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Zhong J, Zhang Y, Sun Y, Wang Q, Dong G, Li X. The efficacy of internet-based cognitive behavioral therapy for adult binge spectrum eating disorders: A meta-analysis. J Affect Disord 2024; 361:684-692. [PMID: 38936703 DOI: 10.1016/j.jad.2024.06.084] [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: 02/06/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Internet-Based Cognitive Behavioral Therapy (iCBT) is an innovative modality of cognitive-behavioral intervention that presents a promising therapeutic strategy for individuals diagnosed with binge spectrum eating disorders. This study employed a meta-analysis methodology to assess the clinical effectiveness and acceptability of iCBT. METHODS We conducted searches in databases such as PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO, collecting literature that met the inclusion criteria until August 5, 2023. RESULTS A comprehensive analysis was conducted, encompassing a total of 11 randomized controlled studies that satisfied the predetermined criteria for inclusion. The summary results demonstrated that iCBT could significantly improve the pathological features related to eating in patients with binge spectrum eating disorders and also significantly reduce the frequency of binge episodes. Additionally, iCBT could ameliorate the depressive and anxious emotions of patients with binge spectrum eating disorders and boost their self-esteem. Furthermore, a notable disparity in dropout rates was seen in comparison to the control group. LIMITATION Heterogeneity across studies,limitations of self-assessment scales and potential publication bias. CONCLUSION iCBT can effectively assist patients with binge spectrum eating disorders in improving clinical symptoms. However, it is important to use caution when interpreting the findings of this study, as there are limitations pertaining to the quantity and quality of the included studies.
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Affiliation(s)
- Jianan Zhong
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China
| | - Yihan Zhang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China
| | - Yifan Sun
- Department of Psychology, The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Qi Wang
- Department of Psychiatry and Psychology, General Hospital of Northern Theater Command, Shenyang, China
| | - Guanxi Dong
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China
| | - Xiaobai Li
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, China.
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Solmi M, Monaco F, Højlund M, Monteleone AM, Trott M, Firth J, Carfagno M, Eaton M, De Toffol M, Vergine M, Meneguzzo P, Collantoni E, Gallicchio D, Stubbs B, Girardi A, Busetto P, Favaro A, Carvalho AF, Steinhausen HC, Correll CU. Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis. World Psychiatry 2024; 23:124-138. [PMID: 38214616 PMCID: PMC10785991 DOI: 10.1002/wps.21182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Eating disorders (EDs) are known to be associated with high mortality and often chronic and severe course, but a recent comprehensive systematic review of their outcomes is currently missing. In the present systematic review and meta-analysis, we examined cohort studies and clinical trials published between 1980 and 2021 that reported, for DSM/ICD-defined EDs, overall ED outcomes (i.e., recovery, improvement and relapse, all-cause and ED-related hospitalization, and chronicity); the same outcomes related to purging, binge eating and body weight status; as well as mortality. We included 415 studies (N=88,372, mean age: 25.7±6.9 years, females: 72.4%, mean follow-up: 38.3±76.5 months), conducted in persons with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified feeding and eating disorders (OSFED), and/or mixed EDs, from all continents except Africa. In all EDs pooled together, overall recovery occurred in 46% of patients (95% CI: 44-49, n=283, mean follow-up: 44.9±62.8 months, no significant ED-group difference). The recovery rate was 42% at <2 years, 43% at 2 to <4 years, 54% at 4 to <6 years, 59% at 6 to <8 years, 64% at 8 to <10 years, and 67% at ≥10 years. Overall chronicity occurred in 25% of patients (95% CI: 23-29, n=170, mean follow-up: 59.3±71.2 months, no significant ED-group difference). The chronicity rate was 33% at <2 years, 40% at 2 to <4 years, 23% at 4 to <6 years, 25% at 6 to <8 years, 12% at 8 to <10 years, and 18% at ≥10 years. Mortality occurred in 0.4% of patients (95% CI: 0.2-0.7, n=214, mean follow-up: 72.2±117.7 months, no significant ED-group difference). Considering observational studies, the mortality rate was 5.2 deaths/1,000 person-years (95% CI: 4.4-6.1, n=167, mean follow-up: 88.7±120.5 months; significant difference among EDs: p<0.01, range: from 8.2 for mixed ED to 3.4 for BN). Hospitalization occurred in 26% of patients (95% CI: 18-36, n=18, mean follow-up: 43.2±41.6 months; significant difference among EDs: p<0.001, range: from 32% for AN to 4% for BN). Regarding diagnostic migration, 8% of patients with AN migrated to BN and 16% to OSFED; 2% of patients with BN migrated to AN, 5% to BED, and 19% to OSFED; 9% of patients with BED migrated to BN and 19% to OSFED; 7% of patients with OSFED migrated to AN and 10% to BN. Children/adolescents had more favorable outcomes across and within EDs than adults. Self-injurious behaviors were associated with lower recovery rates in pooled EDs. A higher socio-demographic index moderated lower recovery and higher chronicity in AN across countries. Specific treatments associated with higher recovery rates were family-based therapy, cognitive-behavioral therapy (CBT), psychodynamic therapy, and nutritional interventions for AN; self-help, CBT, dialectical behavioral therapy (DBT), psychodynamic therapy, nutritional and pharmacological treatments for BN; CBT, nutritional and pharmacological interventions, and DBT for BED; and CBT and psychodynamic therapy for OSFED. In AN, pharmacological treatment was associated with lower recovery, and waiting list with higher mortality. These results should inform future research, clinical practice and health service organization for persons with EDs.
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Affiliation(s)
- Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Regional Centre for Treatment of Eating Disorders, and On Track: Champlain First Episode Psychosis Program, Department of Mental Health, Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Francesco Monaco
- Department of Mental Health, Local Health Unit, Salerno, Italy
- European Biomedical Research Institute of Salerno, Salerno, Italy
| | - Mikkel Højlund
- Department of Psychiatry Aabenraa, Mental Health Services in the Region of Southern Denmark, Aabenraa, Denmark; Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Mike Trott
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
- Centre for Public Health, Queen's University, Belfast, UK
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Marco Carfagno
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Melissa Eaton
- NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia; School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- School of Medical, Indigenous and Health Sciences Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Marco De Toffol
- Department of Mental Health, Local Health Unit, Lecce, Italy
| | | | - Paolo Meneguzzo
- Department of Neuroscience, University of Padua, Padua, Italy
| | | | | | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Anna Girardi
- Department of Neuroscience, University of Padua, Padua, Italy
| | - Paolo Busetto
- Provincial Center for Eating Disorders, Local Health Unit, Treviso, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padua, Padua, Italy
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinic, Zurich, Switzerland
- Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
- Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, Northwell Health, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institutes for Medical Research, Manhasset, NY, USA
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Möllmann A, Heinrichs N, Herwig A. A conceptual framework on body representations and their relevance for mental disorders. Front Psychol 2024; 14:1231640. [PMID: 38250111 PMCID: PMC10796836 DOI: 10.3389/fpsyg.2023.1231640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Many mental disorders are accompanied by distortions in the way the own body is perceived and represented (e.g., eating disorders, body dysmorphic disorder including muscle dysmorphia, or body integrity dysphoria). We are interested in the way these distortions develop and aim at better understanding their role in mental health across the lifespan. For this purpose, we first propose a conceptual framework of body representation that defines this construct and integrates different perspectives (e.g., cognitive neuroscience, clinical psychology) on body representations. The framework consists of a structural and a process model of body representation emphasizing different goals: the structural model aims to support researchers from different disciplines to structure results from studies and help collectively accumulate knowledge about body representations and their role in mental disorders. The process model is reflecting the dynamics during the information processing of body-related stimuli. It aims to serve as a motor for (experimental) study development on how distorted body representations emerge and might be changed. Second, we use this framework to review the normative development of body representations as well as the development of mental disorders that relate to body representations with the aim to further clarify the potential transdiagnostic role of body representations.
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Affiliation(s)
- Anne Möllmann
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
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4
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Hamilton A, Smith SR, Lydecker JA. The Relationship of Self-identified Weight Status With Perceived Mental and Physical Health. J Psychiatr Pract 2023; 29:430-438. [PMID: 37948168 PMCID: PMC10653675 DOI: 10.1097/pra.0000000000000744] [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] [Indexed: 11/12/2023]
Abstract
OBJECTIVE This study examined whether individuals with higher weight (body mass index in the overweight or obesity range) self-identified as having overweight or obesity (Ow/Ob). The study also examined whether self-identifying as having Ow/Ob was associated with perceived mental health, perceived physical health, depression, and eating disorder psychopathology. METHODS Four study groups were created: those with Ow/Ob who self-identified as having Ow/Ob (Ow/Ob+), those with Ow/Ob who did not self-identify as having Ow/Ob (Ow/Ob-), those with core features of binge-eating disorder (BED) and Ow/Ob, and those with bulimia nervosa (BN) and Ow/Ob. Analyses of variance compared study groups on perceived health, depression, and eating disorder psychopathology. RESULTS The BED and BN groups were more likely to self-identify as having overweight/obesity compared with Ow/Ob groups without eating disorders. The Ow/Ob- group had the best-perceived health and the lowest levels of eating disorder psychopathology and depression compared with the other groups. The Ow/Ob+ group had better perceived mental health than the BED and BN groups but did not differ significantly from the Ow/Ob- group in perceived mental health. Perceived physical health in the Ow/Ob+ group was better than in the BED group and worse than in the Ow/Ob- group. The Ow/Ob+ group had higher levels of eating disorder psychopathology than the Ow/Ob- group. CONCLUSIONS Self-identifying as having obesity is associated with eating disorder psychopathology as well as poorer perceived mental and physical health. Providers should engage patients in discussions about their weight with the understanding that self-identifying as having overweight or obesity might indicate the presence of eating disorder psychopathology. Future clinical research should investigate the directionality or possible bidirectionality of this relationship.
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5
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Sahlan RN, Saunders JF, Klimek-Johnson P, Convertino AD, Lavender JM, Fitzsimmons-Craft EE, Nagata JM. Validation of a Farsi version of the Eating Disorder Examination Questionnaire (F-EDE-Q) in adolescents and university students from Iran. J Eat Disord 2023; 11:105. [PMID: 37391832 DOI: 10.1186/s40337-023-00830-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Although the Farsi version of the Eating Disorder Examination-Questionnaire (F-EDE-Q) is frequently utilized to assess disordered eating in Iran, its factor structure, reliability, and validity have not been investigated in Iranian samples, which is the aim of the current investigation. METHOD Using convenience sampling, this study recruited 1112 adolescents and 637 university students to complete disordered eating and mental health-focused questionnaires, including the F-EDE-Q. RESULTS Confirmatory factor analyses of the 22 attitudinal items in the F-EDE-Q indicated that a brief seven-item, three-factor model (i.e., Dietary Restraint, Shape/Weight Overvaluation, Body Dissatisfaction with Shape and Weight) was the only factor structure that fit the data well for either sample. This brief version of the F-EDE-Q was invariant across gender, body weight, and age. Adolescent and university participants with higher weight reported higher average scores on each of the three subscales. Subscale scores showed good internal consistency reliability in the two samples. Further, supporting convergent validity, subscales were significantly associated with measures of body image-related preoccupation and bulimia symptoms, as well as measures of other theoretically related constructs including depressive symptoms and self-esteem. CONCLUSION Findings suggest that this brief, validated measure will enable researchers and clinical providers to appropriately assess disordered eating symptoms in adolescent and young adult Farsi-speaking populations.
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Affiliation(s)
- Reza N Sahlan
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo-SUNY, Buffalo, NY, USA
| | | | | | - Alexandra D Convertino
- University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- The Metis Foundation, San Antonio, TX, USA
| | | | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA.
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Sahlan RN, Sala M. Eating disorder psychopathology and resilience in Iranian college students: A network analysis. J Clin Psychol 2023; 79:497-513. [PMID: 35975401 DOI: 10.1002/jclp.23428] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 06/13/2022] [Accepted: 07/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Eating disorder (ED) psychopathology is common among Iranian college students. Resilience (i.e., the ability to bounce back and adapt in the face of adverse and stressful conditions) has been found to be a protective factor against ED psychopathology in the West. However, no research to date has examined resilience as a protective factor against ED psychopathology in Iran. The current study used network analysis to examine an ED and resilience network in an Iranian sample. METHOD Participants were Iranian college students (N = 478) who completed the Farsi-Eating Disorder Examination-Questionnaire and Farsi-Brief Resilience Scale. We estimated a network of ED symptoms and resilience processes and identified central and bridge symptoms. RESULTS Central ED and resilience nodes were discomfort in seeing one's own body, feeling guilty about eating due to shape/weight, and thinking about shape and weight making it difficult to concentrate. Having a hard time making it through stressful events bridged with binge eating and fear of losing control over eating. CONCLUSION Processes related to managing stress and binge eating appear to maintain the association between ED symptoms and resilience processes.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Margaret Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
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7
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Prnjak K, Jukic I, Mitchison D, Griffiths S, Hay P. Body image as a multidimensional concept: A systematic review of body image facets in eating disorders and muscle dysmorphia. Body Image 2022; 42:347-360. [PMID: 35926364 DOI: 10.1016/j.bodyim.2022.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 10/16/2022]
Abstract
Body image disturbance is core to the psychopathology of eating disorders (EDs), and related disorders such as muscle dysmorphia (MD). Global measures of body image fail to quantify specific aspects of body image disturbance that characterizes EDs, and may be differentially associated to outcomes. The aim of this systematic review was to provide an overview of specific body image facets and synthesize findings from controlled studies that compared clinical ED/MD and control-comparison groups in body image disturbance. One-hundred sixty-seven studies met inclusion criteria, and reported on comparisons among 30,584 individuals in 28 body image facets, which were more broadly grouped into evaluative, perceptual, cognitive-affective and motivational categories for the purpose of the present review. Effect sizes were calculated as Cohen's d for every comparison between ED and control groups. Body dissatisfaction (evaluative category) was the most prevalent facet assessed across studies (62 %), and differences between clinical and control groups were the largest in this category, especially for bulimia nervosa (d = 1.37). Scarcity of studies with male and MD clinical samples, and use of single-item and non-validated measures, should encourage development of instruments for body image facets pertinent to EDs and MD that can be validly applied across gender.
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Affiliation(s)
- Katarina Prnjak
- School of Medicine, Western Sydney University, Sydney, Australia.
| | - Ivan Jukic
- Sport Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand; School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Deborah Mitchison
- School of Medicine, Western Sydney University, Sydney, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- School of Psychology, University of Melbourne, Melbourne, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, Australia; Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, Australia
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Zhang X, Li Y, Zhong Y, Wang Z. Variables Associated With Body Image Concerns in Acromegaly Patients: A Cross-Sectional Study. Front Psychol 2022; 13:733864. [PMID: 35756208 PMCID: PMC9226896 DOI: 10.3389/fpsyg.2022.733864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Acromegaly is often characterized by altered physical (including facial) appearance. However, there is little medical or psychological research on body image concerns in patients with acromegaly. The aim of this study was to identify factors influencing the body image distress in patients with acromegaly and to explore the possible effects of stigma on body image concerns. Design Cross-sectional study. Methods A total of 68 individuals with acromegaly were enrolled in the study. A total of 70 persons with nonfunctional pituitary adenomas were randomly recruited as a healthy control group. Using structured questionnaires, we explored perceived body image using the Body Image Concern Inventory. We also used the Hamilton Anxiety Scale, the Stigma Scale for Chronic Illness, the Brief Illness Perception Questionnaire, and the 36-Item Short-Form Health Survey to evaluate health-associated variables and to analyze factors that affect body image concerns in patients with acromegaly. Results Of the 68 participants, 31 were men and 37 women (mean age ± standard deviation: 46.36 ± 12.47 years). The mean body image concern score was 47.49 ± 13.81 for patients with acromegaly and 21.10 ± 7.44 for patients with nonfunctional pituitary adenoma. The difference between the two groups was statistically significant. A multiple stepwise regression analysis showed that the related factors for body image distress were gender (P = 0.001), age at diagnosis (P = 0.01), and internalized stigma (P < 0.001, Adj. R2 = 0.756). Conclusions People with acromegaly have substantial body image concerns, and these concerns are increased by the stigma associated with this disease; such concerns lead to poor quality of life (QoL). Physicians need to find better ways to control patients' hormone levels, and nurses should provide more information on how to improve body image or find ways to reduce patients' body image distress.
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Affiliation(s)
- Xiaomei Zhang
- Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Yanqing Li
- Medical College, Nantong University, Nantong, China
| | - Yueping Zhong
- Department of Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Ziheng Wang
- Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical College, Nantong University, Nantong, China
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Breton É, Dufour R, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Developmental trajectories of eating disorder symptoms: A longitudinal study from early adolescence to young adulthood. J Eat Disord 2022; 10:84. [PMID: 35725645 PMCID: PMC9210773 DOI: 10.1186/s40337-022-00603-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a critical period for the development of eating disorders, but data is lacking on the heterogeneity of their evolution during that time-period. Group-based trajectories can be used to understand how eating disorders emerge and evolve over time. The aim of this study was to identify groups of individuals with distinct levels of eating disorder symptoms between 12 and 20 years and the onset of different types of symptoms. We also studied sex differences in the evolution and course of eating disorder symptoms from early adolescence to adulthood. METHODS Using archival data from the QLSCD cohort, trajectories of eating disorder symptomatology were estimated from ages 12 to 20 years using semiparametric models. These trajectories included overall eating disorder symptomatology as measured by the SCOFF (Sick, Control, One Stone, Fat, Food), sex, and symptom-specific trajectories. RESULTS Two groups of adolescents following distinct trajectories of eating disorder symptoms were identified. The first trajectory group included 30.9% of youth with sharply rising levels between 12 and 15 years, followed by high levels of symptoms between 15 and 20 years. The second trajectory group included 69.1% of youth with low and stable levels of symptoms between 12 and 20 years. Sex-specific models indicated that the proportion of girls in the high trajectory group was 1.3 times higher than the proportion of boys (42.8% girls vs. 32.3% boys). Trajectories of SCOFF items were similar for loss-of-control eating, feeling overweight, and attributing importance to food. The weight loss item had a different developmental pattern, increasing between 12 and 15 years and then decreasing between 17 and 20 years. CONCLUSIONS The largest increase in eating disorder symptoms in adolescence is between the ages of 12 and 15 . Yet, most prevention programs start after 15 years of age. Our findings suggest that, unlike common practices, eating disorder prevention programs should aim to start before puberty.
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Affiliation(s)
- Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada
| | - Rachel Dufour
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,School of Public Health, University of Montreal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, University Laval, Quebec, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada.,Department of Psychology and Pediatrics, University of Montreal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada. .,Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada. .,Department of Psychology, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada. .,Department of Psychiatry, McGill University, Montreal, Canada.
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eLoriCorps Immersive Body Rating Scale and eLoriCorps Mobile Versions: Validation to Assess Body Image Disturbances from Allocentric and Egocentric Perspectives in a Nonclinical Sample of Adolescents. J Clin Med 2022; 11:jcm11051156. [PMID: 35268247 PMCID: PMC8910931 DOI: 10.3390/jcm11051156] [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] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/28/2022] [Accepted: 02/19/2022] [Indexed: 12/17/2022] Open
Abstract
A growing number of studies have used virtual reality (VR) for the assessment and treatment of body image disturbances (BIDs). This study, conducted in a community sample of adolescents, documents the convergent and discriminant validity between (a) the traditional paper-based Figure Rating Scale (paper-based FRS), (b) the VR-based Body Rating Scale (eLoriCorps-IBRS 1.1), and (c) the mobile app-based Body Rating Scale (eLoriCorps-IBRS 1.1-Mobile). A total of 93 adolescents (14 to 18 years old) participated in the study. Body dissatisfaction and body distortion were assessed through the paper-based FRS, the eLoriCorps-IBRS 1.1 and the eLoriCorps-IBRS 1.1-Mobile. Eating disorder symptoms, body image avoidance, and social physique anxiety were also measured. Correlation analyses were performed. Overall, the results showed a good and statistically significant convergence between allocentric perspectives as measured by the paper-based FRS, the eLoriCorps-IBRS 1.1 and the eLoriCorps-IBRS 1.1-Mobile. As expected, the egocentric perspective measured in VR produced different results from the allocentric perspective, and from cognitive–attitudinal–affective dimensions of BIDs, with the exception of body distortion. These differences support the discriminant validity of the egocentric perspective of eLoriCorps-IBRS 1.1 and are consistent with emerging evidence, highlighting a difference between experiencing the body from an egocentric (i.e., the body as a subject) and allocentric (i.e., the body as an object) perspective. The egocentric perspective could reflect a perceptual–sensory–affective construction of BIDs, whereas allocentric measures seem to be more related to a cognitive–affective–attitudinal construction of BIDs. Moreover, the results support the validity of the eLoriCorps-IBRS 1.1-Mobile with promising perspectives of implementation among young populations.
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Body Image, Anxiety, and Bulimic Behavior during Confinement Due to COVID-19 in Mexico. Healthcare (Basel) 2021; 9:healthcare9111435. [PMID: 34828482 PMCID: PMC8618812 DOI: 10.3390/healthcare9111435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/02/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The potential impact of the COVID-19 pandemic on weight, shape-related appearance behaviors (body image dissatisfaction), and bulimic symptoms in nonclinical participants is poorly evaluated. This study aimed to identify the relationship between labor status, confinement degree due to COVID-19, dissatisfaction with body image, and anxiety and to discover its effect on bulimic behavior in Mexican adults. METHODS A cross-sectional study was conducted with a non-probabilistic sample of 276 participants via an online survey. Questions addressed their anxiety, body image dissatisfaction, and bulimic behavior. RESULTS The path analysis showed direct effects on the confinement degree (β = -0.157); of the labor situation (β = -0.147) and gender (β = 0.129) on anxiety; of dissatisfaction on bulimic behavior (β = 0.443) and anxiety about bulimic behavior (β = 0.184); and dissatisfaction (β = 0.085). CONCLUSIONS The confinement, gender, and labor status are predictors of anxiety, while anxiety and body dissatisfaction directly influence bulimic behavior.
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León-Paucar SD, Calderón-Olivos BC, Calizaya-Milla YE, Saintila J. Depression, dietary intake, and body image during coronavirus disease 2019 quarantine in Peru: An online cross-sectional study. SAGE Open Med 2021; 9:20503121211051914. [PMID: 34659768 PMCID: PMC8511913 DOI: 10.1177/20503121211051914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/21/2021] [Indexed: 01/07/2023] Open
Abstract
Objective: The coronavirus disease 2019 affects the psychological well-being of
populations. In the same way, it can be a potential threat to body image.
The aim of the study was to explore associations between depressive
symptoms, dietary intake, and body image during coronavirus disease 2019
quarantine. Methods: An online cross-sectional study was conducted in 589 Peruvian adults, 297 men
(50.4%) and 292 women (49.6%). The mean age was 30.2 ± 9.4 years (range:
18–59 years). Participants completed three questionnaires, including a food
frequency questionnaire, the Body Shape Questionnaire, and the Patient
Health Questionnaire-9. Moreover, sociodemographic data were collected. The
data were analyzed using the statistical software IBM SPSS version 24, and
the chi-square test was used. A significance level of 5% was considered. Results: A total of 37.7% and 43.6% of the women reported depressive symptoms and
dissatisfaction with body image, respectively. Depressive symptoms were
associated with dietary intake and dissatisfaction with body image
(p < 0.05). Dissatisfaction with body image was associated with dietary
intake (p < 0.01). Conclusions: Depressive symptomatology plays an important role in the dietary intake and
body image of the study population. It is suggested to address these factors
through the implementation of health campaign programs and personalized
therapeutic interventions.
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Affiliation(s)
- Sheyla D León-Paucar
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú
| | - Bella C Calderón-Olivos
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú
| | - Yaquelin E Calizaya-Milla
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú.,Grupo de Investigación en Nutrición y Estilos de Vida (GINEV), Universidad Peruana Unión, Lima, Perú
| | - Jacksaint Saintila
- Escuela de Nutrición Humana, Facultad de Ciencias de la Salud, Universidad Peruana Unión, Lima, Perú.,Grupo de Investigación en Nutrición y Estilos de Vida (GINEV), Universidad Peruana Unión, Lima, Perú
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Lydecker JA, Cotter EW, Grilo CM. Distinctiveness and significance of body dissatisfaction and overvaluation among Latinx/Hispanic and White men and women. Int J Eat Disord 2021; 54:354-364. [PMID: 33247450 PMCID: PMC7956228 DOI: 10.1002/eat.23413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To examine the distinctiveness and significance of two body image constructs, dissatisfaction with weight and shape and overvaluation of weight and shape, with respect to eating disorder psychopathology, weight, and depression in White and Latinx/Hispanic men and women. METHODS Participants were White (n = 1,941) and Latinx/Hispanic (n = 568) adults living in the United States who completed an online battery of established measures of body image, eating disorder psychopathology and behaviors, and depression. RESULTS Two body image constructs, dissatisfaction with weight and shape and overvaluation of weight and shape, were related to each other but showed some important distinctions in their associations with eating- and weight-related variables. Significantly greater proportions of White than Latinx/Hispanic individuals reported co-occurring dissatisfaction and overvaluation, and significantly greater proportions of Latinx/Hispanic than White individuals reported dissatisfaction alone. Ethnicity moderated the association of dissatisfaction and overvaluation with body mass index (BMI), and the association of overvaluation with depression. Ethnicity also had a main effect on binge-eating frequency. CONCLUSIONS Dissatisfaction and overvaluation were distinct among both Latinx/Hispanic and White individuals. However, associations with eating- and weight-related variables varied between ethnicities, suggesting a need for further research on the influence of cultural variables on body image and eating disorder psychopathology.
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Affiliation(s)
| | | | - Carlos M. Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT,Department of Psychology, Yale University, New Haven, CT
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Mazurkiewicz N, Krefta J, Lipowska M. Attitudes Towards Appearance and Body-Related Stigma Among Young Women With Obesity and Psoriasis. Front Psychiatry 2021; 12:788439. [PMID: 34858238 PMCID: PMC8631861 DOI: 10.3389/fpsyt.2021.788439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 10/18/2021] [Indexed: 01/24/2023] Open
Abstract
The goal of this study was to investigate the role of the subjective assessment of one's body image in the relationship between objective indices of appearance and perceived stigma in young women affected by obesity and psoriasis. These are chronic diseases that decrease one's physical attractiveness and are associated with stigmas related to body defects. A total of 188 women in early adulthood took part in the study (M = 25.58; SD = 2.90), including obese women (n = 54), women suffering from psoriasis (n = 57), and a control group (n = 77). The participants completed the Multidimensional Body-Self Relations Questionnaire, Perceived Stigmatisation Questionnaire, and a socio-demographic questionnaire. Anthropometric data were gathered using a body composition analyzer. Objective parameters of body shape were calculated (WHR and ICO). Subjective assessment of one's body and attitudes towards one's body were found to influence perceived stigma, independently of the condition causing the stigma and of the objective appearance of the participant. This study did not support the existence of a relationship between parameters regarding body shape and sense of stigma, even when subjective body assessment acted as a moderator. At the same time, body mass was a strong predictor of levels of perceived stigma. Women affected with obesity perceived a higher level of stigma than the other groups. The severity of psoriasis did not impact the perceived stigma. Moreover, women with psoriasis assessed their health-as a part of the assessment of their bodies-the highest, which may explain the lower perceived stigma in this group.
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