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Goldschmidt AB, Jeong K, Yu L, Egbert AH, Schmidt R, Hilbert A. Executive functioning and treatment outcome among adolescents undergoing cognitive-behavioral therapy for binge-eating disorder. J Child Psychol Psychiatry 2024. [PMID: 38940077 DOI: 10.1111/jcpp.14031] [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] [Accepted: 05/13/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) is an evidence-supported treatment for adolescents with binge-eating disorder (BED). Executive dysfunctions, which are associated with binge eating and elevated body weight in youth, may undermine CBT outcomes by making it difficult for youth to engage with or adhere to treatment, including recalling and/or implementing intervention strategies in real-world contexts. METHODS We assessed 73 adolescents [82.2% female; Mage = 15.0 ± 2.5 year; M baseline standardized body mass index (zBMI) = 1.9 ± 1.0 kg/m2] with BED at baseline, posttreatment, 6-, 12-, and 24-month follow-up. Linear mixed models examined the effects of baseline executive functioning (EF) on loss of control (LOC) eating and weight change following CBT. Linear and logistic regressions probed associations between EF, attendance, and attrition. RESULTS More impulsive decision-making, as reflected in higher baseline scores on the Iowa Gambling Task, predicted better attendance (β = .07; p = .019) and more frequent LOC eating following treatment (β = .12; p = .017). Lower cognitive flexibility, as reflected in lower baseline T-scores on the Comprehensive Trail Making Test complex sequencing index, predicted higher zBMI following treatment (β = -.03; p = .003). Inhibition, concentration, attention, and parent-reported EF behavior symptoms were not associated with outcome, attendance, or attrition. CONCLUSIONS More impulsive decision-making and lower cognitive flexibility were associated with suboptimal response to CBT for BED, although findings should be interpreted with caution in light of the sample size and waitlist control design. Future research should examine whether strengthening EF could improve eating and weight outcomes among adolescents with BED who have lower pre-treatment EF.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kwonho Jeong
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lan Yu
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Amy H Egbert
- Department of Psychological Sciences, University of Connecticut, Storz, CT, USA
| | - Ricarda Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, Integrated Research and Treatment Center AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
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Smith KE, Goldschmidt AB. Treatment of Binge-Eating Disorder Across the Lifespan: An Updated Review of the Literature and Considerations for Future Research. Curr Obes Rep 2024; 13:195-202. [PMID: 38363468 PMCID: PMC11150297 DOI: 10.1007/s13679-024-00553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW The present review describes the recent literature on treatment for binge-eating disorder (BED) in adults and youth, with a particular focus on research gaps, emerging treatments, and future research directions. RECENT FINDINGS Evidence supports the efficacy of several treatment modalities in adults, including self-help treatment, clinician-led psychotherapy, and pharmacotherapy; the largest effect sizes have been found for psychotherapies, most of which were cognitive-behavioral in orientation. Adapted psychotherapies for youth also show promise but lack a robust body of evidence. Predictors, moderators, and mediators of treatment outcome remain poorly understood; individuals with BED continue to experience significant barriers to treatment; and research is needed to address suboptimal treatment response. Recent work has highlighted the potential of adaptive interventions and investigation of novel mechanisms to address these gaps. Research on BED treatment continues to grow, though critical questions must be answered to improve treatment efficacy across the lifespan.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar St #2200, Los Angeles, CA, 90033, USA.
| | - Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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3
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Chong KK, Martinelli C. Weak central coherence, cognitive rigidity and disordered eating in a community sample. Eat Behav 2024; 53:101866. [PMID: 38452626 DOI: 10.1016/j.eatbeh.2024.101866] [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: 08/25/2023] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
Recent evidence has highlighted that a moderate degree of disordered eating has become the norm among the general population. While previous research has demonstrated that individuals with eating disorders exhibit heightened weak central coherence (i.e., attention to detail) and cognitive rigidity, and this plays a key role in the development and maintenance of the disorders, less is known about the relationship between disordered eating and these cognitive styles in subclinical community samples. A community sample of females completed self-report measures of weak central coherence, cognitive rigidity and eating disorder pathology. Unlike previous studies in the area, we first excluded participants with a diagnosis of eating disorder and then confined the analyses to those without clinically significant disordered eating. In line with the clinical literature, we found both cognitive rigidity and weak central coherence to correlate with severity and frequency of disordered eating behaviours and cognitions, suggesting the relationship also exists in subclinical samples. If replicated and expanded upon, these findings may bear important implications for the prevention and early identification of disordered eating in the community.
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Affiliation(s)
- Ka Ka Chong
- Kingston University, Psychology Department, Penrhyn Road, Kingston Upon Thames, United Kingdom of Great Britain and Northern Ireland
| | - Cristina Martinelli
- Kingston University, Psychology Department, Penrhyn Road, Kingston Upon Thames, United Kingdom of Great Britain and Northern Ireland
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Hildebrandt BA, Lee JR, Culbert KM, Sisk CL, Johnson AW, Klump KL. The organizational role of ovarian hormones during puberty on risk for binge-like eating in rats. Physiol Behav 2023; 265:114177. [PMID: 36967031 PMCID: PMC10121844 DOI: 10.1016/j.physbeh.2023.114177] [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] [Received: 02/15/2023] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023]
Abstract
Puberty is a high-risk period for the development of dysregulated eating, including binge eating. While risk for binge eating in animals and humans increases in both males and females during puberty, the increased prevalence is significantly greater in females. Emerging data suggest that the organizational effects of gonadal hormones may contribute to the female preponderance of binge eating. In this narrative review, we discuss studies conducted in animals that have examined these organizational effects as well as the neural systems that may serve as intermediary mechanisms. Relatively few studies have been conducted, but data thus far suggest that pubertal estrogens may organize risk for binge eating, potentially by altering key circuits in brain reward pathways. These promising results highlight the need for future studies to directly test organizational effects of pubertal hormones using hormone replacement techniques and circuit-level manipulations that can identify pathways contributing to binge eating across development.
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Affiliation(s)
- Britny A Hildebrandt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jenna R Lee
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kristen M Culbert
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Cheryl L Sisk
- Department of Psychology, Michigan State University, East Lansing, MI, USA; Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Alexander W Johnson
- Department of Psychology, Michigan State University, East Lansing, MI, USA; Neuroscience Program, Michigan State University, East Lansing, MI, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA.
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5
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Schmidt R, Wandrer H, Boutelle KN, Kiess W, Hilbert A. Associations between eating in the absence of hunger and executive functions in adolescents with binge-eating disorder: An experimental study. Appetite 2023; 186:106573. [PMID: 37062306 DOI: 10.1016/j.appet.2023.106573] [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: 02/13/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
Eating in the absence of hunger (EAH) is one of the key behavioral features of binge-eating disorder (BED) in youth. Although preliminary evidence revealed that adolescent BED co-occurs with deficits in executive functions (EFs), it is unclear whether EFs are related to EAH. Thus, this study experimentally examined whether deficits in EFs predict EAH in adolescents with and without BED. Adolescents (12-20 years) with BED (n = 28) and age-, sex-, and weight-matched controls (n = 28) underwent an EAH paradigm in the laboratory, where they were offered snacks ad libitum after having established satiety during a lunch meal. Cognitive interference, cognitive flexibility, decision making, and EFs in daily life were assessed by neuropsychological tests and self-report. The BED group showed a significantly higher food intake in gram during the EAH trial than controls with medium effect, but no significant group differences in EFs emerged. Dysfunctional decision making in terms of risky decision making, but no other EFs, predicted increased EAH (g, kcal) in the total sample. Although increases in risky decision making over adolescence are well known, this study uniquely revealed that general decision-making abilities driven by short-term reward may account for disinhibited eating behavior. Interventions targeting decision making with focus on reward sensitivity should be evaluated for their efficacy in preventing and reducing disinhibited eating behavior in adolescents.
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Affiliation(s)
- Ricarda Schmidt
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Stephanstrasse 9a, 04103, Leipzig, Germany.
| | - Henrike Wandrer
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Stephanstrasse 9a, 04103, Leipzig, Germany.
| | | | - Wieland Kiess
- University of Leipzig, LIFE Leipzig Research Centre for Civilization Diseases, Philipp-Rosenthal-Strasse 27, D-04103, Leipzig, Germany; University of Leipzig Medical Center, Hospital for Children and Adolescents, Centre for Pediatric Research, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Anja Hilbert
- Leipzig University Medical Center, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Stephanstrasse 9a, 04103, Leipzig, Germany.
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6
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Parker MN, Lavender JM, Schvey NA, Tanofsky-Kraff M. Practical Considerations for Using the Eating Disorder Examination Interview with Adolescents. Adolesc Health Med Ther 2023; 14:63-85. [PMID: 36860931 PMCID: PMC9969870 DOI: 10.2147/ahmt.s220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
Approximately 35 years after its initial publication, the Eating Disorder Examination (EDE) remains one of the most widely used semi-structured interviews for assessing eating disorder diagnoses and symptomatology. Although the interview provides certain advantages over other common measurement approaches (ie, questionnaires), there are particular considerations regarding the EDE that warrant attention, including in its use with adolescents. The aims of this paper are therefore to: 1) provide a brief overview of the interview itself, as well as a description of its origin and underlying conceptual framework; 2) describe relevant factors for administering the interview with adolescents; 3) review potential limitations regarding use of the EDE with adolescents; 4) address considerations for using the EDE with pertinent subpopulations of adolescents who may experience distinct eating disorder symptoms and/or risk factors; and 5) discuss the integration of self-report questionnaires with the EDE. Advantages of using the EDE include the ability for interviewers to clarify complex concepts and mitigate inattentive responding, enhanced orientation to the interview timeframe to improve recall, increased diagnostic accuracy compared to questionnaires, and accounting for potentially salient external factors (eg, food/eating rules imposed by a parent/guardian). Limitations include more extensive training requirements, greater assessment burden, variable psychometric performance across subgroups, lack of items evaluating muscularity-oriented symptoms and avoidant/restrictive food intake disorder diagnostic criteria, and lack of explicit consideration for salient risk factors other than weight and shape concerns (eg, food insecurity).
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Affiliation(s)
- Megan N Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA,The Metis Foundation, San Antonio, TX, USA,Correspondence: Jason M Lavender, Military Cardiovascular Outcomes Research Program, 4301 Jones Bridge Road, Building 17, Suite 2A, Bethesda, MD, 20814, USA, Email
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA
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7
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Transtornos alimentares na infância. PSICO 2022. [DOI: 10.15448/1980-8623.2022.1.38780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Transtornos alimentares são um tema preocupante em qualquer fase de desenvolvimento humano. Essa revisão da literatura teve o objetivo de analisar as produções científicas quanto a transtornos alimentares em crianças, com a busca de artigos publicados entre 2014-2019 nas bases de dados Scielo, Pepsic, BVS (Lilacs) e Periódicos CAPES, utilizando os termos “childhood” AND “eating disorder”, “child” AND “eating disorder”, “children” AND “eating disorder”, “childhood” AND “eating difficulty”. 43 artigos foram selecionados após a aplicação dos critérios de exclusão e inclusão. Os resultados indicaram três tópicos principais discutidos nos estudos: a forma como os cuidadores influenciam na alimentação de crianças, fatores emocionais e psicológicos que influenciam nos transtornos alimentares, e o tratamento de crianças com transtornos alimentares. Concluiu-se que o tema ainda é pouco estudado e o cenário internacional é referência em publicações.
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Keshen AR, Hilbert A, Taylor V, Harris AL, Trappenberg N, Sadek J, Frank GKW, Murray SB. Effect of stimulant medication on loss of control eating in youth with attention deficit/hyperactivity disorder: a prospective, observational case series study protocol. J Eat Disord 2022; 10:152. [PMID: 36320022 PMCID: PMC9628055 DOI: 10.1186/s40337-022-00674-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Loss of control eating (LOC-E) in youth predicts the later development of full-syndrome binge-eating disorder (BED), and therefore, could be a relevant target for prevention treatments. To develop these treatments, it is important to understand the underlying disease processes and mechanisms. Based on the putative role of neurocognitive impairments in the pathogenesis of LOC-E, treatments that modulate these neurocognitive factors warrant further exploration. For instance, stimulants are an effective treatment for impulsivity in youth with attention deficit/hyperactivity disorder (ADHD) and have been shown to improve symptoms of BED in adults. Notably, stimulants have not been examined as a treatment for LOC-E in youth. To explore this gap, we aim to measure change in LOC-E episodes and secondary outcomes in youth with comorbid ADHD and LOC-E who are being started on stimulants. METHODS We will collect prospective observational data on forty 8-to-13-year-old youth diagnosed with comorbid ADHD and LOC-E who are initiating a stimulant for ADHD. Prior to stimulant initiation, participants will complete baseline measures including LOC-E episode frequency in the last 3 months (primary outcome), and secondary outcomes including disordered eating cognitions, emotions and behaviors, ADHD symptom severity, parental LOC-E, impulsivity and reward sensitivity, and anxiety/mood severity. Outcome measurements will be gathered again at 3-months after initiating the stimulant. Within-patient standardized effect sizes with 95% confidence intervals will be calculated from baseline to 3-month follow-up for all outcomes. DISCUSSION Many individuals with LOC-E or binge eating do not fully remit over the course of psychotherapy. Whereas psychotherapy may address psychological and sociocultural domains associated with LOC-E, some individuals with neurocognitive impairments (e.g., ADHD) and neurobiological deficits (e.g., low intrasynaptic dopamine or norepinephrine) may benefit from adjunctive treatment that targets those factors. This will be the first study to provide pilot data for future studies that could examine both the effect of stimulants on LOC-E in youth and underlying mechanisms. TRIAL REGISTRATION Trial registration number: NCT05592119.
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Affiliation(s)
- Aaron R Keshen
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada. .,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Victoria Taylor
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Anastasia L Harris
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Nami Trappenberg
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Guido K W Frank
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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Munsch S, Forrer F, Naas A, Mueller V, Rubo M, Hannoun F, Mugellini E. Correlates of interpersonal emotion regulation problems in Loss of Control eating (LOC) in youth: study protocol of the combined online and App based questionnaire, laboratory and randomized controlled online intervention i-BEAT trial. BMC Psychol 2021; 9:193. [PMID: 34895337 PMCID: PMC8666071 DOI: 10.1186/s40359-021-00690-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Binge Eating Disorder (BED) represents a common eating disorder associated with marked health impairments. A subclinical variant, loss of control eating (LOC) is prevalent in youth. LOC is associated with similar mental distress as full-blown BED, increases the risk to develop a BED and promotes continuous weight gain. The etiology of LOC is not yet fully understood and specialized treatment for youth is scarce. METHODS The i-BEAT study includes a cross-sectional and longitudinal online questionnaire study (N = 600), an App based daily-life approach and a laboratory virtual reality study in N = 60 youths (14-24 years) with and without LOC as well as a controlled randomized online treatment trial to investigate the feasibility, acceptance and efficacy of a CBT and an interpersonal emotion regulation module for youth (N = 120). The primary outcomes include self-reported as well as measured (heart rate variability, gaze behavior, reaction times in stop signal task) associations between emotion regulation problems (such as dealing with RS), psychological impairment and binge eating in a healthy control group and youth with LOC. Secondary outcomes encompass general eating disorder pathology, social anxiety, body mass index, hyperscanning behavior and therapists' rating of patients' condition pre and post treatment. Epigenetic correlates of RS are assessed in healthy controls and youth with LOC and explored before and after treatment. DISCUSSION The expected findings will specify the role of interpersonal emotion regulation problems such as coping with the experience of social exclusion and rejection sensitivity (RS) in LOC and clarify, whether including a training to cope with RS adds to the efficacy of a cognitive behavioral treatment (CBT). TRIAL REGISTRATION German Clinical Trial Register: DRKS00023706. Registered 27 November 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023706.
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Affiliation(s)
- Simone Munsch
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Rue P.-A.-de-Faucigny 2, 1700 Fribourg, Switzerland
| | - Felicitas Forrer
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Rue P.-A.-de-Faucigny 2, 1700 Fribourg, Switzerland
| | - Adrian Naas
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Rue P.-A.-de-Faucigny 2, 1700 Fribourg, Switzerland
| | - Verena Mueller
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Rue P.-A.-de-Faucigny 2, 1700 Fribourg, Switzerland
| | - Marius Rubo
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Fribourg, Rue P.-A.-de-Faucigny 2, 1700 Fribourg, Switzerland
| | - Fouad Hannoun
- Technology for Human Well-Being Institute (HumanTech), University of Applied Sciences of Western Switzerland, Boulevard de Pérolles 80, Fribourg, Switzerland
| | - Elena Mugellini
- Technology for Human Well-Being Institute (HumanTech), University of Applied Sciences of Western Switzerland, Boulevard de Pérolles 80, Fribourg, Switzerland
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Hilbert A. Adipositas und psychische Komorbidität: therapeutische Implikationen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00480-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Interaction Effects of Child Weight Status and Parental Feeding Practices on Children's Eating Disorder Symptomatology. Nutrients 2019; 11:nu11102433. [PMID: 31614777 PMCID: PMC6835784 DOI: 10.3390/nu11102433] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/05/2019] [Accepted: 10/10/2019] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Research on parental feeding practices and non-normative eating behavior including loss of control (LOC) eating and eating disorder psychopathology indicated separate associations of these variables with child weight status, especially in early childhood. This study cross-sectionally examined interaction effects of restriction, monitoring, pressure to eat, and children's weight status on disordered eating in children aged 8-13 years. (2) Methods: A population-based sample of N = 904 children and their mothers completed the Eating Disorder Examination Questionnaire for Children and the Child Feeding Questionnaire. Child anthropometrics were objectively measured. Hierarchical linear and logistic regression analyses were conducted for cross-sectionally predicting global eating disorder psychopathology and recurrent LOC eating by feeding practices and child weight status for younger (8-10 years) and older (11-13 years) ages. (3) Results: Restriction x Child weight status significantly predicted global eating disorder psychopathology in younger children and recurrent LOC eating in older children. Monitoring x Child weight status significantly predicted eating disorder psychopathology in older children. A higher versus lower child weight status was associated with adverse eating behaviors, particularly in children with mothers reporting high restriction and monitoring. (4) Conclusions: Detrimental associations between higher child weight status and child eating disorder symptomatology held especially true for children whose mothers strongly control child food intake.
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12
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To eat or not to eat: Reward delay impulsivity in children with loss of control eating, attention deficit / hyperactivity disorder, a double diagnosis, and healthy children. PLoS One 2019; 14:e0221814. [PMID: 31525207 PMCID: PMC6746378 DOI: 10.1371/journal.pone.0221814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 08/15/2019] [Indexed: 11/21/2022] Open
Abstract
Reward delay impulsivity is a feature of attention deficit/hyperactivity disorder (ADHD) and a likely feature of loss of control eating (LOC-E), which might explain the higher risk of children with ADHD or LOC-E to become obese. The goal of this study was to investigate reward delay impulsivity in children with LOC-E, ADHD, or a double diagnosis, in contrast to healthy children. Children (8 to 13 years) with LOC-E (n = 24), ADHD (n = 33), a double diagnosis (n = 9), and healthy children (n = 34) performed a computer game (door opening task [DOT]) and the delay of gratification task (DoGT) to assess food related facets of reward delay impulsivity. In addition, children reported whether they worried to lose control over eating during the DoGT. There were no group differences in the DOT. However, children with ADHD or a double diagnosis had a significantly higher risk to eat prematurely during the DoGT than children with LOC-E, who were not significantly different from healthy children. Children with a double diagnosis were most likely to worry about losing control over eating during the DoGT, followed by children with LOC-E, and both had a significantly higher probability to worry than healthy children. For children with a double diagnosis the probability to worry was significantly higher than for children with ADHD. If replicated, these findings point to a special relevance of reward delay impulsivity in children with ADHD or a double diagnosis, compared to children with LOC-E. ADHD should be regularly assessed in children with LOC-E.
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13
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Matherne CE, Munn-Chernoff MA, Thornton LM, Rhee SH, Lin S, Corley RP, Stallings MC, Hewitt JK. Perceived family functioning among adolescents with and without loss of control eating. Eat Behav 2019; 33:18-22. [PMID: 30785025 PMCID: PMC6535362 DOI: 10.1016/j.eatbeh.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/05/2019] [Indexed: 10/27/2022]
Abstract
Youth with loss of control eating (LOC) have poorer social relationships than youth without LOC. However, perceived family functioning among youth reporting LOC is relatively unexplored. We examined perceived family functioning among 990 twins (age = 17.47 ± 0.71 years, 53% female) from the Colorado Center for Antisocial Drug Dependence with (n = 158) and without (n = 832) LOC. LOC was assessed with one binary item. Associations between family functioning and LOC were examined using general linear models that accounted for dependence in twin data. Girls with greater family conflict had higher odds of endorsing LOC (p = .02), but not after accounting for depressive symptoms (p = .26). Further analysis indicated that depressive symptoms mediated the association between LOC and family conflict (p = .04). This finding is consistent with an interpersonal model, which proposes that interpersonal difficulties lead to negative emotional states, which promotes LOC as a method of coping with negative affect. Family cohesion and expressiveness were not associated with LOC in girls, and none of the family functioning variables were associated with LOC in boys (ps > .05). Future studies are needed to clarify these relations and to determine any relevant treatment indications.
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Affiliation(s)
| | | | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado Boulder,Institute for Behavioral Genetics, University of Colorado Boulder
| | - Stacy Lin
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder
| | - Michael C. Stallings
- Department of Psychology and Neuroscience, University of Colorado Boulder,Institute for Behavioral Genetics, University of Colorado Boulder
| | - John K. Hewitt
- Department of Psychology and Neuroscience, University of Colorado Boulder,Institute for Behavioral Genetics, University of Colorado Boulder
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14
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Abstract
Binge-eating disorder (BED), first included as a diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, is characterized by recurrent episodes of binge eating without regular compensatory behaviors to prevent weight gain. With a complex multifactorial etiology, BED is the most frequent eating disorder co-occuring with significant psychopathology, mental and physical comorbidity, obesity, and life impairment. Despite its significance, BED is not sufficiently diagnosed or treated. Evidence-based treatments for BED include psychotherapy and structured self-help treatment, with cognitive-behavioral therapy as most well-established approach, and pharmacotherapy with lisdexamfetamine as FDA approved medication with a limitation of use.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig 04103, Germany.
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15
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English LK, Masterson TD, Fearnbach SN, Tanofsky-Kraff M, Fisher J, Wilson SJ, Rolls BJ, Keller KL. Increased brain and behavioural susceptibility to portion size in children with loss of control eating. Pediatr Obes 2019; 14:e12436. [PMID: 30019382 PMCID: PMC7086471 DOI: 10.1111/ijpo.12436] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/26/2018] [Accepted: 05/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Portion size influences intake (i.e. the portion size effect [PSE]), yet determinants of susceptibility to the PSE are unclear. OBJECTIVE We tested whether children who reported an episode of loss of control (LOC) eating over the last 3 months would be more susceptible to the PSE and would show differential brain responses to food cues compared with children with no-LOC. METHODS Across five sessions, children (n = 47; 7-10 years) consumed four test meals at 100%, 133%, 167% and 200% conditions for portion size and completed a functional magnetic resonance imaging scan while viewing pictures of foods varied by portion size and energy density (ED). Incidence of LOC over the past 3 months was self-reported. Random coefficient models were tested for differences in the shape of the PSE curve by LOC status. A whole-brain analysis was conducted to determine response to food cues during the functional magnetic resonance imaging. RESULTS Reported LOC (n = 13) compared with no-LOC (n = 34) was associated with increased susceptibility to the PSE, as evidenced by a positive association with the linear slope (P < 0.005), and negative association with the quadratic slope (P < 0.05) of the intake curve. Children who reported LOC compared with no-LOC showed increased activation in the left cerebellum to small relative to large portions (P < 0.01) and right cerebellum to High-ED relative to Low-ED food cues (P < 0.01). CONCLUSION Children who reported LOC were more susceptible to the PSE and showed alterations in food-cue processing in the cerebellum, a hindbrain region implicated in satiety signalling.
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Affiliation(s)
- L. K. English
- Department of Nutritional Science, The Pennsylvania State University, State College, PA, USA
| | - T. D. Masterson
- Department of Nutritional Science, The Pennsylvania State University, State College, PA, USA
| | - S. N. Fearnbach
- Brain and Metabolism Imaging in Chronic Disease, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - M. Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of Health Sciences, Bethesda, MD, USA
| | - J. Fisher
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, PA, USA
| | - S. J. Wilson
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
| | - B. J. Rolls
- Department of Nutritional Science, The Pennsylvania State University, State College, PA, USA
| | - K. L. Keller
- Department of Nutritional Science, The Pennsylvania State University, State College, PA, USA,Department of Food Science, The Pennsylvania State University, State College, PA, USA
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16
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Altered Processing of Visual Food Stimuli in Adolescents with Loss of Control Eating. Nutrients 2019; 11:nu11020210. [PMID: 30678145 PMCID: PMC6412983 DOI: 10.3390/nu11020210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/14/2019] [Accepted: 01/16/2019] [Indexed: 12/17/2022] Open
Abstract
Loss of control eating (LOC) constitutes a common eating pathology in childhood and adolescence. Models developed for adult patients stress a biased processing of food-related stimuli as an important maintaining factor. To our knowledge, however, no EEG study to date investigated the processing of visual food stimuli in children or adolescents with LOC. Adolescents with at least one self-reported episode of LOC in the last four weeks and a matched control group completed a modified Go/NoGo task, with a numerical target or non-target stimulus being presented on one side of the screen and an irrelevant high-calorie food or neutral stimulus being presented on the opposite side. Mean P3 amplitudes were analyzed. In Go trials, the LOC group’s mean P3 amplitudes were comparable irrespective of distractor category, while for NoGo trials, mean P3 amplitudes were significantly higher when the distractor was a high-calorie food stimulus. This pattern was reversed in the control group. Results are interpreted in light of Gray’s reinforcement sensitivity theory. They might reflect altered processes of behavioral inhibition in adolescents with LOC upon confrontation with visual food stimuli.
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17
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Puls HC, Schmidt R, Hilbert A. Therapist adherence and therapeutic alliance in individual cognitive-behavioural therapy for adolescent binge-eating disorder. EUROPEAN EATING DISORDERS REVIEW 2018; 27:182-194. [PMID: 30334340 DOI: 10.1002/erv.2650] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 08/20/2018] [Accepted: 09/21/2018] [Indexed: 11/05/2022]
Abstract
To evaluate psychological treatments for adolescent binge-eating disorder (BED), reliable information on therapeutic process factors is needed. This study examines therapist adherence and therapeutic alliance and their associations in cognitive-behavioural therapy (CBT) for adolescents with BED. In a randomised-controlled efficacy trial, adherence and alliance were objectively determined based on 247 audio-taped CBT sessions from a sample of N = 64 adolescents with BED. Variability of adherence and alliance, explained by treatment module, patient, and therapist were examined using multilevel modeling. Although adherence and alliance were excellent and unaffected by treatment module and therapist, there was significant between-patient variability for both concepts. Adherence was negatively associated with patient's treatment expectation. Alliance was negatively associated with the number of loss of control eating episodes and positively associated with adherence. Excellent adherence supported the internal validity of CBT for adolescent BED. Associations between process factors and patient characteristics demand adequate supervision in CBT.
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Affiliation(s)
- Hans-Christian Puls
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Leipzig, Germany
| | - Ricarda Schmidt
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Leipzig, Germany
| | - Anja Hilbert
- Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Leipzig, Germany
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18
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Sysko R, Steinglass J, Schebendach J, Mayer LES, Walsh BT. Rigor and reproducibility via laboratory studies of eating behavior: A focused update and conceptual review. Int J Eat Disord 2018; 51:608-616. [PMID: 30132949 DOI: 10.1002/eat.22900] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/11/2018] [Accepted: 05/14/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The eating behavior of individuals with eating disorders has been examined in laboratory settings over the last 30 years. In this focused review, we build on prior research and highlight several feeding laboratory paradigms that have successfully demonstrated quantifiable and observable behavioral disturbances, and thereby add rigor and reproducibility to the examination of disturbances of eating behavior. This review describes the measures commonly obtained via these laboratory techniques. Supporting Information Appendices with detailed information about implementation are provided to allow for the reproducible execution of these techniques across labs. METHODS/RESULTS Literature documenting the existence of objective abnormalities in eating behavior among individuals with eating disorders or in comparison to healthy controls (n > 40) is briefly summarized. These protocols, conducted across at least 17 independent labs, are sensitive and reproducible, can be used to assess subjective and physiological parameters associated with eating, and elucidate the impact of treatment. Laboratory studies from patients with eating disorders compared with healthy controls reproducibly demonstrate both that patients with Anorexia Nervosa ingest fewer calories and that individuals with Bulimia Nervosa and Binge-Eating Disorder ingest more calories when asked to binge-eat. DISCUSSION Feeding laboratory studies have the potential for quantifying the characteristic behavioral psychopathology of patients with eating disorders, and may provide a useful tool to explore the potential utility of new treatments for individuals with Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder.
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Affiliation(s)
- Robyn Sysko
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joanna Steinglass
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
| | - Janet Schebendach
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
| | - Laurel E S Mayer
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
| | - B Timothy Walsh
- Columbia Center for Eating Disorders, Department of Psychiatry, Columbia University of Physicians and Surgeons, New York, New York.,Eating Disorders Research Unit, New York State Psychiatric Institute, New York, New York
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19
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Hilbert A, Kurz S, Dremmel D, Weihrauch Blüher S, Munsch S, Schmidt R. Cue reactivity, habituation, and eating in the absence of hunger in children with loss of control eating and attention-deficit/hyperactivity disorder. Int J Eat Disord 2018; 51:223-232. [PMID: 29341214 DOI: 10.1002/eat.22821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Childhood loss of control (LOC) eating and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid conditions and present with disordered eating behaviors, such as overeating. This study sought to delineate shared and specific abnormalities in physiological, cognitive-motivational, and behavioral components of food-specific impulsivity in children with LOC eating and ADHD. Specifically, children's reactivity and habituation to food and eating in the absence of hunger were examined. METHODS Within this community-based study, four groups of 8-13-year-old children with LOC eating (n = 24), ADHD (n = 32), comorbid LOC eating/ADHD (n = 9), and matched controls (n = 34) received a standard laboratory test meal to establish satiety and were then exposed to their favorite snack food in a cue exposure/reactivity trial, while salivation and desire to eat were repeatedly assessed. Subsequently, they were offered a variety of snack foods ad libitum. RESULTS Children with LOC eating, ADHD, and LOC/ADHD did not differ from controls in salivary reactivity and habituation to food cues. Children with LOC eating and ADHD showed greater cue reactivity of the desire to eat than controls, but groups did not differ in its longer-term increments. At free access, only children with LOC/ADHD consumed significantly more energy than controls. Longer-term increments of desire to eat predicted greater energy intake beyond LOC/ADHD group status. DISCUSSION Desire to eat among children with comorbid LOC eating and ADHD was associated with overeating in the absence of hunger, which may contribute to excess weight gain. Delineation of the specific features of childhood LOC eating versus ADHD warrants further study.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Susanne Kurz
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Daniela Dremmel
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Susann Weihrauch Blüher
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Pediatric Endocrinology, Department of Pediatrics I, Martin Luther University of Halle, Halle, Germany
| | - Simone Munsch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Ricarda Schmidt
- Integrated Research and Treatment Center AdiposityDiseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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20
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Satiety regulation in children with loss of control eating and attention-deficit/hyperactivity disorder: A test meal study. Appetite 2017; 116:90-98. [DOI: 10.1016/j.appet.2017.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 04/14/2017] [Accepted: 04/14/2017] [Indexed: 11/17/2022]
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21
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Shank LM, Crosby RD, Grammer AC, Shomaker LB, Vannucci A, Burke NL, Stojek M, Brady SM, Kozlosky M, Reynolds JC, Yanovski JA, Tanofsky-Kraff M. Examination of the interpersonal model of loss of control eating in the laboratory. Compr Psychiatry 2017; 76:36-44. [PMID: 28410467 PMCID: PMC5478390 DOI: 10.1016/j.comppsych.2017.03.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/04/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The interpersonal model of loss of control (LOC) eating proposes that interpersonal problems lead to negative affect, which in turn contributes to the onset and/or persistence of LOC eating. Despite preliminary support, there are no data examining the construct validity of the interpersonal model of LOC eating using temporally sensitive reports of social stress, distinct negative affective states, and laboratory energy intake. METHOD 117 healthy adolescent girls (BMI: 75th-97th %ile) were recruited for a prevention trial targeting excess weight gain in adolescent girls who reported LOC eating. Prior to the intervention, participants completed questionnaires of recent social stress and consumed lunch from a multi-item laboratory test meal. Immediately before the test meal, participants completed a questionnaire of five negative affective states (anger, confusion, depression, fatigue, anxiety). Bootstrapping mediation models were conducted to evaluate pre-meal negative affect states as explanatory mediators of the association between recent social stress and palatable (desserts and snack-type) food intake. All analyses adjusted for age, race, pubertal stage, height, fat mass percentage, and lean mass. RESULTS Pre-meal state anxiety was a significant mediator for recent social stress and palatable food intake (ps<.05). By contrast, pre-meal state anger, confusion, depression, and fatigue did not mediate the relationship between social stress and palatable food intake (ps>.05). DISCUSSION Pre-meal anxiety appears to be the salient mood state for the interpersonal model among adolescent girls with LOC eating. Interventions that focus on improving both social functioning and anxiety may prove most effective at preventing and/or ameliorating disordered eating and obesity in these adolescents.
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Affiliation(s)
- Lisa M. Shank
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Ross D. Crosby
- Department of Biomedical Statistics & Methodology, Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND, 58107, USA
| | - Anne Claire Grammer
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Lauren B. Shomaker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA,Department of Human Development and Family Studies and Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523-1570, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Natasha L. Burke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Monika Stojek
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda. MD 20892, USA
| | - James C. Reynolds
- Radiology and Imaging Sciences Department, Warren Grant Magnuson Clinical Center, NIH, DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892, USA.
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22
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Kliem S, Schmidt R, Vogel M, Hiemisch A, Kiess W, Hilbert A. An 8-item short form of the Eating Disorder Examination-Questionnaire adapted for children (ChEDE-Q8). Int J Eat Disord 2017; 50:679-686. [PMID: 28122128 DOI: 10.1002/eat.22658] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 11/09/2022]
Abstract
Eating disturbances are common in children placing a vulnerable group of them at risk for full-syndrome eating disorders and adverse health outcomes. To provide a valid self-report assessment of eating disorder psychopathology in children, a short form of the child version of the Eating Disorder Examination (ChEDE-Q) was psychometrically evaluated. Similar to the EDE-Q, the ChEDE-Q provides assessment of eating disorder psychopathology related to anorexia nervosa, bulimia nervosa, and binge-eating disorder; however, the ChEDE-Q does not assess symptoms of avoidant/restrictive food intake disorder, pica, or rumination disorder. In 1,836 participants ages 7 to 18 years, recruited from two independent population-based samples, the factor structure of the recently established 8-item short form EDE-Q8 for adults was examined, including measurement invariance analyses on age, gender, and weight status derived from objectively measured weight and height. For convergent validity, the ChEDE-Q global score, body esteem scale, strengths and difficulties questionnaire, and sociodemographic characteristics were used. Item characteristics and age- and gender-specific norms were calculated. Confirmatory factor analysis revealed good model fit for the 8-item ChEDE-Q. Measurement invariance analyses indicated strict invariance for all analyzed subgroups. Convergent validity was provided through associations with well-established questionnaires and age, gender, and weight status, in expected directions. The newly developed ChEDE-Q8 proved to be a psychometrically sound and economical self-report assessment tool of eating disorder psychopathology in children. Further validation studies are needed, particularly concerning discriminant and predictive validity.
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Affiliation(s)
- Sören Kliem
- Criminological Research Institute of Lower Saxony, Hannover, Germany.,Technical University of Braunschweig, Department of Psychology, Braunschweig, Germany
| | - Ricarda Schmidt
- University of Leipzig Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Germany
| | - Mandy Vogel
- Hospital for Children and Adolescents, Department for Woman and Child Health, Center for Pediatric Research, University of Leipzig Medical Center, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Hiemisch
- Hospital for Children and Adolescents, Department for Woman and Child Health, Center for Pediatric Research, University of Leipzig Medical Center, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Department for Woman and Child Health, Center for Pediatric Research, University of Leipzig Medical Center, Leipzig, Germany.,LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Anja Hilbert
- University of Leipzig Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Leipzig, Germany
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23
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Goldschmidt AB. Are loss of control while eating and overeating valid constructs? A critical review of the literature. Obes Rev 2017; 18:412-449. [PMID: 28165655 PMCID: PMC5502406 DOI: 10.1111/obr.12491] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet its component constructs - overeating and loss of control (LOC) while eating - are poorly understood and difficult to measure. OBJECTIVE The objective of this study is to critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum. DATA SOURCES English-language articles addressing the face, convergent, discriminant and predictive validity of LOC and overeating were included. RESULTS Loss of control and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial and eating behaviour-related factors. Overeating may be best conceptualized as a marker of excess weight status. LIMITATIONS Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted. DISCUSSION Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented.
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Affiliation(s)
- Andrea B Goldschmidt
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA
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24
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Schmidt R, Lüthold P, Kittel R, Tetzlaff A, Hilbert A. Visual attentional bias for food in adolescents with binge-eating disorder. J Psychiatr Res 2016; 80:22-29. [PMID: 27267318 DOI: 10.1016/j.jpsychires.2016.05.016] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/24/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
Abstract
Evidence suggests that adults with binge-eating disorder (BED) are prone of having their attention interfered by food cues, and that food-related attentional biases are associated with calorie intake and eating disorder psychopathology. For adolescents with BED experimental evidence on attentional processing of food cues is lacking. Using eye-tracking and a visual search task, the present study examined visual orienting and disengagement processes of food in youth with BED. Eye-movement data and reaction times were recorded in 25 adolescents (12-20 years) with BED and 25 controls (CG) individually matched for sex, age, body mass index, and socio-economic status. During a free exploration paradigm, the BED group showed a greater gaze duration bias for food images than the CG. Groups did not differ in gaze direction biases. In a visual search task, the BED group showed a greater detection bias for food targets than the CG. Group differences were more pronounced for personally attractive than unattractive food images. Regarding clinical associations, only in the BED group the gaze duration bias for food was associated with increased hunger and lower body mass index, and the detection bias for food targets was associated with greater reward sensitivity. The study provided first evidence of an attentional bias to food in adolescents with BED. However, more research is needed for further specifying disengagement and orienting processes in adolescent BED, including overt and covert attention, and their prospective associations with binge-eating behaviors and associated psychopathology.
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Affiliation(s)
- Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig University Medical Center, Germany.
| | - Patrick Lüthold
- Department of Psychology, University of Fribourg, Switzerland
| | - Rebekka Kittel
- Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig University Medical Center, Germany
| | - Anne Tetzlaff
- Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig University Medical Center, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Medical Psychology and Medical Sociology, Leipzig University Medical Center, Germany
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25
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Puccio F, Fuller-Tyszkiewicz M, Ong D, Krug I. A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression. Int J Eat Disord 2016; 49:439-54. [PMID: 26841006 DOI: 10.1002/eat.22506] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Undertake a meta-analysis to provide a quantitative synthesis of longitudinal studies that assessed the direction of effects between eating pathology and depression. A second aim was to use meta-regression to account for heterogeneity in terms of study-level effect modifiers. METHOD A systematic review was conducted on 42 studies that assessed the longitudinal relationship between eating pathology and depression. Of these 42 studies, multilevel random-effects meta-analyses were conducted on 30 eligible studies. RESULTS Meta-analysis results showed that eating pathology was a risk factor for depression (rm = 0.13) and that depression was a risk factor for eating pathology (rm = 0.16). Meta-regression analyses showed that these effects were significantly stronger for studies that operationalized eating pathology as an eating disorder diagnosis versus eating pathology symptoms, and for studies that operationalized the respective outcome measure as a categorical variable (e.g., a diagnosis of a disorder or where symptoms were "present"/"absent") versus a continuous measure. Results also showed that in relation to eating pathology type, the effect of an eating disorder diagnosis and bulimic symptoms on depression was significantly stronger for younger participants. DISCUSSION Eating pathology and depression are concurrent risk factors for each other, suggesting that future research would benefit from identifying factors that are etiological to the development of both constructs. RESUMEN OBJETIVO Llevar a cabo un meta-análisis para proporcionar una síntesis cuantitativa de los estudios longitudinales que evaluaron la dirección de los efectos entre la alimentación patológica y la depresión. Un segundo objetivo fue utilizar la meta-regresión para dar cuenta de la heterogeneidad en términos de modificadores del efecto a nivel de estudio. MÉTODO: Una revisión sistemática se llevó a cabo en 42 estudios que evaluaron la relación longitudinal entre la alimentación patológica y la depresión. De estos 42 estudios, se realizaron meta-análisis de multinivel de efectos aleatorios en 30 estudios elegibles. RESULTADOS Los resultados del meta-análisis mostraron que la alimentación patológica era un factor de riesgo para depresión (rm=0.13) y que la depresión era un factor de riesgo para la alimentación patológica (rm=0.16). Los análisis de meta-regresión mostraron que estos efectos eran significativamente más fuertes para estudios que operacionalizaban la alimentación patológica como un diagnóstico de trastorno de la conducta alimentaria versus síntomas de alimentación patológica, y para los estudios que operacionalizaban la medida respectiva de resultado como una variable categórica (e.g., un diagnóstico de trastorno o cuando los síntomas estaban "presentes"/"ausentes") versus una medida continua. Los resultados mostraron que en relación al tipo de alimentación patológica, el efecto de un diagnóstico de trastorno de la conducta alimentaria y síntomas bulímicos en la depresión era significativamente más fuerte para participantes más jóvenes. DISCUSIÓN: La alimentación patológica y la depresión son factores de riesgo concurrentes uno para el otro, lo que sugiere que la investigación futura se beneficiaría de identificar factores que son etiológicos al desarrollo de ambos constructos. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016;49:439-454).
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Affiliation(s)
- Francis Puccio
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Deborah Ong
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Isabel Krug
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Schlüter N, Schmidt R, Kittel R, Tetzlaff A, Hilbert A. Loss of control eating in adolescents from the community. Int J Eat Disord 2016; 49:413-20. [PMID: 26711325 DOI: 10.1002/eat.22488] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/10/2015] [Accepted: 11/11/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Loss of control (LOC) eating is a salient indicator of eating disorder psychopathology in adolescents and is associated with marked distress. While research has focused on the relevance of episode size, clinical significance of LOC eating frequency has rarely been explored. Therefore, this study aimed at identifying LOC eating prevalence with respect to its recurrence and associated variables in a community-based sample. METHOD Participants were 1,643 adolescents, aged 12-20 years (62.4% female). Based on EDE-Q self-report, participants were categorized as those reporting recurrent (N = 156; 9.5%), nonrecurrent (N = 226; 13.8%), and no LOC eating (N = 1261; 76.7%). RESULTS Adolescents with recurrent LOC eating reported clinically relevant and significantly greater eating disorder psychopathology, functional impairment, and distress because of LOC eating, and a significantly higher body mass index (BMI, kg/m(2) ) than adolescents with nonrecurrent and those without LOC eating. DISCUSSION These results underline that LOC eating is a common eating behavior among adolescents in the community associated with clinical characteristics of eating disorders, and could therefore be a risk factor for developing full- or partial-syndrome eating disorders. Further research on the classification of eating disorders in adolescents with LOC eating and severity indicators is warranted.
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Affiliation(s)
- Nora Schlüter
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Rebekka Kittel
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Anne Tetzlaff
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, Leipzig University Medical Center, 04103, Leipzig, Germany
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Gowey MA, Reiter-Purtill J, Becnel J, Peugh J, Mitchell JE, Zeller MH. Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity. Appetite 2016; 99:211-218. [PMID: 26775646 DOI: 10.1016/j.appet.2016.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 01/03/2016] [Accepted: 01/12/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. METHODS Fifty-four AYA females with severe obesity (MBMI = 48.71 kg/m(2); Mage = 18.29, R = 15-21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. RESULTS Breakfast was the most frequently skipped meal (consumed 3-4 times/week). Eating out was common (4-5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. CONCLUSIONS Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional impact on functioning (e.g., psychosocial health, weight loss behaviors).
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Affiliation(s)
- Marissa A Gowey
- Nutrition Obesity Research Center, University of Alabama at Birmingham, United States.
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
| | - Jennifer Becnel
- School of Human Environmental Sciences, Program in Human Development and Family Sciences, University of Arkansas, United States
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States
| | - Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
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Vannucci A, Nelson EE, Bongiorno DM, Pine DS, Yanovski JA, Tanofsky-Kraff M. Behavioral and neurodevelopmental precursors to binge-type eating disorders: support for the role of negative valence systems. Psychol Med 2015; 45:2921-2936. [PMID: 26040923 PMCID: PMC4589435 DOI: 10.1017/s003329171500104x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pediatric loss-of-control (LOC) eating is a robust behavioral precursor to binge-type eating disorders. Elucidating precursors to LOC eating and binge-type eating disorders may refine developmental risk models of eating disorders and inform interventions. METHOD We review evidence within constructs of the Negative Valence Systems (NVS) domain, as specified by the Research Domain Criteria framework. Based on published studies, we propose an integrated NVS model of binge-type eating-disorder risk. RESULTS Data implicate altered corticolimbic functioning, neuroendocrine dysregulation, and self-reported negative affect as possible risk factors. However, neuroimaging and physiological data in children and adolescents are sparse, and most prospective studies are limited to self-report measures. CONCLUSIONS We discuss a broad NVS framework for conceptualizing early risk for binge-type eating disorders. Future neural and behavioral research on the developmental trajectory of LOC and binge-type eating disorders is required.
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Affiliation(s)
- Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Eric E. Nelson
- Section on Development and Affective Neuroscience of the National Institute of Mental Health, National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Diana M. Bongiorno
- Section on Development and Affective Neuroscience of the National Institute of Mental Health, National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience of the National Institute of Mental Health, National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS, Bethesda, MD
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29
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Matherne CE, Tanofsky-Kraff M, Altschul AM, Shank LM, Schvey NA, Brady SM, Galescu O, Demidowich AP, Yanovski SZ, Yanovski JA. A preliminary examination of Loss of Control Eating Disorder (LOC-ED) in middle childhood. Eat Behav 2015; 18:57-61. [PMID: 25913008 PMCID: PMC4504801 DOI: 10.1016/j.eatbeh.2015.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 04/02/2015] [Accepted: 04/07/2015] [Indexed: 11/16/2022]
Abstract
Loss of Control Eating Disorder (LOC-ED) has been proposed as a diagnostic category for children 6-12years with binge-type eating. However, characteristics of youth with LOC-ED have not been examined. We tested the hypothesis that the proposed criteria for LOC-ED would identify children with greater adiposity, more disordered eating attitudes, and greater mood disturbance than those without LOC-ED. Participants were 251 youth (10.29years±1.54, 53.8% female, 57.8% White, 35.5% Black, 2.0% Asian, 4.8% Hispanic, 53.0% overweight). Youth were interviewed regarding eating attitudes and behaviors, completed questionnaires to assess general psychopathology, and underwent measurements of body fat mass. Using previously proposed criteria for LOC-ED, children were classified as LOC-ED (n=19), LOC in the absence of the full disorder (subLOC, n=33), and youth not reporting LOC (noLOC, n=199). LOC-ED youth had higher BMIz (p=0.001) and adiposity (p=0.003) and reported greater disordered eating concerns (p<0.001) compared to noLOC youth. Compared to subLOC youth, LOC-ED youth had non-significantly higher BMIz (p=0.11), and significantly higher adiposity (p=0.04) and disordered eating attitudes (p=0.02). SubLOC youth had greater disordered eating concerns (p<0.001) and BMIz (p=0.03) but did not differ in adiposity (p=0.33) compared to noLOC youth. These preliminary data suggest that LOC-ED youth are elevated on disordered eating cognitions and anthropometric measures compared to youth without LOC-ED. Longitudinal studies are needed to determine if those with LOC-ED are at particularly increased risk for progression of disordered eating and excess weight gain.
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Affiliation(s)
- Camden E. Matherne
- Uniformed Services University of the Health Sciences (USUHS),Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Marian Tanofsky-Kraff
- Uniformed Services University of the Health Sciences (USUHS), United States; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, United States.
| | - Anne M. Altschul
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Lisa M. Shank
- Uniformed Services University of the Health Sciences (USUHS),Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Natasha A. Schvey
- Uniformed Services University of the Health Sciences (USUHS),Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Ovidiu Galescu
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS,Obesity and Eating Disorders Program, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, DHHS
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS
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Abstract
The Diagnostic and Statistical Manual of Mental Disorders (i.e., DSM-5) currently recognizes three primary eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. The origins of eating disorders are complex and remain poorly understood. However, emerging research highlights a dimensional approach to understanding the multifactorial etiology of eating disorders as a means to inform assessment, prevention, and treatment efforts. Guided by research published since 2011, this review summarizes recent findings elucidating risk factors for the development of eating disorders across the lifespan in three primary domains: (1) genetic/biological, (2) psychological, and (3) socio-environmental. Prospective empirical research in clinical samples with full-syndrome eating disorders is emphasized with added support from cross-sectional studies, where relevant. The developmental stages of puberty and the transition from adolescence to young adulthood are discussed as crucial periods for the identification and prevention of eating disorders. The importance of continuing to elucidate the mechanisms underlying gene by environmental interactions in eating disorder risk is also discussed. Finally, controversial topics in the field of eating disorder research and the clinical implications of this research are summarized.
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31
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Jarcho JM, Tanofsky-Kraff M, Nelson EE, Engel SG, Vannucci A, Field SE, Romer AL, Hannallah L, Brady SM, Demidowich AP, Shomaker LB, Courville AB, Pine DS, Yanovski JA. Neural activation during anticipated peer evaluation and laboratory meal intake in overweight girls with and without loss of control eating. Neuroimage 2015; 108:343-53. [PMID: 25550068 PMCID: PMC4323624 DOI: 10.1016/j.neuroimage.2014.12.054] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 12/15/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022] Open
Abstract
The interpersonal model of loss of control (LOC) eating proposes that socially distressing situations lead to anxious states that trigger excessive food consumption. Self-reports support these links, but the neurobiological underpinnings of these relationships remain unclear. We therefore examined brain regions associated with anxiety in relation to LOC eating and energy intake in the laboratory. Twenty-two overweight and obese (BMIz: 1.9±0.4) adolescent (15.8±1.6y) girls with LOC eating (LOC+, n=10) and without LOC eating (LOC-, n=12) underwent functional magnetic resonance imaging (fMRI) during a simulated peer interaction chatroom paradigm. Immediately after the fMRI scan, girls consumed lunch ad libitum from a 10,934-kcal laboratory buffet meal with the instruction to "let yourself go and eat as much as you want." Pre-specified hypotheses regarding activation of five regions of interest were tested. Analysis of fMRI data revealed a significant group by peer feedback interaction in the ventromedial prefrontal cortex (vmPFC), such that LOC+ had less activity following peer rejection (vs. acceptance), while LOC- had increased activity (p<.005). Moreover, functional coupling between vmPFC and striatum for peer rejection (vs. acceptance) interacted with LOC status: coupling was positive for LOC+, but negative in LOC- (p<.005). Activity of fusiform face area (FFA) during negative peer feedback from high-value peers also interacted with LOC status (p<.005). A positive association between FFA activation and intake during the meal was observed among only those with LOC eating. In conclusion, overweight and obese girls with LOC eating may be distinguished by a failure to engage regions of prefrontal cortex implicated in emotion regulation in response to social distress. The relationship between FFA activation and food intake supports the notion that heightened sensitivity to incoming interpersonal cues and perturbations in socio-emotional neural circuits may lead to overeating in order to cope with negative affect elicited by social discomfort in susceptible youth.
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Affiliation(s)
- Johanna M Jarcho
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA.
| | - Eric E Nelson
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Scott G Engel
- Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, 700 1st Ave S, Fargo, ND 58103, USA
| | - Anna Vannucci
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Sara E Field
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Adrienne L Romer
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Louise Hannallah
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Sheila M Brady
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Andrew P Demidowich
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Lauren B Shomaker
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Amber B Courville
- Nutrition Department, Clinical Center, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of Health (NIH), 9000 Rockville Pike, Bldg 15K, Bethesda, MD 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 10 Center Dr, Bethesda, MD 20892, USA
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