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Eijsbroek VC, Kjell K, Schwartz HA, Boehnke JR, Fried EI, Klein DN, Gustafsson P, Augenstein I, Bossuyt PMM, Kjell O. The LEADING Guideline: Reporting Standards for Expert Panel, Best-Estimate Diagnosis, and Longitudinal Expert All Data (LEAD) Studies. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.19.24304526. [PMID: 38699296 PMCID: PMC11065032 DOI: 10.1101/2024.03.19.24304526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Accurate assessments of symptoms and diagnoses are essential for health research and clinical practice but face many challenges. The absence of a single error-free measure is currently addressed by assessment methods involving experts reviewing several sources of information to achieve a more accurate or best-estimate assessment. Three bodies of work spanning medicine, psychiatry, and psychology propose similar assessment methods: The Expert Panel, the Best-Estimate Diagnosis, and the Longitudinal Expert All Data (LEAD). However, the quality of such best-estimate assessments is typically very difficult to evaluate due to poor reporting of the assessment methods and when it is reported, the reporting quality varies substantially. Here we tackle this gap by developing reporting guidelines for such studies, using a four-stage approach: 1) drafting reporting standards accompanied by rationales and empirical evidence, which were further developed with a patient organization for depression, 2) incorporating expert feedback through a two-round Delphi procedure, 3) refining the guideline based on an expert consensus meeting, and 4) testing the guideline by i) having two researchers test it and ii) using it to examine the extent previously published articles report the standards. The last step also demonstrates the need for the guideline: 18 to 58% (Mean = 33%) of the standards were not reported across fifteen randomly selected studies. The LEADING guideline comprises 20 reporting standards related to four groups: The Longitudinal design; the Appropriate data; the Evaluation - experts, materials, and procedures; and the Validity group. We hope that the LEADING guideline will be useful in assisting researchers in planning, reporting, and evaluating research aiming to achieve best-estimate assessments.
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Affiliation(s)
| | | | - H Andrew Schwartz
- Department of Computer Science, Stony Brook University, New York, the United States
| | - Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, Scotland
| | - Eiko I Fried
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, New York, the United States
| | | | - Isabelle Augenstein
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Patrick M M Bossuyt
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Oscar Kjell
- Department of Psychology, Lund University, Lund, Sweden
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2
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Mattingley S, Youssef GJ, Graeme L, Sloan E, Manning V, Hall K. Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people. J Clin Psychol 2024; 80:261-278. [PMID: 37597248 DOI: 10.1002/jclp.23579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 04/24/2023] [Accepted: 07/23/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. METHOD Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. RESULTS Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. CONCLUSIONS These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.
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Affiliation(s)
- Sophie Mattingley
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - George J Youssef
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Liam Graeme
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Elise Sloan
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Victoria Manning
- Monash Addiction Research Centre (MARC), Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
- Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, Victoria, Australia
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Gilmartin TL, Gurvich C, Dipnall JF, Sharp G. Dimensional personality pathology and disordered eating in young adults: measuring the DSM-5 alternative model using the PID-5. Front Psychol 2023; 14:1113142. [PMID: 37434891 PMCID: PMC10330766 DOI: 10.3389/fpsyg.2023.1113142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/30/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction The Personality Inventory for DSM-5 (PID-5) is a self-report measure of personality pathology designed to measure pathological personality traits outlined in the DSM-5 alternative model of personality disorders. Within the extensive literature exploring the relationship between personality and disordered eating, there are few that explore the relationship between the PID-5 and disordered eating behaviours in a non-clinical sample of males and females: restrictive eating, binge eating, purging, chewing and spitting, excessive exercising and muscle building. Methods An online survey assessed disordered eating, PID-5 traits and general psychopathology and was completed by 394 female and 167 male participants aged 16-30. Simultaneous equations path models were systematically generated for each disordered eating behaviour to identify how the PID-5 scales, body dissatisfaction and age predicted behaviour. Results The results indicated that each of the six disordered behaviours were associated with a unique pattern of maladaptive personality traits. The statistical models differed between males and females indicating possible differences in how dimensional personality pathology and disordered eating relate. Discussion It was concluded that understanding disordered eating behaviour in the context of personality pathology may assist formulating potentially risky behaviour.
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Affiliation(s)
- Tanya Louise Gilmartin
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Joanna F. Dipnall
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Centre for Innovation in Mental and Physical Health and Clinical Treatment, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Gemma Sharp
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Eielsen HP, Vrabel K, Hoffart A, Rø Ø, Rosenvinge JH. Reciprocal relationships between personality disorders and eating disorders in a prospective 17-year follow-up study. Int J Eat Disord 2022; 55:1753-1764. [PMID: 36214278 PMCID: PMC10092669 DOI: 10.1002/eat.23823] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to report the presence of categorical and dimensional personality disorders (PD) in adults with longstanding eating disorders (ED) over a period of 17 years and to investigate whether changes in PD predict changes in ED symptoms or vice versa. METHODS In total, 62 of the 80 living patients (78% response rate) with anorexia nervosa (n = 23), bulimia nervosa (n = 25), or other specified feeding or ED (n = 14) at baseline were evaluated during hospital treatment and at 1-year, 2-year, 5-year, and 17-year follow-up. PD were assessed using the Structured Clinical Interview for DSM-IV Axis II disorders, and the eating disorder examination (EDE) interview was used to assess ED. Data were analyzed using multilevel modeling. RESULTS From baseline to the 17-year follow-up, the number of patients with any PD decreased significantly from 74.2% to 24.2%, and the total number of PD diagnoses declined from 80 to 22. Mean EDE score was significantly reduced from 4.2 (SD: 1.1) to 2.0 (SD: 1.6). There was a positive association between ED and PD where the initial level of either disorder was followed by similar levels of the other disorder throughout the entire follow-up period. High baseline levels of borderline PD predicted less decrease in ED symptoms. No significant within-person effects were found. CONCLUSIONS Both ED and PD significantly declined over time. As the severity of either disorder seems to be associated with the other, thorough assessment and treatment that incorporates both the ED psychopathology and the personality disturbances are advisable. PUBLIC SIGNIFICANCE STATEMENT While personality disorders were highly prevalent in the sample of patients with longstanding eating disorders, both disorders were significantly reduced at the 17-year follow-up. The disorders are related in the sense that an initial high level of either disorder is associated with a high level of the other over time. A thorough assessment and attention to both illnesses are advisable in therapy. CLINICAL TRIAL IDENTIFIER NCT03968705.
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Affiliation(s)
- Hanna Punsvik Eielsen
- Research Institute, Modum Bad Psychiatric Centre, Vikersund, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - KariAnne Vrabel
- Research Institute, Modum Bad Psychiatric Centre, Vikersund, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Asle Hoffart
- Research Institute, Modum Bad Psychiatric Centre, Vikersund, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Øyvind Rø
- Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway.,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jan H Rosenvinge
- Department of Psychology, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
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5
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Garland J, Miller S. Borderline personality disorder: part 1 – assessment and diagnosis. BJPSYCH ADVANCES 2020. [DOI: 10.1192/bja.2019.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
SUMMARYGeneral adult psychiatrists are largely responsible for the care of patients with personality disorders in community and in-patient settings, and this can be associated with diagnostic and management challenges. In the first of two articles focusing specifically on borderline personality disorder (BPD), we summarise the core clinical features of the disorder and discuss appropriate diagnostic practice.
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Miller AE, Racine SE, Klonsky ED. Symptoms of anorexia nervosa and bulimia nervosa have differential relationships to borderline personality disorder symptoms. Eat Disord 2019; 29:1-14. [PMID: 31305226 DOI: 10.1080/10640266.2019.1642034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Eating disorders (EDs) and borderline personality disorder (BPD) are highly comorbid. BPD is characterized by the presence of at least five of nine symptoms. Given the number/variety of emotional and interpersonal symptoms that comprise BPD, some BPD traits may relate to EDs, whereas others may not be associated. This study examined relationships between BPD symptoms and symptoms of bulimia nervosa (BN) and anorexia nervosa (AN), including whether the nine BPD symptoms differentially relate to BN versus AN. Participants were 208 adolescent psychiatric inpatients. BPD symptoms, measured via structured interview, correlated more strongly with self-reported BN than AN symptoms. BN and AN symptoms were greater among individuals who endorsed unstable relationships, affective instability, emptiness, identity disturbance, inappropriate anger, dissociation/paranoia, and suicidal behavior. BN, but not AN symptoms, were higher when impulsivity was endorsed. Avoiding abandonment was neither related to BN nor AN. Affective instability, impulsivity, and anger had substantially larger associations with BN compared to AN, while identity disturbance was more strongly related to AN than BN. Findings provide useful information for targeting specific BPD symptoms to help prevent and reduce co-occurring EDs and BPD and the negative consequences associated with this comorbidity.
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Affiliation(s)
- Alexia E Miller
- a Department of Psychology , McGill University , Montreal , QC , Canada
- b Department of Psychology , University of British Columbia , Vancouver , Canada
| | - Sarah E Racine
- a Department of Psychology , McGill University , Montreal , QC , Canada
| | - E David Klonsky
- b Department of Psychology , University of British Columbia , Vancouver , Canada
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Hessler JB, Heuser J, Schlegl S, Bauman T, Greetfeld M, Voderholzer U. Impact of comorbid borderline personality disorder on inpatient treatment for bulimia nervosa: analysis of routine data. Borderline Personal Disord Emot Dysregul 2019; 6:1. [PMID: 30680217 PMCID: PMC6335811 DOI: 10.1186/s40479-018-0098-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/14/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A substantial rate of patients with bulimia nervosa (BN) also suffer from Borderline personality disorder (BN + BPD). It is widely unknown how these comorbid patients with BN + BPD present and respond to inpatient treatment. Aims of the study were to examine (1) specific characteristics of patients with BN + BPD at admission, discharge, and during treatment, and (2) differential effects of inpatient treatment for BN vs. BN + BPD. METHOD We analyzed routine data of inpatients admitted for the treatment of BN between 2013 and 2017 in a specialized hospital for eating disorders. (1) Cross-sectional differences were examined with independent t-tests and χ2-tests; and (2) treatment effects pertaining to eating disorders symptoms, depression, psychosocial functioning and general psychopathology with repeated measures analysis of variance. RESULTS Of 1298 inpatients (96% female), 13.2% also had a diagnosis of BPD. (1) Patients with BN + BPD had more previous inpatient treatments (p = 0.001), had a longer length of stay (p = 0.003), gained more weight during treatment (p = 0.006), and were more often irregularly discharged (p = 0.018) as well as rated as unfit to work at discharge (p = 0.003). (2) Both groups improved in all examined variables (all main effects treatment p < 0.001). Patients with BN + BPD showed worse symptoms aggregated across admission and discharge (all main effects diagnosis p < 0.05). Patients with BN + BPD showed smaller improvements (interaction treatment×discharge) in depressive symptoms (p = 0.018), perfectionism (p = 0.009), and asceticism (p = 0.035) and discharge scores mostly lay in the range of the admission scores of the BN-only group. CONCLUSION Patients with BN + BPD improve during intense and specialized inpatient treatment, yet, retain pronounced impairment at discharge despite longer treatment. Treatment needs to be improved and should focus on transdiagnostic symptoms of BN and BPD.
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Affiliation(s)
| | - Jörg Heuser
- Schoen Clinic Roseneck, Am Roseneck 6, D-83209, Prien am Chiemsee, Germany
| | - Sandra Schlegl
- Department of Psychiatry and Psychotherapy, University Hospital of Munich (LMU), Munich, Germany
| | - Tabea Bauman
- Schoen Clinic Roseneck, Am Roseneck 6, D-83209, Prien am Chiemsee, Germany
| | - Martin Greetfeld
- Schoen Clinic Roseneck, Am Roseneck 6, D-83209, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Am Roseneck 6, D-83209, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg im Breisgau, Germany
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Jacob L, Haro JM, Koyanagi A. Attention deficit hyperactivity disorder symptoms and disordered eating in the English general population. Int J Eat Disord 2018; 51:942-952. [PMID: 30256445 DOI: 10.1002/eat.22934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/12/2018] [Accepted: 07/12/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder (ADHD) symptoms and eating problems often coexist, but many of the previous studies have not taken into account key variables which may be important in this association. Thus, the goal of this study was to assess the association between ADHD symptoms and disordered eating, while taking into account of a variety of factors. METHOD This study used cross-sectional, nationally representative data from 7,403 people aged ≥16 years from England who participated in the 2007 Adult Psychiatric Morbidity Survey (APMS). ADHD symptoms were assessed with the Adult ADHD Self-Report Scale (ASRS) Screener. Questions from the five-item SCOFF screening instrument were used to identify possible ED. Multivariable logistic regression analyses were conducted. RESULTS The prevalence of possible eating disorder (ED) was much higher among those with ADHD symptoms (ASRS score ≥14) compared to those without ADHD symptoms (19.2 vs. 5.7%). ADHD symptoms were associated with possible ED (odds ratio [OR] = 3.48; 95% confidence interval [CI] = 2.56-4.72) after adjustment for age, sex, and ethnicity. After further adjustment for alcohol dependence, drug use, intelligence quotient, stressful life events, perceived stress, impulsivity, depression, anxiety disorder, and borderline personality disorder (BPD) traits, the OR was attenuated to 1.32 (95% CI = 0.82-2.13). Anxiety and BPD were the factors that led to the largest degree of attenuation. DISCUSSION A high prevalence of disordered eating in individuals with ADHD was observed. Factors such as co-existing anxiety and BPD traits may be particularly important in this association. Future research should focus on the factors involved in the association between ADHD symptoms and disordered eating behavior.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
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Minnick AM, Cachelin FM, Durvasula R. Personality Disorders and Psychological Functioning Among Latina Women with Eating Disorders. Behav Med 2017; 43:200-207. [PMID: 28767016 PMCID: PMC6105924 DOI: 10.1080/08964289.2016.1276429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Little is known about personality disorders (PD) and comorbidities among Latinas with eating disorders (ED). The dysregulation and chronicity of PDs can complicate and augment the symptomatology of EDs. This set of analyses provides a preliminary examination of PD and psychopathology in a sample of Latina women with ED. Participants (N = 34) were administered the Structured Clinical Interview for the Diagnostic and Statistical Manual, Eating Disorders Examination, and Millon Clinical Multiaxial Inventory-III to assess personality pathology, and questionnaires (Beck Depression Inventory-II and Brief Symptom Inventory) to assess psychological functioning. Results indicated the most common clinically significant trait in the sample was depressive personality (50% of the sample had a score of 75 or higher on this trait). For Bulimia Nervosa (BN) and Binge Eating Disorder (BED), avoidant (41%) and depressive (65%) personalities, respectively, were the most common clinically significant traits. Anxiety disorders were the most common psychiatric diagnoses, and 52.9% of the sample reported both clinically significant PD traits and other major psychopathology. There were no significant differences between the BED and BN groups on prevalence of PD traits and psychopathology. This pilot study highlights the need for further examination of PD and psychopathology in Latinas with ED. Unlike previous research with White women, we found no differences on PD and psychopathology between BED and BN, and the most prevalent PDs among Latinas were different than White women. Personality and psychological functioning should be assessed in all patients with ED, with ongoing research focused on identifying patterns in understudied groups such as Latinas, a practice that may improve treatment for this underserved population.
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Affiliation(s)
- Alyssa M. Minnick
- University of North Carolina at Charlotte, Health Psychology Ph.D. Program
| | - Fary M. Cachelin
- University of North Carolina at Charlotte, Health Psychology Ph.D. Program
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10
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Reas DL, Pedersen G, Rø Ø. Impulsivity-related traits distinguish women with co-occurring bulimia nervosa in a psychiatric sample. Int J Eat Disord 2016; 49:1093-1096. [PMID: 27567004 DOI: 10.1002/eat.22606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/05/2016] [Accepted: 08/02/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE This study investigated impulsivity-related personality traits using the Revised NEO Personality Inventory (NEO PI-R) in women diagnosed with co-occurring bulmia nervosa and borderline personality disorder (BN-BPD), borderline personality disorder (BPD no-BN), or major depressive disorder (MDD-only). METHOD The sample included 672 adult female admissions to a psychiatric day hospital treatment program. The NEO PI-R facets of impulsiveness (N5), excitement-seeking (E5), self-discipline (C5), and deliberation (C6) provided a proxy assessment of impulsivity-related traits tapping negative urgency, sensation-seeking, lack of perseverance, and lack of premeditation/planning. RESULTS After adjusting for age, BN-BPD displayed significantly higher levels of negative urgency and lack of premeditation than BPD without co-occurring BN. Women with BN-BPD also had significantly higher levels of impulsivity traits than MDD across domains, except for lack of perseverance. DISCUSSION Impulsivity-related traits of negative urgency and lack of premeditation significantly differentiated women with versus without co-occurring BN among women with borderline personality disorder. Lower levels of impulsivity-related traits in women with MDD indicated that effects were not simply attributable to any form of psychopathology. Of the impulsivity traits, negative urgency demonstrated the strongest effect, providing further evidence of the important relationship between negative urgency and the expression of bulimic symptomology. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1093-1096).
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Affiliation(s)
- Deborah L Reas
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway
| | - Geir Pedersen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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Koyanagi A, Stickley A, Haro JM. Psychotic-like experiences and disordered eating in the English general population. Psychiatry Res 2016; 241:26-34. [PMID: 27152907 DOI: 10.1016/j.psychres.2016.04.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/10/2016] [Accepted: 04/15/2016] [Indexed: 12/25/2022]
Abstract
There are no studies on psychotic-like experiences (PLEs) and disordered eating in the general population. We aimed to assess this association in the English adult population. Data from the 2007 Adult Psychiatric Morbidity Survey (APMS) were analyzed. This was a nationally representative survey comprising 7403 English adults aged ≥16 years. The Psychosis Screening Questionnaire was used to identify the past 12-month occurrence of five forms of psychotic symptoms. Questions from the five-item SCOFF screening instrument were used to identify those with eating disorder (ED) symptoms and possible ED in the past year. The prevalence of any PLE was 5.1% (female) and 5.4% (male), while that of possible ED was 9.0% (female) and 3.5% (male). After adjustment for potential confounders, possible ED was associated with hypomania/mania in females (OR=3.23 95%CI=1.002-10.39), strange experiences [females (OR=1.85 95%CI=1.07-3.20) and males (OR=3.54 95%CI=1.65-7.57)], and any PLE in males (OR=3.44 95%CI=1.85-6.39). An interaction analysis revealed that the association was stronger among males for: auditory hallucinations and uncontrolled eating; and any PLE with uncontrolled eating, food dominance, and possible ED. Clinical practitioners should be aware that PLEs and disordered eating behavior often coexist. When one condition is detected, screening for the other may be advisable, especially among males.
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Affiliation(s)
- Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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12
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Utzinger LM, Haukebo JE, Simonich H, Wonderlich SA, Cao L, Lavender JM, Mitchell JE, Engel SG, Crosby RD. A latent profile analysis of childhood trauma in women with bulimia nervosa: Associations with borderline personality disorder psychopathology. Int J Eat Disord 2016; 49:689-94. [PMID: 27038436 PMCID: PMC5268761 DOI: 10.1002/eat.22532] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/10/2016] [Accepted: 02/13/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim of this study was to empirically examine naturally occurring groups of individuals with bulimia nervosa (BN) based on their childhood trauma (CT) histories and to compare these groups on a clinically relevant external validator, borderline personality disorder (BPD) psychopathology. METHOD This study examined the relationship between CT and BPD psychopathology among 133 women with BN using latent profile analysis (LPA) to classify participants based on histories of CT. Participants completed the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/P), the Diagnostic Interview for Borderlines-Revised (DIB-R), and the Childhood Trauma Questionnaire (CTQ). RESULTS The LPA revealed four trauma profiles: low/no trauma, emotional trauma, sexual trauma, and polytrauma. Results indicated that the sexual and polytrauma profiles displayed significantly elevated scores on the DIB-R and that the low/no and emotional trauma profiles did not differ significantly on the DIB-R. Secondary analyses revealed elevated levels of a composite CT score among those with both BN and BPD psychopathology compared to those with BN only. DISCUSSION These findings suggest that both childhood sexual abuse and the additive effects of childhood polytrauma may be linked to BPD psychopathology in BN. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:689-694).
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Affiliation(s)
- Linsey M. Utzinger
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Heath Sciences, Fargo, ND,Correspondence concerning this article should be addressed to Linsey M. Utzinger, Neuropsychiatric Research Institute, 120 South 8th Street, Fargo, ND 58103.
| | - Justine E. Haukebo
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | - Heather Simonich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | - Stephen A. Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Heath Sciences, Fargo, ND
| | - Li Cao
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND
| | - Jason M. Lavender
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Heath Sciences, Fargo, ND
| | - James E. Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Heath Sciences, Fargo, ND
| | - Scott G. Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Heath Sciences, Fargo, ND
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND,Department of Clinical Neuroscience, University of North Dakota School of Medicine and Heath Sciences, Fargo, ND
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13
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Wolfe BE, Dunne JP, Kells MR. Nursing Care Considerations for the Hospitalized Patient with an Eating Disorder. Nurs Clin North Am 2016; 51:213-35. [PMID: 27229277 DOI: 10.1016/j.cnur.2016.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Eating disorders are chronic psychiatric illnesses with significant medical complications, psychological distress, and psychiatric comorbidity. Although many patients are treated on an outpatient basis, inpatient care for the more severely ill hospitalized patient can be challenging given the severity of illness and concurrent issues requiring intervention. This article provides an overview of the clinical characteristics of eating disorders typically seen for inpatient care, focusing primarily on anorexia nervosa and bulimia nervosa, and the associated key areas for nursing assessment, diagnoses, and plan of care during hospitalization.
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Affiliation(s)
- Barbara E Wolfe
- Boston College Wm. F. Connell School of Nursing, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - Julie P Dunne
- Boston College Wm. F. Connell School of Nursing, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | - Meredith R Kells
- Boston College Wm. F. Connell School of Nursing, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
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14
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Cook B, Karr TM, Zunker C, Mitchell JE, Thompson R, Sherman R, Erickson A, Cao L, Crosby RD. The influence of exercise identity and social physique anxiety on exercise dependence. J Behav Addict 2015; 4:195-9. [PMID: 26551910 PMCID: PMC4627681 DOI: 10.1556/2006.4.2015.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous research has identified exercise identity and social physique anxiety as two independent factors that are associated with exercise dependence. AIMS The purpose of our study was to investigate the unique and interactive effect of these two known correlates of exercise dependence in a sample of 1,766 female runners. METHODS Regression analyses tested the main effects of exercise identity and social physique anxiety on exercise dependence. An interaction term was calculated to examine the potential moderating effect of social physique anxiety on the exercise identity and exercise dependence relationship. RESULTS Results indicate a main effect for exercise identity and social physique anxiety on exercise dependence; and the interaction of these factors explained exercise dependence scores beyond the independent effects. Thus, social physique anxiety acted as a moderator in the exercise identity and exercise dependence relationship. DISCUSSION Our results indicate that individuals who strongly identify themselves as an exerciser and also endorse a high degree of social physique anxiety may be at risk for developing exercise dependence. CONCLUSIONS Our study supports previous research which has examined factors that may contribute to the development of exercise dependence and also suggests a previously unknown moderating relationship for social physique anxiety on exercise dependence.
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Affiliation(s)
- Brian Cook
- Neuropsychiatric Research Institute, Fargo, ND, USA,University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA,California State University, Monterey Bay, Seaside, CA, USA,* Corresponding author: Brian Cook, PhD; CSUMB Kinesiology Department, 100 Campus Center Drive, Valley Hall / 82D-101, Seaside, CA 93955, USA; Phone: +1(831) 582-5455; E-mail:
| | | | | | - James E. Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, USA,University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Ron Thompson
- The Victory Program at McCallum Place, St. Louis, MO, USA
| | | | - Ann Erickson
- Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Li Cao
- Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Fargo, ND, USA,University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
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15
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Carta MG, Norcini-Pala A, Moro MF, Balestrieri M, Caraci F, Dell'Osso L, Sciascio GD, Faravelli C, Hardoy MC, Aguglia E, Roncone R, Nardi AE, Drago F. Does Mood Disorder Questionnaire identify sub-threshold bipolarity? Evidence studying worsening of quality of life. J Affect Disord 2015; 183:173-8. [PMID: 26021966 DOI: 10.1016/j.jad.2015.04.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE It is debated whether the Mood Disorder Questionnaire (MDQ) can generate false positives by screening other disorders as bipolar, or identify sub-threshold bipolarity. The aim is to verify if Quality of Life (QoL) impairment in MQD positives in the community is due to MDQ positivity itself, or to psychiatric diagnosis associated with MDQ positivity (supporting the former hypothesis). METHOD Community survey. Sample randomized after stratification of the adult population in the records of seven Italian regions. TOOLS MDQ; Short Form Health Survey (SF-12); semi-structured clinical interview carried out by clinicians. RESULTS Positives at MDQ show worsening QoL with an attributable burden of 2.8 ± 1.8 lower than in MDD (5.6 ± 3.6, p < 0.001) or Eating Disorders (4.4 ± 6.6, p < 0.03) and similar to Panic Disorder (2.9 ± 0.9, p = 0.44). The burden is lower in the middle-aged (25-59 years) than in the young (18-24) (4.65 ± 4.5 vs 2.58 ± 2.0, p=0.007) or in the elderly (≥60) (4.12 ± 3.2; p = 0.024). In the elderly the burden is independent from comorbid psychiatric disorders. LIMITATIONS This is a preliminary study based on one survey not designed to test this specific hypothesis, thus its results have a heuristic value only. CONCLUSIONS The worsening of QoL due to positivity at MDQ is largely independent from comorbid conditions, supporting the hypothesis that MDQ positivity identifies a specific area of suffering that is "subthreshold" to the psychiatric diagnosis, and relevant for public health.
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Affiliation(s)
| | | | - Maria Francesca Moro
- Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | | | - Filippo Caraci
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Institute of Psychiatry, University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Carlo Faravelli
- Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Firenze, Italy
| | - Maria Carolina Hardoy
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Rita Roncone
- Department of Health, Life and Environmental Sciences, Unit of Psychiatry, University of L'Aquila, L'Aquila, Italy
| | - Antonio Egidio Nardi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Filippo Drago
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
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16
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Rosenvinge JH, Pettersen G. Epidemiology of eating disorders part III: social epidemiology and case definitions revisited. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/21662630.2015.1022197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Luca A, Luca M, Calandra2 C. Eating Disorders in Late-life. Aging Dis 2015; 6:48-55. [PMID: 25657852 PMCID: PMC4306473 DOI: 10.14336/ad.2014.0124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 12/16/2022] Open
Abstract
Eating disorders are a heterogeneous group of complex psychiatric disorders characterized by abnormal eating behaviours that lead to a high rate of morbidity, or even death, if underestimated and untreated. The main disorders enlisted in the chapter of the Diagnostic and Statistic Manual of Mental Disorders-5 dedicated to "Feeding and Eating Disorders" are: anorexia nervosa, bulimia nervosa and binge eating disorder. Even though these abnormal behaviours are mostly diagnosed during childhood, interesting cases of late-life eating disorders have been reported in literature. In this review, these eating disorders are discussed, with particular attention to the diagnosis and management of those cases occurring in late-life.
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Affiliation(s)
- Antonina Luca
- Department “G.F. Ingrassia” Section of Neuroscience, University of Catania (Sicily), Italy
| | - Maria Luca
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital “Policlinico-Vittorio Emanuele” of Catania (Sicily), Italy. Via S. Sofia 78, 95100 Catania
| | - Carmela Calandra2
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital “Policlinico-Vittorio Emanuele” of Catania (Sicily), Italy. Via S. Sofia 78, 95100 Catania
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