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Mammì A, Bova V, Martino I, Sammarra I, Ferlazzo E, Pascarella A, Abelardo D, Marsico O, Torino C, Cianci V, Viola G, Pecoraro V, Beghi M, Gambardella A, Pujia A, Aguglia U, Gasparini S. Functional seizures and binge eating disorder: A cross-sectional study. Epilepsy Behav 2024; 158:109943. [PMID: 39002280 DOI: 10.1016/j.yebeh.2024.109943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVE Functional seizures (FS) are brief, involuntary changes in behaviour or consciousness, distinct from epileptic seizures, potentially associated with psychological dissociation. Binge eating disorder (BED) was linked to psychological and somatic dissociation also. However, any connection between FS and BED is insufficiently explored. We aimed to assess BED prevalence in individuals with FS, anxiety/depression (AD), and healthy subjects (HS), to investigate dissociation's link to binge eating, and to explore psychological characteristics of FS individuals. METHOD Participants underwent evaluations based on ILAE guidelines and DSM-5 criteria, including questionnaires assessing binge eating, dissociation, anxiety, depression and personality traits. Inclusion criteria were age > 18 years, no history of substance abuse, no history of epilepsy, and no use of medications inducing eating disorders. RESULTS We found significantly more frequent and severe binge-eating symptoms in individuals with FS and AD compared to HS. Depression and dissociation correlated with binge-eating symptoms in both AD and FS groups. The PID-5 facet 'Perseveration' predicted binge-eating attitudes only in FS individuals; they reported more childhood emotional neglect and increased disinhibition compared do AD people. DISCUSSION This study underscores the commonality of binge-eating symptoms in FS individuals, emphasizing its association with dissociation symptoms. This finding support the hypothesis of a link between dissociation and eating disorders. Unique clinical characteristics in individuals with FS were identified, as a compulsive dimension related to binge-eating symptoms, providing a comprehensive understanding of their psychological profile and guiding targeted therapeutic interventions.
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Affiliation(s)
- Anna Mammì
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Valentina Bova
- Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Iolanda Martino
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy
| | - Ilaria Sammarra
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy
| | - Edoardo Ferlazzo
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Angelo Pascarella
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Domenico Abelardo
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Oreste Marsico
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Claudia Torino
- IFC-CNR, National Research Council - Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Vittoria Cianci
- Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | - Giulia Viola
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy
| | - Valeria Pecoraro
- Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
| | | | - Antonio Gambardella
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy
| | - Umberto Aguglia
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy.
| | - Sara Gasparini
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan Hospital, Reggio Calabria, Italy
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Siegel JA, Mendoza RR, Tesselaar JM, DeJesus J, Elbe CI, Caravelli NS, Troy L, Fenton M, Victoria B, Herrera J, Blashill AJ. "I felt so powerful to have this love in me": A grounded theory analysis of the experiences of people living with and recovering from eating disorders while in diverse romantic relationships. Body Image 2024; 49:101709. [PMID: 38615591 DOI: 10.1016/j.bodyim.2024.101709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 04/16/2024]
Abstract
Romantic partners have the potential to influence attitudes and behaviors related to body image and disordered eating. However, the role that romantic relationships can play in eating disorder (ED) recovery has not been comprehensively investigated. The present study aimed to explore the ways that people living with and recovering from EDs experience their romantic relationships, with the specific objective of developing a novel theoretical framework, grounded in the experiences of people in diverse romantic relationships, to guide future research on the topic. Semi-structured individual interviews were conducted with 66 people (45 cisgender women, 11 cisgender men, 9 nonbinary people, and 1 transgender man) living with and recovering from EDs while in romantic relationships. Our grounded theory analysis yielded a theoretical model of ED management in romantic relationships, revealing that Individual and Relationship Characteristics intersected with Relationship-Related Stressors and were navigated using Eating Disorder and Relationship Management Strategies. Combined with Partner Support and Tensions, these management strategies were related to Relationship and Mental Health Outcomes, which affected and were affected by Future Concerns. Future researchers should continue to build on, expand, and modify this model and further explore the role of romantic relationships in the experience of people living with EDs.
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Affiliation(s)
| | | | | | | | - Connor I Elbe
- Department of Psychology, San Diego State University, USA
| | | | - Lynae Troy
- Department of Psychology, San Diego State University, USA
| | - Margo Fenton
- Department of Psychology, San Diego State University, USA
| | | | | | - Aaron J Blashill
- Department of Psychology, San Diego State University, SDSU/UCSD Joint Doctoral Program in Clinical Psychology, USA
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Romano KA, Sandoval CM, Lewis RJ, Heron KE. Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships. Ann Behav Med 2024; 58:412-421. [PMID: 38581675 PMCID: PMC11112276 DOI: 10.1093/abm/kaae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND AND PURPOSE The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.
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Affiliation(s)
- Kelly A Romano
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Robin J Lewis
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Kristin E Heron
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
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4
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Martin GM, Tremblay J, Gagnon-Girouard MP. Sexual self-concept, functioning, and practices of women with binge eating episodes. Eat Weight Disord 2023; 28:37. [PMID: 37069446 PMCID: PMC10108796 DOI: 10.1007/s40519-023-01565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/21/2023] [Indexed: 04/19/2023] Open
Abstract
PURPOSE Positive sexuality has received little empirical attention in relation to eating disorders. Two tendencies related to sexuality have been identified among women with anorexia nervosa (avoidance) and bulimia nervosa (disinhibition), but it is unclear if they also apply to women with binge eating episodes without compensatory behaviors. This study aimed at (1) exploring the sexual self-concept, functioning, and practices of women with binge eating episodes with or without comorbid restrictive and/or compensatory behaviors, considering past experiences of violence, and (2) verifying the presence of distinct profiles of sexual dispositions among this population. METHODS In total, 253 women reporting recurrent episodes of loss of control related to food intake in the past 5 years, completed a web-based questionnaire. Descriptive and correlational analyses were conducted to outline participants' sexual self-concept, functioning, and practices and to examine the relationship between these factors. A two-step cluster analysis was also performed to determine whether participants presented distinct profiles of sexual dispositions. RESULTS Participants were generally characterized by a negative sexual self-concept and poor sexual functioning. While a first subgroup of participants displayed a pattern of sexual difficulties and avoidance, a second subgroup had a positive sexual self-concept, better sexual functioning and a wider range of sexual practices. Subgroups did not differ relative to binge eating. CONCLUSIONS Sexuality offers a platform for positive embodiment, which can lead to the improvement of body image and mind-body connection and may thus constitute an essential clinical target to improve treatment related to binge eating episodes. LEVEL OF EVIDENCE Level II: The experimental study is a non-randomized controlled trial.
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Affiliation(s)
- Geneviève Manuela Martin
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, G1V 0A6, Québec, Canada.
| | - Jérôme Tremblay
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
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Hartman CA, Richards JS, Vrijen C, Oldehinkel AJ, Oerlemans AM, Kretschmer T. Cohort Profile Update: The TRacking Adolescents' Individual Lives Survey-The Next Generation (TRAILS NEXT). Int J Epidemiol 2022; 51:e267-e275. [PMID: 35462400 PMCID: PMC9557833 DOI: 10.1093/ije/dyac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/29/2022] [Indexed: 12/17/2022] Open
Affiliation(s)
- Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jennifer S Richards
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Charlotte Vrijen
- Department of Pedagogical Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anoek M Oerlemans
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Pedagogical Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Tina Kretschmer
- Department of Pedagogical Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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Holden CL, Rollins P, Gonzalez M. Health-Promoting Behaviors, Relationship Satisfaction, and Resilience Among a Community Sample. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-021-09624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Baer NR, Zoellick JC, Deutschbein J, Anton V, Bergmann MM, Schenk L. Dietary preferences in the context of intra-couple dynamics: Relationship types within the German NutriAct family cohort. Appetite 2021; 167:105625. [PMID: 34364966 DOI: 10.1016/j.appet.2021.105625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022]
Abstract
To promote healthy diets in older age, a comprehensive understanding of factors influencing dietary behaviour and underlying preferences is essential. Romantic relationships are focal socialisation contexts, in which diet-related preferences and practices are dynamically negotiated. Our aim was to reconstruct intra-couple dynamics shaping dietary preferences and comparatively analyse relationship types among older couples. Data basis was the NutriAct Family Study - a German web-based cohort. Analyses were based on three a priori defined relationship types: 1) both partners' mutual adaptation of dietary preferences (symmetrical convergence), 2) unilateral adaptation (asymmetrical convergence) and 3) persistence of individual preferences. Relationship types were, among others, comparatively analysed using ANOVAs. Intra-couple dynamics within the asymmetrical convergence type were measured by multivariate logistic regression. The dyadic sample consisted of 398 couples resp. N = 796 individuals aged 63.99 years (SD = 6.15). All three relationship types were identified (symmetrical convergence: n = 62, 15.6 %; asymmetrical convergence: n = 199, 50.0 %; persistence: n = 137, 34.4 %). Within the asymmetrical convergence type, women were more likely to take a dominant role compared to their male partners (OR: 24.40; 95%CI: 14.37-41.41). This study demonstrates the fundamental influence of intra-couple dynamics on individual dietary preferences, whereby traditional gender roles have shown to play a central moderating role. Our study findings are relevant for the development and implementation of public health (nutrition) strategies, since they highlight the importance of understanding dietary preferences as jointly constructed and shaped in the intra-couple context, rather than as isolated, individually developed ones. In this context, future research directions and practical implications targeting not only individuals but involving couples are discussed.
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Affiliation(s)
- Nadja-Raphaela Baer
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Jan C Zoellick
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Johannes Deutschbein
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Verena Anton
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Research, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Abstract
Committed, long-term romantic relationships are ubiquitous among modern society. They are one of the most important contexts for the development, maintenance, and treatment of psychopathology. In this review, I first place psychopathology within the most commonly cited theoretical model of marital satisfaction and stability and then discuss how relationship satisfaction is conceptualized and assessed in this literature. In the second half of the review, I describe the theories regarding how romantic relationships may be connected to psychopathology. Relationship distress is easily incorporated into a diathesis-stress model as an important trigger for psychopathology. Next, I review cross-sectional research, longitudinal research, and treatment efficacy research linking relationship quality and psychopathology. I provide evidence for the robustness of these effects and areas where research must expand. I finish with a summary section that synthesizes what is known about the mechanisms linking relationship distress and psychopathology.
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Affiliation(s)
- Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana 47907, USA;
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Köhler H, Kröger C, Watschke A, Gruner-Labitzke K, Böker C, Markov V. Changes in Patients' Relationship Satisfaction After Weight Loss Surgery: Results of a Study of Persons with Morbid Obesity and Their Relationship Satisfaction Before and 1 Year After Bariatric Surgery. Obes Surg 2021; 31:1431-1437. [PMID: 33403507 DOI: 10.1007/s11695-020-05147-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in relationship satisfaction (RS) is still limited. The present study examines whether a patient's RS changes after having bariatric surgery, in response to the surgery-induced weight loss. The predictive value of further variables such as age and sex are also investigated. METHODS A total of 145 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. RS was assessed with a reliable and valid short form of a standardized self-report measure, which was completed before, 6 months and 12 months after surgery. RESULTS Loss of excess weight at 6 and 12 months post-surgery was 49% and 66.3%, respectively. The repeated measures ANOVA for the factor "PFB-K" revealed a statistically significant effect, with F (2, 288) = 7.40, p = .001, and η2 = .05, and for the factor "BMI" with F (2, 288) = 505.99, p < .001, and η2 = .78. The highest mean RS score was observed 6 months post-surgery. Sex showed a statistical trend of influence on RS: F (1, 143) = 3.24, p = .074, and η2 = .022. At all three measurement points, men showed higher mean RS scores than women. CONCLUSION Bariatric surgery leads to significant weight loss and indicates an increase in RS. While a correlation with the amount of weight lost remains unclear, a trend was seen towards higher RS in subjects with higher weight loss. Men in particular reported higher RS.
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Affiliation(s)
- Hinrich Köhler
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Leipziger Str. 24, 38124, Braunschweig, Germany.
| | - Christoph Kröger
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
| | - Anna Watschke
- Department of Psychology, University of Braunschweig, Braunschweig, Germany
| | - Kerstin Gruner-Labitzke
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Leipziger Str. 24, 38124, Braunschweig, Germany
| | - Clara Böker
- Department of General, Visceral, Vascular, and Bariatric Surgery, Klinikum Nordstadt, Hannover, Germany
| | - Valentin Markov
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
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Boswell RG, Potenza MN, Grilo CM. The Neurobiology of Binge-eating Disorder Compared with Obesity: Implications for Differential Therapeutics. Clin Ther 2021; 43:50-69. [PMID: 33257092 PMCID: PMC7902428 DOI: 10.1016/j.clinthera.2020.10.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Emerging work indicates divergence in the neurobiologies of binge-eating disorder (BED) and obesity despite their frequent co-occurrence. This review highlights specific distinguishing aspects of BED, including elevated impulsivity and compulsivity possibly involving the mesocorticolimbic dopamine system, and discusses implications for differential therapeutics for BED. METHODS This narrative review describes epidemiologic, clinical, genetic, and preclinical differences between BED and obesity. Subsequently, this review discusses human neuroimaging work reporting differences in executive functioning, reward processing, and emotion reactivity in BED compared with obesity. Finally, on the basis of the neurobiology of BED, this review identifies existing and new therapeutic agents that may be most promising given their specific targets based on putative mechanisms of action relevant specifically to BED. FINDINGS BED is characterized by elevated impulsivity and compulsivity compared with obesity, which is reflected in divergent neurobiological characteristics and effective pharmacotherapies. Therapeutic agents that influence both reward and executive function systems may be especially effective for BED. IMPLICATIONS Greater attention to impulsivity/compulsivity-related, reward-related, and emotion reactivity-related processes may enhance conceptualization and treatment approaches for patients with BED. Consideration of these distinguishing characteristics and processes could have implications for more targeted pharmacologic treatment research and interventions.
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Affiliation(s)
- Rebecca G Boswell
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA.
| | - Marc N Potenza
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Yale School of Medicine, Child Study Center, New Haven, CT, USA; Yale University, Department of Neuroscience, New Haven, CT, USA
| | - Carlos M Grilo
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA; Yale University, Department of Psychology, New Haven, CT, USA
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Karam AM, Eichen DM, Fitzsimmons-Craft EE, Wilfley DE. An examination of the interpersonal model of binge eating over the course of treatment. EUROPEAN EATING DISORDERS REVIEW 2020; 28:66-78. [PMID: 31497914 PMCID: PMC7031004 DOI: 10.1002/erv.2700] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/26/2019] [Accepted: 08/06/2019] [Indexed: 11/12/2022]
Abstract
The current study examined the interpersonal model of binge eating, which posits that interpersonal problems lead to negative affect, which results in binge eating, over the course of two psychotherapy treatments (interpersonal psychotherapy and cognitive behavioural therapy) in 162 adults with binge-eating disorder. A series of longitudinal simple mediation analyses preliminarily showed that treatment addresses the mechanisms of the interpersonal model of binge eating as theoretically proposed in predicting reductions in binge eating, the primary dependent variable, and the secondary dependent variables including global eating disorder psychopathology, shape concern, and weight concern, but not reductions in restraint or eating concern. Moderated mediation analyses did not fully support treatment differences, as changes in the mechanisms of the interpersonal model occurred in both treatments and suggest both treatments addressed negative affect and interpersonal precipitants of eating disorder symptomatology. Future research should replicate this study using variables that do not overlap in time to investigate causation of the model, and more generally, further examine theoretical treatment models and treatment mediators as this research could help improve efficacy of treatment for binge-eating disorder.
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Affiliation(s)
- Anna M Karam
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Dawn M Eichen
- Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | | | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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12
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O'Connor P, Daly L, Higgins A. Partners' experiences of living with a person with an eating disorder: A grounded theory study. J Adv Nurs 2019; 75:1741-1750. [PMID: 31012143 DOI: 10.1111/jan.14032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/05/2019] [Accepted: 03/05/2019] [Indexed: 12/01/2022]
Abstract
AIM To explore the experiences of intimate partners of people with an eating disorder. DESIGN Qualitative grounded theory study. METHODS In-depth interviews were conducted with 18 partners of people with an eating disorder from 2013-2016. Data were analysed using the principles of classic grounded theory including, concurrent data collection and analysis, theoretical sampling, constant comparative analysis and memo writing. RESULTS Partners encounter disruptions to their lives when their significant other experiences an eating disorder. As a result, partners engage in a four-stage cyclical process involving: encountering a disruption; becoming an informed self; countering the disruption and reclaimed livability. By engaging in this process partners learn to support their significant other, remain committed to the relationship and recover their own lives. The process is drawn together and defined as the theory of 'Reconstructing Livability'. CONCLUSION The theory of 'Reconstructing Livability' provides a unique conceptualization of the experiences of partners who are living with a person with an eating disorder. It highlights the challenges faced by partners when supporting the recovery of their significant other and the intimate relationship, while reclaiming their own lives. IMPACT This study addresses the dearth of knowledge and understanding of partners' experiences. Partners engage in a process to enable them support recovery of their significant other and their own lives, but this is hindered by the challenges and unmet needs they experience. The theory provides a basis on which nurses can provide effective and timely supports to partners.
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Affiliation(s)
- Patricia O'Connor
- Department of Nursing and Midwifery, St. Patricks University Hospital, Trinity College Dublin, Ireland
| | - Louise Daly
- Department of Nursing and Midwifery, Trinity College Dublin, Ireland
| | - Agnes Higgins
- Department of Nursing and Midwifery, Trinity College Dublin, Ireland
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Hilbert A, Bodenmann G. Kognitive Verhaltenstherapie für Paare: Fallstudie einer doppelten Binge-Eating-Störung. PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Runfola CD, Kirby JS, Baucom DH, Fischer MS, Baucom BRW, Matherne CE, Pentel KZ, Bulik CM. A pilot open trial of UNITE-BED: A couple-based intervention for binge-eating disorder. Int J Eat Disord 2018; 51:1107-1112. [PMID: 30189106 DOI: 10.1002/eat.22919] [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: 12/15/2017] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the feasibility, acceptability, and preliminary efficacy of a couple-based intervention for binge-eating disorder (BED), called UNiting couples In the Treatment of Eating disorders-BED edition (UNITE-BED). METHOD In an open pilot trial, 11 couples in which one or both adult partners had a diagnosis of DSM-5 threshold or sub-threshold BED participated in 22 weekly sessions of UNITE-BED. Patients also received individual treatment, outside of the context of the trial. Couples completed measures on treatment satisfaction, eating disorder symptom severity, depression, anxiety, emotion regulation, and relational functioning at post-treatment and 3-month follow-up. Statistical analyses were conducted to identify change over the course of treatment. RESULTS UNITE was feasible and acceptable to the majority of couples (9% dropout; high satisfaction ratings). Objective binge abstinence was 81.8% and subjective binge abstinence was 45.5% by post-treatment. Patient binge-eating symptomatology reduced over the course of treatment with results maintained at follow up. Patients' depression symptoms decreased and patients' emotion regulation improved at both time points. DISCUSSION Including partners in treatment for BED may be beneficial. Results support further evaluation of the efficacy of couple-based interventions for BED in larger randomized-controlled trials.
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Affiliation(s)
- Cristin D Runfola
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Jennifer S Kirby
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Brian R W Baucom
- Department of Psychology, University of Utah, Salt Lake City, Utah
| | - Camden E Matherne
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Kimberly Z Pentel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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15
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Marzilli E, Cerniglia L, Cimino S. A narrative review of binge eating disorder in adolescence: prevalence, impact, and psychological treatment strategies. ADOLESCENT HEALTH MEDICINE AND THERAPEUTICS 2018; 9:17-30. [PMID: 29379325 PMCID: PMC5759856 DOI: 10.2147/ahmt.s148050] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Binge eating disorder (BED) represents one of the most problematic clinical conditions among youths. Research has shown that the developmental stage of adolescence is a critical stage for the onset of eating disorders (EDs), with a peak prevalence of BED at the age of 16–17 years. Several studies among adults with BED have underlined that it is associated with a broad spectrum of negative consequences, including higher concern about shape and weight, difficulties in social functioning, and emotional-behavioral problems. This review aimed to examine studies focused on the prevalence of BED in the adolescent population, its impact in terms of physical, social, and psychological outcomes, and possible strategies of psychological intervention. The review of international literature was made on paper material and electronic databases ProQuest, PsycArticles, and PsycInfo, and the Scopus index were used to verify the scientific relevance of the papers. Epidemiological research that examined the prevalence of BED in adolescent samples in accordance with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition showed a prevalence ranging from 1% to 4%. More recently, only a few studies have investigated the prevalence of BED, in accordance with the Diagnostic and Statistical Manual of Disorders, Fifth Edition criteria, reporting a prevalence of ~1%–5%. Studies that focused on the possible impact that BED may have on physical, psychological, and social functioning showed that adolescents with BED have an increased risk of developing various adverse consequences, including obesity, social problems, substance use, suicidality, and other psychological difficulties, especially in the internalizing area. Despite the evidence, to date, reviews on possible and effective psychological treatment for BED among young population are rare and focused primarily on adolescent females.
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Affiliation(s)
- Eleonora Marzilli
- Department of Dynamic and Clinical Psychology, Psychology and Medicine Faculty, Sapienza - University of Rome
| | - Luca Cerniglia
- Department of Psychology, Psychology Faculty, International Telematic University Uninettuno, Rome, Italy
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, Psychology and Medicine Faculty, Sapienza - University of Rome
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16
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Peat CM, Berkman ND, Lohr KN, Brownley KA, Bann CM, Cullen K, Quattlebaum MJ, Bulik CM. Comparative Effectiveness of Treatments for Binge-Eating Disorder: Systematic Review and Network Meta-Analysis. EUROPEAN EATING DISORDERS REVIEW 2017; 25:317-328. [DOI: 10.1002/erv.2517] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/19/2017] [Accepted: 03/20/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Christine M. Peat
- Department of Psychiatry; University of North Carolina; Chapel Hill NC USA
- Department of Neurosurgery; University of North Carolina; Chapel Hill NC USA
| | | | | | | | | | | | | | - Cynthia M. Bulik
- Department of Psychiatry; University of North Carolina; Chapel Hill NC USA
- Department of Nutrition; University of North Carolina; Chapel Hill NC USA
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
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17
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Brownley KA, Berkman ND, Peat CM, Lohr KN, Cullen KE, Bann CM, Bulik CM. Binge-Eating Disorder in Adults: A Systematic Review and Meta-analysis. Ann Intern Med 2016; 165:409-20. [PMID: 27367316 PMCID: PMC5637727 DOI: 10.7326/m15-2455] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The best treatment options for binge-eating disorder are unclear. PURPOSE To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. DATA SOURCES English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. STUDY SELECTION 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. DATA EXTRACTION 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. DATA SYNTHESIS Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], -6.50 [CI, -8.82 to -4.18]) and SGAs (MD, -3.84 [CI, -6.55 to -1.13]) reduced binge-eating-related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, -1.97 [CI, -3.67 to -0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. LIMITATIONS Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely assessed beyond end of treatment. CONCLUSION Cognitive behavioral therapy, lisdexamfetamine, SGAs, and topiramate reduced binge eating and related psychopathology, and lisdexamfetamine and topiramate reduced weight in adults with binge-eating disorder. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality.
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Affiliation(s)
- Kimberly A Brownley
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Nancy D Berkman
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Christine M Peat
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Kathleen N Lohr
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Katherine E Cullen
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Carla M Bann
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M Bulik
- From University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; RTI International, Research Triangle Park, North Carolina; and Karolinska Institutet, Stockholm, Sweden
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Abstract
A significant number of adults with eating disorders fail to achieve relief from the disorder, with many dropping out of treatment or relapsing. The standard treatment remains individual therapy despite partners being negatively affected and typically wanting to help in an effective and loving way. We propose that couple-based interventions, which leverage the support of a partner and the relationship in treatment, may improve outcome and recovery rates for adults with eating disorders. In this article, we survey the empirical literature supporting the treatment of adults in a couple context and describe our existing and emerging couple-based interventions for eating disorders.
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Affiliation(s)
- Jennifer S Kirby
- a Department of Psychiatry , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
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19
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Macpherson-Sánchez AE. Integrating fundamental concepts of obesity and eating disorders: implications for the obesity epidemic. Am J Public Health 2015; 105:e71-85. [PMID: 25713933 PMCID: PMC4358173 DOI: 10.2105/ajph.2014.302507] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 12/12/2022]
Abstract
Physiological mechanisms promote weight gain after famine. Because eating disorders, obesity, and dieting limit food intake, they are famine-like experiences. The development of the concept of meeting an ideal weight was the beginning of increasing obesity. Weight stigma, the perception of being fat, lack of understanding of normal growth and development, and increased concern about obesity on the part of health providers, parents, and caregivers have reinforced each other to promote dieting. Because weight suppression and disinhibition provoke long-term weight increase, dieting is a major factor producing the obesity epidemic. The integrated eating disorder-obesity theory included in this article emphasizes that, contrary to dieters, lifetime weight maintainers depend on physiological processes to control weight and experience minimal weight change.
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Affiliation(s)
- Ann E Macpherson-Sánchez
- Ann E. Macpherson-Sánchez is with the Department of Agricultural Education, University of Puerto Rico, Mayagüez
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20
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Ivanova IV, Tasca GA, Hammond N, Balfour L, Ritchie K, Koszycki D, Bissada H. Negative affect mediates the relationship between interpersonal problems and binge-eating disorder symptoms and psychopathology in a clinical sample: a test of the interpersonal model. EUROPEAN EATING DISORDERS REVIEW 2015; 23:133-8. [PMID: 25582510 DOI: 10.1002/erv.2344] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/08/2014] [Accepted: 12/10/2014] [Indexed: 11/11/2022]
Abstract
This study evaluated the validity of the interpersonal model of binge-eating disorder (BED) psychopathology in a clinical sample of women with BED. Data from a cross-sectional sample of 255 women with BED were examined for the direct effects of interpersonal problems on BED symptoms and psychopathology, and indirect effects mediated by negative affect. Structural equation modelling analyses demonstrated that higher levels of interpersonal problems were associated with greater negative affect, and greater negative affect was associated with higher frequency of BED symptoms and psychopathology. There was a significant indirect effect of interpersonal problems on BED symptoms and psychopathology mediated through negative affect. Interpersonal problems may lead to greater BED symptoms and psychopathology, and this relationship may be partially explained by elevated negative affect. The results of the study are the first to provide support for the interpersonal model of BED symptoms and psychopathology in a clinical sample of women.
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Woods SB, Priest JB, Roush T. The biobehavioral family model: testing social support as an additional exogenous variable. FAMILY PROCESS 2014; 53:672-685. [PMID: 24981970 DOI: 10.1111/famp.12086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n = 1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends' social support, and relatives' social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (χ(2) = 846.04, p = .000, SRMR = .039, CFI = .924, TLI = .914, RMSEA = .043). Negative marital interactions predicted biobehavioral reactivity (β = .38, p < .001), as did relatives' social support, inversely (β = -.16, p < .001). Biobehavioral reactivity predicted disease activity (β = .40, p < .001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.
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Affiliation(s)
- Sarah B Woods
- Department of Family Sciences, Texas Woman's University, Denton, TX
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Baucom DH, Belus JM, Adelman CB, Fischer MS, Paprocki C. Couple-based interventions for psychopathology: a renewed direction for the field. FAMILY PROCESS 2014; 53:445-461. [PMID: 24773298 DOI: 10.1111/famp.12075] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article provides a rationale and empirical support for providing couple-based interventions when one partner in a relationship is experiencing individual psychopathology. Several investigations indicate that relationship distress and psychopathology are associated and reciprocally influence each other, such that the existence of relationship distress predicts the development of subsequent psychopathology and vice versa. Furthermore, findings indicate that for several disorders, individual psychotherapy is less effective if the client is in a distressed relationship. Finally, even within happy relationships, partners often inadvertently behave in ways that maintain or exacerbate symptoms for the other individual. Thus, within both satisfied and distressed relationships, including the partner in a couple-based intervention provides an opportunity to use the partner and the relationship as a resource rather than a stressor for an individual experiencing some form of psychological distress. The authors propose that a promising approach to including the partner in treatment involves (a) integrating intervention principles from empirically supported interventions for individual therapy for specific disorders with (b) knowledge of how to employ relationships to promote individual and dyadic change. Based on this logic, the article includes several examples to demonstrate how couple-based interventions can be focused on a specific type of psychopathology, including encouraging empirical findings for these interventions. The article concludes with recommendations for how clinicians and researchers can adapt their knowledge of couple therapy to assist couples in which one partner is experiencing notable psychological distress or diagnosable psychopathology.
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Affiliation(s)
- Donald H Baucom
- Psychology Department, University of North Carolina, Chapel Hill, NC
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23
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Developmental disruption by binge-eating disorder and bulimia nervosa: critical windows for detection and intervention. Epidemiol Psychiatr Sci 2014; 23:43-5. [PMID: 24054093 PMCID: PMC6998285 DOI: 10.1017/s204579601300053x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Knoph C, Holle AV, Zerwas S, Torgersen L, Tambs K, Stoltenberg C, Bulik CM, Reichborn-Kjennerud T. Course and predictors of maternal eating disorders in the postpartum period. Int J Eat Disord 2013; 46:355-68. [PMID: 23307499 PMCID: PMC3622173 DOI: 10.1002/eat.22088] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2012] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate course and predictors of eating disorders in the postpartum period. METHOD A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for prepregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. RESULTS Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. DISCUSSION This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with prepregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors.
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Affiliation(s)
- Cecilie Knoph
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leila Torgersen
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kristian Tambs
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Camilla Stoltenberg
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway,Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ted Reichborn-Kjennerud
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychiatry, University of Oslo, Oslo, Norway
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Arcelus J, Yates A, Whiteley R. Romantic relationships, clinical and sub-clinical eating disorders: a review of the literature. SEXUAL AND RELATIONSHIP THERAPY 2012. [DOI: 10.1080/14681994.2012.696095] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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