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Murray SB, Alba C, Duval CJ, Nagata JM, Cabeen RP, Lee DJ, Toga AW, Siegel SJ, Jann K. Aberrant functional connectivity between reward and inhibitory control networks in pre-adolescent binge eating disorder. Psychol Med 2023; 53:3869-3878. [PMID: 35301976 DOI: 10.1017/s0033291722000514] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Behavioral features of binge eating disorder (BED) suggest abnormalities in reward and inhibitory control. Studies of adult populations suggest functional abnormalities in reward and inhibitory control networks. Despite behavioral markers often developing in children, the neurobiology of pediatric BED remains unstudied. METHODS 58 pre-adolescent children (aged 9-10-years) with BED (mBMI = 25.05; s.d. = 5.40) and 66 age, BMI and developmentally matched control children (mBMI = 25.78; s.d. = 0.33) were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development (ABCD) Study. We investigated group differences in resting-state functional MRI functional connectivity (FC) within and between reward and inhibitory control networks. A seed-based approach was employed to assess nodes in the reward [orbitofrontal cortex (OFC), nucleus accumbens, amygdala] and inhibitory control [dorsolateral prefrontal cortex, anterior cingulate cortex (ACC)] networks via hypothesis-driven seed-to-seed analyses, and secondary seed-to-voxel analyses. RESULTS Findings revealed reduced FC between the dlPFC and amygdala, and between the ACC and OFC in pre-adolescent children with BED, relative to controls. These findings indicating aberrant connectivity between nodes of inhibitory control and reward networks were corroborated by the whole-brain FC analyses. CONCLUSIONS Early-onset BED may be characterized by diffuse abnormalities in the functional synergy between reward and cognitive control networks, without perturbations within reward and inhibitory control networks, respectively. The decreased capacity to regulate a reward-driven pursuit of hedonic foods, which is characteristic of BED, may in part, rest on this dysconnectivity between reward and inhibitory control networks.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Celina Alba
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Ryan P Cabeen
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Darrin J Lee
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
- Department of Neurological Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
- USC Neurorestoration Center, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Steven J Siegel
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
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Raisi A, Zerbini V, Piva T, Belvederi Murri M, Menegatti E, Caruso L, Masotti S, Grazzi G, Mazzoni G, Mandini S. Treating Binge Eating Disorder With Physical Exercise: A Systematic Review and Meta-analysis. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:523-530. [PMID: 37245147 DOI: 10.1016/j.jneb.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This review aimed to collect evidence about the effectiveness of exercise programs for managing binge eating disorder (BED) (recurrent binge eating episodes). METHODS Meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in PubMed, Scopus, Web of Science, and Cochrane Library. Randomized controlled trials were eligible for inclusion if they reported the effect of an exercise-based program on BED symptoms in adults. Outcomes were changes in binge eating symptom severity, measured through validated assessment instruments, after an exercise-based intervention. Study results were pooled using the Bayesian model averaging for random and fixed effects meta-analysis. RESULTS Of 2,757 studies, 5 trials were included, with 264 participants. The mean age was 44.7 ± 8.1 years for the intervention group and 46.6 ± 8.5 years for the control group. All participants were female. A significant improvement was observed between groups (standardized mean difference, 0.94; 95% credibility interval, -1.46 to -0.31). Patients obtained significant improvements either following supervised exercise programs or home-based exercise prescriptions. IMPLICATIONS FOR RESEARCH AND PRACTICE These findings suggest that physical exercise, within a multidisciplinary clinical and psychotherapeutic approach, may be an effective intervention for managing BED symptoms. Further comparative studies are needed to clarify which exercise modality is associated with greater clinical benefits.
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Affiliation(s)
- Andrea Raisi
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Valentina Zerbini
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Tommaso Piva
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
| | - Martino Belvederi Murri
- Institute of Psychiatry Department of Neuroscience and Rehabilitation University of Ferrara, Ferrara, Italy
| | - Erica Menegatti
- Departement of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Lorenzo Caruso
- Departement of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Sabrina Masotti
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Public Health Department, AUSL Ferrara, Ferrara, Italy; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL
| | - Gianni Mazzoni
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Public Health Department, AUSL Ferrara, Ferrara, Italy
| | - Simona Mandini
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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The phenomenon of abnormal eating and taste perception: What’s the link in subjects with obesity and eating disorders? Food Qual Prefer 2023. [DOI: 10.1016/j.foodqual.2022.104744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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4
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Murray SB, Duval CJ, Balkchyan AA, Cabeen RP, Nagata JM, Toga AW, Siegel SJ, Jann K. Regional gray matter abnormalities in pre-adolescent binge eating disorder: A voxel-based morphometry study. Psychiatry Res 2022; 310:114473. [PMID: 35220054 DOI: 10.1016/j.psychres.2022.114473] [Citation(s) in RCA: 9] [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: 11/20/2021] [Revised: 02/02/2022] [Accepted: 02/19/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with an array of multisystemic organ morbidity, broad psychiatric morbidity, and obesity. Despite behavioral markers often developing in early childhood, the neurobiological markers of early-onset BED remain understudied, and developmental pathophysiology remains poorly understood. METHODS 71 preadolescent children (aged 9-10-years) with BED and 74 age, BMI and developmentally matched control children were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development (ABCD) Study. We investigated group differences in gray matter density (GMD) via voxel-based morphometry (VBM). We additionally performed region of interest analyses, assessing the association between GMD in nodes of the reward (orbitofrontal cortex; OFC) and inhibitory control (dorsolateral prefrontal cortex; dlPFC) networks, and parent-reported behavioral inhibition and approach tendencies. RESULTS Diffuse elevations in cortical GMD were noted in those with BED, which spanned prefrontal, parietal, and temporal regions. No areas of reduced GMD were noted in those with BED. No alterations in subcortical GMD were noted. Brain-behavioral associations suggest a distinct and negative relationship between GMD in the OFC and dlPFC, respectively, and self-reported markers of hedonic behavioral approach tendencies. CONCLUSIONS Early-onset BED may be characterized by diffuse morphological abnormalities in gray matter density, suggesting alterations in cortical architecture which may reflect decreased synaptic pruning and arborization, or decreased myelinated fibers and therefore inter-regional afferents.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Translational Research in Eating Disorders Program, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States.
| | - Christina J Duval
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Translational Research in Eating Disorders Program, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Ane A Balkchyan
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States; Translational Research in Eating Disorders Program, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Ryan P Cabeen
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Arthur W Toga
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Steven J Siegel
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Kay Jann
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
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Debeuf T, Verbeken S, Boelens E, Volkaert B, Van Malderen E, Michels N, Braet C. Emotion regulation training in the treatment of obesity in young adolescents: protocol for a randomized controlled trial. Trials 2020; 21:153. [PMID: 32039739 PMCID: PMC7011608 DOI: 10.1186/s13063-019-4020-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prevalence rates of childhood obesity are increasing. The current multidisciplinary treatments for (childhood) obesity are effective but only moderately and in the short term. A possible explanation for the onset and maintenance of childhood obesity is that it reflects a maladaptive mechanism for regulating high levels of stress and emotions. Therefore, the current RCT study aims to test the effectiveness of adding an emotion regulation training to care as usual (multidisciplinary obesity treatment) in young inpatients (10-14) involved in an obesity treatment program compared to care as usual alone. The research model for this RCT study states that when high levels of stress are regulated in a maladaptive way, this can contribute to the development of obesity. METHODS The current study will recruit 140 youngsters (10-14 years) who are involved in an inpatient multidisciplinary obesity treatment (MOT) program. After giving consent to participate in the study, youngsters will be randomly assigned, during consecutive waves, to one of two conditions: care as usual (receiving MOT) or intervention (receiving MOT in addition to emotion regulation training). The training itself consists of 12 weekly sessions, followed by a booster session after 3 and 5 months. The participants will be tested pretraining, post-training, and at 6 months' follow-up. We hypothesize that, compared to the control condition, youngsters in the intervention condition will (1) use more adaptive emotion regulation strategies and (2) report less emotional eating, both primary outcome measures. Moreover, on the level of secondary outcome measures, we hypothesize that youngsters in the intervention condition, compared with the control condition, will (3) report better sleep quality, (4) undergo improved weight loss and weight loss maintenance, and (5) experience better long-term (6-months) psychological well-being. DISCUSSION This study will add to both the scientific and clinical literature on the role of emotion regulation in the development and maintenance of different psychopathologies, as emotion regulation is a transdiagnostic factor. TRIAL REGISTRATION The RCT study protocol is registered at ISRCTN Registry, with study ID "ISRCTN 83822934." Registered on 13 December 2017.
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Affiliation(s)
- Taaike Debeuf
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Elisa Boelens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Brenda Volkaert
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Eva Van Malderen
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Nathalie Michels
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Developing an Acceptance-Based Behavioral Weight Loss Treatment for Individuals With Binge Eating Pathology: A Preliminary Proof of Concept Study and Clinical Case Series. COGNITIVE AND BEHAVIORAL PRACTICE 2019; 26:395-410. [PMID: 31827317 DOI: 10.1016/j.cbpra.2018.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Binge eating (BE; i.e., the consumption of a large amount of food in a discrete time period, accompanied by a sense of loss of control) is highly comorbid with overweight or obesity and is the primary symptom of binge eating disorder (BED). Current gold-standard treatment for BED (i.e., CBT) does not produce meaningful weight loss, thus failing to address a critical treatment target. This article describes the development of a novel acceptance-based behavioral treatment (ABBT) for individuals with clinically significant BE desiring to reduce BE symptoms and achieve concurrent weight loss. We discuss the development and structure of the novel treatment approach, and describe the test of a proof of concept version of the treatment in a clinical case series of four individuals. In the context of each clinical case description, we present initial acceptability of the treatment and challenges faced in treatment development and delivery. Finally, we discuss future research directions for the treatment, which could improve BE symptoms and weight loss outcomes for individuals with BE pathology.
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Arduini T, Iorio D, Patacchini E. Weight, reference points, and the onset of eating disorders. JOURNAL OF HEALTH ECONOMICS 2019; 65:170-188. [PMID: 31030114 DOI: 10.1016/j.jhealeco.2019.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/11/2019] [Accepted: 03/12/2019] [Indexed: 06/09/2023]
Abstract
We investigate whether the development of eating disorders, in the form of purging, is influenced by peers' body size through interpersonal comparisons. Using detailed information on recent cohorts of U.S. teenagers, we document a sizeable and significant negative effect of high school peers' body mass index (BMI) on purging behavior during the adolescence for females, but not for males. Interpersonal comparisons operate through the formation of a distorted self-perception: teenage girls with relatively thin female peers perceive themselves as heavier than they actually are. The girls who are more susceptible to peer influences are those having peers who are thinner, more popular, more (verbally) able, and with more educated parents.
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Naets T, Vervoort L, Ysebaert M, Van Eyck A, Verhulst S, Bruyndonckx L, De Winter B, Van Hoorenbeeck K, Tanghe A, Braet C. WELCOME: improving WEight controL and CO-Morbidities in children with obesity via Executive function training: study protocol for a randomized controlled trial. BMC Public Health 2018; 18:1075. [PMID: 30157826 PMCID: PMC6116429 DOI: 10.1186/s12889-018-5950-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Obesity is a widespread problem that not only leads to medical and psychological diseases in adults, but also in children and adolescents at an early stage in life. Because of its global burden on both the individual and society, it is necessary to develop effective evidence-based treatments. Current "Multidisciplinary Obesity Treatments" (MOT) already provide significant weight loss, but still leave room for more long-lasting improvements. In this protocol paper, we outline the research goals of the WELCOME trial, based on a substantial proof of concept. METHODS In this Randomized Controlled Trial (RCT) - conducted in both an inpatient and two outpatient treatment settings - existing MOT will be supplemented with an Executive Function (EF) training and compare effects on various parameters in an experimental versus an active control group of obese youngsters (8-18 years old). WELCOME aims to (a) train youngsters' executive functions to facilitate effects on weight loss, psychological and medical comorbidities, (b) to enhance the long-term effects by continuing the training in the daily home context with booster sessions, and (c) to investigate its effects until a 6-month follow-up. In comparison to the active control group, better progress is expected in the experimental group on following variables: weight, psychological comorbidities (unhealthy eating behavior, internalizing symptoms, impaired self-esteem) and medical comorbidities (metabolic syndromes, endothelia dysfunction, tonsillar hypertrophy and sleep obstruction). DISCUSSION It is stated that this EF-training for enhancing self-control abilities is necessary for a long-lasting effect of childhood obesity treatment interventions. TRIAL REGISTRATION The Study Procotol was registered on 10/05/2017 (n° ISRCTN14722584 ).
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Affiliation(s)
- Tiffany Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Leentje Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Marijke Ysebaert
- Department of Pediatrics, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
| | - Annelies Van Eyck
- Department of Pediatrics, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
| | - Stijn Verhulst
- Department of Pediatrics, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
| | - Luc Bruyndonckx
- Department of Pediatrics, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
| | - Benedicte De Winter
- Department of Pediatrics, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
| | - Kim Van Hoorenbeeck
- Department of Pediatrics, Antwerp University and University Hospital Antwerp, Antwerp, Belgium
| | | | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
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Berona J, Richmond R, Rienecke RD. Heterogeneous weight restoration trajectories during partial hospitalization treatment for anorexia nervosa. Int J Eat Disord 2018; 51:914-920. [PMID: 30058155 DOI: 10.1002/eat.22922] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/12/2018] [Accepted: 06/12/2018] [Indexed: 02/06/2023]
Abstract
UNLABELLED Early response to treatment has been shown to predict good outcome in family-based treatment, but little is known about who responds quickly. OBJECTIVE The purpose of the current study was to examine the short-term weight gain trajectories among youth receiving partial hospitalization program services for anorexia nervosa (AN), and to identify predictors of these trajectories. METHOD Adolescent and young adults (n = 102) with AN or subthreshold AN completed semi-structured interviews and self-report measures on admission to a family-based partial hospitalization program. Patients participated in programming 5 days a week. RESULTS Three weight gain trajectories were found to indicate slow, moderate, and rapid weight gain trajectories. All rapid responders gained at least four lbs. in the first 4 weeks of treatment, compared to 86.1% of moderate responders and 51.2% of slow responders. Patients were less likely to have a moderate or rapid response trajectory if they had a mood disorder diagnosis and higher parental expressed emotion. Additionally, the presence of compensatory behavior increased the likelihood of having a rapid response. DISCUSSION Despite the sometimes chronic nature of AN, most patients fell into one of the two favorable response trajectories. The identification of these trajectories underscores the importance of considering the core disordered eating behaviors (i.e., restricting, binge eating, and purging), comorbid psychopathology, and parental expressed emotion.
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Affiliation(s)
- Johnny Berona
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois
| | - Rebekah Richmond
- MUSC Friedman Center for Eating Disorders, Medical University of South Carolina, Charleston, South Carolina
| | - Renee D Rienecke
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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Calugi S, Milanese C, Sartirana M, El Ghoch M, Sartori F, Geccherle E, Coppini A, Franchini C, Dalle Grave R. The Eating Disorder Examination Questionnaire: reliability and validity of the Italian version. Eat Weight Disord 2017; 22:509-514. [PMID: 27039107 DOI: 10.1007/s40519-016-0276-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/18/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To examine the validity and reliability of a new Italian language version of the latest edition of the Eating Disorder Examination Questionnaire (EDE-Q 6.0). METHODS The sixth edition of the EDE-Q was translated into Italian and administered to 264 Italian-speaking inpatient and outpatient (257 females in their mid-20s) with eating disorder (75.4% anorexia nervosa) and 216 controls (205 females). RESULTS Internal consistency was high for both the global EDE-Q and all subscale scores. Test-retest reliability was good to excellent (0.66-0.83) for global and subscale scores, and for items assessing key behavioral features of eating disorders (0.55-0.91). Patients with an eating disorder displayed significantly higher EDE-Q scores than controls, demonstrating the good criterion validity of the tool. Confirmatory factor analysis revealed a good fit for a modified seven-item three-factor structure. CONCLUSIONS The study showed the good psychometric properties of the new Italian version of the EDE-Q 6.0, and validated its use in Italian eating disorder patients, particularly in young females with anorexia nervosa.
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Affiliation(s)
- Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy.
| | - Chiara Milanese
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Massimiliano Sartirana
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Federica Sartori
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Eleonora Geccherle
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Andrea Coppini
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Cecilia Franchini
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, Verona, Italy
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de Jong M, Korrelboom K, van der Meer I, Deen M, Hoek HW, Spinhoven P. Effectiveness of enhanced cognitive behavioral therapy (CBT-E) for eating disorders: study protocol for a randomized controlled trial. Trials 2016; 17:573. [PMID: 27914473 PMCID: PMC5135785 DOI: 10.1186/s13063-016-1716-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 11/19/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND While eating disorder not otherwise specified (EDNOS) is the most common eating disorder (ED) diagnosis in routine clinical practice, no specific treatment methods for this diagnosis have yet been developed and studied. Enhanced cognitive behavioral therapy (CBT-E) has been described and put to the test as a transdiagnostic treatment protocol for all EDs, including EDNOS. Initial research in the UK suggests that CBT-E is more effective for EDs, especially bulimia nervosa (BN) and EDNOS, than the earlier version of CBT. These positive results of CBT-E have to be replicated in more detail, preferably by independent researchers in different countries. Being the first Dutch study into CBT-E, the results from this national multicenter study - on three sites specialized in EDs - will deliver important information about the effectiveness of CBT-E in several domains of ED pathology, while providing input for the upcoming update of the Dutch Multidisciplinary Guideline for the Treatment of Eating Disorders. METHODS/DESIGN A multicenter randomized controlled trial will be conducted. One hundred and thirty-two adult outpatients (aged 18 years and older) with an ED diagnosis and a Body Mass index (BMI) of between 17.5 and 40 will be randomly allocated to the control or the intervention group. Subjects in the control group will receive Treatment as Usual (standard outpatient treatment provided at the participating sites). Subjects in the intervention group will receive 20 sessions of CBT-E in 20 weeks. The design is a 2 (group) × 5 (time) repeated measures factorial design in which neither therapists nor patients will be blinded for treatment allocation. The primary outcome measure is recovery from the ED. Secondary outcome measures include ED psychopathology, common mental disorders, anxiety and depressive symptoms, health-related quality of life, health care use and productivity loss. Self-esteem, perfectionism and interpersonal problems will be examined as putative predictors and mediators of the effect of treatment. Also, an economic evaluation from a societal perspective will be undertaken. All relevant effects, direct and indirect costs will be included. Utility scores will measure the effects. Measurements will take place at pretreatment, 6 weeks, 20 weeks, 40 weeks and 80 weeks. DISCUSSION This effectiveness study into CBT-E has the aim of broadening the scope and generalizability of former studies. If CBT-E appears to be at least as effective as traditional diagnosis-specific treatments for a broad range of ED patients, training in one protocol would be sufficient for clinicians to treat patients with different kinds of EDs. It gives the opportunity to offer treatment for a severe mental disorder with fewer resources, thereby increasing the accessibility of specialized care for patients with an ED. TRIAL REGISTRATION Netherlands Trial Register, NTR4485 . Registered on 2 April 2014.
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Affiliation(s)
- Martie de Jong
- Center for Eating Disorders - PsyQ, part of Parnassia Psychiatric Institute, The Hague, The Netherlands.
| | - Kees Korrelboom
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Iris van der Meer
- Center for Eating Disorders - PsyQ, part of Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Leiden University, Institute of Psychology, Methodology and Statistics Unit, Leiden, The Netherlands
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Philip Spinhoven
- Leiden University, Institute of Psychology, Leiden, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Rienecke RD, Richmond R, Lebow J. Therapeutic alliance, expressed emotion, and treatment outcome for anorexia nervosa in a family-based partial hospitalization program. Eat Behav 2016; 22:124-128. [PMID: 27289048 DOI: 10.1016/j.eatbeh.2016.06.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/01/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
Abstract
Adolescent therapeutic alliance has been found to be associated with improvements in eating disorder cognitions and with early weight gain. The current study assessed patient and parent therapeutic alliance, correlates of parent alliance, and relationship between alliance and treatment outcome. Fifty-six patients with anorexia nervosa completed measures of therapeutic alliance and eating disorder symptoms. Patients' parents completed measures of therapeutic alliance, expressed emotion, and psychopathology. Patients' alliance predicted cognitive and behavioral symptomatology at end of treatment (β=-0.39, p=0.001), though it was not related to changes in weight (β=0.12, p=0.377). Maternal hostility was associated with lower maternal alliance (r=-0.34, p=0.05). Findings suggest that maternal hostility should be addressed in treatment, and that patient alliance may be important in achieving psychological recovery from disordered eating.
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Affiliation(s)
- Renee D Rienecke
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Rebekah Richmond
- Medical University of South Carolina, 135 Rutledge Ave., MSC 561, Charleston, SC 29425, USA.
| | - Jocelyn Lebow
- Department of Psychiatry & Behavioral Sciences, University of Miami, 1120 NW 14th St., Miami, FL 33136, USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
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13
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Acceptance and Commitment Therapy for Women Diagnosed With Binge Eating Disorder: A Case-Series Study. COGNITIVE AND BEHAVIORAL PRACTICE 2015. [DOI: 10.1016/j.cbpra.2014.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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14
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Are common measures of dietary restraint and disinhibited eating reliable and valid in obese persons? Appetite 2015; 87:344-51. [DOI: 10.1016/j.appet.2014.12.226] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 12/09/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022]
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15
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Effects of Rumination and Acceptance on Body Dissatisfaction in Binge Eating Disorder. EUROPEAN EATING DISORDERS REVIEW 2014; 22:338-45. [DOI: 10.1002/erv.2312] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/08/2014] [Accepted: 07/09/2014] [Indexed: 12/26/2022]
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16
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Book A, Berant E. The contribution of difficulties in separation–individuation and emotional regulation to obesity among adolescent girls. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2014. [DOI: 10.1080/21507686.2013.878367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Naumann E, Trentowska M, Svaldi J. Increased salivation to mirror exposure in women with binge eating disorder. Appetite 2013; 65:103-10. [DOI: 10.1016/j.appet.2013.01.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 12/12/2012] [Accepted: 01/21/2013] [Indexed: 12/25/2022]
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18
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The relationship between fat mass, eating behaviour and obesity-related psychological traits in overweight and obese individuals. Appetite 2012; 59:656-61. [DOI: 10.1016/j.appet.2012.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 07/05/2012] [Accepted: 07/25/2012] [Indexed: 01/16/2023]
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Abstract
Binge eating disorder (BED) is a newly characterized eating disorder that encompasses individuals who have severe distress and dysfunction due to binge eating, but who do not regularly engage in inappropriate compensatory behaviors. While relatively uncommon in the general community, BED becomes more prevalent with increasing severity of obesity. BED is associated with early onset of obesity, frequent weight cycling, body shape disparagement, and psychiatric disorders. These associations occur independent of the degree of obesity. Although many individuals with BED have good short-term weight loss regardless of treatment modality, as a group they may be prone to greater attrition during weight-loss treatment and more rapid regain of lost weight. Current treatments geared toward binge eating behaviors include antidepressant medications, cognitive behavioral psychotherapy, and interpersonal psychotherapy; however, these treatments have little efficacy in promoting weight loss, and only modest success in long-term reduction of binge eating. As a significant proportion of obese individuals entering weight-loss treatment and research programs are likely to meet criteria for BED, those conducting clinical research should be aware of this distinct subgroup and determine the contribution of BED to outcome measures.
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Affiliation(s)
- S Z Yanovski
- Division of Digestive Diseases and Nutrition, NIDDK, National Institutes of Health, Bethesda, MD, USA
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20
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The role of body image flexibility in the relationship between disordered eating cognitions and disordered eating symptoms among non-clinical college students. Eat Behav 2012; 13:240-5. [PMID: 22664403 DOI: 10.1016/j.eatbeh.2012.03.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 02/09/2012] [Accepted: 03/22/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE A growing body of evidence suggests that rigid and inflexible regulation and coping are at the core of psychopathology, including disordered eating (DE) problems. Employing two cross-sectional studies, the present paper investigated whether body image flexibility (BIF), a specific type of psychological flexibility, mediates the relations between DE cognitions and overall DE pathology. METHOD Ethnically diverse non-clinical college undergraduates (Study 1 N=208; Study 2 N=178) completed an anonymous online survey. RESULTS BIF was found to partially mediate the relationship between DE cognitions and overall DE pathology after controlling for gender and body mass index (BMI). DISCUSSION Our findings suggest that the link between DE cognitions and overall DE pathology is established in part through an inflexible and avoidant coping style specific to negative body image. Clinical implications include targeting BIF as a mechanism of change and treating DE pathology with acceptance- and mindfulness-based behavioral interventions.
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21
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Berg KC, Peterson CB, Frazier P, Crow SJ. Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 2012; 45:428-38. [PMID: 21744375 PMCID: PMC3668855 DOI: 10.1002/eat.20931] [Citation(s) in RCA: 696] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2011] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The purpose of this study was to systematically review the reliability of scores on the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q) and to examine the validity of their use as measures of eating disorder symptoms. METHOD Articles describing the psychometric properties of the EDE and EDE-Q were identified in a systematic search of major computer databases and a review of reference lists. Articles were selected based on a priori inclusion and exclusion criteria. RESULTS Fifteen studies were identified that examined the psychometrics of the EDE, whereas 10 studies were found that examined the psychometrics of the EDE-Q. DISCUSSION Both instruments demonstrated reliability of scores. There is evidence that scores on the EDE and EDE-Q correlate with scores on measures of similar constructs and support for using the instruments to distinguish between cases and non-cases. Additional research is needed to broaden the generalizability of the findings.
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Affiliation(s)
- Kelly C Berg
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA.
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22
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Yip SW, White MA, Grilo CM, Potenza MN. An exploratory study of clinical measures associated with subsyndromal pathological gambling in patients with binge eating disorder. J Gambl Stud 2011; 27:257-70. [PMID: 20577790 DOI: 10.1007/s10899-010-9207-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Both binge eating disorder (BED) and pathological gambling (PG) are characterized by impairments in impulse control. Subsyndromal levels of PG have been associated with measures of adverse health. The nature and significance of PG features in individuals with BED is unknown. Ninety-four patients with BED (28 men and 66 women) were classified by gambling group based on inclusionary criteria for Diagnostic and Statistical Manual-IV (DSM-IV) PG and compared on a range of behavioral, psychological and eating disorder (ED) psychopathology variables. One individual (1.1% of the sample) met criteria for PG, although 18.7% of patients with BED displayed one or more DSM-IV criteria for PG, hereafter referred to as problem gambling features. Men were more likely than women to have problem gambling features. BED patients with problem gambling features were distinguished by lower self-esteem and greater substance problem use. After controlling for gender, findings of reduced self-esteem and increased substance problem use among patients with problem gambling features remained significant. In patients with BED, problem gambling features are associated with a number of heightened clinical problems.
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Affiliation(s)
- Sarah W Yip
- Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, USA.
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23
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Svaldi J, Caffier D, Tuschen-Caffier B. Attention to ugly body parts is increased in women with binge eating disorder. PSYCHOTHERAPY AND PSYCHOSOMATICS 2011; 80:186-8. [PMID: 21389757 DOI: 10.1159/000317538] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Accepted: 06/20/2010] [Indexed: 11/19/2022]
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Ahrberg M, Trojca D, Nasrawi N, Vocks S. Body Image Disturbance in Binge Eating Disorder: A Review. EUROPEAN EATING DISORDERS REVIEW 2011; 19:375-81. [DOI: 10.1002/erv.1100] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Merle Ahrberg
- Department of Psychology; Ruhr-University Bochum; Germany
| | | | - Nadia Nasrawi
- Department of Psychology; Ruhr-University Bochum; Germany
| | - Silja Vocks
- Department of Psychology; Ruhr-University Bochum; Germany
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25
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de Souza M, Mussap AJ, Cummins RA. Primary and secondary control over eating behaviors. Eat Behav 2010; 11:223-30. [PMID: 20850056 DOI: 10.1016/j.eatbeh.2010.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 05/01/2010] [Accepted: 05/20/2010] [Indexed: 11/15/2022]
Abstract
The relationships between subjective control, body image, and eating behaviors were examined within the framework of the Optimization in Primary and Secondary Control model (OPS model; Heckhausen, 1999). This model characterizes control as an adaptive and strategic process in which the target of control includes internal as well as external states, and in which the purpose is either to facilitate goal pursuit by engaging with the goal or managing the consequences of goal failure by disengaging from the goal. A convenience sample of 180 Australian women (age: M=26.49, SD=5.03) completed the Optimization of Primary and Secondary Control Scale (OPS scale Heckhausen, 1999), as well as measures of attitudinal and behavioral factors comprising Stice's (1994) dual-pathway model of bulimia. A series of path analyses revealed that the control strategies involved in goal engagement are directly associated with increased dietary restraint and purging, whereas the control strategies involved in goal disengagement are indirectly associated with these factors, and with negative affect, by way of reduced body dissatisfaction and reduced frequency of appearance comparisons. These results suggest that goal engagement strategies, which are typically adaptive in other contexts, are associated with potentially hazardous attitudes and behaviors in the context of the body. The results also suggest that an ability to disengage from body weight goals is associated with a reduced likelihood of developing disordered eating.
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26
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Schulz S, Laessle RG. Associations of negative affect and eating behaviour in obese women with and without binge eating disorder. Eat Weight Disord 2010; 15:e287-93. [PMID: 21406953 DOI: 10.1007/bf03325311] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The present study was planned to investigate differences in psychopathological features, eating behaviour and eating habits between obese women with and without BED. It also aimed to identify specific relationships between affective symptoms and eating behaviour in obese women with BED. Eighty-four obese women were studied (40 with BED, 44 non-BED). Psychiatric comorbidities were assessed with the structured diagnostic interview for DSM-IV (SCID). Depressive symptoms were measured with the Beck Depression Inventory (BDI) and anxiety with the state-trait anxiety inventory (STAI). Eating habits (emotional and restrained eating) were assessed by the Dutch eating behaviour questionnaire (DEBQ). Food diaries were used for assessing naturalistic eating behaviour (food intake) and mood before and after food intake. BED subjects exhibited higher levels of comorbidity (in particular mood disorders, anxiety disorders and substance-related disorders), higher depressive symptoms, trait anxiety, external and emotional eating scores than non-BED subjects. Regression analyses revealed that anxiety and emotional eating were significant predictors for BED status. In the BED group, depressive symptoms were significantly related to emotional eating and food intake and negatively related to restraint. Anxiety was significantly related to emotional eating. In general, food intake significantly enhanced mood. Mood was worse on the days with self-reported binge eating episodes than on nonbinge days. These results are discussed with regard to aetiological models for BED and for BED being a distinct diagnostic category separate from obesity.
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Affiliation(s)
- S Schulz
- Department of Clinical and Physiological Psychology, University of Trier, 54286 Trier, Germany
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27
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Svaldi J, Bender C, Tuschen-Caffier B. Explicit memory bias for positively valenced body-related cues in women with binge eating disorder. J Behav Ther Exp Psychiatry 2010; 41:251-7. [PMID: 20199768 DOI: 10.1016/j.jbtep.2010.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 01/27/2010] [Accepted: 02/08/2010] [Indexed: 12/15/2022]
Abstract
Overweight women with and without binge eating disorder (BED) are characterized by a marked body dissatisfaction, which may in part be due to the negative comments about their weight. Weight-related teasing and discrimination is reported both by healthy overweight women and women with BED, whereas body dissatisfaction is markedly increased among women with BED. Therefore, a memory bias for negatively valenced body-related cues is suspected to occur as a mediating factor in women with BED. In an experimental study, 18 women with BED were compared to 18 overweight healthy female controls (HC) on a free recall task containing four word categories: positively valenced with and without body-related content and negatively valenced with and without body-related content. While both groups showed a bias towards negatively valenced shape-/weight-related words, women with BED retrieved positively valenced shape-/weight-related words significantly less often compared to overweight HC. Findings suggest that it may be the reduced ability to attend to positively valenced shape-/weight-related information, rather than the activation of negative body schemata that differentiates overweight women with BED from overweight women without BED. Results are discussed in the context of cognitive biases in the maintenance of body dissatisfaction.
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Affiliation(s)
- J Svaldi
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Engelbergerstrasse 41, 79106 Freiburg, Germany.
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28
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Wilson GT, Sysko R. Frequency of binge eating episodes in bulimia nervosa and binge eating disorder: Diagnostic considerations. Int J Eat Disord 2009; 42:603-10. [PMID: 19610014 PMCID: PMC3864806 DOI: 10.1002/eat.20726] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In DSM-IV, to be diagnosed with Bulimia Nervosa (BN) or the provisional diagnosis of Binge Eating Disorder (BED), an individual must experience episodes of binge eating is "at least twice a week" on average, for 3 or 6 months, respectively. The purpose of this review was to examine the validity and utility of the frequency criterion for BN and BED. METHOD Published studies evaluating the frequency criterion were reviewed. RESULTS Our review found little evidence to support the validity or utility of the DSM-IV frequency criterion of twice a week binge eating; however, the number of studies available for our review was limited. DISCUSSION A number of options are available for the frequency criterion in DSM-V, and the optimal diagnostic threshold for binge eating remains to be determined.
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Affiliation(s)
- G Terence Wilson
- Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
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29
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Abstract
BACKGROUND A specific manual-based form of cognitive behavioural therapy (CBT) has been developed for the treatment of bulimia nervosa (CBT-BN) and other common related syndromes such as binge eating disorder. Other psychotherapies and modifications of CBT are also used. OBJECTIVES To evaluate the efficacy of CBT, CBT-BN and other psychotherapies in the treatment of adults with bulimia nervosa or related syndromes of recurrent binge eating. SEARCH STRATEGY Handsearch of The International Journal of Eating Disorders since first issue; database searches of MEDLINE, EXTRAMED, EMBASE, PsycInfo, CURRENT CONTENTS, LILACS, SCISEARCH, CENTRAL and the The Cochrane Collaboration Depression, Anxiety & Neurosis Controlled Trials Register; citation list searching and personal approaches to authors were used. Search date June 2007. SELECTION CRITERIA Randomised controlled trials of psychotherapy for adults with bulimia nervosa, binge eating disorder and/or eating disorder not otherwise specified (EDNOS) of a bulimic type which applied a standardised outcome methodology and had less than 50% drop-out rate. DATA COLLECTION AND ANALYSIS Data were analysed using the Review Manager software program. Relative risks were calculated for binary outcome data. Standardised mean differences were calculated for continuous variable outcome data. A random effects model was applied. MAIN RESULTS 48 studies (n = 3054 participants) were included. The review supported the efficacy of CBT and particularly CBT-BN in the treatment of people with bulimia nervosa and also (but less strongly due to the small number of trials) related eating disorder syndromes.Other psychotherapies were also efficacious, particularly interpersonal psychotherapy in the longer-term. Self-help approaches that used highly structured CBT treatment manuals were promising. Exposure and Response Prevention did not enhance the efficacy of CBT.Psychotherapy alone is unlikely to reduce or change body weight in people with bulimia nervosa or similar eating disorders. AUTHORS' CONCLUSIONS There is a small body of evidence for the efficacy of CBT in bulimia nervosa and similar syndromes, but the quality of trials is very variable and sample sizes are often small. More and larger trials are needed, particularly for binge eating disorder and other EDNOS syndromes. There is a need to develop more efficacious therapies for those with both a weight and an eating disorder.
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Affiliation(s)
- Phillipa PJ Hay
- Building 3Mental Health School of MedicineCampbelltown Campus University of Western SydneyLocked Bag 1797Penrith SouthNew South WalesAustralia2570
| | - Josué Bacaltchuk
- Universidade Federal de São PauloDepartment of PsychiatryRua Casa do Ator 764 apto 102São Paulo ‐ SPBrazil04546‐003
| | - Sergio Stefano
- Universidade Federal de São PauloDepartment of PsychiatryRua Casa do Ator 764 apto 102São Paulo ‐ SPBrazil04546‐003
| | - Priyanka Kashyap
- St. Xavier's College, University of MumbaiDepartment of Life Sciences and BiochemistryMumbaiIndia400001
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Body-related film clip triggers desire to binge in women with binge eating disorder. Behav Res Ther 2009; 47:790-6. [DOI: 10.1016/j.brat.2009.06.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 06/10/2009] [Accepted: 06/10/2009] [Indexed: 12/28/2022]
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HEFFERNAN KAREN. Assessment of eating disorders. J Ment Health 2009. [DOI: 10.1080/09638239550037271] [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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Abstract
OBJECTIVE This study tested the psychometric properties of two commonly used measures of dietary restraint, the Three Factor Eating Questionnaire and the Eating Disorder Examination Questionnaire. METHOD Restraint data from 512 overweight/obese participants with binge eating disorder (BED) were subjected to exploratory and confirmatory factor analyses. RESULTS Factor analyses of the restraint variables indicated a two-factor solution, interpreted as "Regimented" and "Lifestyle" restraint. Stepwise regression analyses revealed that Regimented restraint was more predictive of eating pathology, whereas Lifestyle restraint appeared to be protective of eating problems. Neither type of restraint was related to binge eating. Cluster analysis of the restraint dimensions yielded three distinct subgroups of patients who differed significantly on several important eating- and weight-related features. DISCUSSION Future research is needed to test the significance of these restraint constructs over time in both the development of obesity and binge eating problems as well as their treatment.
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Affiliation(s)
- Marney A White
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
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Passos TCBM, Yazigi L, Claudino AM. Aspectos ideativos no transtorno da compulsão alimentar periódica: estudo com o Rorschach. PSICO-USF 2008. [DOI: 10.1590/s1413-82712008000100009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pessoas com diagnóstico de transtorno da compulsão alimentar periódica (DSM-IV) são descritas como propensas a distúrbios nos processos de pensamento que são relevantes para a manutenção do quadro e para o tratamento. Este é um estudo exploratório visando avaliar o funcionamento cognitivo de sujeitos com o diagnóstico citado, sendo escolhido como instrumento o método de Rorschach, que permite acessar aspectos psicológicos menos sujeitos ao controle consciente do que os aferidos por escalas e auto-relatos. Foram selecionadas variáveis do Rorschach associadas ao funcionamento ideacional. A amostra constitui-se de 43 mulheres (média de 37,2 anos de idade), que, no Rorschach, evidenciam dificuldades na atividade ideativa, com predominância de um nível concreto e imaturo de ideação, perda dos limites da realidade e dos limites entre os eventos. Também há tendência a cognições de tom negativo. O uso defensivo de intelectualizações frágeis predispõe a sobrecargas emocionais. Mas também é observada a capacidade para pensar de forma flexível e construtiva, recurso associado a bom prognóstico em psicoterapias.
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Stefano SC, Bacaltchuk J, Blay SL, Appolinário JC. Antidepressants in short-term treatment of binge eating disorder: systematic review and meta-analysis. Eat Behav 2008; 9:129-36. [PMID: 18329590 DOI: 10.1016/j.eatbeh.2007.03.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Revised: 02/07/2007] [Accepted: 03/16/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effects of antidepressant interventions for patients with Binge Eating Disorder (BED). METHOD A systematic review and meta-analysis of available randomized controlled trials including a quality appraisal was conducted. Six databases: PUBMED, EMBASE, PSYINFO, LILACS, The Cochrane Collaboration Controlled Trials Register and The Cochrane Depression, Anxiety and Neurosis Group Database of Trials were searched using an electronic search strategy. Articles published during the period from January 1994 to December 2005 were included. RESULTS From the 3357 articles initially identified, 19 full manuscripts were selected and analyzed and 7 studies fulfilled the inclusion criteria and were included in the final analysis. Data from the meta-analysis revealed that binge-eating remission rates were higher in patients receiving antidepressants when compared with placebo. No difference in body weight has been found as measured by short-term change in body mass index. Most studies were short-term trials (median duration: 8 weeks). The only 16-week duration study did not show superiority of antidepressants over placebo. CONCLUSION Available data are not sufficient to formally recommend antidepressants as a single first line therapy for both short-term remission of binge-eating episodes and weight reduction in patients with BED. BED is a chronic condition and very short-term studies (8 weeks) may be of limited value.
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Affiliation(s)
- Sérgio Carlos Stefano
- Psychiatry Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
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Adipositas ist mehr als eine Essstörung - die multidimensionale Betrachtung einer Pandemie. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2008; 54:4-31. [DOI: 10.13109/zptm.2008.54.1.4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jarosz PA, Dobal MT, Wilson FL, Schram CA. Disordered eating and food cravings among urban obese African American women. Eat Behav 2007; 8:374-81. [PMID: 17606235 DOI: 10.1016/j.eatbeh.2006.11.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 09/13/2006] [Accepted: 11/10/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The prevalence of night eating syndrome (NES), binge eating disorder (BED), and bulimia nervosa (BN) and the general experience of food cravings were examined in 88 obese urban African American women. METHOD Participants were administered The Questionnaire on Eating and Weight Patterns-R, the Night Eating Syndrome Questionnaire, and the State and Trait Food Cravings Questionnaire, Trait version (FCQ-T). RESULTS Twenty-eight percent reported symptoms of eating disorders (18.9% NES, 6.4% recurrent binge eating, 2.2% both NES and recurrent binge eating). Those reporting disordered eating had significantly higher total FCQ-T scores than those not reporting disordered eating. Persons endorsing recurrent binge eating had the highest mean score, followed by those reporting NES. Those who identified themselves as binge eaters and night eaters were not significantly different from each other, but both groups were significantly different than the no eating disorder symptoms group on various subscales of the FCQ-T. DISCUSSION Obese African American women report significant levels of NES and binge eating which may contribute to the development and/ or maintenance of obesity.
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Affiliation(s)
- Patricia A Jarosz
- College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, MI, USA.
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Ljotsson B, Lundin C, Mitsell K, Carlbring P, Ramklint M, Ghaderi A. Remote treatment of bulimia nervosa and binge eating disorder: A randomized trial of Internet-assisted cognitive behavioural therapy. Behav Res Ther 2007; 45:649-61. [PMID: 16899213 DOI: 10.1016/j.brat.2006.06.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Revised: 06/01/2006] [Accepted: 06/09/2006] [Indexed: 11/28/2022]
Abstract
The present study investigated the efficacy of self-help based on cognitive behaviour therapy in combination with Internet support in the treatment of bulimia nervosa and binge eating disorder. After confirming the diagnosis with an in-person interview, 73 patients were randomly allocated to treatment or a waiting list control group. Treated individuals showed marked improvement after 12 weeks of self-help compared to the control group on both primary and secondary outcome measures. Intent-to-treat analyses revealed that 37% (46% among completers) had no binge eating or purging at the end of the treatment and a considerable number of patients achieved clinically significant improvement on most of the other measures as well. The results were maintained at the 6-month follow-up, and provide evidence to support the continued use and development of self-help programmes.
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Affiliation(s)
- B Ljotsson
- Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, SE-171 76 Stockholm, Sweden
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38
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Abstract
OBJECTIVE This article examines the relationship between the emergence of disordered eating and the history of weight and dieting in obese youngsters. METHOD Both child and parent reports were obtained from 40 obese disordered eaters (objective bulimic episodes, n = 20; objective overeating episodes, n = 20) and 40 obese matched controls aged 10-16 years. RESULTS No significant differences between subsamples with regard to weight and dieting history were found. In dieters, it was shown that overweight onset preceded dieting onset, which in turn preceded dietary restraint onset. Despite some discordance regarding precise onset ages of different behaviors, parent and child re ports revealed the same temporal sequences. CONCLUSION A developmental pathway from weight problems through dieting to binge eating is plausible for a subgroup of obese children. Convergence between parent and child reports supports the assumption that children's reports are a viable means of monitoring dieting and weight behaviors.
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Affiliation(s)
- Line Claus
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Levine MD, Ringham RM, Kalarchian MA, Wisniewski L, Marcus MD. Overeating among seriously overweight children seeking treatment: results of the children's eating disorder examination. Int J Eat Disord 2006; 39:135-40. [PMID: 16231347 PMCID: PMC2892332 DOI: 10.1002/eat.20218] [Citation(s) in RCA: 39] [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] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We sought to examine rates of eating disorder symptoms among seriously overweight children seeking treatment using the Eating Disorder Examination for Children (ChEDE) and to provide initial data about their association with treatment outcome. METHOD Overweight children (N = 27) 8-13 years old were interviewed using the ChEDE before participating in a family-based behavioral treatment program. Height and weight were measured pretreatment, posttreatment, and approximately 8 months posttreatment. RESULTS Fifteen percent of children reported subjective bulimic episodes (SBE). Weight loss did not differ for children with and without SBEs, but concerns about body shape were related to larger weight losses during treatment. CONCLUSION A considerable minority of treatment-seeking overweight children report an episodic sense of loss of control over eating. Loss of control is related to other disordered eating attitudes and behaviors, but does not appear to affect treatment outcome. Future studies are needed to replicate these initial findings.
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Affiliation(s)
- Michele D Levine
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
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Manwaring JL, Hilbert A, Wilfley DE, Pike KM, Fairburn CG, Dohm FA, Striegel-Moore RH. Risk factors and patterns of onset in binge eating disorder. Int J Eat Disord 2006; 39:101-7. [PMID: 16231343 PMCID: PMC2710505 DOI: 10.1002/eat.20208] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The current study examined risk factors in women with binge eating disorder (BED) who began binging before dieting (binge-first [BF]) compared with women with BED who began dieting before binging (diet-first [DF]). It further aimed to replicate findings regarding eating disorder and general psychopathology among BF versus DF subtypes. METHOD One hundred fifty-five women with BED completed the Oxford Risk Factor Interview to retrospectively assess risk factors occurring before eating disturbance onset. Clinical interview assessed eating disorder and general psychopathology. RESULTS Overall, no significant differences in risk factors emerged between the groups. The BF group had a significantly earlier onset of BED than the DF group. In contradistinction to previous studies, the DF group endorsed more eating disorder psychopathology and lifetime diagnosis of any substance use disorder. CONCLUSION Limited support was seen for different risk factors in BF versus DF women, suggesting similar etiologic pathways in both subtypes.
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Affiliation(s)
| | - Anja Hilbert
- Department of Psychiatry, Washington UniversitySt. Louis, Missouri
| | - Denise E Wilfley
- Department of Psychiatry, Washington UniversitySt. Louis, Missouri
- Department of Medicine, Washington UniversitySt. Louis, Missouri
- Department of Pediatrics, Washington UniversitySt. Louis, Missouri
- Department of Psychology, Washington UniversitySt. Louis, Missouri
- * Correspondence to: Denise E. Wilfley, PhD, Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110. E-mail:
| | - Kathleen M Pike
- Department of Psychiatry, Columbia UniversityNew York, New York
| | | | - Faith-Anne Dohm
- Graduate School of Education and Allied Professions, Fairfield UniversityFairfield, Connecticut
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de Man Lapidoth J, Ghaderi A, Norring C. Eating disorders and disordered eating among patients seeking non-surgical weight-loss treatment in Sweden. Eat Behav 2006; 7:15-26. [PMID: 16360619 DOI: 10.1016/j.eatbeh.2005.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 04/27/2005] [Accepted: 05/26/2005] [Indexed: 11/17/2022]
Abstract
The aim of this cross-sectional descriptive study of 194 Swedish men and women seeking non-surgical weight-loss treatment was to investigate the presence of eating disorders and binge eating symptoms and to compare these two groups of patients with a group without eating disorder- or binge eating symptoms. The groups were compared in regard to co-morbid psychopathology, Health Related Quality of Life (HRQL) and anthropometric data. Of the total sample, 9.8% fulfilled criteria for any eating disorder. An additional 7.2% indicated binge eating symptoms without having an eating disorder. The three groups were significantly different in regard to psychopathology scales and most HRQL items. Eating disorders and binge eating symptoms are common among patients seeking non-surgical weight-loss treatments in Sweden and both groups showed elevated levels of co-morbid psychopathology and lower HRQL compared to patients without disordered eating. These findings point to the importance of assessing the full range of eating disorder symptoms and disorders as well as HRQL and co-morbid psychopathology before weight-loss treatment, as these factors might affect treatment outcome.
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Hilbert A, Tuschen–Caffier B. Body–Related Cognitions in Binge–Eating Disorder and Bulimia Nervosa. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2005. [DOI: 10.1521/jscp.2005.24.4.561] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Didie ER, Fitzgibbon M. Binge eating and psychological distress: is the degree of obesity a factor? Eat Behav 2005; 6:35-41. [PMID: 15567109 DOI: 10.1016/j.eatbeh.2004.08.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2004] [Accepted: 08/31/2004] [Indexed: 11/21/2022]
Abstract
The purpose of the present study was to examine whether individuals with Binge Eating Disorder (BED) demonstrate comparable levels of eating pathology and psychological distress independent of weight status. Male and female participants with BED (N = 96) completed the Questionnaire on Eating and Weight Patterns-Revised; Beck Depression Inventory (BDI), Symptom Checklist (SCL)-90-Revised, and Eating Disorder Inventory-2 (EDI-2). Participants were divided into categories of normal/overweight, obese, and severely obese based on their body mass index (BMI). Analysis of variance was performed using scores on the psychological measures with subjects grouped according to weight status. Participants with BED did not differ on any of the measures of psychological or eating symptoms regardless of weight status. These results replicate and extend previous findings, suggesting that binge eating pathology independent of weight status, accounts for psychological distress among binge eaters.
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44
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Hilbert A, Tuschen-Caffier B. Body image interventions in cognitive-behavioural therapy of binge-eating disorder: a component analysis. Behav Res Ther 2004; 42:1325-39. [PMID: 15381441 DOI: 10.1016/j.brat.2003.09.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Revised: 08/25/2003] [Accepted: 09/03/2003] [Indexed: 10/26/2022]
Abstract
The present study sought to investigate effects of body exposure in the treatment of binge-eating disorder (BED). Cognitive-behavioural therapy with a body exposure component (CBT-E) was compared with CBT with a cognitive restructuring component focused on body image (CBT-C). Twenty-eight patients diagnosed with BED were randomly assigned to CBT-E or CBT-C, both delivered in a group format. Negative automatic thoughts about one's body, dysfunctional assumptions about shape and weight, and body dissatisfaction were assessed using experimental thought-sampling techniques, a clinical interview (Eating Disorder Examination), and self-report questionnaires. At posttreatment and at 4-month follow-up, CBT-E and CBT-C were equally effective in improving body image disturbance on all indicators assessed. Both CBT-E and CBT-C produced substantial and stable improvements in the specific and general eating disorder psychopathology. Results suggest that both treatment components are equally effective in the treatment of BED.
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Affiliation(s)
- Anja Hilbert
- Washington University in St. Louis, Department of Psychiatry, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA.
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45
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Andersen GS, Stunkard AJ, Sørensen TIA, Petersen L, Heitmann BL. Night eating and weight change in middle-aged men and women. Int J Obes (Lond) 2004; 28:1338-43. [PMID: 15278102 DOI: 10.1038/sj.ijo.0802731] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the association between the habit of eating at night, and the 5-y preceding and 6-y subsequent weight changes in a middle-aged population, with particular focus on the obese. DESIGN Prospective study with initial examination of the cohort in 1982-83, re-examination in 1987-88 and a third examination in 1992-93. SUBJECTS The Danish MONICA cohort includes an age- and sex-stratified random sample of the population from the Western part of the Copenhagen County. Out of 2,987 subjects participating in 1987-88, a total of 1,050 women and 1,061 men had been examined in 1982-83, and 1993-94 too. Subjects working night shifts were excluded. MEASUREMENTS Night eating in 1987-88, 5-y preceding and 6-y subsequent weight change. RESULTS In total, 9.0% women and 7.4% men reported 'getting up at night to eat'. Obese women with night eating experienced an average 6-y weight gain of 5.2 kg (P=0.004), whereas only 0.9 kg average weight gain was seen among obese women who did not get up at night to eat. No significant associations were found among all women, or between night eating and the 5-y preceding weight change for women. Night eating and weight change were not associated among men. CONCLUSION Night eating was not associated with later weight gain, except among already obese women, suggesting that getting up at night to eat may be a contributor to further weight gain among the obese.
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Affiliation(s)
- G S Andersen
- Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, DK-1399 Copenhagen K, Denmark
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46
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Decaluwé V, Braet C. Assessment of eating disorder psychopathology in obese children and adolescents: interview versus self-report questionnaire. Behav Res Ther 2004; 42:799-811. [PMID: 15149900 DOI: 10.1016/j.brat.2003.07.008] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2002] [Revised: 03/07/2003] [Accepted: 07/08/2003] [Indexed: 11/15/2022]
Abstract
The present study compared two methods for assessing binge eating and related eating disorder psychopathology in obese children and adolescents. A comparison was made between the child version of the Eating Disorder Examination (ChEDE) and the self-report version of the interview (ChEDE-Q). A total of 139 children and adolescents (aged 10-16 years) seeking inpatient treatment for obesity completed the ChEDE questionnaire and were administered the ChEDE interview afterwards. The ChEDE and ChEDE-Q were significantly correlated for the four subscales: restraint, eating concern, weight concern and shape concern. The ChEDE-Q generated consistently higher levels of eating disorder psychopathology. There was a significant discrepancy for the assessment of a more complex feature such as binge eating. Overall, the current study found lower levels of agreement between the EDE and EDE-Q than previously reported in adult samples. It appears that children and adolescents have difficulties in identifying binge-eating episodes when they receive no detailed instruction. It is concluded that a clinical interview is necessary to identify eating disorders in obese children and that a self-report questionnaire can only be used as a screening tool. Even then, thorough clarification of the definition of the eating disorder features is needed when using a self-report questionnaire.
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Affiliation(s)
- Veerle Decaluwé
- Department of Development, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000 Ghent, Belgium
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Binford RB, Pederson Mussell M, Peterson CB, Crow SJ, Mitchell JE. Relation of binge eating age of onset to functional aspects of binge eating in binge eating disorder. Int J Eat Disord 2004; 35:286-92. [PMID: 15048944 DOI: 10.1002/eat.10272] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study examined whether age of binge eating onset in binge eating disorder (BED) is related to affective binge eating antecedents and consequences. METHOD Participants included women (N = 44) with BED who participated in a group cognitive-behavioral therapy (CBT) study. Measures included the Eating Hedonics Questionnaire, Beck Depression Inventory, Multidimensional Personality Questionnaire Negative Emotionality factor, Restraint Scale, Three-Factor Eating Questionnaire Restraint factor, and Eating Behaviors-IV. Participants were classified according to reported age of binge eating onset, with early onset defined as </=13 years (EOB; n = 25) and later onset >13 years (LOB; n = 19). RESULTS Compared with LOB, EOB was associated with reductions in postbinge subjective anxiety, but not depression. DISCUSSION This study suggested that EOB in BED may be associated with binge eating as an affective means of coping, particularly with anxiety, and further supported age of binge eating onset as a clinically meaningful way to delineate BED subclassifications.
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Affiliation(s)
- Roslyn B Binford
- Eating Disorders Research Program, Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA.
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48
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Abstract
BACKGROUND Bulimia nervosa and related syndromes such as binge eating disorder are common in young Western women. A specific manual-based form of cognitive behaviour therapy (CBT) has been developed for the treatment of bulimia nervosa (CBT-BN). Other psychotherapies, some from a different theoretical framework, and some modifications of CBT are also used. OBJECTIVES To evaluate the efficacy of CBT and CBT-BN and compare them with other psychotherapies in the treatment of adults with bulimia nervosa or related syndromes of recurrent binge eating. SEARCH STRATEGY A handsearch of The International Journal of Eating Disorders since its first issue; database searches of MEDLINE, EXTRAMED, EMBASE, PsycInfo, CURRENT CONTENTS, LILACS, SCISEARCH, CENTRAL and the The Cochrane Collaboration Depression, Anxiety & Neurosis Controlled Trials Register; citation list searching and personal approaches to authors were used. SELECTION CRITERIA All studies that have tested any form of psychotherapy for adults with non-purging bulimia nervosa, binge eating disorder and/or other types of eating disorders of a bulimic type (eating disorder, not otherwise specified, or EDNOS), and which applied a randomised controlled and standardised outcome methodology. DATA COLLECTION AND ANALYSIS Data were analysed using the Review Manager software program. Relative risks were calculated for binary outcome data. Standardized mean differences were calculated for continuous variable outcome data. A fixed effects model was used to analyse the data. Sensitivity analyses of a number of measures of trial quality were conducted. Data were not reported in such a way to permit subgroup analyses, but the effects of treatment on depressive symptoms, psychosocial and/or interpersonal functioning, general psychiatric symptoms and weight were examined where possible. Funnel plots were drawn to investigate the presence of publication bias. MAIN RESULTS The review supported the efficacy of cognitive-behavioural psychotherapy (CBT) and particularly CBT-BN in the treatment of people with bulimia nervosa and also (but less strongly due to the small number of trials) related eating disorder syndromes. CBT was also shown to be effective in group settings. Other psychotherapies were also efficacious, particularly interpersonal psychotherapy in the longer-term. Self-help approaches that used highly structured CBT treatment manuals, were promising albeit with more modest results generally, and their evaluation in bulimia nervosa merits further research. Exposure and Response Prevention did not appear to enhance the efficacy of CBT.Psychotherapy alone is unlikely to reduce or change body weight in people with bulimia nervosa or similar eating disorders. REVIEWERS' CONCLUSIONS There is a small body of evidence for the efficacy of cognitive-behaviour therapy in bulimia nervosa and similar syndromes, but the quality of trials is very variable and sample sizes are often small. More trials of CBT are needed, particularly for binge eating disorder and other EDNOS syndromes. Trials evaluating other psychotherapies and less intensive psychotherapies should also be conducted.
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Affiliation(s)
- P J Hay
- Psychiatry, School of Medicine, James Cook University, School of Medicine, James Cook University, Townsville, Queensland, Australia, 4811
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Vervaet M, van Heeringen C, Audenaert K. Personality-related characteristics in restricting versus binging and purging eating disordered patients. Compr Psychiatry 2004; 45:37-43. [PMID: 14671735 DOI: 10.1016/j.comppsych.2003.09.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The current study sought to examine differences in personality-related characteristics between restricting anorexia nervosa (RAN), binging/purging anorexia (BPAN), and purging bulimia nervosa (BN) patients. Scores on the Temperament and Character Inventory (TCI) and on the Dutch Eating Behaviour Questionnaire (DEBQ) were compared for 166 RAN, 78 BPAN, and 151 BN patients. Bingers/purgers showed a higher score for restrained, external and emotional eating and a lower score for a subscale of "self-directedness" compared to patients who never binge and purge. Personality differences were most marked between RAN and BN patients, while personality characteristics of BPAN patients tended to be similar to those of BN patients. BN patients showed higher scores on "novelty seeking" and the subscales "exploratory excitability," "impulsivity," and "extravagance," and lower scores on "self-directedness," compared to restricting patients. Moreover RAN patients also showed higher scores on subscales of character dimensions, compared to BN patients. The higher the scores on novelty seeking, the lower the scores on several character scales, which has important implications for the reinforcement of behavior and the treatment of eating disorders.
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Affiliation(s)
- M Vervaet
- Centre for Eating Disorders, University Department of Psychiatry, Ghent University Hospital, Belgium
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50
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Abstract
OBJECTIVE Current controversy exists regarding the status of binge eating disorder (BED) as a diagnostic entity. A critique of the literature is provided to address the question of whether BED represents a clinically significant syndrome. METHOD The scientific evidence is considered through addressing five questions that are key in evaluating the clinical utility of any mental disorder. RESULTS Individuals with BED meaningfully differ from individuals without eating disorders, and share important similarities to, yet are distinct from, individuals with anorexia nervosa (AN) and bulimia nervosa (BN). BED is associated with co-occurring physical and mental illnesses, as well as impaired quality of life and social functioning. Questions about the course of the disorder and the optimal treatment regimen for the syndrome need to be explored further. DISCUSSION BED's distinctive combination of core eating disorder psychopathology, and other co-occurring physical and psychiatric conditions, impaired psychosocial functioning, and overweight constitute an eating disorder of clinical severity and a significant public health problem.
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Affiliation(s)
- Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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