factors for eating disorders. Understanding young people's views about factors underlying body dissatisfaction and dieting may be helpful for those designing preventative interventions. This study explored adolescents' views on causes of body dissatisfaction and dieting and recommendations for prevention. Four 1-h focus groups were conducted with 22 female adolescents (aged 13-15 years). Transcripts were explored using thematic analysis. Body dissatisfaction and dieting was explained by four themes: peer acceptance; social comparison online; pressure from family; and pressure from the media and fashion industries. There were seven areas of recommendation for prevention: building sources of support; learning to be critical of the media; monitoring the school gym; working with parents; educating about signs and symptoms of eating disorders; working with people who have suffered from eating disorders; and providing help from professionals. Implications of these findings for the development of prevention programmes are discussed.
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Kessler RC, Berglund PA, Chiu WT, Deitz AC, Hudson JI, Shahly V, Aguilar-Gaxiola S, Alonso J, Angermeyer MC, Benjet C, Bruffaerts R, de Girolamo G, de Graaf R, Maria Haro J, Kovess-Masfety V, O'Neill S, Posada-Villa J, Sasu C, Scott K, Viana MC, Xavier M. The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biol Psychiatry 2013; 73:904-14. [PMID: 23290497 PMCID: PMC3628997 DOI: 10.1016/j.biopsych.2012.11.020] [Citation(s) in RCA: 766] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 11/21/2012] [Accepted: 11/21/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND Little population-based data exist outside the United States on the epidemiology of binge eating disorder (BED). Cross-national BED data are presented here and compared with bulimia nervosa (BN) data in the World Health Organization (WHO) World Mental Health Surveys. METHODS Community surveys with 24,124 respondents (ages 18+) across 14 mostly upper-middle and high-income countries assessed lifetime and 12-month DSM-IV mental disorders with the WHO Composite International Diagnostic Interview. Physical disorders were assessed with a chronic conditions checklist. RESULTS Country-specific lifetime prevalence estimates are consistently (median; interquartile range) higher for BED (1.4%; .8-1.9%) than BN (.8%; .4-1.0%). Median age of onset is in the late teens to early 20s for both disorders but slightly younger for BN. Persistence is slightly higher for BN (6.5 years; 2.2-15.4) than BED (4.3 years; 1.0-11.7). Lifetime risk of both disorders is elevated for women and recent cohorts. Retrospective reports suggest that comorbid DSM-IV disorders predict subsequent onset of BN somewhat more strongly than BED and that BN predicts subsequent comorbid disorders somewhat more strongly than does BED. Significant comorbidities with physical conditions are due almost entirely to BN and to a somewhat lesser degree BED predicting subsequent onset of these conditions. Role impairments are similar for BN and BED. Fewer than half of lifetime BN or BED cases receive treatment. CONCLUSIONS Binge eating disorder represents a public health problem at least equal to BN. Low treatment rates highlight the clinical importance of questioning patients about eating problems even when not included among presenting complaints.
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Affiliation(s)
- Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
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Early Onset Binge Eating and Purging Eating Disorders: Course and Outcome in a Population-Based Study of Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 41:1083-96. [DOI: 10.1007/s10802-013-9747-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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238
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Kelly NR, Bulik CM, Mazzeo SE. Executive functioning and behavioral impulsivity of young women who binge eat. Int J Eat Disord 2013; 46:127-39. [PMID: 23325731 DOI: 10.1002/eat.22096] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the link between binge eating, executive functioning, and behavioral impulsivity. METHOD Fifty women who reported engaging in weekly binge eating in the absence of regular compensatory behaviors and 66 women with no history of binge eating completed several self-report questionnaires and a brief neuropsychological battery, including the Wisconsin Card Sorting Task and Conner's Continuous Performance Task. RESULTS Hierarchical regression analyses revealed that groups did not differ in executive functioning after controlling for depression, anxiety, body mass, general intelligence, and psychotropic medication use. Correlation analyses suggest that individuals who endorse more frequent binge eating might have greater difficulties thinking flexibly or shifting attention. Individuals who binge eats are also more likely to behave impulsively, but only for emotional reasons. DISCUSSION Although this study is unable to determine whether these cognitive and behavioral factors precede or follow binge-eating episodes, outcomes have implications for treatment and prevention.
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Affiliation(s)
- Nichole R Kelly
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
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239
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Hay PJ. What is an eating disorder? Implications for current and future diagnostic criteria. Aust N Z J Psychiatry 2013; 47:208-11. [PMID: 23463079 DOI: 10.1177/0004867412460105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Phillipa J Hay
- School of Medicine, University of Western Sydney, Penrith, Australia.
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240
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Flett GL, Hewitt PL. Disguised Distress in Children and Adolescents “Flying Under The Radar”. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2013. [DOI: 10.1177/0829573512468845] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
It is now recognized that there is a very high prevalence of psychological disorders among children and adolescents and relatively few receive psychological treatment. In the current article, we present the argument that levels of distress and dysfunction among young people are substantially underestimated and the prevalence of psychological problems is higher than realized because of a variety of factors. In particular, it is suggested that psychological problems are underestimated due, in part, to the presence of subthreshold conditions that do not meet diagnostic criteria yet involve substantial distress and impairment. In addition, we focus on a subset of children and adolescents who experience profound distress yet keep it hidden or disguised because of a personality style characterized by self-concealment and a tendency to engage in perfectionistic self-presentation. The characteristics of these students who are “flying under the radar” are described with a discussion of associated familial, cultural, and school factors that reduce the likelihood of these students ever seeking help. Given our premise that psychological problems are substantially underestimated, it is apparent that schools have a vitally important role in mental health promotion in terms of the need for proactive system-wide preventive interventions led by school mental health counsellors. Broad programs are needed to bolster levels of resilience and the willingness to seek help among all children and adolescents but especially among those students who would otherwise not be on anyone’s radar screen.
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Affiliation(s)
| | - Paul L. Hewitt
- University of British Columbia, Vancouver, British Columbia, Canada
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241
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Sonneville KR, Horton NJ, Micali N, Crosby RD, Swanson SA, Solmi F, Field AE. Longitudinal associations between binge eating and overeating and adverse outcomes among adolescents and young adults: does loss of control matter? JAMA Pediatr 2013; 167:149-55. [PMID: 23229786 PMCID: PMC3654655 DOI: 10.1001/2013.jamapediatrics.12] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To investigate the association between overeating (without loss of control) and binge eating (overeating with loss of control) and adverse outcomes. DESIGN Prospective cohort study. SETTING Adolescents and young adults living throughout the United States. PARTICIPANTS Sixteen thousand eight hundred eighty-two males and females participating in the Growing Up Today Study who were 9 to 15 years old at enrollment in 1996. MAIN EXPOSURE Overeating and binge eating assessed via questionnaire every 12 to 24 months between 1996 and 2005. MAIN OUTCOME MEASURES Risk of becoming overweight or obese, starting to binge drink frequently, starting to use marijuana, starting to use other drugs, and developing high levels of depressive symptoms. Generalized estimating equations were used to estimate associations. All models controlled for age and sex; additional covariates varied by outcome. RESULTS Among this large cohort of adolescents and young adults, binge eating was more common among females than males. In fully adjusted models, binge eating, but not overeating, was associated with incident overweight/obesity (odds ratio, 1.73; 95% CI, 1.11-2.69) and the onset of high depressive symptoms (odds ratio, 2.19; 95% CI, 1.40-3.45). Neither overeating nor binge eating was associated with starting to binge drink frequently, while both overeating and binge eating predicted starting to use marijuana and other drugs. CONCLUSIONS Although any overeating, with or without loss of control, predicted the onset of marijuana and other drug use, we found that binge eating is uniquely predictive of incident overweight/obesity and the onset of high depressive symptoms. These findings suggest that loss of control is an important indicator of severity of overeating episodes.
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Affiliation(s)
- Kendrin R. Sonneville
- Division of Adolescent Medicine, Department of Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, MA,Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Nicholas J. Horton
- Department of Mathematics and Statistics, Smith College, Northampton, MA
| | - Nadia Micali
- University College London, Institute of Child Health, Behavioural and Brain Sciences Unit, London, UK
| | - Ross D. Crosby
- Neuropsychiatric Research Institute and Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Sonja A. Swanson
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
| | - Francesca Solmi
- University College London, Institute of Child Health, Behavioural and Brain Sciences Unit, London, UK
| | - Alison E. Field
- Division of Adolescent Medicine, Department of Medicine, Children’s Hospital Boston and Harvard Medical School, Boston, MA,Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA,Department of Epidemiology, Harvard School of Public Health, Boston, MA
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242
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Davis KR, Fischer S. The influence of trait anger, trait anxiety and negative urgency on disordered eating. PERSONALITY AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.paid.2012.08.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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243
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Allen KL, Crosby RD, Oddy WH, Byrne SM. Eating disorder symptom trajectories in adolescence: effects of time, participant sex, and early adolescent depressive symptoms. J Eat Disord 2013; 1:32. [PMID: 24999411 PMCID: PMC4081731 DOI: 10.1186/2050-2974-1-32] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 06/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a period of developmental risk for eating disorders and eating disorder symptoms. This study aimed to describe the prevalence and trajectory of five core eating disorder behaviours (binge eating, purging, fasting, following strict dietary rules, and hard exercise for weight control) and a continuous index of dietary restraint and eating, weight and shape concerns, in a cohort of male and female adolescents followed from 14 to 20 years. It also aimed to determine the effect of early adolescent depressive symptoms on the prevalence and trajectory of these different eating disorder symptoms. Participants (N = 1,383; 49% male) were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a prospective cohort study that has followed participants from pre-birth to age 20 years. An adapted version of the Eating Disorder Examination-Questionnaire was used to assess eating disorder symptoms at ages 14, 17 and 20 years. The Beck Depression Inventory for Youth was used to assess depressive symptoms at age 14. Longitudinal changes in the prevalence of eating disorder symptoms were tested using generalised estimating equations and linear mixed models. RESULTS Symptom trajectories varied according to the eating disorder symptom studied, participant sex, and the presence of depressive symptoms in early adolescence. For males, eating disorder symptoms tended to be stable (for purging, fasting and hard exercise) or decreasing (for binge eating and global symptom scores) from 14 to 17 years, and then stable to 20 years. For females, fasting and global symptom scores increased from age 14 to peak in prevalence at age 17. Rates of binge eating in females were stable from age 14 to age 17 and increased significantly thereafter, whilst rates of purging and hard exercise increased from age 14 to age 17, and then remained elevated through to age 20. Depressive symptoms at age 14 impacted on eating disorder symptom trajectories in females, but not in males. CONCLUSIONS Prevention, screening and intervention initiatives for adolescent eating disorders need to be tailored to gender and age. Purging behaviour appears to be an important target for work with early to middle adolescent females.
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Affiliation(s)
- Karina L Allen
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Western Australia ; School of Psychology, The University of Western Australia, Crawley, Western Australia
| | - Ross D Crosby
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA ; Department of Biostatistics, Neuropsychiatric Research Institute, Fargo, North Dakota, USA
| | - Wendy H Oddy
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Western Australia
| | - Susan M Byrne
- School of Psychology, The University of Western Australia, Crawley, Western Australia
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244
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Clinical characteristics and distinctiveness of DSM-5 eating disorder diagnoses: findings from a large naturalistic clinical database. J Eat Disord 2013; 1:31. [PMID: 24999410 PMCID: PMC4081791 DOI: 10.1186/2050-2974-1-31] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/11/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND DSM-IV eating disorder (ED) diagnoses have been criticized for lack of clinical utility, diagnostic instability, and over-inclusiveness of the residual category "ED not otherwise specified" (EDNOS). Revisions made in DSM-5 attempt to generate a more scientifically valid and clinically relevant system of ED classification. The aim with the present study was to examine clinical characteristics and distinctiveness of the new DSM-5 ED diagnoses, especially concerning purging disorder (PD). METHODS Using a large naturalistic Swedish ED database, 2233 adult women were diagnosed using DSM-5. Initial and 1-year follow-up psychopathology data were analyzed. Measures included the Eating Disorder Examination Questionnaire, Structural Eating Disorder Interview, Clinical Impairment Assessment, Structural Analysis of Social Behavior, Comprehensive Psychiatric Rating Scale, and Structured Clinical Interview for DSM-IV Axis I Disorders. RESULTS Few meaningful differences emerged between anorexia nervosa binge/purge subtype (ANB/P), PD, and bulimia nervosa (BN). Unspecified Feeding and Eating Disorders (UFED) showed significantly less severity compared to other groups. CONCLUSIONS PD does not appear to constitute a distinct diagnosis, the distinction between atypical AN and PD requires clarification, and minimum inclusion criteria for UFED are needed. Further sub-classification is unlikely to improve clinical utility. Instead, better delineation of commonalities is important.
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Elliott CA, Tanofsky-Kraff M, Mirza NM. Parent report of binge eating in Hispanic, African American and Caucasian youth. Eat Behav 2013; 14:1-6. [PMID: 23265393 PMCID: PMC3680352 DOI: 10.1016/j.eatbeh.2012.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 08/07/2012] [Accepted: 10/03/2012] [Indexed: 11/16/2022]
Abstract
Binge eating is prevalent among weight loss treatment-seeking youth. However, there are limited data on the relationship between binge eating and weight in racial or ethnically diverse youth. We therefore examined 409 obese (BMI≥95th percentile for age and sex) treatment-seeking Hispanic (29.1%), Caucasian (31.7%), and African American (39.2%), boys and girls (6-18 years). Weight, height, waist circumference, and body fat were measured to assess body composition. Depressive symptoms were measured with the Children's Depression Inventory and disordered eating cognitions were measured with the Children's Eating Attitudes Test. Accounting for age, sex, body fat mass, and height, the odds of parents reporting that their child engaged in binge eating were significantly higher among Caucasian compared to African American youth, with Hispanic youth falling non-significantly between these two groups. Youth with binge eating had greater body adiposity (p=.02), waist circumference (p=.02), depressive symptoms (p=.01), and disordered eating attitudes (p=.04), with no difference between racial or ethnic group. We conclude that, regardless of race or ethnicity, binge eating is prevalent among weight loss treatment-seeking youth and is associated with adiposity and psychological distress. Further research is required to elucidate the extent to which binge eating among racially and ethnically diverse youth differentially impacts weight loss outcome.
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Affiliation(s)
- Camden A Elliott
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, USA.
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Stice E, Rohde P, Shaw H, Marti CN. Efficacy trial of a selective prevention program targeting both eating disorders and obesity among female college students: 1- and 2-year follow-up effects. J Consult Clin Psychol 2012; 81:183-189. [PMID: 23231574 DOI: 10.1037/a0031235] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Evaluate the effects of a prevention program targeting both eating disorders and obesity at 1- and 2-year follow-ups. METHOD Female college students at risk for these outcomes because of body image concerns (N = 398) were randomized to the Healthy Weight 2 group-based 4-hr prevention program, which promotes lasting healthy improvements to dietary intake and physical activity and nutrition science health behavior change principles, or an educational brochure control condition. RESULTS Intervention participants showed significantly less body dissatisfaction and eating disorder symptoms and lower eating disorder onset through 2-year follow-up versus controls, but the former 2 effects were small. There were no main effects for body mass index (BMI), depressive symptoms, dieting, caloric intake, physical activity, or obesity onset. Moderator analyses revealed stronger eating disorder symptom effects for youths with initially elevated symptoms and lower pressure to be thin, stronger BMI effects for youths with initially elevated symptoms and BMI scores, and weaker eating disorder symptom effects for youths with initially elevated pressure to be thin. CONCLUSIONS The 60% reduction in eating disorder onset over the 2-year follow-up was clinically significant and a novel effect for a prevention program, but the main effects on continuous outcomes were small, suggesting that adding nutrition science principles weakened the intervention efficacy. Effects on both eating disorder symptoms and BMI were greater for those with elevated eating disorder symptoms and BMI at pretest, implying that it might be useful to target these individuals in future trials.
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Allen KL, Mori TA, Beilin L, Byrne SM, Hickling S, Oddy WH. Dietary intake in population-based adolescents: support for a relationship between eating disorder symptoms, low fatty acid intake and depressive symptoms. J Hum Nutr Diet 2012; 26:459-69. [PMID: 23216519 DOI: 10.1111/jhn.12024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Relatively little is known about the dietary intake and nutritional status of community-based individuals with eating disorders. This research aimed to: (i) describe the dietary intake of population-based adolescents with an eating disorder and (ii) examine associations between eating disorder symptoms, fatty acid intake and depressive symptoms in adolescents with and without an eating disorder. METHODS Data were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a population-based cohort study that has followed participants from birth to young adulthood. This research utilised self-report data from the 17-year Raine Study assessment. Participants comprised 429 female adolescents who completed comprehensive questionnaire measures on dietary intake, eating disorder symptoms and depressive symptoms. RESULTS Adolescents with an eating disorder (n = 66) reported a significantly lower intake of total fat, saturated fat, omega-6 fatty acid, starch, vitamin A and vitamin E compared to adolescents without an eating disorder (n = 363). Adolescents with an eating disorder and pronounced depressive symptoms (n = 23) also reported a significantly lower intake of polyunsaturated fat and omega-3 and omega-6 fatty acid than adolescents with an eating disorder but no marked depression (n = 43). In the eating disorder sample but not the control sample, omega-3 and omega-6 fatty acid correlated significantly and negatively with eating disorder symptoms and with depressive symptoms. CONCLUSIONS Support is provided for a relationship between low omega-3 and omega-6 fatty acid intake and depressive symptoms in adolescents with eating disorders. Research is needed to examine the feasibility and effectiveness of fatty acid supplementation in this high-risk group.
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Affiliation(s)
- K L Allen
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia; School of Psychology, The University of Western Australia, Perth, WA, Australia
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Stice E, Marti CN, Rohde P. Prevalence, incidence, impairment, and course of the proposed DSM-5 eating disorder diagnoses in an 8-year prospective community study of young women. JOURNAL OF ABNORMAL PSYCHOLOGY 2012; 122:445-57. [PMID: 23148784 DOI: 10.1037/a0030679] [Citation(s) in RCA: 474] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We examined prevalence, incidence, impairment, duration, and course for the proposed DSM-5 eating disorders in a community sample of 496 adolescent females who completed annual diagnostic interviews over 8 years. Lifetime prevalence by age 20 was 0.8% for anorexia nervosa (AN), 2.6% for bulimia nervosa (BN), 3.0% for binge eating disorder (BED), 2.8% for atypical AN, 4.4% for subthreshold BN, 3.6% for subthreshold BED, 3.4% for purging disorder (PD), and combined prevalence of 13.1% (5.2% had AN, BN, or BED; 11.5% had feeding and eating disorders not elsewhere classified; FED-NEC). Peak onset age was 19-20 for AN, 16-20 for BN, and 18-20 for BED, PD, and FED-NEC. Youth with these eating disorders typically reported greater functional impairment, distress, suicidality, mental health treatment, and unhealthy body mass index, though effect sizes were relatively smaller for atypical AN, subthreshold BN, and PD. Average episode duration in months ranged from 2.9 for BN to 11.2 for atypical AN. One-year remission rates ranged from 71% for atypical AN to 100% for BN, subthreshold BN, and BED. Recurrence rates ranged from 6% for PD to 33% for BED and subthrehold BED. Diagnostic progression from subthreshold to threshold eating disorders was higher for BN and BED (32% and 28%) than for AN (0%), suggesting some sort of escalation mechanism for binge eating. Diagnostic crossover was greatest from BED to BN. Results imply that the new DSM-5 eating disorder criteria capture clinically significant psychopathology and usefully assign eating disordered individuals to homogeneous diagnostic categories.
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Affiliation(s)
- Eric Stice
- Oregon Research Institute, Eugene, OR 97403, USA.
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Abstract
AIM Early intervention in eating disorders (EDs) has been a neglected area. Peak onset is in adolescence, suggesting that early intervention should include parents. We synthesize findings from five key theoretical domains, and present pilot data from a phase-specific early intervention for new onset EDs in young people. METHODS From literature searches, we reviewed current knowledge on risk factors for EDs; ED prevention in young people; the evidence base for treatment for young people with EDs; early intervention in other mental health fields; and parenting interventions. Based on these findings, we devised and piloted a parent group intervention. RESULTS Presenting features are typically parental concern about changes in eating behaviour and/or weight loss. There is a delay between symptom onset and help seeking, by which time the illness is well established. Early intervention should therefore target parents and be delivered at secondary rather than primary care. Effective treatments favour family-focused interventions with parental responsibility for symptom management. We hypothesized that a parents' group might be effective for addressing the specific emotional experience of parents in the early stages and their relative lack of knowledge and understanding. Pilot data show significant improvements in knowledge, skills, confidence, understanding and their child's adherence to meal plans as a result of a 6-week parent group intervention. CONCLUSION A parent group intervention addressing themes identified from risk factor, prevention and treatment research is a potentially promising approach to early intervention for EDs. The impact of the intervention on patient outcome needs evaluation.
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Affiliation(s)
- Dasha E Nicholls
- Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London, UK.
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Abstract
Disordered eating behaviors are common in the adolescent population. These behaviors are especially dangerous for young females with type 1 diabetes due to frequent alterations in insulin levels. This article provides an overview of disordered eating in adolescent females with type 1 diabetes, including prevalence and morbidity, insulin omission and associated health outcomes, risk factors, and suggestions for screening and prevention.
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Affiliation(s)
- Terri L Schmitt
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
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