1
|
Sharpe SL, Adams M, Smith EK, Urban B, Silverstein S. Inaccessibility of care and inequitable conceptions of suffering: a collective response to the construction of "terminal" anorexia nervosa. J Eat Disord 2023; 11:66. [PMID: 37131268 PMCID: PMC10152768 DOI: 10.1186/s40337-023-00791-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/21/2023] [Indexed: 05/04/2023] Open
Abstract
Informed by our lived experiences with eating disorders, our work providing direct support to communities underserved by existing healthcare structures, and our commitment to social justice, we are deeply troubled by several aspects of the proposed characteristics for "terminal" anorexia nervosa outlined by Gaudiani et al. in Journal of Eating Disorders (10:23, 2022). We have identified two substantial areas of concern in the proposed characteristics provided by Gaudiani et al. and the subsequent publication by Yager et al. (10:123, 2022). First, the original article and the subsequent publication fail to adequately address the widespread inaccessibility of eating disorder treatment, the lack of parameters for what constitutes "high quality care", and the prevalence of trauma experienced in treatment settings for those who do access treatment. Second, the characteristics proposed for "terminal" anorexia nervosa are constructed largely based on subjective and inconsistent valuations of suffering which build on and contribute to harmful and inaccurate eating disorder stereotypes. Overall, we believe these proposed characteristics in their current form stand to detract from, rather than assist, the ability of patients and providers to make informed, compassionate, and patient-centered decisions about safety and autonomy both for individuals with enduring eating disorders and for individuals with more recently diagnosed eating disorders.
Collapse
Affiliation(s)
- Sam L Sharpe
- Fighting Eating Disorders in Underrepresented Populations (FEDUP) Collective, 4400 North Congress Avenue Suite 100, West Palm Beach, FL, 33407, USA.
| | - Marissa Adams
- Fighting Eating Disorders in Underrepresented Populations (FEDUP) Collective, 4400 North Congress Avenue Suite 100, West Palm Beach, FL, 33407, USA
| | - Emil K Smith
- Fighting Eating Disorders in Underrepresented Populations (FEDUP) Collective, 4400 North Congress Avenue Suite 100, West Palm Beach, FL, 33407, USA
| | - Bek Urban
- Fighting Eating Disorders in Underrepresented Populations (FEDUP) Collective, 4400 North Congress Avenue Suite 100, West Palm Beach, FL, 33407, USA
| | - Scout Silverstein
- Fighting Eating Disorders in Underrepresented Populations (FEDUP) Collective, 4400 North Congress Avenue Suite 100, West Palm Beach, FL, 33407, USA
| |
Collapse
|
2
|
Schnepper R, Richard A, Georgii C, Arend AK, Naab S, Voderholzer U, Wilhelm FH, Blechert J. Bad mood food? Increased versus decreased food cue reactivity in anorexia nervosa and bulimia nervosa during negative emotions. EUROPEAN EATING DISORDERS REVIEW 2021; 29:756-769. [PMID: 34176193 DOI: 10.1002/erv.2849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/02/2021] [Accepted: 05/31/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Emotion regulation difficulties in anorexia nervosa (AN) and bulimia nervosa (BN) might underlie bingeing and purging in BN, extreme fasting in AN, or combinations of these symptoms in binge-purge type AN. In this study, we tested for decreased food cue reactivity in response to negative emotions in AN, and the opposite pattern for BN. Furthermore, we explored subgroup differences (restrictive vs. binge-purging AN; history of AN in BN). METHOD Patients with AN (n = 41), BN (n = 39), and matched controls (n = 70) completed an emotional eating questionnaire. In a laboratory experiment, we induced negative emotions and measured food cue reactivity (pleasantness, desire to eat (DTE), and corrugator muscle activity). RESULTS AN reported emotional undereating, while BN reported emotional overeating. In the laboratory task, BN showed increased DTE and an appetitive corrugator response during negative emotions, selectively towards high-calorie foods. AN showed generalized reduced cue reactivity to high-calorie food regardless of emotional state. This pattern appears to be characteristic of restrictive AN, while cue reactivity of both BN subgroups pointed towards emotional overeating. CONCLUSIONS The emotional over- versus undereating framework might help to explain bingeing and restricting along the anorectic-bulimic disorder spectrum, which calls for novel transdiagnostic theories and subgroup-specific treatments.
Collapse
Affiliation(s)
- Rebekka Schnepper
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Anna Richard
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Claudio Georgii
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Ann-Kathrin Arend
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Silke Naab
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
| | - Frank H Wilhelm
- Department of Psychology, Division of Clinical Psychology and Psychopathology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| |
Collapse
|
3
|
Jennings KM, Bodell LP, Crosby RD, Haynos AF, Wildes JE. Mixture Modeling to Characterize Anorexia Nervosa: Integrating Personality and Eating Disorder Psychopathology. J Am Psychiatr Nurses Assoc 2021; 27:231-239. [PMID: 31291805 PMCID: PMC7081379 DOI: 10.1177/1078390319862029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND: Efforts to examine alternative classifications (e.g., personality) of anorexia nervosa (AN) using empirical techniques are crucial to elucidate diverse symptom presentations, personality traits, and psychiatric comorbidities. AIMS: The purpose of this study was to use an empirical approach (mixture modeling) to test an alternative classification of AN as categorical, dimensional, or hybrid categorical-dimensional construct based on the co-occurrence of personality psychopathology and eating disorder clinical presentation. METHODS: Patients with AN (N = 194) completed interviews and questionnaires at treatment admission and 3-month follow-up. Mixture modeling was used to test whether indicators best classified AN as categorical, dimensional, or hybrid. RESULTS: A four-latent class, one-latent dimension mixture model that was variant across groups provided the best fit to the data. Results suggest that all classes were characterized by low self-esteem and self-harming and suicidality tendencies. Individuals assigned to Latent Class 2 (LC2; n = 21) had a greater tendency toward being impulsive and easily angered and having difficulties controlling anger compared with those in LC1 (n = 84) and LC3 (n = 66). Moreover, individuals assigned to LC1 and LC3 were more likely to have a poor outcome from intensive treatment compared with those in LC4 (n = 21). Findings indicate that the dimensional aspect within each class measured frequency of specific eating disorder behaviors but did not predict treatment outcomes. CONCLUSIONS: These results emphasize the complexity of AN and the importance of considering how facets of clinical presentation beyond eating disorder behaviors may have different treatment and prognostic implications.
Collapse
Affiliation(s)
- Karen M Jennings
- Karen M. Jennings, PhD, RN, PMHNP-BC, University of Rhode Island, Providence, RI, USA
| | - Lindsay P Bodell
- Lindsay P. Bodell, PhD, Western University, London, Ontario, Canada
| | - Ross D Crosby
- Ross D. Crosby, PhD, Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Ann F Haynos
- Ann F. Haynos, PhD, University of Minnesota, Minneapolis, MN, USA
| | | |
Collapse
|
4
|
Chapa DAN, Hagan KE, Forbush KT, Clark KE, Tregarten JP, Argue S. Longitudinal trajectories of behavior change in a national sample of patients seeking eating-disorder treatment. Int J Eat Disord 2020; 53:917-925. [PMID: 32275088 DOI: 10.1002/eat.23272] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Rapid response to treatment, indicated by substantial decreases in eating-disorder (ED) symptoms within the first 4-6 weeks of treatment, is the most reliable predictor of treatment outcomes for EDs. However, there is limited research evaluating short-term longitudinal trajectories of ED symptoms during treatment. Thus, it is difficult to know which aspects of ED psychopathology are slow or fast to change. The purpose of this study was to elucidate three-month trajectories of ED psychopathology during treatment and test whether ED diagnosis influenced the direction and rate of change. METHOD Participants were Recovery Record users seeking treatment for an ED (N = 4,568; 86.8% female). Participants completed the Eating Pathology Symptoms Inventory once per month for 3 months. RESULTS Latent growth curve models indicated that ED diagnosis influenced the rate of ED behavior change. Anorexia nervosa was associated with faster reductions in cognitive restraint, excessive exercise, restricting, yet slower reductions in body dissatisfaction, and binge eating. Bulimia nervosa was associated with faster reductions in binge eating, cognitive restraint, excessive exercise, and purging. Binge-eating disorder was associated with faster reductions in body dissatisfaction and binge eating, yet slower reductions in restricting. CONCLUSIONS Our results have implications for future research by providing initial information about the direction and rate of ED change over the course of treatment. If clinicians and researchers know which ED symptoms are slow to change, on average, across diagnostic groups, treatment protocols could be adjusted to target slow changing symptoms more quickly, and therefore improve ED treatment outcomes.
Collapse
Affiliation(s)
| | - Kelsey E Hagan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey E Clark
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | | | | |
Collapse
|
5
|
Kroplewski Z, Szcześniak M, Furmańska J, Gójska A. Assessment of Family Functioning and Eating Disorders - The Mediating Role of Self-Esteem. Front Psychol 2019; 10:921. [PMID: 31068882 PMCID: PMC6491868 DOI: 10.3389/fpsyg.2019.00921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 04/05/2019] [Indexed: 12/25/2022] Open
Abstract
The aim of the study was to measure whether people at increased risk for eating disorders (EDs) and people without an increased risk of EDs differ from each other in the assessment of family functioning (FF) and self-esteem (SE) dimensions. Moreover, the correlations between FF, EDs, and SE were verified, looking for the mediating role of SE in the context of the FF and EDs. The research was conducted on the group of 160 people aged from 18 to 47 years, including 74 people at increased risk for EDs. We used: The Family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve); The SCOFF Questionnaire; The Multidimensional Self-Esteem Inventory, MSEI. Analyses indicate that the compared groups differ significantly in terms of EDs, assessment of FF, and all components of SE, in such a way that people without an increased risk of EDs are characterized by a more positive assessment of FF and higher SE in all its dimensions. All SE dimensions, except defensive high SE, are mediators in the relationship of FF with EDs. In therapeutic interactions, it is worth focusing on the SE dimensions, as they are one of the mediation elements in the relationship between the assessment of FF and EDs.
Collapse
Affiliation(s)
- Zdzisław Kroplewski
- Faculty of Humanities, Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Małgorzata Szcześniak
- Faculty of Humanities, Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Joanna Furmańska
- Faculty of Humanities, Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Anita Gójska
- Faculty of Humanities, Institute of Psychology, University of Szczecin, Szczecin, Poland
| |
Collapse
|
6
|
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: 20] [Impact Index Per Article: 3.3] [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.
Collapse
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
| |
Collapse
|
7
|
Harper JA, Brodrick B, Van Enkevort E, McAdams CJ. Neuropsychological and Cognitive Correlates of Recovery in Anorexia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2017; 25:491-500. [PMID: 28799287 DOI: 10.1002/erv.2539] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To identify clinical or cognitive measures either predictive of illness trajectory or altered with sustained weight recovery in adult women with anorexia nervosa. METHODS Participants were recruited from prior studies of women with anorexia nervosa (AN-C) and in weight-recovery following anorexia nervosa (AN-WR). Participants completed a neuropsychological battery at baseline and clinical assessments at both baseline and follow-up. Groups based on clinical outcome (continued eating disorder, AN-CC; newly in recovery, AN-CR; sustained weight-recovery, AN-WR) were compared by using one-way ANOVAs with Bonferroni-corrected post hoc comparisons. RESULTS Women with continued eating disorder had poorer neuropsychological function and self-competence at baseline than AN-CR. AN-CR showed changes in depression and externalizing bias, a measure of self-related attributions. AN-WR differed from both AN-CC and AN-CR at baseline in externalizing bias, but only from AN-CC at outcome. DISCUSSION Neuropsychological function when recently ill may be a prognostic factor, while externalizing bias may provide a clinical target for recovery. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Collapse
Affiliation(s)
- Jessica A Harper
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA
| | - Brooks Brodrick
- Department of Internal Medicine, University of Texas Southwestern Medical Center, TX, USA
| | - Erin Van Enkevort
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA
| | - Carrie J McAdams
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA.,Department of Psychiatry, Children's Medical Center, TX, USA.,Department of Psychiatry, Texas Health Presbyterian Hospital of Dallas, TX, USA
| |
Collapse
|
8
|
Treasure J. Applying evidence-based management to anorexia nervosa. Postgrad Med J 2016; 92:525-31. [PMID: 26944338 DOI: 10.1136/postgradmedj-2015-133282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 02/11/2016] [Indexed: 12/28/2022]
Abstract
AIM This paper considers how the three principles of evidence based practice (clinical expertise, scientific evidence, and patient preference) can be applied to the complexity of treatment for anorexia nervosa AN. METHOD A narrative review of the evidence of these three domains is presented. Clinical cases are used to illustrate how the formulation and management can be put into practice at different stages of illness. RESULTS The management of anorexia nervosa is complex. First, individuals with the illness do not regard the manifestations of the illness as a source of concern rather they are embraced and integrated into their identity. This contrasts to the reaction of other people who are terrified by the overt signs of ill health. Thus engagement into treatment is problematic. Second, the core symptom restricted eating, produces malnutrition which impacts on brain, body, and the social network. Thus a mixture of psychological and physical problems gradually accumulates over the course of the illness. This means that the treatment targets increase over time. CONCLUSION Thus treatment has to work with motivation and readiness to change and tackle the various domains of ill health.
Collapse
|
9
|
Van Autreve S, De. Baene W, Baeken C, van Heeringen K, Vancayseele N, Vervaet M. Differential Neural Correlates of Set-Shifting in the Bingeing-Purging and Restrictive Subtypes of Anorexia Nervosa: An fMRI Study. EUROPEAN EATING DISORDERS REVIEW 2016; 24:277-85. [PMID: 26856396 DOI: 10.1002/erv.2437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/05/2015] [Accepted: 01/09/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Sara Van Autreve
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Wouter De. Baene
- Department of Experimental Psychology, Faculty of Psychology and Educational Sciences; Ghent University; Belgium
- Department of Cognitive Neuropsychology; Tilburg University; The Netherlands
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Kees van Heeringen
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Nikita Vancayseele
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| | - Myriam Vervaet
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences; Ghent University; Belgium
| |
Collapse
|
10
|
Colton PA, Olmsted MP, Daneman D, Farquhar JC, Wong H, Muskat S, Rodin GM. Eating Disorders in Girls and Women With Type 1 Diabetes: A Longitudinal Study of Prevalence, Onset, Remission, and Recurrence. Diabetes Care 2015; 38:1212-7. [PMID: 25887359 DOI: 10.2337/dc14-2646] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/08/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Girls and women with type 1 diabetes are at increased risk for developing eating disorders (EDs), and these disorders are associated with serious diabetes-related medical complications. This study describes the longitudinal course of disturbed eating behavior (DEB) and EDs in a cohort with type 1 diabetes. RESEARCH DESIGN AND METHODS A total of 126 girls with type 1 diabetes receiving care for diabetes at The Hospital for Sick Children in Toronto participated in a series of seven interview-based assessments of ED behavior and psychopathology over a 14-year period, beginning in late childhood. Survival analysis was used. RESULTS Mean age was 11.8 ± 1.5 years at time 1 and 23.7 ± 2.1 years at time 7. At time 7, 32.4% (23/71) met the criteria for a current ED, and an additional 8.5% (6/71) had a subthreshold ED. Mean age at ED onset (full syndrome or below the threshold) was 22.6 years (95% CI 21.6-23.5), and the cumulative probability of onset was 60% by age 25 years. The average time between onset of ED and subsequent ED remission was 4.3 years (95% CI 3.1-5.5), and the cumulative probability of remission was 79% by 6 years after onset. The average time between remission of ED and subsequent recurrence was 6.5 years (95% CI 4.4-8.6), and the cumulative probability of recurrence was 53% by 6 years after remission. CONCLUSIONS In this longitudinal study, EDs were common and persistent, and new onset of ED was documented well into adulthood. Further research regarding prevention and treatment for this vulnerable group is urgently needed.
Collapse
Affiliation(s)
- Patricia A Colton
- Department of Psychiatry, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Marion P Olmsted
- Department of Psychiatry, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Denis Daneman
- The Hospital for Sick Children, Toronto, Canada Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Jamie C Farquhar
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Harmonie Wong
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Stephanie Muskat
- Department of Psychiatry, University Health Network, Toronto, Canada
| | - Gary M Rodin
- Department of Psychiatry, University Health Network, Toronto, Canada Department of Psychiatry, University of Toronto, Toronto, Canada
| |
Collapse
|
11
|
Zander ME, De Young KP. Individual differences in negative affect and weekly variability in binge eating frequency. Int J Eat Disord 2014; 47:296-301. [PMID: 24222630 DOI: 10.1002/eat.22222] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/07/2013] [Accepted: 10/11/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the relationship of neuroticism and negative affect (NA) lability with weekly binge eating fluctuations between binge eating disorder (BED) and bulimia nervosa (BN). METHOD Individuals with BED (n = 30) and BN (n = 54) from the community completed self-report measures at baseline and prospectively for 12 consecutive weeks. Weekly data were analyzed by using (mean) squared successive deviation to account for fluctuations in NA and binge eating from week to week. RESULTS Generalized estimating equations revealed the presence of a two-way interaction between neuroticism and NA lability predicting binge eating fluctuations (Wald χ(2) = 8.25; df = 1; p = .004), indicating that higher NA lability was only related to larger fluctuations in the frequency of binge eating episodes when present in individuals who were also high on neuroticism. An interaction was also detected between eating disorder diagnosis and NA lability, but this was accounted for by differences in average NA between the diagnoses. DISCUSSION This study highlights the relevance of two traits and their interaction in understanding individual differences in binge eating fluctuations. Additionally, findings indicate that diagnostic differences in average NA may impact binge eating fluctuations and NA lability.
Collapse
Affiliation(s)
- Mary E Zander
- Department of Psychology, University of North Dakota, 319 Harvard St., Stop 8380, Grand Forks, North Dakota, 58202
| | | |
Collapse
|
12
|
Hay PJ, Buettner P, Mond J, Paxton SJ, Quirk F, Rodgers B. A community-based study of enduring eating features in young women. Nutrients 2012; 4:413-24. [PMID: 22690324 PMCID: PMC3367265 DOI: 10.3390/nu4050413] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 04/05/2012] [Accepted: 05/18/2012] [Indexed: 12/04/2022] Open
Abstract
We conducted a prospective exploration of the temporal course of eating disorder (ED) symptoms in two cohorts of community women. One hundred and twenty-two young women (Cohort 1) identified in a general population based survey with ED symptoms of clinical severity agreed to participate in a 5-year follow-up study. A comparative sample (Cohort 2) of 706 similar aged self-selected college women (221 with disordered eating) was recruited one year later. Both ED groups were given a health literacy package in the first year. ED symptoms, health related quality of life, and psychological distress were assessed annually with the Eating Disorder Examination Questionnaire, the Short Form-12 Health Survey and the Kessler Psychological Distress Scale, respectively. Forty percent (Cohort 1) and 30.3% (Cohort 2) completed questionnaires at each year of follow-up. In both groups, there was early improvement in ED symptoms which plateaued after the first year, and participants retained high EDE-Q scores at 5 years. BMI increased as expected. Mental health related quality of life scores did not change but there were small improvements in psychological distress scores. The findings suggest little likelihood of spontaneous remission of ED problems in community women.
Collapse
Affiliation(s)
- Phillipa J. Hay
- School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia
- School of Medicine, James Cook University, Townsville QLD 4811, Australia; (P.B.); (F.Q.)
| | - Petra Buettner
- School of Medicine, James Cook University, Townsville QLD 4811, Australia; (P.B.); (F.Q.)
| | - Jonathan Mond
- School of Public Health, James Cook University, Townsville QLD 4811, Australia;
| | - Susan J. Paxton
- School of Psychological Sciences, La Trobe University, Melbourne VIC 3086, Australia;
| | - Frances Quirk
- School of Medicine, James Cook University, Townsville QLD 4811, Australia; (P.B.); (F.Q.)
| | - Bryan Rodgers
- Australian Demographic and Social Research Institute, The Australian National University, Canberra ACT 0200, Australia;
| |
Collapse
|