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Darcy AM, Doyle AC, Lock J, Peebles R, Doyle P, Le Grange D. The Eating Disorders Examination in adolescent males with anorexia nervosa: how does it compare to adolescent females? Int J Eat Disord 2012; 45:110-4. [PMID: 22170022 PMCID: PMC3241004 DOI: 10.1002/eat.20896] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2010] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The study aimed to explore the Eating Disorder Examination (EDE) for adolescent males with eating disorders (EDs) compared with adolescent females with EDs. METHOD Data were collected from 48 males and matched on percent median body weight (MBW) and age to 48 females at two sites. RESULTS Adolescent males with anorexia nervosa-type presentation scored significantly lower than matched females on Shape Concern, Weight Concern, and Global score. They also scored lower on a number of individual items. DISCUSSION The EDE has clinical utility with adolescent males with anorexic-type presentation although males' scoring ranges are consistently lower than those from adolescent females with similar clinical presentations. Males scored significantly lower on a number of items representing core symptoms such as desire to lose weight. More research is needed to gain a better understanding of the experience of adolescent males with EDs, particularly in relation to the nature of shape concern.
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Affiliation(s)
- Alison M. Darcy
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California,Correspondence to: Alison Darcy; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305.
| | - Angela Celio Doyle
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California
| | - Rebecka Peebles
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University School of Medicine, Mountain View, California
| | - Peter Doyle
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medical Center, Chicago, Illinois
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202
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Le Grange D, Lock J, Agras WS, Moye A, Bryson SW, Jo B, Kraemer HC. Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. Behav Res Ther 2011; 50:85-92. [PMID: 22172564 DOI: 10.1016/j.brat.2011.11.003] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 11/18/2011] [Accepted: 11/21/2011] [Indexed: 10/14/2022]
Abstract
Few of the limited randomized controlled trails (RCTs) for adolescent anorexia nervosa (AN) have explored the effects of moderators and mediators on outcome. This study aimed to identify treatment moderators and mediators of remission at end of treatment (EOT) and 6- and 12-month follow-up (FU) for adolescents with AN (N = 121) who participated in a multi-center RCT of family-based treatment (FBT) and individual adolescent focused therapy (AFT). Mixed effects modeling were utilized and included all available outcome data at all time points. Remission was defined as ≥ 95% IBW plus within 1 SD of the Eating Disorder Examination (EDE) norms. Eating related obsessionality (Yale-Brown-Cornell Eating Disorder Total Scale) and eating disorder specific psychopathology (EDE-Global) emerged as moderators at EOT. Subjects with higher baseline scores on these measures benefited more from FBT than AFT. AN type emerged as a moderator at FU with binge-eating/purging type responding less well than restricting type. No mediators of treatment outcome were identified. Prior hospitalization, older age and duration of illness were identified as non-specific predictors of outcome. Taken together, these results indicate that patients with more severe eating related psychopathology have better outcomes in a behaviorally targeted family treatment (FBT) than an individually focused approach (AFT).
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Affiliation(s)
- Daniel Le Grange
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA.
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203
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Haedt-Matt AA, Keel PK. Revisiting the affect regulation model of binge eating: a meta-analysis of studies using ecological momentary assessment. Psychol Bull 2011; 137:660-681. [PMID: 21574678 DOI: 10.1037/a0023660] [Citation(s) in RCA: 497] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The affect regulation model of binge eating, which posits that patients binge eat to reduce negative affect (NA), has received support from cross-sectional and laboratory-based studies. Ecological momentary assessment (EMA) involves momentary ratings and repeated assessments over time and is ideally suited to identify temporal antecedents and consequences of binge eating. This meta-analytic review includes EMA studies of affect and binge eating. Electronic database and manual searches produced 36 EMA studies with N = 968 participants (89% Caucasian women). Meta-analyses examined changes in affect before and after binge eating using within-subjects standardized mean gain effect sizes (ESs). Results supported greater NA preceding binge eating relative to average affect (ES = 0.63) and affect before regular eating (ES = 0.68). However, NA increased further following binge episodes (ES = 0.50). Preliminary findings suggested that NA decreased following purging in bulimia nervosa (ES = -0.46). Moderators included diagnosis (with significantly greater elevations of NA prior to bingeing in binge eating disorder compared to bulimia nervosa) and binge definition (with significantly smaller elevations of NA before binge vs. regular eating episodes for the Diagnostic and Statistical Manual of Mental Disorders definition compared to lay definitions of binge eating). Overall, results fail to support the affect regulation model of binge eating and challenge reductions in NA as a maintenance factor for binge eating. However, limitations of this literature include unidimensional analyses of NA and inadequate examination of affect during binge eating, as binge eating may regulate only specific facets of affect or may reduce NA only during the episode.
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204
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Dejong H, Perkins S, Grover M, Schmidt U. The prevalence of irritable bowel syndrome in outpatients with bulimia nervosa. Int J Eat Disord 2011; 44:661-4. [PMID: 21997430 DOI: 10.1002/eat.20901] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2010] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examined the prevalence of irritable bowel syndrome (IBS) in patients with bulimia nervosa (BN), and the relationship between these disorders. METHOD Sixty-four participants with a diagnosis of BN or a related condition were recruited from an outpatient eating disorders service. Questionnaire and interview measures were used to assess bulimic symptoms and attitudes, IBS symptoms, anxiety and depression. Cases of IBS were identified using the Manning criteria. RESULTS There was a high prevalence of IBS in the patient group (68.8%), but IBS status was not predicted by any of the other variables measured. Patients who met criteria for IBS reported more frequent self-induced vomiting than those who did not (U = 256.0, p = 0.038). DISCUSSION There is evidence of an high incidence of IBS in outpatients with BN, but the relationship between these conditions remains unclear. Future research should consider possible common risk factors.
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Affiliation(s)
- Hannah Dejong
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK.
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205
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Butryn ML, Juarascio A, Lowe MR. The relation of weight suppression and BMI to bulimic symptoms. Int J Eat Disord 2011; 44:612-7. [PMID: 21997424 PMCID: PMC4852137 DOI: 10.1002/eat.20881] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2010] [Indexed: 11/05/2022]
Abstract
OBJECTIVE High levels of weight suppression have been associated with greater binge eating and weight gain as well as poorer treatment outcome in bulimia nervosa. This study examined the relationship between weight suppression and bulimia nervosa symptoms and explored how weight suppression might interact with body mass index (BMI) in accounting for level of symptomatology at presentation for treatment. METHOD Participants were 64 women with threshold or sub-threshold bulimia nervosa. A clinical interview assessed binge eating and purging. RESULTS Weight suppression and the interaction between BMI and weight suppression predicted frequency of binge eating such that participants with low BMI and high weight suppression engaged in the most binge eating. High levels of weight suppression also predicted more frequent purging. DISCUSSION Additional research is warranted to examine mediators of these relationships.
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Affiliation(s)
- Meghan L Butryn
- Drexel University, Department of Psychology, Philadelphia, Pennsylvania, USA.
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206
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Bratland-Sanda S, Martinsen EW, Rosenvinge JH, Rø O, Hoffart A, Sundgot-Borgen J. Exercise dependence score in patients with longstanding eating disorders and controls: the importance of affect regulation and physical activity intensity. EUROPEAN EATING DISORDERS REVIEW 2011; 19:249-55. [PMID: 21584917 DOI: 10.1002/erv.971] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To examine associations among exercise dependence score, amount of physical activity and eating disorder (ED) symptoms in patients with longstanding ED and non-clinical controls. METHODS Adult female inpatients (n = 59) and 53 age-matched controls participated in this cross sectional study. Assessments included the eating disorders examination, eating disorders inventory, exercise dependence scale, reasons for exercise inventory, and MTI Actigraph accelerometer. RESULTS Positive associations were found among vigorous, not moderate, physical activity, exercise dependence score and ED symptoms in patients. In the controls, ED symptoms were negatively associated with vigorous physical activity and not correlated with exercise dependence score. Exercise for negative affect regulation, not weight/appearance, and amount of vigorous physical activity were explanatory variables for exercise dependence score in both groups. CONCLUSIONS The positive associations among exercise dependence score, vigorous physical activity and ED symptoms need proper attention in the treatment of longstanding ED.
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207
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Loeb KL, Jones J, Roberto CA, Sonia Gugga S, Marcus SM, Attia E, Timothy Walsh B. Adolescent-adult discrepancies on the eating disorder examination: a function of developmental stage or severity of illness? Int J Eat Disord 2011; 44:567-72. [PMID: 21823141 PMCID: PMC4117237 DOI: 10.1002/eat.20882] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2010] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Across studies, adolescents score lower on measures of eating disorder pathology than adults, but it is unclear whether such findings reflect discrepancies inherent to site/study or true developmental differences. The aim of this study was to determine whether age predicts subscale and diagnostic scores of the Eating Disorder Examination (EDE) in adolescents and adults with anorexia nervosa (AN) admitted to a single research center within the same period of time. METHOD The sample consisted of 16 adolescent and 20 adult consecutive admissions to parallel, age-specific, research-based AN treatment programs. Participants completed a baseline evaluation at admission that included the EDE, depression measures, and global assessment of functioning scales. RESULTS Age significantly predicted EDE scores in univariate regression analyses. However, in multivariate models that included severity indices of general and specific psychopathology as covariates, age was no longer a significant predictor of severity of eating disorder symptoms. DISCUSSION This study adds to the growing body of data showing lower scores on the EDE for adolescents with AN relative to their adult counterparts, while eliminating potential site confounds. Results indicate that the higher adult scores may be carried in part by a more overall severe and chronic general clinical profile.
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Affiliation(s)
- Katharine L Loeb
- School of Psychology, Fairleigh Dickinson University, Teaneck, New Jersey 07666, USA.
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208
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DeJong H, Hillcoat J, Perkins S, Grover M, Schmidt U. Illness perception in bulimia nervosa. J Health Psychol 2011; 17:399-408. [DOI: 10.1177/1359105311416874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The study was designed to extend our understanding of illness perceptions in patients with bulimia nervosa (BN). Seventy-eight participants with BN or BN-type Eating Disorder Not Otherwise Specified (EDNOS-BN) completed the Revised Illness Perception Questionnaire (IPQ-R) ( Moss-Morris et al., 2002 ). Clinical variables were also assessed. Participants experienced their ED as chronic, with serious consequences and high associated levels of anxiety and depression. The disorder was attributed primarily to psychological causes. The results indicate the perceived severity of BN, and high level of associated distress. These findings highlight the potential for targeting illness perceptions in treatment.
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209
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Watkins B, Cooper PJ, Lask B. History of Eating Disorder in Mothers of Children with Early Onset Eating Disorder or Disturbance. EUROPEAN EATING DISORDERS REVIEW 2011; 20:121-5. [DOI: 10.1002/erv.1125] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 02/28/2011] [Accepted: 03/27/2011] [Indexed: 11/11/2022]
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210
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Wang GJ, Geliebter A, Volkow ND, Telang FW, Logan J, Jayne MC, Galanti K, Selig PA, Han H, Zhu W, Wong CT, Fowler JS. Enhanced striatal dopamine release during food stimulation in binge eating disorder. Obesity (Silver Spring) 2011; 19:1601-8. [PMID: 21350434 PMCID: PMC3144277 DOI: 10.1038/oby.2011.27] [Citation(s) in RCA: 226] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Subjects with binge eating disorder (BED) regularly consume large amounts of food in short time periods. The neurobiology of BED is poorly understood. Brain dopamine, which regulates motivation for food intake, is likely to be involved. We assessed the involvement of brain dopamine in the motivation for food consumption in binge eaters. Positron emission tomography (PET) scans with [(11)C]raclopride were done in 10 obese BED and 8 obese subjects without BED. Changes in extracellular dopamine in the striatum in response to food stimulation in food-deprived subjects were evaluated after placebo and after oral methylphenidate (MPH), a drug that blocks the dopamine reuptake transporter and thus amplifies dopamine signals. Neither the neutral stimuli (with or without MPH) nor the food stimuli when given with placebo increased extracellular dopamine. The food stimuli when given with MPH significantly increased dopamine in the caudate and putamen in the binge eaters but not in the nonbinge eaters. Dopamine increases in the caudate were significantly correlated with the binge eating scores but not with BMI. These results identify dopamine neurotransmission in the caudate as being of relevance to the neurobiology of BED. The lack of correlation between BMI and dopamine changes suggests that dopamine release per se does not predict BMI within a group of obese individuals but that it predicts binge eating.
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Affiliation(s)
- Gene-Jack Wang
- Medical Department, Brookhaven National Laboratory, Upton, New York, USA.
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211
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Krabbenborg MAM, Danner UN, Larsen JK, Veer N, Elburg AA, Ridder DTD, Evers C, Stice E, Engels RCME. The Eating Disorder Diagnostic Scale: Psychometric Features Within a Clinical Population and a Cut-off Point to Differentiate Clinical Patients from Healthy Controls. EUROPEAN EATING DISORDERS REVIEW 2011; 20:315-20. [DOI: 10.1002/erv.1144] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 04/07/2011] [Accepted: 06/10/2011] [Indexed: 10/17/2022]
Affiliation(s)
| | | | - Junilla K. Larsen
- Behavioural Science Institute; Radboud University Nijmegen; The Netherlands
| | - Nienke Veer
- Department of Psychiatry; Sint Antonius Hospital; The Netherlands
| | - Annemarie A. Elburg
- Altrecht Eating Disorders Rintveld; Altrecht Mental Health Institute; The Netherlands
| | - Denise T. D. Ridder
- Department of Clinical and Health Psychology; Utrecht University; The Netherlands
| | - Catharine Evers
- Department of Clinical and Health Psychology; Utrecht University; The Netherlands
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212
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Goldschmidt A, Wilfley DE, Eddy KT, Boutelle K, Zucker N, Peterson CB, Celio-Doyle A, Le Grange D. Overvaluation of shape and weight among overweight children and adolescents with loss of control eating. Behav Res Ther 2011; 49:682-8. [PMID: 21835393 DOI: 10.1016/j.brat.2011.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 07/15/2011] [Accepted: 07/25/2011] [Indexed: 11/15/2022]
Abstract
Little is known about the phenomenology of pediatric loss of control (LOC) eating. Overvaluation of shape and weight, however, appears to be diagnostically meaningful among binge eating adults. We explored the significance of shape and weight overvaluation among children and adolescents with LOC eating. Participants (n = 526) included 149 overweight youth with LOC eating and 377 overweight controls (CON). Participants were categorized as those reporting at least moderate overvaluation (LOC-Mod, n = 74; CON-Mod, n = 106) or less than moderate overvaluation (LOC-Low, n = 75; CON-Low, n = 271), and compared on measures of eating-related and general psychopathology. LOC-Mod evidenced lower self-esteem than CON-Low, and greater behavioral problems than CON-Mod and CON-Low, but did not differ from LOC-Low in these domains. With the exception of LOC-Low and CON-Mod, all groups differed on global eating-disorder severity, with LOC-Mod scoring the highest. Overvaluation of shape and weight appears to be of questionable importance in defining subtypes of youth with LOC eating. However, as overvaluation and LOC eating each independently predicts eating-disorder onset, their confluence may confer even further risk for eating-disorder development. Longitudinal studies should address this possibility. Developmentally appropriate discussion about body image disturbance may be indicated in interventions targeting pediatric LOC eating and/or obesity.
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Affiliation(s)
- Andrea Goldschmidt
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 South Maryland Avenue, MC 3077, Chicago, IL 60637, USA.
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213
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Nilsson K, Engström I, Hägglöf B. Family climate and recovery in adolescent onset eating disorders: a prospective study. EUROPEAN EATING DISORDERS REVIEW 2011; 20:e96-102. [PMID: 21774042 DOI: 10.1002/erv.1127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This prospective study investigated the self-assessed family climate of adolescent patients and their parents during treatment of and recovery from eating disorders. METHOD One hundred two girls aged 13-17 years with eating disorders, answered the self-report Family Climate Scale (FCS) and Eating Disorders Inventory for Children at initial assessment and after 18 and 36 months. The FCS was also answered by their parents at the same time points. RESULTS Self-assessed family climate and eating disorder symptoms were similar for recovered (R) and nonrecovered (NR) adolescents at initial assessment and at 18 months. At 36 months, FCS Closeness was higher for R, and FCS Distance was lower for R compared with NR. Parents of R adolescents had higher scores on FCS Closeness and lower scores on FCS Chaos compared with parents of NR adolescents at the 36-month follow-up. CONCLUSION Self-reported family climate was associated with recovery. Changes in eating disorder symptoms preceded changes in family climate.
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Affiliation(s)
- Karin Nilsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Umeå University, Sweden.
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214
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Wadden TA, Faulconbridge LF, Jones-Corneille LR, Sarwer DB, Fabricatore AN, Thomas JG, Wilson GT, Alexander MG, Pulcini ME, Webb VL, Williams NN. Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study. Obesity (Silver Spring) 2011; 19:1220-8. [PMID: 21253005 PMCID: PMC3085093 DOI: 10.1038/oby.2010.336] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous studies have suggested that binge eating disorder (BED) impairs weight loss following bariatric surgery, leading some investigators to recommend that patients receive behavioral treatment for this condition before surgery. However, many of these investigations had significant methodological limitations. The present observational study used a modified intention-to-treat (ITT) population to compare 1-year changes in weight in 59 surgically treated participants, determined preoperatively to be free of a current eating disorder, with changes in 36 individuals judged to have BED. Changes in weight and binge eating in the latter group were compared with those in 49 obese individuals with BED who sought lifestyle modification for weight loss. BED was assessed using criteria proposed for the Diagnostic and Statistical Manual (DSM) 5. At 1 year, surgically treated participants without BED lost 24.2% of initial weight, compared with 22.1% for those with BED (P > 0.309). Both groups achieved clinically significant improvements in several cardiovascular disease (CVD) risk factors. Participants with BED who received lifestyle modification lost 10.3% at 1 year, significantly (P < 0.001) less than surgically treated BED participants. The mean number of binge eating days (in the prior 28 days) fell sharply in both BED groups at 1 year. These two groups did not differ significantly in BED remission rates or in improvements in CVD risk factors. The present results, obtained in carefully studied participants, indicate that the preoperative presence of BED does not attenuate weight loss or improvements in CVD risk factors at 1 year in surgically treated patients. Longer follow-up of participants is required.
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Affiliation(s)
- Thomas A Wadden
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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215
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de Bruin APK, Oudejans RRD, Bakker FC, Woertman L. Contextual body image and athletes' disordered eating: The contribution of athletic body image to disordered eating in high performance women athletes. EUROPEAN EATING DISORDERS REVIEW 2011; 19:201-15. [DOI: 10.1002/erv.1112] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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216
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Allen KL, Fursland A, Watson H, Byrne SM. Eating disorder diagnoses in general practice settings: Comparison with structured clinical interview and self-report questionnaires. J Ment Health 2011; 20:270-80. [DOI: 10.3109/09638237.2011.562259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Karina L. Allen
- Centre for Clinical Interventions,
Northbridge, Western Australia, Australia
| | - Anthea Fursland
- Centre for Clinical Interventions,
Northbridge, Western Australia, Australia
| | - Hunna Watson
- Centre for Clinical Interventions,
Northbridge, Western Australia, Australia
| | - Susan M. Byrne
- Centre for Clinical Interventions,
Northbridge, Western Australia, Australia
- School of Psychology, The University of Western Australia,
Crawley, Western Australia, Australia
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia,
Subiaco, Western Australia, Australia
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217
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Abstract
BACKGROUND Several diagnostic and screening instruments are available for child and adolescent eating disorders. However, limitations have been identified in many of these. METHOD We review the most frequently used assessment measures for eating disorders in children and adolescents. RESULTS Several of the available instruments have significant limitations, although relevant strengths are identified. CONCLUSIONS Limitations in the current available instruments for child and adolescent eating disorders should be addressed in order to improve recognition and treatment.
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Affiliation(s)
- Nadia Micali
- Department of Child and Adolescent Psychiatry, PO Box 85, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. E-mail :
| | - Jennifer House
- Department of Child and Adolescent Psychiatry, PO Box 85, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. E-mail :
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218
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Carter JC, Bewell-Weiss CV. Nonfat phobic anorexia nervosa: clinical characteristics and response to inpatient treatment. Int J Eat Disord 2011; 44:220-4. [PMID: 21400560 DOI: 10.1002/eat.20820] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study was to compare patients admitted to a specialized inpatient program for anorexia nervosa (AN) with and without a fear of weight gain in terms of specific eating disorder symptoms, general psychopathology, and treatment outcome. METHOD Measures of specific and general psychopathology were administered at admission to and discharge from the inpatient program. Of the 138 participants, 81% (n = 112) were categorized as having clinical levels of "fear of weight gain" and 19% (n = 26) were categorized as having subclinical levels of this feature. RESULTS The subclinical-level group had lower scores on measures of eating disorder psychopathology, depression, general psychiatric disturbance, and obsessive-compulsive symptomatology, but higher self-esteem scores. There were no differences found in terms of age of onset of AN, duration of illness, AN subtype, body mass index, or treatment outcome. DISCUSSION The current findings provide evidence that underweight patients who deny a fear of weight gain are less disturbed in terms of both eating disorder pathology and general psychopathology.
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Affiliation(s)
- Jacqueline C Carter
- Eating Disorders Program, Toronto General Hospital, University Health Network, Toronto, Canada.
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219
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Hill DM, Craighead LW, Safer DL. Appetite-focused dialectical behavior therapy for the treatment of binge eating with purging: a preliminary trial. Int J Eat Disord 2011; 44:249-61. [PMID: 20196109 DOI: 10.1002/eat.20812] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This treatment development study investigated the acceptability and efficacy of a modified version of dialectical behavior therapy (DBT) for bulimia nervosa (BN), entitled appetite focused DBT (DBT-AF). METHOD Thirty-two women with binge/purge episodes at least one time per week were randomly assigned to 12 weekly sessions of DBT-AF (n = 18) or to a 6-week delayed treatment control (n = 14). Participants completed the EDE interview and self-report measures at baseline, 6 weeks, and posttreatment. RESULTS Treatment attrition was low, and DBT-AF was rated highly acceptable. At 6 weeks, participants who were receiving DBT-AF reported significantly fewer BN symptoms than controls. At posttest, 26.9% of the 26 individuals who entered treatment (18 initially assigned and 8 from the delayed treatment control) were abstinent from binge/purge episodes for the past month; 61.5% no longer met full or subthreshold criteria for BN. Participants demonstrated a rapid rate of response to treatment and achieved clinically significant change. DISCUSSION Results suggest that DBT-AF warrants further investigation as an alternative to DBT or cognitive behavior therapy for BN.
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Affiliation(s)
- Diana M Hill
- Department of Psychology, University of Colorado at Boulder, Boulder, Colorado, USA.
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220
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Allen KL, Byrne SM, Lampard A, Watson H, Fursland A. Confirmatory factor analysis of the Eating Disorder Examination-Questionnaire (EDE-Q). Eat Behav 2011; 12:143-51. [PMID: 21385645 DOI: 10.1016/j.eatbeh.2011.01.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 11/17/2010] [Accepted: 01/17/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare the goodness-of-fit of five models of Eating Disorder Examination-Questionnaire (EDE-Q) data, in clinical and community samples. METHOD The EDE-Q was administered to 228 eating disorder patients and 211 non-eating disordered university students. Confirmatory factor analysis was used to compare the validity of the original four EDE-Q subscales with that of brief one-factor, extended one-factor, two-factor, and three-factor models. Measurement invariance across the two samples was considered. RESULTS The only model to provide an acceptable fit to the data was the brief one-factor model consisting of eight Weight and Shape Concern items. Scores on this scale correlated highly with the original EDE-Q subscales. CONCLUSION The reliability of the EDE-Q may be increased if a modified scoring system is used. This complements findings from recent research with the Eating Disorder Examination (EDE).
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Affiliation(s)
- Karina L Allen
- Centre for Clinical Interventions, Northbridge, Western Australia, Australia.
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221
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An fMRI investigation of the fronto-striatal learning system in women who exhibit eating disorder behaviors. Neuroimage 2011; 56:1749-57. [PMID: 21419229 DOI: 10.1016/j.neuroimage.2011.03.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 03/04/2011] [Accepted: 03/09/2011] [Indexed: 11/22/2022] Open
Abstract
In the present study, we sought to examine whether the fronto-striatal learning system, which has been implicated in bulimia nervosa, would demonstrate altered BOLD activity during probabilistic category learning in women who met subthreshold criteria for bulimia nervosa (Sub-BN). Sub-BN, which falls within the clinical category of Eating Disorder Not Otherwise Specified (EDNOS), is comprised of individuals who demonstrate recurrent binge eating, efforts to minimize their caloric intake and caloric retention, and elevated levels of concern about shape, weight, and/or eating, but just fail to meet the diagnostic threshold for bulimia nervosa (BN). fMRI data were collected from eighteen women with subthreshold-BN (Sub-BN) and nineteen healthy control women group-matched for age, education and body mass index (MC) during the weather prediction task. Sub-BN participants demonstrated increased caudate nucleus and dorsolateral prefrontal cortex (DLPFC) activation during the learning of probabilistic categories. Though the two subject groups did not differ in behavioral performance, over the course of learning, Sub-BN participants showed a dynamic pattern of brain activity differences when compared to matched control participants. Regions implicated in episodic memory, including the medial temporal lobe (MTL), retrosplenial cortex, middle frontal gyrus, and anterior and posterior cingulate cortex showed decreased activity in the Sub-BN participants compared to MCs during early learning which was followed by increased involvement of the DLPFC during later learning. These findings demonstrate that women with Sub-BN demonstrate differences in fronto-striatal learning system activity, as well as a distinct functional pattern between fronto-striatal and MTL learning systems during the course of implicit probabilistic category learning.
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222
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FRAMPTON IAN, WISTING LINE, ØVERÅS MARIA, MIDTSUND MARIE, LASK BRYAN. Reliability and validity of the Norwegian translation of the Child Eating Disorder Examination (ChEDE). Scand J Psychol 2011; 52:196-9. [DOI: 10.1111/j.1467-9450.2010.00833.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Steinglass JE, Sysko R, Glasofer D, Albano AM, Simpson HB, Walsh BT. Rationale for the application of exposure and response prevention to the treatment of anorexia nervosa. Int J Eat Disord 2011; 44:134-41. [PMID: 20127936 PMCID: PMC3638259 DOI: 10.1002/eat.20784] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Anorexia nervosa (AN) is a life threatening and difficult to treat illness with a high relapse rate. Current treatments are inadequate and new approaches to treatment are needed. METHOD We review the data on anxiety in AN, the relationship between anxiety disorders and AN, and the use of Exposure and Response Prevention in treatment. RESULTS The overlap between AN and anxiety disorders suggest a model of AN in which baseline anxiety features yield eating related fears, avoidance behaviors, and ritualized safety behaviors that promote the underweight state and the perpetuation of the disorder. We propose an Exposure and Response Prevention treatment to prevent relapse in AN. DISCUSSION Overlap between AN and anxiety disorders suggests that Exposure and Response Prevention may be a new and beneficial approach to preventing relapse in individuals with AN.
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Affiliation(s)
- Joanna E Steinglass
- Columbia University, New York State Psychiatric Institute, New York 10032, New York, USA.
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224
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Reas DL, Wisting L, Kapstad H, Lask B. Convergent Validity of the Eating Disorder Examination and the Eating Disorder Examination-Questionnaire Among University Women in Norway. EUROPEAN EATING DISORDERS REVIEW 2011; 19:357-61. [DOI: 10.1002/erv.1068] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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225
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Lehoux PM, Howe N. Perceived non‐shared environment, personality traits, family factors and developmental experiences in bulimia nervosa. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 46:47-66. [PMID: 17472201 DOI: 10.1348/014466506x111285] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The role of perceived non-shared environmental influences and personality traits in the risk of developing bulimia nervosa (BN) was compared in 40 women with BN and their non-eating disordered sisters. METHODS The two sisters were compared for (a) eating pathology, (b) perceived non-shared environmental factors (differential family relationships, developmental teasing, traumatic experiences), (c) personality traits (impulsivity, affective instability, narcissism), and (d) psychopathology (anxiety, depression). RESULTS Specific perceived non-shared risk factors (e.g. perceptions of teasing), nonspecific non-shared risk factors (e.g. insecure paternal attachment) and personality traits (e.g. narcissism) distinguished women with BN from sisters. In the final logistic regression, insecure paternal attachment predicted the risk for BN, while trends were apparent for narcissism and developmental teasing after controlling for psychopathology. CONCLUSIONS Our correlational cross-sectional design does not allow for investigation of direction of effects. However, it is an important first step in identifying possible perceived non-shared environmental influences and personality traits that may constitute vulnerability factors predisposing individuals to the development of BN. Findings are discussed in the light of existing models of risk factors for the etiology of BN.
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Affiliation(s)
- Pascale M Lehoux
- Centre Hospitalier de l'Université de Montreal, Montréal, Quebec, Canada.
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226
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Jansen A, Smeets T, Martijn C, Nederkoorn C. I see what you see: The lack of a self-serving body-image bias in eating disorders. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 45:123-35. [PMID: 16480571 DOI: 10.1348/014466505x50167] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Eating-disordered subjects feel unattractive, and the current idea is that this feeling reflects a distorted body image. A distorted body image requires a mismatch between the negative self-judgments and more objective judgments of the body. DESIGN AND METHODS To examine whether eating-disordered subjects have valid reasons for their feelings of unattractiveness, the body images of eating-symptomatic subjects and control models were compared with inter-subjective evaluations of these bodies given by two community samples (panels; N=72, N=88). RESULTS Although the objective body sizes of the eating-symptomatic subjects were in the normal range and not different from control bodies, the first panel rated the (headless) bodies of the eating-symptomatic subjects as less attractive. This finding was replicated with the second panel. There was also large agreement between the eating-symptomatic subjects and the second panel on the specific body parts that were indicated as unattractive. Contrary to the eating-symptomatic subjects, the control models showed a strong positively biased perception of their own attractiveness: they rated their own bodies more positively than others rated them. CONCLUSION Consensual validation of the harsh body appraisals of eating-symptomatic subjects was found. Interestingly, the normal controls were the ones that showed a biased body image; they rated themselves far more attractive than other people rated them. These data suggest that the real problem in eating disorders is not a distorted body image but a lack of a distorted body image, that is, the lack of a self-serving body-image bias.
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Affiliation(s)
- Anita Jansen
- Department of Experimental Psychology, University of Maastricht, The Netherlands
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227
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Rø O, Reas DL, Lask B. Norms for the Eating Disorder Examination Questionnaire among female university students in Norway. Nord J Psychiatry 2010; 64:428-32. [PMID: 20429744 DOI: 10.3109/08039481003797235] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Eating Disorder Examination (EDE) is a semi-structured interview used worldwide for diagnostic purposes and to assess the core psychopathology of an eating disorder. The Eating Disorder Examination Questionnaire 6.0 (EDE-Q) has been developed as a self-report questionnaire version of the full-length interview. AIM This study was conducted to establish norms among female university students in Norway and to test the reliability of the Norwegian version of the EDE-Q. METHOD The questionnaire was administered to 670 young adult women with a mean age (±standard deviation) of 24.8±6.9 years. RESULT Participants' mean global EDE-Q score was 1.42±1.07 and subscales means were as follows: 1.44±1.23 for restraint, 0.63±0.88 for eating concern, 2.00±1.42 for shape concern, and 1.63±1.36 for weight concern. Acceptable levels of internal consistency were observed; Cronbach's alpha coefficients were 0.94 for the global EDE-Q score and 0.75-0.90 for the subscales. To evaluate the temporal stability of the EDE-Q, a total of 159 participants completed the measure 1 week later. Spearman's correlation coefficients were 0.93 for global EDE-Q and for the subscales 0.82-0.91, indicating a satisfactory level of test-retest reliability. CONCLUSION The EDE-Q was easily administered and required only a few minutes to complete. This brief questionnaire provides a psychometrically established and cost-savings method of quickly assessing the core psychopathology of an eating disorder.
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Affiliation(s)
- Oyvind Rø
- Modum Bad, Research Institute, Vikersund, Norway.
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228
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Dahl JK, Eriksen L, Vedul-Kjelsås E, Strømmen M, Kulseng B, Mårvik R, Holen A. Prevalence of all relevant eating disorders in patients waiting for bariatric surgery: a comparison between patients with and without eating disorders. Eat Weight Disord 2010; 15:e247-55. [PMID: 21406948 DOI: 10.1007/bf03325306] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To study the prevalence of all relevant eating disorders in 157 obese patients waiting for bariatric surgery. Another aim was to explore for possible differences between gender, and those with and without ED. The dependent variables were: socio-demographic characteristics, BMI, obesity onset, and obesity-related somatic diseases. METHODS ED was assessed using the self-report questionnaire, "Eating Disorders in Obesity" (EDO). The patients answered a questionnaire that targeted socio-demographic and health information. RESULTS Subgroups were based on the patients responses to items on the EDO: 1 patient (0.6%) with Bulimia Nervosa (BN), 6 (3.8%) with Eating Disorder Not Otherwise Specified (EDNOS), 21 (13.4%) with Binge Eating Disorder (BED), and 23 (14.6%) with Binge Eating (BE). The patients in the EDNOS group were those who lacked one criterion of the BN diagnosis. The patients in the BE group lacked one criterion of the BED diagnosis. Twenty-eight (17.8%) fulfilled the DSM-IV-TR criteria for ED. When patients with BE were added, 51 patients (32.5%) were identified with ED or sub-threshold ED. In the explorative part of the study, no gender differences in socio-demographic variables, BMI, obesity onset, and obesity-related somatic diseases emerged. With the exception of age, no differences were found in these variables between those with and without ED. CONCLUSION Employing all relevant eating disorders and binge eating symptoms (BE) for this population identified patients with pathological eating behaviors, which are not detected in previous studies measuring only BED and BE.
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Affiliation(s)
- J K Dahl
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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229
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Cortese S, Morcillo Peñalver C. Comorbidity between ADHD and obesity: exploring shared mechanisms and clinical implications. Postgrad Med 2010; 122:88-96. [PMID: 20861592 DOI: 10.3810/pgm.2010.09.2205] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recent studies suggest an association between attention-deficit/hyperactivity disorder (ADHD) and obesity. In this article, we systematically review and critically discuss evidence on the prevalence of ADHD in obese patients as well as the weight status of individuals with ADHD. Relevant articles were searched in PubMed, PsychInfo, and ISI Web of Science (January 1980 to June 2010). We found that current evidence indicates a high prevalence of ADHD in clinical samples of patients seeking treatment for their obesity. Moreover, available studies show that individuals with ADHD have higher-than-average body mass index z scores and/or a significantly higher prevalence of obesity compared with subjects without ADHD. Three mechanisms underlying the association between ADHD and obesity have been proposed: 1) it is possible that obesity and/or factors associated with it (such as sleep-disordered breathing) manifest as ADHD-like symptoms; 2) ADHD and obesity share common biological dysfunctions; and 3) ADHD contributes to obesity. With regards to the possible clinical implications, our findings suggest that it is noteworthy to screen for ADHD in patients with obesity and to look for abnormal eating behaviors as possible contributing factors of obesity in patients with ADHD. Based on preliminary findings, appropriate treatment of ADHD may improve the weight status of individuals with both obesity and ADHD.
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Affiliation(s)
- Samuele Cortese
- Department of Psychiatry, Child and Adolescent Psychiatry Unit, University Hospital Clocheville, 34, Rue Jules Charpentier, 37000 Tours, France.
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230
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Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. ACTA ACUST UNITED AC 2010; 67:1025-32. [PMID: 20921118 DOI: 10.1001/archgenpsychiatry.2010.128] [Citation(s) in RCA: 485] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
CONTEXT Evidence-based treatment trials for adolescents with anorexia nervosa are few. OBJECTIVE To evaluate the relative efficacy of family-based treatment (FBT) and adolescent-focused individual therapy (AFT) for adolescents with anorexia nervosa in full remission. DESIGN Randomized controlled trial. SETTING Stanford University and The University of Chicago (April 2005 until March 2009). PARTICIPANTS One hundred twenty-one participants, aged 12 through 18 years, with DSM-IV diagnosis of anorexia nervosa excluding the amenorrhea requirement. Intervention Twenty-four outpatient hours of treatment over 12 months of FBT or AFT. Participants were assessed at baseline, end of treatment (EOT), and 6 months' and 12 months' follow-up posttreatment. MAIN OUTCOME MEASURES Full remission from anorexia nervosa defined as normal weight (≥95% of expected for sex, age, and height) and mean global Eating Disorder Examination score within 1 SD of published means. Secondary outcome measures included partial remission rates (>85% of expected weight for height plus those who were in full remission) and changes in body mass index percentile and eating-related psychopathology. RESULTS There were no differences in full remission between treatments at EOT. However, at both the 6- and 12-month follow-up, FBT was significantly superior to AFT on this measure. Family-based treatment was significantly superior for partial remission at EOT but not at follow-up. In addition, body mass index percentile at EOT was significantly superior for FBT, but this effect was not found at follow-up. Participants in FBT also had greater changes in Eating Disorder Examination score at EOT than those in AFT, but there were no differences at follow-up. CONCLUSION Although both treatments led to considerable improvement and were similarly effective in producing full remission at EOT, FBT was more effective in facilitating full remission at both follow-up points. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00149786.
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Affiliation(s)
- James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA 94305, USA.
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231
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Darcy AM, Katz S, Fitzpatrick KK, Forsberg S, Utzinger L, Lock J. All better? How former anorexia nervosa patients define recovery and engaged in treatment. EUROPEAN EATING DISORDERS REVIEW 2010; 18:260-70. [PMID: 20589765 DOI: 10.1002/erv.1020] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to explore how individuals with anorexia nervosa (AN) engage in treatment and define recovery. A mixed methods design was used to triangulate the experience of 20 women with a history of AN. Interview data were analysed thematically to explore frequency of emergent themes and current eating disorder psychopathology was assessed using standardized self-report measures. Participants' mean age was 29.35 (SD = 12.11). Participants' scores were indicative of persistent psychopathology. Those with more involvement in treatment choice had better motivation to change and normalized eating. Participants' definition of recovery mapped on well to current research conceptualizations, though a substantial proportion of the group expressed some ambivalence around the concept. Results are interpreted in the context of self-determination theory of motivation and suggest that patients should be involved collaboratively in the formulation of shared goals and concepts of recovery in treatment settings.
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Affiliation(s)
- Alison M Darcy
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA 94305, USA.
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232
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McAlpine DE, Frisch MJ, Rome ES, Clark MM, Signore C, Lindroos AK, Allison KC. Bariatric surgery: a primer for eating disorder professionals. EUROPEAN EATING DISORDERS REVIEW 2010; 18:304-17. [PMID: 20589766 DOI: 10.1002/erv.1012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obesity is a public health epidemic with medical, psychological and economic consequences. It continues to increase globally in prevalence and severity. Despite numerous behaviourally, medically or pharmacologically guided treatments, an effective non-surgical long-term treatment approach has not been identified. Bariatric surgery has surfaced as a viable option for a subset of individuals with medically complicated obesity who have failed non-surgical approaches. Pre-operative evaluation followed by post-operative, longitudinal follow-up by a multidisciplinary team specializing in surgery, medicine, psychiatry/psychology, exercise science and nutrition constitutes recognized and necessary standard of care for these complex patients. More information is needed regarding factors that interfere with successful outcomes and mechanisms of optimal follow-up for bariatric surgery patients to prevent and detect post-operative medical, psychological and social difficulties. We will review these issues with a focus on issues relevant to eating disorders professionals.
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Affiliation(s)
- Donald E McAlpine
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, Rochester, MN 55905, USA.
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233
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Jones W, Morgan J. Eating disorders in men: a review of the literature. JOURNAL OF PUBLIC MENTAL HEALTH 2010. [DOI: 10.5042/jpmh.2010.0326] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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234
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A season-of-birth/DRD4 interaction predicts maximal body mass index in women with bulimia nervosa. Neuropsychopharmacology 2010; 35:1729-33. [PMID: 20336060 PMCID: PMC3055483 DOI: 10.1038/npp.2010.38] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We have earlier reported that season of birth interacts with the hypofunctional 7-repeat (7R) allele of the dopamine-4 receptor gene (DRD4) to promote weight gain and obesity in women with seasonal affective disorder (SAD). This study examined whether this gene-environment interaction influences body weight regulation in women with bulimia nervosa (BN). In 188 female probands with BN, we performed an analysis of covariance predicting maximum lifetime body mass index (BMI) using season-of-birth, DRD4 genotype (7R present/absent), and past history of anorexia nervosa (yes/no) as independent variables, and age at maximum weight as the co-variate. Consistent with our SAD study, the birth-season x DRD4 interaction was a significant predictor of maximal BMI. Although in SAD, the spring-birth/7R+ group had markedly elevated maximal BMIs and high rates of obesity, in this BN sample, the fall-birth/7R+ group exhibited the highest BMI values (N=17: mean maximal BMI=28.2 kg/m(2) (SE 0.9) vs 25.2 kg/ m(2) (SE 0.3) for all other probands combined (N=171); p=0.002). The lifetime rate of obesity (BMI>30) was also higher in the fall-birth/7R+ vs 'other' group (29.9 vs 8.8%, respectively, p=0.008). These data offer further evidence that season of birth interacts with the 7R allele of DRD4 to influence body weight regulation in female overeating populations.
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235
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Grilo CM, Crosby RD, Peterson CB, Masheb RM, White MA, Crow SJ, Wonderlich SA, Mitchell JE. Factor structure of the eating disorder examination interview in patients with binge-eating disorder. Obesity (Silver Spring) 2010; 18:977-81. [PMID: 19798064 PMCID: PMC3652230 DOI: 10.1038/oby.2009.321] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the widespread use of the Eating Disorder Examination (EDE) as a primary assessment instrument in studies of eating and weight disorders, little is known about the psychometric aspects of this interview measure. The primary purpose of this study was to evaluate the factor structure of the EDE interview in a large series of patients with binge-eating disorder (BED). Participants were 688 treatment-seeking patients with BED who were reliably administered the EDE interview by trained research clinicians at three research centers. Exploratory factor analysis (EFA) performed on EDE interview data from a random split-half of the study group suggested a brief 7-item 3-factor structure. Confirmatory factor analysis (CFA) performed on the second randomly selected half of the study group supported this brief 3-factor structure of the EDE interview. The three factors were interpreted as Dietary Restraint, Shape/Weight Overvaluation, and Body Dissatisfaction. In this series of patients with BED, factor analysis of the EDE interview did not replicate the original subscales but revealed an alternative factor structure. Future research must further evaluate the psychometric properties, including the factor structure, of the EDE interview in this and other eating-disordered groups. The implications of these factor analytic findings for understanding and assessing the specific psychopathology of patients with BED are discussed.
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Affiliation(s)
- Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
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236
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Byrne SM, Allen KL, Lampard AM, Dove ER, Fursland A. The factor structure of the eating disorder examination in clinical and community samples. Int J Eat Disord 2010; 43:260-5. [PMID: 19350647 DOI: 10.1002/eat.20681] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the factor structure of the Eating Disorder Examination (EDE) in three different samples and to compare the goodness-of-fit of five models of EDE data. METHOD The EDE was administered to eating disordered (n = 158), treatment-seeking obese (n = 170) and non-eating disordered community-based (n = 329) participants. Confirmatory factor analysis was used to compare the validity of the original four-factor EDE model with that of three-, two-, and one-factor models. RESULTS None of the tested models provided a "good fit" to the data in any sample, with the exception of a brief one-factor model in the eating disorder group. Estimations of internal consistency, reliability, and validity were superior for the one-, two-, and three-factor models compared to the four-factor model in all samples. DISCUSSION Overall, there was more support for a one-factor model of EDE data than for a multi-factorial model. It may be more appropriate to use Global EDE scores than individual subscale scores for research purposes.
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Affiliation(s)
- Susan M Byrne
- School of Psychology, The University of Western Australia, Crawley, Western Australia, Australia.
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237
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Randomized controlled clinical trial of yoga in the treatment of eating disorders. J Adolesc Health 2010; 46:346-51. [PMID: 20307823 PMCID: PMC2844876 DOI: 10.1016/j.jadohealth.2009.08.007] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Revised: 08/19/2009] [Accepted: 08/25/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE This was a pilot project designed to assess the effect of individualized yoga treatment on eating disorder outcomes among adolescents receiving outpatient care for diagnosed eating disorders (anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified). METHODS A total of 50 girls and 4 boys aged 11-21 years were randomized to an 8-week trial of standard care vs. individualized yoga plus standard care. Of these, 27 were randomized to standard care and 26 to yoga plus standard care (attrition: n = 4). Standard care (every other week physician and/or dietician appointments) was required to meet ethical guidelines. The No Yoga group was offered yoga after study completion as an incentive to maintain participation. Outcomes evaluated at baseline, end of trial, and 1-month follow-up included Eating Disorder Examination (EDE), Body Mass Index (BMI), Beck Depression Inventory, State-Trait Anxiety Inventory, and Food Preoccupation questionnaire. RESULTS The Yoga group demonstrated greater decreases in eating disorder symptoms. Specifically, the EDE scores decreased over time in the Yoga group, whereas the No Yoga group showed some initial decline but then returned to baseline EDE levels at week 12. Food preoccupation was measured before and after each yoga session, and decreased significantly after all sessions. Both groups maintained current BMI levels and decreased in anxiety and depression over time. CONCLUSIONS Individualized yoga treatment decreased EDE scores at 12 weeks, and significantly reduced food preoccupation immediately after yoga sessions. Yoga treatment did not have a negative effect on BMI. Results suggest that individualized yoga therapy holds promise as adjunctive therapy to standard care.
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238
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Young-Hyman DL, Davis CL. Disordered eating behavior in individuals with diabetes: importance of context, evaluation, and classification. Diabetes Care 2010; 33:683-9. [PMID: 20190297 PMCID: PMC2827531 DOI: 10.2337/dc08-1077] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Deborah L Young-Hyman
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta, Georgia, USA.
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239
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Diagnostic classification of eating disorders in children and adolescents: how does DSM-IV-TR compare to empirically-derived categories? J Am Acad Child Adolesc Psychiatry 2010; 49:277-87; quiz 293. [PMID: 20410717 PMCID: PMC2904981 DOI: 10.1016/j.jaac.2009.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this study was to empirically derive eating disorder phenotypes in a clinical sample of children and adolescents using latent profile analysis (LPA), and to compare these latent profile (LP) groups to the DSM-IV-TR eating disorder categories. METHOD Eating disorder symptom data collected from 401 youth (aged 7 through 19 years; mean 15.14 +/- 2.35 years) seeking eating disorder treatment were included in LPA; general linear models were used to compare LP groups to DSM-IV-TR eating disorder categories on pretreatment and outcome indices. RESULTS Three LP groups were identified: LP1 (n = 144), characterized by binge eating and purging ("Binge/purge"); LP2 (n = 126), characterized by excessive exercise and extreme eating disorder cognitions ("Exercise-extreme cognitions"); and LP3 (n = 131), characterized by minimal eating disorder behaviors and cognitions ("Minimal behaviors/cognitions"). Identified LPs imperfectly resembled DSM-IV-TR eating disorders. LP1 resembled bulimia nervosa; LP2 and LP3 broadly resembled anorexia nervosa with a relaxed weight criterion, differentiated by excessive exercise and severity of eating disorder cognitions. The LP groups were more differentiated than the DSM-IV-TR categories across pretreatment eating disorder and general psychopathology indices, as well as weight change at follow-up. Neither LP nor DSM-IV-TR categories predicted change in binge/purge behaviors. Validation analyses suggest these empirically derived groups improve upon the current DSM-IV-TR categories. CONCLUSIONS In children and adolescents, revisions for DSM-V should consider recognition of patients with minimal cognitive eating disorder symptoms.
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Goldschmidt AB, Hilbert A, Manwaring JL, Wilfley DE, Pike KM, Fairburn CG, Striegel-Moore RH. The significance of overvaluation of shape and weight in binge eating disorder. Behav Res Ther 2010; 48:187-93. [PMID: 19897174 PMCID: PMC2829349 DOI: 10.1016/j.brat.2009.10.008] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 10/14/2009] [Accepted: 10/15/2009] [Indexed: 11/27/2022]
Abstract
As publication of DSM-V draws near, research is needed to validate the diagnostic scheme for binge eating disorder (BED). Shape and weight overvaluation has stimulated considerable debate in this regard, given associations with psychosocial impairment and poor treatment outcome in BED. This study sought to further explore the convergent validity and diagnostic specificity of shape and weight overvaluation in BED. A total of 160 women with BED, and 108 women with non-eating disordered psychiatric disorders were recruited from the community. Women with BED were classified as more or less severe based on a global measure of eating-related psychopathology; subsequent receiver operating characteristics analysis determined that a threshold of at least "moderate" overvaluation best predicted membership into a more severe group. BED participants with threshold overvaluation exhibited poorer psychosocial functioning than those with subthreshold overvaluation, as well as participants with other psychiatric disorders. Discriminant function analysis revealed that threshold overvaluation predicted a diagnosis of BED versus other psychiatric disorder with 67.7% accuracy. Results suggest that shape and weight overvaluation is a useful diagnostic specifier in BED. Continued research is warranted to examine its predictive validity in natural course and treatment outcome studies.
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Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychology, Washington University, 660 South
Euclid Avenue, Campus Box 8134, St. Louis, MO, 63110, USA;
(Ms. Goldschmidt);
(Ms. Manwaring)
| | - Anja Hilbert
- Department of Psychology, Philipps University of Marburg,
Gutenbergstrasse 18, Marburg, Germany;
| | - Jamie L. Manwaring
- Department of Psychology, Washington University, 660 South
Euclid Avenue, Campus Box 8134, St. Louis, MO, 63110, USA;
(Ms. Goldschmidt);
(Ms. Manwaring)
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of
Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA;
| | - Kathleen M. Pike
- Department of Psychology, Temple University Japan Campus,
Azabu Hall 6th Floor, Minami-Azabu 2-8-12, Minato-ku, Tokyo, Japan, 106-0047;
| | | | - Ruth H. Striegel-Moore
- Department of Psychology, Wesleyan University, 207 High
Street, Middletown, CT 06459, USA;
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241
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Tchanturia K, Lock J. Cognitive remediation therapy for eating disorders: development, refinement and future directions. Curr Top Behav Neurosci 2010; 6:269-87. [PMID: 21243481 DOI: 10.1007/7854_2010_90] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In this chapter, we aim to address some basic conceptual and practical questions about cognitive remediation therapy (CRT) for eating disorders. We begin by providing an overall historical, conceptual, and theoretical framework for CRT. Next, we discuss the specific indications for how and why CRT might be useful for eating disorders based on existing neuropsychological research evidence. We also provide an overview of the types of tasks and stimuli used in CRT and a general protocol for a manualized version of CRT. In addition, modifications of the adult CRT manual for use with adolescents as well as preliminary acceptability of the approach with this younger age group are described. We also propose various ways to integrate CRT in a variety of inpatient and outpatient programmes. Finally, a discussion of potential future directions in research using the tools of neurocognitive assessment, imaging and treatment research is provided.
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Affiliation(s)
- Kate Tchanturia
- Department of Psychological Medicine, King's College London, UK.
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242
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Swanson H, Power K, Collin P, Deas S, Paterson G, Grierson D, Yellowlees A, Park K, Taylor L. The relationship between parental bonding, social problem solving and eating pathology in an anorexic inpatient sample. EUROPEAN EATING DISORDERS REVIEW 2010; 18:22-32. [DOI: 10.1002/erv.967] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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243
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Pretorius N, Waller G, Gowers S, Schmidt U. Validity of the Eating Disorders Examination-Questionnaire when used with adolescents with bulimia nervosa and atypical bulimia nervosa. Eat Weight Disord 2009; 14:e243-8. [PMID: 20179414 DOI: 10.1007/bf03325125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To validate the online questionnaire form of the Eating Disorders Examination (EDE-Q) against the interview version (EDE) in a clinic and community sample of adolescents with bulimia nervosa (BN) or atypical BN (eating disorder not otherwise specified with bulimic features - EDNOS-BN). METHOD Adolescents with BN (N=58) or EDNOS-BN (N=37) completed the EDE over the telephone and the EDE-Q online. RESULTS There were moderate to high correlations between the attitudinal scales. Eating was rated as more pathological on the EDE-Q than the EDE, except dietary restraint. As in research among adults, agreement between the two measures was low regarding binge eating episodes, but better for vomiting episodes. When compared with the EDE, the EDE-Q attitudinal scales were more valid for BN than for EDNOS-BN patients, and more valid for the clinic sample. CONCLUSION The online version of the EDE-Q has partial validity for use with adolescents. The EDE-Q might be reporting a more accurate description of current status, as it avoids possible filtering and approval aspects.
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Affiliation(s)
- N Pretorius
- Eating Disorders Section, Institute of Psychiatry, King's College, University of London, London SE5 8AF, UK
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244
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Agras WS, Crow S, Mitchell JE, Halmi KA, Bryson S. A 4-year prospective study of eating disorder NOS compared with full eating disorder syndromes. Int J Eat Disord 2009; 42:565-70. [PMID: 19544557 PMCID: PMC2862563 DOI: 10.1002/eat.20708] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the course of Eating Disorder NOS (EDNOS) compared with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). METHOD Prospective study of 385 participants meeting DSM-IV criteria for AN, BN, BED, and EDNOS at three sites. Recruitment was from the community and specialty clinics. Participants were followed at 6-month intervals during a 4-year period using the Eating Disorder Examination as the primary assessment. RESULTS EDNOS remitted significantly more quickly that AN or BN but not BED. There were no differences between EDNOS and full ED syndromes, or the subtypes of EDNOS, in time to relapse following first remission. Only 18% of the EDNOS group had never had or did not develop another ED diagnosis during the study; however, this group did not differ from the remaining EDNOS group. DISCUSSION EDNOS appears to be a way station between full ED syndromes and recovery, and to a lesser extent from recovery or EDNOS status to a full ED. Implications for DSM-V are examined.
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Affiliation(s)
- W. Stewart Agras
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA,Correspondence to: Dr W. Stewart Agras (, Telephone: 650-725-5734, Fax: 650-723-9807)
| | - Scott Crow
- Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN
| | - James E Mitchell
- Neuropsychiatric Research Institute and Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Services, Fargo, ND
| | | | - Susan Bryson
- Department of Psychiatry, Stanford University School of Medicine, Stanford, CA
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Green MA, Scott NA, Cross SE, Liao KYH, Hallengren JJ, Davids CM, Carter LP, Kugler DW, Read KE, Jepson AJ. Eating disorder behaviors and depression: a minimal relationship beyond social comparison, self-esteem, and body dissatisfaction. J Clin Psychol 2009; 65:989-99. [DOI: 10.1002/jclp.20586] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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246
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Conti MA, Slater B, Latorre MDRDDO. [Validity and reproducibility of Escala de Evaluación da Insatisfación Corporal para Adolescentes]. Rev Saude Publica 2009; 43:515-24. [PMID: 19448917 DOI: 10.1590/s0034-89102009000300016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Accepted: 11/03/2008] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To validate a body dissatisfaction scale for adolescents. METHODS The study included 386 female and male adolescents aged 10 to 17 years enrolled in a private elementary and middle school in the city of São Bernardo do Campo, southeastern Brazil, in 2006. 'Escala de Evaluación da Insatisfación Corporal para Adolescentes' (body dissatisfaction scale for adolescents) was translated and culturally adapted. The Portuguese instrument was evaluated for internal consistency using Cronbach's alpha, factor analysis with Varimax rotation, discriminant validity by comparing score means according to nutritional status (low weight, normal weight, and at risk of overweight and obesity) using the Kruskal-Wallis test. Concurrent validity was assessed using Spearman's rank correlation coefficient between scores and body mass index, waist-hip ratio and waist circumference. Reproducibility was evaluated using Wilcoxon test, and intraclass correlation coefficient. RESULTS The translated and back-translated scale showed good agreement with the original one. The translated scale had good internal consistency in all subgroups studied (males and females in early and intermediate adolescence) and was able to discriminate adolescents according to their nutritional status. In the concurrent analysis, all three measures were correlated, except for males in early adolescence. Its reproducibility was ascertained. CONCLUSIONS The 'Escala de Evaluación da Insatisfación Corporal para Adolescentes' was successfully translated into Portuguese and adapted to the Brazilian background and showed good results. It is recommended for the evaluation of the attitudinal component of body image in adolescents.
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Affiliation(s)
- Maria Aparecida Conti
- Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Green MA, Hallengren JJ, Davids CM, Riopel CM, Skaggs AK. An association between eating disorder behaviors and autonomic dysfunction in a nonclinical population. A pilot study. Appetite 2009; 53:139-42. [DOI: 10.1016/j.appet.2009.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 05/04/2009] [Accepted: 05/07/2009] [Indexed: 11/16/2022]
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248
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Fox JRE, Froom K. Eating disorders: A basic emotion perspective. Clin Psychol Psychother 2009; 16:328-35. [DOI: 10.1002/cpp.622] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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249
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Schvey NA, Tanofsky-Kraff M, Yanoff LB, Checchi JM, Shomaker LB, Brady S, Savastano DM, Ranzenhofer LM, Yanovski SZ, Reynolds JC, Yanovski JA. Disordered-eating attitudes in relation to bone mineral density and markers of bone turnover in overweight adolescents. J Adolesc Health 2009; 45:33-9. [PMID: 19541247 PMCID: PMC2722035 DOI: 10.1016/j.jadohealth.2008.12.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 12/19/2008] [Accepted: 12/29/2008] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine the relationships between cognitive eating restraint and both bone mineral density (BMD) and markers of bone turnover in overweight adolescents. METHODS One hundred thirty-seven overweight (BMI 39.1 +/- 6.8 kg/m(2)) African American and Caucasian adolescent (age = 14.4 +/- 1.4 years) girls (66.4%) and boys were administered the Eating Disorder Examination (EDE) interview and Eating Inventory (EI) questionnaire and underwent dual energy X-ray absorptiometry (DXA) to measure total lumbar spine BMD. Markers of bone formation (serum bone specific alkaline phosphatase and osteocalcin), bone resorption (24-hour urine N-telopeptides), and stress (urine free cortisol) were measured. RESULTS After accounting for the contribution of demographics, height, weight, serum 25-hydroxyvitamin D, and depressive symptoms, adolescents' weight concern, as assessed by interview, was a significant contributor to the model of urine free cortisol (beta = .30, p < .05). Shape concern, as also assessed by interview, was significantly associated with lumbar spine bone mineral density (beta = -.15, p < .05). Dietary restraint was not a significant predictor in any of these models. CONCLUSIONS These findings suggest that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors. Future research is required to illuminate the relationship between bone health and disordered-eating attitudes in overweight adolescents.
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Affiliation(s)
- Natasha A. Schvey
- Unit 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 (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS
| | - Marian Tanofsky-Kraff
- Unit 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 (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS
| | - Lisa B. Yanoff
- Unit 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 (NIH), DHHS
| | - Jenna M. Checchi
- Unit 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 (NIH), DHHS,Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS
| | - Lauren B. Shomaker
- Unit 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 (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS
| | - Sheila Brady
- Unit 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 (NIH), DHHS
| | - David M. Savastano
- Unit 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 (NIH), DHHS
| | - Lisa M. Ranzenhofer
- Unit 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 (NIH), DHHS,Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Digestive Kidney Diseases, NIH, DHHS,Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS
| | - Susan Z. Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS
| | - James C. Reynolds
- Nuclear Medicine Department, Hatfield Clinical Research Center, NIH, DHHS
| | - Jack A. Yanovski
- Unit 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 (NIH), DHHS
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Evans AH, Strafella AP, Weintraub D, Stacy M. Impulsive and compulsive behaviors in Parkinson's disease. Mov Disord 2009; 24:1561-70. [DOI: 10.1002/mds.22505] [Citation(s) in RCA: 172] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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