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Aloi M, Moniaci M, Rania M, Carbone EA, Martino G, Segura-Garcia C, Liuzza MT. Relationship between disgust and orthorexia nervosa and psychometric properties of the Italian Dusseldorf orthorexia scale in a general population sample. J Eat Disord 2023; 11:174. [PMID: 37789371 PMCID: PMC10546774 DOI: 10.1186/s40337-023-00899-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND It remains unclear among clinicians and researchers whether orthorexia nervosa (ON) is a part of the obsessive-compulsive disorder spectrum or eating disorders. Disgust seems to be a shared psychopathological factor in these clinical presentations, indicating a potentially crucial role in ON. On the other hand, numerous psychometric tools have been developed to evaluate ON. The Dusseldorf Orthorexia Scale (DOS) was recently validated in an Italian sample. However, the study's primary limitation was that the scale was only administered to undergraduate university students. This study aimed to investigate the psychometric properties (including factorial structure, reliability, and measurement invariance conditional on sex) of the Italian version of the DOS (I-DOS) on a sample from the general population. Additionally, the study sought to determine the nomological validity of the I-DOS by examining its relationship with disgust sensitivity. METHODS A sample of 521 participants took part in this study and completed a battery that assessed ON and disgust sensitivity. To assess the I-DOS structure, reliability, and measurement invariance we respectively conducted confirmatory factor analysis (CFA), computed McDonalds's omega, and performed hierarchical series of multigroup CFAs. Then, we tested the relationship between ON and disgust sensitivity. RESULTS CFA confirmed the unifactorial model of I-DOS and it respected the configural, metric, and strict invariance while a partial scalar invariance was achieved. It also showed good reliability with an omega of 0.87. In addition, we found a positive relationship between ON and disgust sensitivity, thus confirming the nomological validity of I-DOS. CONCLUSIONS Our findings suggest that the Italian version of the Dusseldorf orthorexia scale (I-DOS) exhibits strong psychometric properties and can be an effective instrument for assessing ON in a general population sample. Notably, the most significant and innovative outcome was the positive correlation between ON and disgust sensitivity. As disgust has been linked to other clinical presentations, this preliminary result could serve as a foundation for future research exploring this phenomenon in greater detail.
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Affiliation(s)
- Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Martina Moniaci
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy
| | - Elvira Anna Carbone
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Cristina Segura-Garcia
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital "Mater Domini", Catanzaro, Italy.
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
| | - Marco Tullio Liuzza
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, 88100, Catanzaro, Italy
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Kot E, Grzegorzewski P, Kostecka B, Kucharska K. Self-disgust and disgust sensitivity are increased in anorexia nervosa inpatients, but only self-disgust mediates between comorbid and core psychopathology. EUROPEAN EATING DISORDERS REVIEW 2021; 29:879-892. [PMID: 34655142 DOI: 10.1002/erv.2862] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The possible role of abnormal disgust processing in the development and course of anorexia nervosa (AN) has been emphasized in theoretical models and research. However, disgust toward external stimuli and self-disgust have not yet been investigated together in a clinical sample of AN patients. Therefore, the purpose of the study was to measure these constructs and examine their role in shaping eating pathology in AN patients and healthy controls (HCs), considering comorbid depressive and anxiety psychopathology. The study also aimed at testing the possible mediational roles of both disgust types in the associations between comorbid psychopathology and eating disorders (EDs) characteristics. METHOD Altogether, 63 inpatients with AN and 57 HCs partook in the study. Participants completed the Eating Disorder Inventory-3, State-Trait Anxiety Inventory, Beck Depression Inventory-II, Disgust Scale-Revised and Self-Disgust Scale. RESULTS AN patients manifested higher self-disgust and disgust sensitivity than HCs. In addition, self-disgust predicted the severity of EDs characteristics and mediated the links of depressive symptoms and trait anxiety with EDs characteristics in both groups. DISCUSSION Our findings imply the putative role of self-disgust in the development of EDs psychopathology in HCs and in its maintenance in AN patients.
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Affiliation(s)
- Emilia Kot
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Piotr Grzegorzewski
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Barbara Kostecka
- II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
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Reilly EE, Bohrer B, Sullivan D, Essayli JH, Farrell NR, Brown TA, Gorrell S, Anderson LM, Cooper M, C Schreyer C, Olesnycky O, Peros O, Schaumberg K. Registered report: Initial development and validation of the eating disorders safety behavior scale. Int J Eat Disord 2021; 54:660-667. [PMID: 33638564 PMCID: PMC8044048 DOI: 10.1002/eat.23479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/07/2022]
Abstract
Anxiety and eating disorders (EDs) often co-occur, prompting calls to explore anxiety-related maintenance processes in ED samples. Safety behaviors, which function to prevent a feared outcome from occurring or to reduce anxiety associated with a feared stimulus, are observed across anxiety disorders and, along with overt avoidance behaviors, are an important target in treatment. Data suggest that individuals with EDs also engage in safety behaviors. However, no existing assessments provide a comprehensive measure of eating-disorder-specific overt avoidance and safety behaviors. The goal of this Stage 1 Registered Report is to develop a comprehensive self-report measure of ED-specific safety behaviors. In Study 1, we will recruit 50 women with EDs to complete the scale and provide feedback on the response scale. Feedback from these participants will be used to refine the measure. In Study 2, we will evaluate the psychometric properties of the measure in a large sample of women with EDs (n dependent on the size of measurement) and a community sample without current or a history of ED symptoms. We will explore the measure factor structure, known-groups validity by comparing scores from women with EDs to healthy controls, internal consistency, and convergent and divergent validity with other psychological instruments.
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Affiliation(s)
- Erin E Reilly
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Brittany Bohrer
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Daniel Sullivan
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Jamal H Essayli
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Saint Paul, Minnesota, USA
| | - Marita Cooper
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Colleen C Schreyer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Olenka Olesnycky
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Olivia Peros
- Department of Psychology, Hofstra University, Hempstead, New York, USA
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5
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Ferreira J, Bem-Haja P, Alho L, Soares SC. Subjective Experience of Disgust. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2021. [DOI: 10.1027/2512-8442/a000059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Individual differences in the experience of disgust are known to influence the development and maintenance of several psychopathologies. Aims: This study examined the psychometric properties of the Portuguese version of the Disgust Propensity and Sensitivity Scale – Revised (DPSS-R). Method: The factor validity, the reliability of the Portuguese version of DPSS-R, the convergent validity, and the relationship with other scales were assessed in 229 participants. Results: The modified two-factor model, disgust propensity and sensitivity, was confirmed with good fit indexes and with acceptable convergent and discriminant validity. Overall, the internal consistency and the composite reliability of the DPSS-R were appropriate. The DPSS-R also revealed significant associations with the Disgust Scale, Maudsley Obsessive-Compulsive Inventory, Spider Phobia Questionnaire – Revised, and State-Trait Anxiety Inventory. Specifically, the disgust propensity factor was found to be a significant predictor of fear of spiders and trait anxiety, whereas both DPSS-R factors predicted obsessive-compulsive symptoms. Finally, women reported higher levels of disgust propensity and sensitivity than men. Conclusion: The Portuguese version of the DPSS-R proved to be a valid and reliable measure of disgust propensity and sensitivity and, therefore, with potential relevance for application in both research and clinical practice.
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Affiliation(s)
- Jacqueline Ferreira
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, Portugal
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Portugal
| | - Pedro Bem-Haja
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, Portugal
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Portugal
| | - Laura Alho
- Lusófona University of Humanities and Technology, Lisbon, Portugal
| | - Sandra C. Soares
- William James Center for Research (WJCR.UA), Department of Education and Psychology, University of Aveiro, Portugal
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
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Schaumberg K, Reilly EE, Gorrell S, Levinson CA, Farrell NR, Brown TA, Smith KM, Schaefer LM, Essayli JH, Haynos AF, Anderson LM. Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research. Clin Psychol Rev 2020; 83:101952. [PMID: 33221621 DOI: 10.1016/j.cpr.2020.101952] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
Eating disorders (EDs) and anxiety disorders (ADs) evidence shared risk and significant comorbidity. Recent advances in understanding of anxiety-based disorders may have direct application to research and treatment efforts for EDs. The current review presents an up-to-date, behavioral conceptualization of the overlap between anxiety-based disorders and EDs. We identify ways in which anxiety presents in EDs, consider differences between EDs and ADs relevant to treatment adaptions, discuss how exposure-based strategies may be adapted for use in ED treatment, and outline directions for future mechanistic, translational, and clinical ED research from this perspective. Important research directions include: simultaneous examination of the extent to which EDs are characterized by aberrant avoidance-, reward-, and/or habit-based neurobiological and behavioral processes; improvement in understanding of how nutritional status interacts with neurobiological characteristics of EDs; incorporation of a growing knowledge of biobehavioral signatures in ED treatment planning; development of more comprehensive exposure-based treatment approaches for EDs; testing whether certain exposure interventions for AD are appropriate for EDs; and improvement in clinician self-efficacy and ability to use exposure therapy for EDs.
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Affiliation(s)
| | | | - Sasha Gorrell
- University of California, San Francisco, United States of America
| | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences, United States of America
| | | | - Tiffany A Brown
- University of California, San Diego, United States of America
| | - Kathryn M Smith
- Sanford Health, United States of America; University of Southern California, United States of America
| | | | | | - Ann F Haynos
- University of Minnesota, United States of America
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7
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Swami V, Horne G, Furnham A. COVID-19-related stress and anxiety are associated with negative body image in adults from the United Kingdom. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 170:110426. [PMID: 33046945 PMCID: PMC7539826 DOI: 10.1016/j.paid.2020.110426] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/18/2022]
Abstract
The stress and anxiety caused by the coronavirus (COVID-19) pandemic presents a serious threat to psychological well-being in populations worldwide and may also extend to body image outcomes. To test this hypothesis, we conducted a preliminary study in which an online sample of adults from the United Kingdom (N = 506, age M = 34.25 years) were asked to complete measures of perceived stress, stressful life events, trait anxiety, COVID-19-related stress and anxiety, and negative body image (body dissatisfaction and drive for thinness in women, body fat and muscularity dissatisfaction in men). The results of hierarchical regressions indicated that COVID-19-related stress and anxiety explained significant incremental variance in body image outcomes (Adj. ΔR 2 = .02 to .10), over-and-above demographics (age and body mass index) and perceived stress, trait anxiety, and stressful life events. These findings suggest that COVID-19-related stress and anxiety may shape body image outcomes under conditions of physical and social distancing.
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Affiliation(s)
- Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - George Horne
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Adrian Furnham
- Department of Leadership and Organizational Behaviour, Norwegian Business School, Oslo, Norway
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8
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Petisco-Rodríguez C, Sánchez-Sánchez LC, Fernández-García R, Sánchez-Sánchez J, García-Montes JM. Disordered Eating Attitudes, Anxiety, Self-Esteem and Perfectionism in Young Athletes and Non-Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6754. [PMID: 32948005 PMCID: PMC7559299 DOI: 10.3390/ijerph17186754] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/29/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023]
Abstract
Eating disorders are associated with short and long-term consequences that can affect sports performance. The purposes of this study were to investigate whether female athletes, particularly gymnasts and footballers, exhibit more eating problems compared to female non-athletes, and to identify individual personality characteristics including anxiety, self-esteem, and perfectionism as possible contributors to eating disorder risk. In a sample of 120 participants, 80 adolescent female athletes were compared to a control condition of 40 non-athletes (mean age 17.2 ± 2.82). Participants responded to a questionnaire package to investigate the presence of disordered eating (SCOFF) and psychological variables in relation to disordered eating symptoms or eating disorder status. Subsequently, anthropometric measures were obtained individually by trained staff. There were statistically significant differences between conditions. One of the most important results was the score in SCOFF (Mann-Whitney = 604, p < 0.05; Cohen's d = 0.52, r = 0.25), being higher in control than in the gymnast condition. These results suggest that non-athlete female adolescents show more disturbed eating behaviours and thoughts than female adolescents from aesthetic sport modalities and, therefore, may have an enhanced risk of developing clinical eating disorders.
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Affiliation(s)
- Cristina Petisco-Rodríguez
- Research Group Planning and Assessment of Training and Athletic Performance, Faculty of Education, Pontifical University of Salamanca, Calle Henry Collet, 52-70, 37007 Salamanca, Spain; (C.P.-R.); (J.S.-S.)
| | - Laura C. Sánchez-Sánchez
- Department of Evolutionary and Educational Psychology, Faculty of Science Education and Sport, University of Granada, Calle Santander, N° 1, 52071 Melilla, Spain
| | - Rubén Fernández-García
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento, S/N, La Cañada de San Urbano, 04120 Almería, Spain;
| | - Javier Sánchez-Sánchez
- Research Group Planning and Assessment of Training and Athletic Performance, Faculty of Education, Pontifical University of Salamanca, Calle Henry Collet, 52-70, 37007 Salamanca, Spain; (C.P.-R.); (J.S.-S.)
| | - José Manuel García-Montes
- Department of Psychology, University of Almeria, Carretera Sacramento, S/N, La Cañada de San Urbano, 04120 Almería, Spain;
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Lapidus RC, Puhl M, Kuplicki R, Stewart JL, Paulus MP, Rhudy JL, Feinstein JS, Khalsa SS. Heightened affective response to perturbation of respiratory but not pain signals in eating, mood, and anxiety disorders. PLoS One 2020; 15:e0235346. [PMID: 32667951 PMCID: PMC7363095 DOI: 10.1371/journal.pone.0235346] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/14/2020] [Indexed: 12/14/2022] Open
Abstract
Several studies have recently suggested that an abnormal processing of respiratory interoceptive and nociceptive (painful) stimuli may contribute to eating disorder (ED) pathophysiology. Mood and anxiety disorders (MA) are also characterized by abnormal respiratory symptoms, and show substantial comorbidity with ED. However, no studies have examined both respiratory and pain processing simultaneously within ED and MA. The present study systematically evaluated responses to perturbations of respiratory and nociceptive signals across the levels of physiology, behavior, and symptom report in a transdiagnostic ED sample (n = 51) that was individually matched to MA individuals (n = 51) and healthy comparisons (HC; n = 51). Participants underwent an inspiratory breath-holding challenge as a probe of respiratory interoception and a cold pressor challenge as a probe of pain processing. We expected both clinical groups to report greater stress and fear in response to respiratory and nociceptive perturbation than HCs, in the absence of differential physiological and behavioral responses. During breath-holding, both the ED and MA groups reported significantly more stress, feelings of suffocation, and suffocation fear than HC, with the ED group reporting the most severe symptoms. Moreover, anxiety sensitivity was related to suffocation fear only in the ED group. The heightened affective responses in the current study occurred in the absence of group differences in behavioral (breath hold duration, cold pressor duration) and physiological (end-tidal carbon dioxide, end-tidal oxygen, heart rate, skin conductance) responses. Against our expectations, there were no group differences in the response to cold pain stimulation. A matched-subgroup analysis focusing on individuals with anorexia nervosa (n = 30) produced similar results. These findings underscore the presence of abnormal respiratory interoception in MA and suggest that hyperreactivity to respiratory signals may be a potentially overlooked clinical feature of ED.
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Affiliation(s)
- Rachel C Lapidus
- Laureate Institute for Brain Research, Tulsa, OK, United States of America.,Department of Psychology, University of Tulsa, Tulsa, OK, United States of America
| | - Maria Puhl
- Laureate Institute for Brain Research, Tulsa, OK, United States of America
| | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, OK, United States of America
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States of America.,Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States of America
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States of America.,Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States of America
| | - Jamie L Rhudy
- Department of Psychology, University of Tulsa, Tulsa, OK, United States of America
| | - Justin S Feinstein
- Laureate Institute for Brain Research, Tulsa, OK, United States of America.,Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States of America
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, United States of America.,Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States of America
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Rodgers RF, Lombardo C, Cerolini S, Franko DL, Omori M, Fuller‐Tyszkiewicz M, Linardon J, Courtet P, Guillaume S. The impact of the COVID-19 pandemic on eating disorder risk and symptoms. Int J Eat Disord 2020; 53:1166-1170. [PMID: 32476175 PMCID: PMC7300468 DOI: 10.1002/eat.23318] [Citation(s) in RCA: 268] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/17/2020] [Accepted: 05/17/2020] [Indexed: 12/12/2022]
Abstract
The current COVID-19 pandemic has created a global context likely to increase eating disorder (ED) risk and symptoms, decrease factors that protect against EDs, and exacerbate barriers to care. Three pathways exist by which this pandemic may exacerbate ED risk. One, the disruptions to daily routines and constraints to outdoor activities may increase weight and shape concerns, and negatively impact eating, exercise, and sleeping patterns, which may in turn increase ED risk and symptoms. Relatedly, the pandemic and accompanying social restrictions may deprive individuals of social support and adaptive coping strategies, thereby potentially elevating ED risk and symptoms by removing protective factors. Two, increased exposure to ED-specific or anxiety-provoking media, as well as increased reliance on video conferencing, may increase ED risk and symptoms. Three, fears of contagion may increase ED symptoms specifically related to health concerns, or by the pursuit of restrictive diets focused on increasing immunity. In addition, elevated rates of stress and negative affect due to the pandemic and social isolation may also contribute to increasing risk. Evaluating and assessing these factors are key to better understanding the impact of the pandemic on ED risk and recovery and to inform resource dissemination and targets.
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Affiliation(s)
- Rachel F. Rodgers
- APPEAR, Department of Applied PsychologyNortheastern UniversityBostonMassachusettsUSA,Department of Psychiatric Emergency & Acute Care Lapeyronie Hospital, CHRU MontpellierMontpellierFrance,Department of PsychologySapienza University of RomeRomeItaly
| | | | - Silvia Cerolini
- Department of PsychologySapienza University of RomeRomeItaly
| | - Debra L. Franko
- APPEAR, Department of Applied PsychologyNortheastern UniversityBostonMassachusettsUSA
| | - Mika Omori
- Department of PsychologyOchanomizu UniversityTokyoJapan
| | | | - Jake Linardon
- School of PsychologyDeakin UniversityMelbourneVictoriaAustralia
| | - Philippe Courtet
- Department of Psychiatric Emergency & Acute Care Lapeyronie Hospital, CHRU MontpellierMontpellierFrance
| | - Sebastien Guillaume
- Department of Psychiatric Emergency & Acute Care Lapeyronie Hospital, CHRU MontpellierMontpellierFrance
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11
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Disgust and fear: common emotions between eating and phobic disorders. Eat Weight Disord 2020; 25:79-86. [PMID: 29766462 DOI: 10.1007/s40519-018-0512-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/01/2018] [Indexed: 10/16/2022] Open
Abstract
Eating disorders (ED) are prevalent mental illnesses composed mainly of anorexia nervosa, bulimia nervosa and binge eating disorders. Anxiety disorders are another set of mental illnesses, with phobic disorder (PD) being the most prevalent disorder. ED and PD are highly comorbid. The aim of this study is to assess, in 131 individuals attending an outpatient clinic for different health issues, the level of fear related to situations generating avoidance such as in social anxiety and specific phobias according to the fear questionnaire (FQ), the level of disgust according to the disgust scale (DS-R) and the vulnerability towards ED according to the SCOFF scale to demonstrate that high levels of both fear and disgust increase the vulnerability towards ED. The study demonstrated that the level of disgust increased when fear increases (r = 0.377, p < 0.001 for the first part of the FQ; r = 0.225, p = 0.01 for the second part of the FQ). Moreover, individuals with vulnerability towards having an ED presented a higher level of disgust than individuals without this vulnerability (p = 0.009). Furthermore, individuals with vulnerability towards ED have a higher level of anxiety related to PD subtypes (p = 0.008 for agoraphobia; p = 0.001 for injection/blood phobia) as well as to social anxiety (p = 0.01), independently from having a depressive or another anxiety disorder. In the multivariate analysis, a history of psychiatric consultation has been the only significantly different parameter between individuals with or without vulnerability towards ED (p = 0.0439). Accordingly, fear and disgust are negative emotions that seem to be clinically associated which better explains the comorbidity of ED with PD. LEVEL OF EVIDENCE: Level III. Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.
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12
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Liu X, Li J, Turel O, Chen R, He Q. Food-Specific Inhibitory Control Mediates the Effect of Disgust Sensitivity on Body Mass Index. Front Psychol 2019; 10:2391. [PMID: 31695662 PMCID: PMC6817461 DOI: 10.3389/fpsyg.2019.02391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/07/2019] [Indexed: 11/13/2022] Open
Abstract
Disgust is an emotion that drives food avoidance. People vary in their responses to disgust, which is captured by their disgust sensitivity. Disgust sensitivity is clinically significant because it can influence eating behaviors, and indirectly people's body mass index (BMI). Inhibitory control can also influence BMI through the role that such reflective abilities play in governing food intake. In this study, we relied on neural models of disgust to suggest that disgust and inhibitory control are intertwined, and that inhibitory control facilitates the translation of disgust sensitivity into BMI. Mediation analyses applied to 46 subjects, including 29 normal body weight [BMI = 18.34 kg/m2 (SD = 1.58)] and 17 overweight/obese [BMI = 26.03 kg/m2 (SD = 2.58)] subjects, were used to test the hypothesis. Subjects completed the Chinese version of the Disgust Scale-Revised, and an inhibition control test (Food-Specific Stop-Signal Task). There were negative correlations between the disgust sensitivity score (DS) and body mass index (BMI), and between DS and stop-signal reaction time (SSRT). Moreover, BMI was positively correlated with SSRT. The mediation model results showed that disgust sensitivity was associated with BMI and that this relationship was mediated via inhibition control. There was no significant effect of DS on BMI, while the effect of SSRT on BMI was significant. This suggested that the effect of disgust sensitivity on BMI was fully mediated through food-specific inhibitory control. This supports our hypothesis that BMI is affected by disgust sensitivity and that this relationship is mediated by inhibition control. These findings reveal a key mechanism that underlies disgust sensitivity-BMI association and point to future research and potential interventions aimed at food intake management.
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Affiliation(s)
- Xing Liu
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Ji Li
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Ofir Turel
- Information Systems and Decision Sciences, California State University, Fullerton, CA, United States
| | - Rui Chen
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Qinghua He
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Chongqing Collaborative Innovation Center for Brain Science, Southwest University, Chongqing, China
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Schaumberg K, Zerwas S, Goodman E, Yilmaz Z, Bulik CM, Micali N. Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence. J Child Psychol Psychiatry 2019; 60:686-696. [PMID: 30353925 PMCID: PMC6482103 DOI: 10.1111/jcpp.12984] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cross-sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent-reported anxiety in mid-childhood (age 10) and child-reported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population-based sample. METHODS Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14. RESULTS Parent-reported anxiety symptoms at age 10 yielded 5 factors: obsessive-compulsive disorder (OCD) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 (OR = 1.11, p = .007), whereas Factor 4 predicted diagnoses of anorexia nervosa (OR = 1.10, p = .01) and disordered eating by age 16 (OR = 1.08, p = .001). CONCLUSIONS Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescent-onset ED symptoms and ED diagnoses.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Erica Goodman
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Psychology, University of North Dakota, United States
| | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Nutrition, University of North Carolina at Chapel Hill, United States
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States
- Institute of Child Health, University College London, United Kingdom
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14
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Khairallah C, Zoghbi M, Richa S, Bou Khalil R. Disgust, impulsivity and depressive dimensions in subjects at risk for bulimia nervosa and/or binge eating disorder. Asian J Psychiatr 2019; 39:32-34. [PMID: 30522004 DOI: 10.1016/j.ajp.2018.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE the study aims to assess the depressive symptoms, the disgust feeling and the impulsivity index in subjects showing a high risk of binge eating disorder (BED) and/or bulimia nervosa (BN) through a cross-sectional study of 150 participants. RESULTS There was no significant difference regarding age, sex, employment and marital status between subjects at high risk for BED/BN (Group A) and controls (Group B). However, participants in group A presented higher scores of depressions (p = 0.021), impulsivity (p = 0.027) and Disgust (p = 0.030) with significant associations. CONCLUSION The neurobiological basis for these associations might be related to a dysfunction in the insular cortex.
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Affiliation(s)
| | - Marouan Zoghbi
- Biostatistics, Saint-Joseph University, Achrafieh, Lebanon
| | - Sami Richa
- Department of Psychiatry, Hotel Dieu de France Hospital, Achrafieh, Lebanon
| | - Rami Bou Khalil
- Department of Psychiatry, Hotel Dieu de France Hospital, Achrafieh, Lebanon
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Stasik-O'Brien SM, Schmidt J. The role of disgust in body image disturbance: Incremental predictive power of self-disgust. Body Image 2018; 27:128-137. [PMID: 30218943 DOI: 10.1016/j.bodyim.2018.08.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 08/21/2018] [Accepted: 08/21/2018] [Indexed: 12/23/2022]
Abstract
The relationship between disgust and symptoms of disorders characterized by body image disturbance (BID) is increasingly being examined. In cognitive-behavioral models of psychopathology, disgust may function as a negative emotional response to perceived body defects, leading to avoidance and compulsive behavior. Little research has examined the role of self-disgust - a form of disgust that may be particularly relevant to the body. The present study is a descriptive analysis of the association between BID and self-disgust, controlling for other related variables. Two non-clinical samples completed measures of BID, self-disgust, negative affect, anxiety sensitivity, disgust propensity, and disgust sensitivity. Although BID was associated with all three forms of disgust at the bivariate level, in multivariate analyses self-disgust emerged as a unique predictor of BID, above and beyond all included variables, although effect sizes were small. Potential implications for understanding, preventing, and treating body image-related disorders are discussed.
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16
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von Spreckelsen P, Glashouwer KA, Bennik EC, Wessel I, de Jong PJ. Negative body image: Relationships with heightened disgust propensity, disgust sensitivity, and self-directed disgust. PLoS One 2018; 13:e0198532. [PMID: 29870558 PMCID: PMC5988313 DOI: 10.1371/journal.pone.0198532] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 05/21/2018] [Indexed: 11/18/2022] Open
Abstract
Consistent with the view that disgust might be involved in persistent body dissatisfaction, there is preliminary evidence showing a positive correlation between measures of negative body image and indices of both trait disgust and self-directed disgust. In two correlational studies among undergraduates (N = 577 and N = 346, respectively) we aimed at replicating and extending these findings by testing a series of critical relationships, which follow from our hypotheses that 1) trait disgust propensity would increase the risk of developing a negative body image by increasing the likelihood of feeling self-disgust, and 2) trait disgust sensitivity would heighten the impact of self-disgust on the development of persistent negative body appraisals. Replicating previous research, both studies showed that negative body image was positively related to self-disgust, disgust propensity and disgust sensitivity. Mediation analyses showed that, in line with our model, self-disgust partly accounted for the association between disgust propensity and negative body image. Although disgust sensitivity showed an independent relationship with body image, disgust sensitivity did not moderate the association between self-disgust and negative body image. All in all, findings are consistent with the view that self-disgust-induced avoidance may contribute to persistent negative body appraisals.
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Affiliation(s)
- Paula von Spreckelsen
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | - Klaske A. Glashouwer
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
- Center for Eating Disorders, Accare, Child and Adolescent Psychiatry, Groningen, The Netherlands
| | - Elise C. Bennik
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Ineke Wessel
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Peter J. de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
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17
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Anderson LM, Reilly EE, Thomas JJ, Eddy KT, Franko DL, Hormes JM, Anderson DA. Associations among fear, disgust, and eating pathology in undergraduate men and women. Appetite 2018; 125:445-453. [PMID: 29481914 DOI: 10.1016/j.appet.2018.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/21/2018] [Accepted: 02/18/2018] [Indexed: 10/18/2022]
Abstract
Fear and disgust are distinct emotions that have been independently linked with EDs and may motivate avoidance behaviors that may be relevant targets for ED interventions (e.g., food rejection). Despite similar motivational function, it is possible that one emotion is more strongly associated with ED symptoms, relative to the other. Given that emerging evidence suggests that disgust-based behavior may be more difficult to change than fear-based behaviors, research is needed to evaluate whether each emotion differentially relates to ED symptoms. Therefore, the current study tested the relative importance of fear and disgust in accounting for variance in ED symptoms. Participants included undergraduate men (n = 127) and women (n = 263) from a university in the northeast US. Participants completed self-report measures assessing demographics, disordered eating attitudes and behaviors, and visual analog scales assessing fear and disgust responses to high-calorie food images, low-calorie food images, and non-food fear and disgust images. Bivariate correlations revealed significant positive associations among fear, disgust, and EDE-Q global symptom scores. Relative weights analysis results yielded relative importance weights that suggested disgust responding to high calorie food images accounts for the greatest total variance in EDE-Q global symptom scores in men, and fear responding to high calorie food images accounts for the greatest total variance in EDE-Q scores in women. Findings provide initial evidence that investigative and clinical efforts should consider fear and disgust as unique facets of negative affect with different patterns of relative importance to ED symptoms in undergraduate men and women.
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Affiliation(s)
- Lisa M Anderson
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA; Department of Psychiatry, University of Minnesota, 2450 Riverside Avenue, F227, Minneapolis, MN, 55454, USA.
| | - Erin E Reilly
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA; Department of Psychiatry, University of California - San Diego, 4510 Executive Drive, Suite 330, San Diego, CA, 92121, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, 2 West, Room 305, Boston, MA, 02215, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, 2 West, Room 305, Boston, MA, 02215, USA
| | - Debra L Franko
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200, Boston, MA 02114, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, 2 West, Room 305, Boston, MA, 02215, USA; Department of Applied Psychology, Northeastern University, 110 Churchill Hall, 360 Huntington Ave., Boston, MA, 02115, USA
| | - Julia M Hormes
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
| | - Drew A Anderson
- Department of Psychology, University at Albany, State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA
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Bosman RC, Borg C, de Jong PJ. Optimising Extinction of Conditioned Disgust. PLoS One 2016; 11:e0148626. [PMID: 26849211 PMCID: PMC4743916 DOI: 10.1371/journal.pone.0148626] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/31/2015] [Indexed: 11/18/2022] Open
Abstract
Maladaptive disgust responses are tenacious and resistant to exposure-based interventions. In a similar vein, laboratory studies have shown that conditioned disgust is relatively insensitive to Conditioned Stimulus (CS)-only extinction procedures. The relatively strong resistance to extinction might be explained by disgust’s adaptive function to motivate avoidance from contamination threats (pathogens) that cannot be readily detected and are invisible to the naked eye. Therefore, the mere visual presentation of unreinforced disgust eliciting stimuli might not be sufficient to correct a previously acquired threat value of the CS+. Following this, the current study tested whether the efficacy of CS-only exposure can be improved by providing additional safety information about the CS+. For the CSs we included two neutral items a pea soup and a sausage roll, whereas for the Unconditioned Stimulus (US) we used one video clip of a woman vomiting and a neutral one about glass blowing. The additional safety information was conveyed by allowing actual contact with the CS+ or by observing an actress eating the food items representing the CS+. When additional safety information was provided via allowing direct contact with the CS+, there was a relatively strong post-extinction increase in participants’ willingness-to-eat the CS+. This beneficial effect was still evident at one-week follow up. Also self-reported disgust was lower at one-week follow up when additional safety information was provided. The current findings help explain why disgust is relatively insensitive to CS-only extinction procedures, and provide helpful starting points to improve interventions that are aimed to reduce distress in disgust-related psychopathology.
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Affiliation(s)
- Renske C. Bosman
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Charmaine Borg
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
- * E-mail:
| | - Peter J. de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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Uzunian LG, Vitalle MSDS. Habilidades sociais: fator de proteção contra transtornos alimentares em adolescentes. CIENCIA & SAUDE COLETIVA 2015; 20:3495-508. [DOI: 10.1590/1413-812320152011.18362014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo desse estudo foi revisar a literatura a cerca da relação entre transtornos alimentares e habilidades sociais em adolescentes. Pesquisou-se as bases de dados Medline, SciELO e Lilacs, cruzando os descritores “transtornos alimentares”, “anorexia nervosa”, “bulimia nervosa” e “comportamento alimentar”, com os descritores “psicologia social” e “isolamento social”, e com as palavras chave “competência social”, “habilidade social” e “relação interpessoal”. Incluiu-se estudos com adolescentes, nos idiomas português, inglês e espanhol, e publicações realizadas entre os anos de 2007 a 2012. A busca resultou em 63 artigos, sendo incluídos 50 nesta revisão. A maioria dos estudos foi conduzido no Brasil e nos Estados Unidos. Do total, 43 eram artigos originais. Os estudos visavam compreender como o estado emocional poderia influenciar no estabelecimento dos transtornos alimentares, assim como as relações interpessoais e a relação entre os pares. Os artigos também discutiram a influência da mídia e da sociedade neste processo. A partir da análise dos estudos, observou-se que quanto maior o repertório de habilidades sociais dos adolescentes, maior será o fator de proteção contra o desenvolvimento de transtornos alimentares.
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20
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Shaw AM, Llabre MM, Timpano KR. Affect Intolerance and Hoarding Symptoms: A Structural Equation Modeling Approach. Int J Cogn Ther 2015. [DOI: 10.1521/ijct_2015_8_05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Eating Disorder Symptoms and Suicidal Ideation: The Moderating Role of Disgust. EUROPEAN EATING DISORDERS REVIEW 2015; 23:545-52. [DOI: 10.1002/erv.2373] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/18/2015] [Accepted: 05/01/2015] [Indexed: 11/07/2022]
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22
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Anorexia nervosa and its relation to depression, anxiety, alexithymia and emotional processing deficits. Eat Weight Disord 2014; 19:209-16. [PMID: 24474662 DOI: 10.1007/s40519-014-0101-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 01/11/2014] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Psychopathological changes and dysfunction in emotion processing have been described for anorexia nervosa (AN). Yet, findings are applicable to adult patients only. Furthermore, potential for discriminative power in clinical practice in relation to clinical parameters has to be discussed. The aim of this study was to investigate psychopathology and emotional face processing in adolescent female patients with AN. METHODS In a sample of 15 adolescent female patients with AN (16.2 years, SD ± 1.26) and 15 age and sex matched controls we assessed alexithymia, depression, anxiety and empathy in addition to emotion labelling and social information processing. RESULTS AN patients had significantly higher alexithymia, higher levels of depression, and state and trait anxiety compared to controls. There was a trend for a lower ability to recognize disgust. Happiness as a positive emotion was recognized better. All facial expressions were recognized significantly faster by AN patients. Associations of pathological eating behaviour and trait anxiety were seen. CONCLUSION In accordance with the stress reduction hypothesis, typical psychopathology of alexithymia, anxiety and depression is prevalent in female adolescent AN patients. It is present detached from physical stability. Pathogenesis of AN is multifactorial and already fully present in adolescence. An additional reinforcement process can be discussed. For clinical practice, those parameters might have a better potential for early prognostic factors related to AN than physical parameters and possible implication for intervention is given.
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23
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Ille R, Schöggl H, Kapfhammer HP, Arendasy M, Sommer M, Schienle A. Self-disgust in mental disorders -- symptom-related or disorder-specific? Compr Psychiatry 2014; 55:938-43. [PMID: 24480418 DOI: 10.1016/j.comppsych.2013.12.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 12/26/2013] [Accepted: 12/28/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Dysfunctional disgust experiences occur in a variety of mental disorders. Previous research focused on disgust proneness directed towards stimuli in the external environment. However, self-disgust, the devaluation of one' own physical appearance and personality (personal disgust) as well as one' own behavior (behavioral disgust) has hardly been investigated thus far, although it may play a crucial role in specific psychopathologies. METHODS We investigated 112 patients diagnosed with different mental disorders (major depression, schizophrenia, borderline personality disorder (BPD), eating disorders, and spider phobia) and 112 matched mentally healthy individuals. Participants answered the Questionnaire for the Assessment of Self-Disgust (QASD) with two subscales 'personal disgust' and 'behavioral disgust', and the Brief Symptom Inventory (BSI) that provides an overview of patients' psychological problems and their intensity. RESULTS Compared to healthy controls self-disgust was elevated in mental disorders. Personal disgust was more pronounced than behavioral disgust in patients, whereas there was no difference in controls. Patients with BPD and eating disorders reported the highest scores on both subscales. Findings also suggest that self-disgust is related to specific psychological problems. In mental disorders psychoticism and hostility were the best predictors for personal disgust, while anxiety and interpersonal sensitivity predicted behavioral disgust. Additionally, we found disorder-specific predictors for personal disgust (e.g., hostility in schizophrenia). Finally, traumatic events during childhood constitute a risk factor for self-disgust. CONCLUSIONS The current study provides first evidence for the differential meaning of self-disgust for specific mental disorders and symptoms.
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Affiliation(s)
- Rottraut Ille
- Institute of Psychology, Karl-Franzens-University of Graz, Austria; University Hospital of Psychiatry, Medical University of Graz, Austria.
| | - Helmut Schöggl
- University Hospital of Psychiatry, Medical University of Graz, Austria
| | | | - Martin Arendasy
- Institute of Psychology, Karl-Franzens-University of Graz, Austria
| | - Markus Sommer
- Institute of Psychology, Karl-Franzens-University of Graz, Austria
| | - Anne Schienle
- Institute of Psychology, Karl-Franzens-University of Graz, Austria
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Moncrieff-Boyd J, Byrne S, Nunn K. Disgust and Anorexia Nervosa: confusion between self and non-self. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21662630.2013.820376] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Espeset EMS, Gulliksen KS, Nordbø RHS, Skårderud F, Holte A. The Link Between Negative Emotions and Eating Disorder Behaviour in Patients with Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2012; 20:451-60. [DOI: 10.1002/erv.2183] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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26
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Davey GCL. Disgust: the disease-avoidance emotion and its dysfunctions. Philos Trans R Soc Lond B Biol Sci 2012; 366:3453-65. [PMID: 22042921 DOI: 10.1098/rstb.2011.0039] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This review analyses the accumulating evidence from psychological, psychophysiological, neurobiological and cognitive studies suggesting that the disease-avoidance emotion of disgust is a predominant emotion experienced in a number of psychopathologies. Current evidence suggests that disgust is significantly related to small animal phobias (particularly spider phobia), blood-injection-injury phobia and obsessive-compulsive disorder contamination fears, and these are all disorders that have primary disgust elicitors as a significant component of their psychopathology. Disgust propensity and sensitivity are also significantly associated with measures of a number of other psychopathologies, including eating disorders, sexual dysfunctions, hypochondriasis, height phobia, claustrophobia, separation anxiety, agoraphobia and symptoms of schizophrenia--even though many of these psychopathologies do not share the disease-avoidance functionality that characterizes disgust. There is accumulating evidence that disgust does represent an important vulnerability factor for many of these psychopathologies, but when disgust-relevant psychopathologies do meet the criteria required for clinical diagnosis, they are characterized by significant levels of both disgust and fear/anxiety. Finally, it has been argued that disgust may also facilitate anxiety and distress across a broad range of psychopathologies through its involvement in more complex human emotions such as shame and guilt, and through its effect as a negative affect emotion generating threat-interpretation biases.
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Affiliation(s)
- Graham C L Davey
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK.
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27
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Disordered Eating Attitudes in Relation to Anxiety Levels, Self-esteem and Body Image in Female Basketball Players. J Exerc Sci Fit 2011. [DOI: 10.1016/s1728-869x(12)60006-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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28
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Cowdrey FA, Park RJ, Harmer CJ, McCabe C. Increased neural processing of rewarding and aversive food stimuli in recovered anorexia nervosa. Biol Psychiatry 2011; 70:736-743. [PMID: 21714958 DOI: 10.1016/j.biopsych.2011.05.028] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/24/2011] [Accepted: 05/24/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Recent evidence has shown that individuals with acute anorexia nervosa and those recovered have aberrant physiological responses to rewarding stimuli. We hypothesized that women recovered from anorexia nervosa would show aberrant neural responses to both rewarding and aversive disorder-relevant stimuli. METHODS Using functional magnetic resonance imaging (fMRI), the neural response to the sight and flavor of chocolate, and their combination, in 15 women recovered from restricting-type anorexia nervosa and 16 healthy control subjects matched for age and body mass index was investigated. The neural response to a control aversive condition, consisting of the sight of moldy strawberries and a corresponding unpleasant taste, was also measured. Participants simultaneously recorded subjective ratings of "pleasantness," "intensity," and "wanting." RESULTS Despite no differences between the groups in subjective ratings, individuals recovered from anorexia nervosa showed increased neural response to the pleasant chocolate taste in the ventral striatum and pleasant chocolate sight in the occipital cortex. The recovered participants also showed increased neural response to the aversive strawberry taste in the insula and putamen and to the aversive strawberry sight in the anterior cingulate cortex and caudate. CONCLUSIONS Individuals recovered from anorexia nervosa have increased neural responses to both rewarding and aversive food stimuli. These findings suggest that even after recovery, women with anorexia nervosa have increased salience attribution to food stimuli. These results aid our neurobiological understanding and support the view that the neural response to reward may constitute a neural biomarker for anorexia nervosa.
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Affiliation(s)
- Felicity A Cowdrey
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom.
| | - Rebecca J Park
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Ciara McCabe
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
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29
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Aharoni R, Hertz MM. Disgust sensitivity and anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2011; 20:106-10. [PMID: 21789779 DOI: 10.1002/erv.1124] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 02/28/2011] [Accepted: 03/18/2011] [Indexed: 11/12/2022]
Abstract
BACKGROUND Previous studies found inconsistent differences in disgust sensitivity between patients with a variety of eating disorders and normal controls. AIM The objective of this study was to compare disgust sensitivity between a larger and more specific sample of anorexia nervosa (AN) patients and control subjects. METHOD We compared the scores on the 'disgust sensitivity scale' of AN patients (N = 62) and control subjects (N = 62) using a multivariate analysis of variance. All subjects were women. RESULTS AN patients scored consistently higher on all domains of disgust sensitivity. This difference was significant for six of eight disgust domains. The largest significant difference between the groups was on the domains food and magical thinking. CONCLUSION Our findings elaborate on previous findings and are in line with recent neurological findings suggesting that disgust and insular impairments are associated with AN. Clinical implications of our findings are discussed.
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Affiliation(s)
- Ruth Aharoni
- Clinic for anxiety and OCD, Mental Health Center, Copenhagen, Denmark.
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30
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Costarelli V, Antonopoulou K, Mavrovounioti C. Psychosocial characteristics in relation to disordered eating attitudes in greek adolescents. EUROPEAN EATING DISORDERS REVIEW 2010; 19:322-30. [PMID: 20672250 DOI: 10.1002/erv.1030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The study explores possible links between eating attitudes in Greek adolescents and certain psychosocial characteristics such as self-esteem, empathy and anxiety. A total of 202 students (109 boys and 93 girls), 15-18 years old, have been recruited. The following questionnaires were used: the Eating Attitudes Test (EAT-26), the State-Trait Anxiety Inventory, the Self-Perception Profile for Adolescents, the Multidimensional Body-Self-Questionnaire-Overweight Preoccupation and the Index of Empathy of Children and Adolescents. The EAT-26 revealed that 18.3% of the total sample of students (12.8% of boys and 24.7% of girls) reported having disordered eating attitudes. Adolescents with disordered eating attitudes had significantly higher levels of anxiety and scored less in self-reported physical appearance and romantic appeal. Empathy and global self-esteem did not differ significantly between the two groups. Adolescents with disordered eating attitudes have certain psychosocial characteristics which differentiate them from the students with healthier eating attitudes.
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Affiliation(s)
- V Costarelli
- Department of Home Economics and Ecology, Harokopio University, Athens, Greece.
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Fox JRE, Froom K. Eating disorders: A basic emotion perspective. Clin Psychol Psychother 2009; 16:328-35. [DOI: 10.1002/cpp.622] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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