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Schroeder PA, Collantoni E, Lohmann J, Butz MV, Plewnia C. Virtual reality assessment of a high-calorie food bias: Replication and food-specificity in healthy participants. Behav Brain Res 2024; 471:115096. [PMID: 38849007 DOI: 10.1016/j.bbr.2024.115096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 05/07/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Theoretical models and behavioural studies indicate faster approach behaviour for high-calorie food (approach bias) among healthy participants. A previous study with Virtual Reality (VR) and online motion-capture quantified this approach bias towards food and non-food cues in a controlled VR environment with hand movements. The aim of this study was to test the specificity of a manual approach bias for high-calorie food in grasp movements compared to low-calorie food and neutral objects of different complexity, namely, simple balls and geometrically more complex office tools. METHODS In a VR setting, healthy participants (N = 27) repeatedly grasped or pushed high-calorie food, low-calorie food, balls and office tools in randomized order with 30 item repetitions. All objects were rated for valence and arousal. RESULTS High-calorie food was less attractive and more arousing in subjective ratings than low-calorie food and neutral objects. Movement onset was faster for high-calorie food in push-trials, but overall push responses were comparable. In contrast, responses to high-calorie food relative to low-calorie food and to control objects were faster in grasp trials for later stages of interaction (grasp and collect). Non-parametric tests confirmed an approach bias for high-calorie food. CONCLUSION A behavioural bias for food was specific to high-calorie food objects. The results confirm the presence of bottom-up advantages in motor-cognitive behaviour for high-calorie food in a non-clinical population. More systematic variations of object fidelity and in clinical populations are outstanding. The utility of VR in assessing approach behaviour is confirmed in this study by exploring manual interactions in a controlled environment.
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Affiliation(s)
- Philipp A Schroeder
- Department of Psychology, University of Tübingen, Schleichstr. 4, Tübingen 72076, Germany; German Center for Mental Health (DZPG), Germany.
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Johannes Lohmann
- Cognitive Modeling, Department of Computer Science, University of Tübingen, Sand 14, Tübingen 72076, Germany
| | - Martin V Butz
- Department of Psychology, University of Tübingen, Schleichstr. 4, Tübingen 72076, Germany; Cognitive Modeling, Department of Computer Science, University of Tübingen, Sand 14, Tübingen 72076, Germany
| | - Christian Plewnia
- German Center for Mental Health (DZPG), Germany; Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstr. 14, Tübingen 72076, Germany
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2
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Gillespie KM, Dymond AH, Li X, Schweitzer D, Branjerdporn G, Khan S, Hii Q, Keller S, Bartlett SE. A Systematic Review and Narrative Synthesis of Cognitive Training in the Treatment of Mental Illness and Substance Use Disorder. J Clin Med 2024; 13:4348. [PMID: 39124616 PMCID: PMC11312778 DOI: 10.3390/jcm13154348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
Introduction: The one unifying and distinguishing feature of all neuropsychiatric illnesses is the co-occurrence of cognitive dysfunction. Cognitive training (CT) was developed to enhance neural connectivity and cognition and improve day-to-day functioning. However, the benefits of CT are still debated. This current systematic review aimed to examine the efficacy of CT and to identify diagnostic and CT characteristics associated with superior outcomes across a range of psychiatric disorders. Method: Studies investigating CT in psychiatric illnesses were extracted from Embase, PubMed, CINAHL, PsycINFO, and PsycARTICLES up to 17 August 2023. Inclusion criteria were randomised control trials (RCT) and English language. The primary search strategy included terms relating to cognitive training, cognitive remediation, cognitive enhancement, or cognitive rehabilitation and randomised control trials, clinical trials, or experiments. Risk of bias was assessed using RevMan Web version 8.1.1. Narrative synthesis was used to analyse findings. Due to the heterogeneity of participant demographics, diagnoses, and interventions, meta-analyses were considered inappropriate. Results: Fifteen studies, including a total of 1075 participants, were identified. Approximately 67% of studies reported significant improvements in at least one trained domain of cognitive function after CT, and 47% observed improvements in psychiatric symptoms or function. Cognitive transfer effects were not observed. Sample sizes for studies were generally small, and most CT durations were 6 weeks or less. Conclusions: Findings suggest that CT can improve cognitive function in trained domains, though little evidence of cognitive transfer effects was observed. Due to the lack of standardisation in CT format and delivery, and inadequate measures of psychiatric symptoms or daily function, there is insufficient evidence to conclude whether or not this technique may benefit cognitive impairment in psychiatric disorders, or lead to subsequent improvement in disease symptomatology. Further studies of longer duration and using consistent methodologies must be conducted to identify the benefits of CT in psychiatric disorders.
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Affiliation(s)
- Kerri M. Gillespie
- School of Clinical Sciences, Translational Research Institute, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
| | - Alexander H. Dymond
- Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (A.H.D.); (S.K.)
| | - Xin Li
- Mater Hospital, South Brisbane, QLD 4101, Australia; (X.L.); (D.S.); (G.B.)
| | - Daniel Schweitzer
- Mater Hospital, South Brisbane, QLD 4101, Australia; (X.L.); (D.S.); (G.B.)
| | - Grace Branjerdporn
- Mater Hospital, South Brisbane, QLD 4101, Australia; (X.L.); (D.S.); (G.B.)
| | - Saleha Khan
- Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; (A.H.D.); (S.K.)
| | - Quang Hii
- Forensic and Secure Services, The Park—Centre for Mental Health, Wacol, QLD 4076, Australia; (Q.H.); (S.K.)
| | - Suzie Keller
- Forensic and Secure Services, The Park—Centre for Mental Health, Wacol, QLD 4076, Australia; (Q.H.); (S.K.)
| | - Selena E. Bartlett
- School of Clinical Sciences, Translational Research Institute, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
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3
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Norton B, Sheen J, Burns L, Enticott PG, Fuller-Tyszkiewicz M, Kirkovski M. Overlap of eating disorders and neurodivergence: the role of inhibitory control. BMC Psychiatry 2024; 24:454. [PMID: 38890597 PMCID: PMC11186180 DOI: 10.1186/s12888-024-05837-6] [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: 01/09/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Difficulties with inhibitory control have been identified in eating disorders (EDs) and neurodevelopmental disorders (NDs; including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder), and there appear to be parallels between the expression of these impairments. It is theorised that impairments in inhibitory control within NDs may represent a unique vulnerability for eating disorders (EDs), and this same mechanism may contribute to poorer treatment outcomes. This review seeks to determine the state of the literature concerning the role of inhibitory control in the overlap of EDs and neurodivergence. METHOD A scoping review was conducted to summarise extant research, and to identify gaps in the existing knowledge base. Scopus, Medline, PsycInfo, Embase, and ProQuest were systematically searched. Studies were included if the study measured traits of ADHD or autism, and symptoms of ED, and required participants to complete a performance task measure of inhibitory control. Where studies included a cohort with both an ND and ED, these results had to be reported separately from cohorts with a singular diagnosis. Studies were required to be published in English, within the last 10 years. RESULTS No studies explored the relationship between autism and EDs using behavioural measures of inhibitory control. Four studies exploring the relationship between ADHD and EDs using behavioural measures of inhibitory control met selection criteria. These studies showed a multifaceted relationship between these conditions, with differences emerging between domains of inhibitory control. ADHD symptoms predicted poorer performance on measures of response inhibition in a non-clinical sample; this was not replicated in clinical samples, nor was there a significant association with EDs. Both ADHD and ED symptoms are associated with poor performance on attentional control measures; where these diagnoses were combined, performance was worse than for those with a singular diagnosis of ADHD. This was not replicated when compared to those with only ED diagnoses. CONCLUSION Impairments in attentional control may represent a unique vulnerability for the development of an ED and contribute to poor treatment outcomes. Further research is needed to explore the role of inhibitory control in EDs, ADHD and autism, including the use of both self-report and behavioural measures to capture the domains of inhibitory control.
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Affiliation(s)
- Bethany Norton
- School of Psychology, Deakin University, Geelong, Australia.
| | - Jade Sheen
- School of Psychology, Deakin University, Geelong, Australia
| | - Lewis Burns
- School of Psychology, Deakin University, Geelong, Australia
| | | | | | - Melissa Kirkovski
- School of Psychology, Deakin University, Geelong, Australia.
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
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Norris ML, Obeid N, El-Emam K. Examining the role of artificial intelligence to advance knowledge and address barriers to research in eating disorders. Int J Eat Disord 2024; 57:1357-1368. [PMID: 38597344 DOI: 10.1002/eat.24215] [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] [Received: 11/17/2023] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To provide a brief overview of artificial intelligence (AI) application within the field of eating disorders (EDs) and propose focused solutions for research. METHOD An overview and summary of AI application pertinent to EDs with focus on AI's ability to address issues relating to data sharing and pooling (and associated privacy concerns), data augmentation, as well as bias within datasets is provided. RESULTS In addition to clinical applications, AI can utilize useful tools to help combat commonly encountered challenges in ED research, including issues relating to low prevalence of specific subpopulations of patients, small overall sample sizes, and bias within datasets. DISCUSSION There is tremendous potential to embed and utilize various facets of artificial intelligence (AI) to help improve our understanding of EDs and further evaluate and investigate questions that ultimately seek to improve outcomes. Beyond the technology, issues relating to regulation of AI, establishing ethical guidelines for its application, and the trust of providers and patients are all needed for ultimate adoption and acceptance into ED practice. PUBLIC SIGNIFICANCE Artificial intelligence (AI) offers a promise of significant potential within the realm of eating disorders (EDs) and encompasses a broad set of techniques that offer utility in various facets of ED research and by extension delivery of clinical care. Beyond the technology, issues relating to regulation, establishing ethical guidelines for application, and the trust of providers and patients are needed for the ultimate adoption and acceptance of AI into ED practice.
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Affiliation(s)
- Mark L Norris
- Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, Ontario, Canada
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Nicole Obeid
- CHEO Research Institute, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Khaled El-Emam
- CHEO Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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5
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Firth J, Torous J, López-Gil JF, Linardon J, Milton A, Lambert J, Smith L, Jarić I, Fabian H, Vancampfort D, Onyeaka H, Schuch FB, Firth JA. From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions. World Psychiatry 2024; 23:176-190. [PMID: 38727074 PMCID: PMC11083903 DOI: 10.1002/wps.21188] [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: 05/13/2024] Open
Abstract
In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.
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Affiliation(s)
- Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - John Torous
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - José Francisco López-Gil
- One Health Research Group, Universidad de las Americas, Quito, Ecuador
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jake Linardon
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Alyssa Milton
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Australian Research Council, Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | | | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ivan Jarić
- Laboratoire Ecologie, Systématique et Evolution, Université Paris-Saclay, Gif-sur-Yvette, France
- Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Hannah Fabian
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Health Sciences, Universidad Autônoma de Chile, Providência, Chile
| | - Josh A Firth
- Department of Biology, University of Oxford, Oxford, UK
- School of Biology, University of Leeds, Leeds, UK
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Pedra Cruz Bettin B, Urquiza Nogueira L, Bertasso de Araujo PA, Antunes LC. Visual art- and music-based interventions as adjuvants in the treatment of eating disorders: a systematic review and a theoretical model. Arts Health 2024; 16:167-188. [PMID: 37259246 DOI: 10.1080/17533015.2023.2218408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/13/2023] [Indexed: 06/02/2023]
Abstract
AIM To assess the effect of visual art- and music-based interventions in the treatment of eating disorders. METHODS This study was registered in PROSPERO (CRD42020161503). Six databases (CINAHL, EMBASE, Lilacs, PsycINFO, PubMed and The Cochrane Library) were consulted. The searches were performed on 19 June 2019, and updated on 18 March 2022. No restriction on language, date, or publication status was applied. Methodological quality was assessed using Joanna Briggs Institute's instruments. All steps were performed by two independent reviewers and a third participated in the event of disagreement. RESULTS Eight studies were included. Few statistically significant results were found. Overall, both interventions might help to reduce negative emotional states. CONCLUSION Visual art- and music-based interventions present limited and inconclusive scientific evidence in patients with eating disorders and therefore their effectiveness is currently unknown. A theoretical model is proposed to guide future research. Further studies are needed to clarify their clinical relevance.
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Affiliation(s)
- Bibiana Pedra Cruz Bettin
- Multiprofessional Residency in Family Health, University of Santa Catarina State, Florianópolis, SC, Brazil
| | - Lauriana Urquiza Nogueira
- Multiprofessional Residency in Family Health, University of Santa Catarina State, Florianópolis, SC, Brazil
| | | | - Luciana C Antunes
- Health Sciences Center, Department of Nutrition, Clinical Nutrition Division, Federal University of Santa Catarina, SC, Brazil
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Zhu LY, Trolio V, Miller AE, Bicaker E, Racine SE. Daily instability in body dissatisfaction in individuals with and without eating disorders. Body Image 2024; 49:101688. [PMID: 38442437 DOI: 10.1016/j.bodyim.2024.101688] [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: 08/11/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
Body dissatisfaction (BD) includes negative thoughts and feelings about one's body shape. Although typically assessed as a trait, BD has been found to fluctuate within a day. The present study examined whether daily instability in BD differs according to trait BD, eating disorder (ED) diagnosis, and engagement in maladaptive exercise. Participants with EDs (n = 166) and controls (n = 44) completed a self-report measure of trait BD and reported BD and engagement in maladaptive exercise five times daily for 14 days as part of an ecological momentary assessment protocol. BD instability was calculated as adjusted mean squared successive difference. On average across assessments, participants with EDs reported a 16% change in their BD ratings between consecutive assessments, which was significantly higher than the 12% change in controls. Trait BD was significantly inversely associated with BD instability in individuals with EDs, but not in controls. BD instability did not differ across ED diagnoses or between days with versus without maladaptive exercise. Findings suggest that BD is a dynamic state that varies within a day, especially in participants with EDs. Further research is needed to clarify whether this heightened instability in BD is a clinically relevant factor underlying ED symptoms.
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Affiliation(s)
- Lisa Y Zhu
- Department of Psychology, McGill University, Canada
| | | | | | - Ege Bicaker
- Department of Psychology, McGill University, Canada
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8
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Brooks SJ, Dahl K, Dudley-Jones R, Schiöth HB. A neuroinflammatory compulsivity model of anorexia nervosa (NICAN). Neurosci Biobehav Rev 2024; 159:105580. [PMID: 38417395 DOI: 10.1016/j.neubiorev.2024.105580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 03/01/2024]
Affiliation(s)
- S J Brooks
- Department of Surgical Sciences, Uppsala University, Sweden; School of Psychology, Liverpool John Moores University, UK; Neuroscience Research Laboratory (NeuRL), Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
| | - K Dahl
- Department of Surgical Sciences, Uppsala University, Sweden
| | - R Dudley-Jones
- School of Psychology, Liverpool John Moores University, UK
| | - H B Schiöth
- Department of Surgical Sciences, Uppsala University, Sweden
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9
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Stonawski V, Mai-Lippold SA, Graap H, Moll GH, Kratz O, Van Doren J, Horndasch S. Processing of food stimuli in anorexia nervosa: An ERP-study comparing adolescents and adults. EUROPEAN EATING DISORDERS REVIEW 2024; 32:281-297. [PMID: 37850962 DOI: 10.1002/erv.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/09/2023] [Accepted: 10/01/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is associated with altered processing of disorder-relevant stimuli. Event-related potentials (ERP) - such as the Late Positive Potential (LPP) - give information about the underlying mechanisms of central nervous stimulus processing. METHODS Patients with AN (22 adolescents, 23 adults) and healthy controls (HCs; 17 adolescents, 24 adults) were included. Neutral, low, and high calorie food-images were rated for valence and arousal; EEG activity was recorded and LPPs (early: 350-700 ms; late: 800-1200 ms) were extracted. Effects of patient status, age group, and stimulus category were analyzed via mixed 2 × 2 × 3-AN(C)OVAs. RESULTS Patients with AN rated high calorie stimuli lower in valence and higher in arousal than HCs. Controlling for hunger, food stimuli elicited higher early LPPs than neutral ones in patients and HCs. For the late LPP, patients with AN showed larger amplitudes. CONCLUSION Results suggest a highly automatic attentional bias towards low-calorie foods. Patients with AN seem to have more intense cognitive processing independent of stimulus material. More research is needed to validate and clarify differences between early and late LPP measures as well as the operationalization and relevance of hunger status.
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Affiliation(s)
- Valeska Stonawski
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sandra A Mai-Lippold
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Holmer Graap
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jessica Van Doren
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stefanie Horndasch
- Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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10
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Rösch SA, Schmidt R, Hilbert A. Predictors of neurofeedback treatment outcome in binge-eating disorder: An exploratory study. Int J Eat Disord 2023; 56:2283-2294. [PMID: 37737523 DOI: 10.1002/eat.24062] [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] [Received: 05/10/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE Knowledge on predictors for treatment response to psychotherapy in binge-eating disorder (BED) is mixed and not yet available for increasingly popular neurofeedback (NF) treatment targeting self-regulation of aberrant brain activity. This study examined eating disorder- and psychopathology-related predictors for NF treatment success in BED. METHOD Patients with BED (N = 78) were randomized to 12 sessions of real-time functional near-infrared spectroscopy (rtfNIRS)-NF, targeting individual prefrontal cortex signal up-regulation, electroencephalography (EEG)-NF, targeting down-regulation of fronto-central beta activity, or waitlist (WL). The few studies assessing predictors for clinical outcomes after NF and evidenced predictors for psychotherapy guided the selection of baseline eating disorder-related predictors, including objective binge-eating (OBE) frequency, eating disorder psychopathology (EDP), food cravings, and body mass index (BMI), and general psychopathology-related predictors, including depressive and anxiety symptoms, impulsivity, emotion dysregulation, and self-efficacy. These questionnaire-based or objectively assessed (BMI) predictors were regressed on outcomes OBE frequency and EDP as key features of BED at post-treatment (t1) and 6-month follow-up (t2) in preregistered generalized mixed models (https://osf.io/4aktp). RESULTS Higher EDP, food cravings, and BMI predicted worse outcomes across all groups at t1 and t2. General psychopathology-related predictors did not predict outcomes at t1 and t2. Explorative analyses indicated that lower OBE frequency and higher self-efficacy predicted lower OBE frequency, and lower EDP predicted lower EDP after the waiting period in WL. DISCUSSION Consistent with findings for psychotherapy, higher eating disorder-related predictors were associated with higher EDP and OBE frequency. The specificity of psychopathological predictors for NF treatment success warrants further examination. PUBLIC SIGNIFICANCE This exploratory study firstly assessed eating disorder- and psychopathology-related predictors for neurofeedback treatment outcome in binge-eating disorder and overweight. Findings showed an association between higher eating disorder symptoms and worse neurofeedback outcomes, indicating special needs to be considered in neurofeedback treatment for patients with a higher binge-eating disorder symptom burden. In general, outcomes and assignment to neurofeedback treatment may be improved upon consideration of baseline psychological variables.
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Affiliation(s)
- Sarah A Rösch
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
- International Max Planck Research School NeuroCom, Leipzig, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Leipzig University Medical Center, Leipzig, Germany
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11
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Forester G, Johnson JS, Reilly EE, Lloyd EC, Johnson E, Schaefer LM. Back to the future: Progressing memory research in eating disorders. Int J Eat Disord 2023; 56:2032-2048. [PMID: 37594119 PMCID: PMC10843822 DOI: 10.1002/eat.24045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Human behaviors, thoughts, and emotions are guided by memories of the past. Thus, there can be little doubt that memory plays a fundamental role in the behaviors (e.g., binging), thoughts (e.g., body-image concerns), and emotions (e.g., guilt) that characterize eating disorders (EDs). Although a growing body of research has begun to investigate the role of memory in EDs, this literature is limited in numerous ways and has yet to be integrated into an overarching framework. METHODS In the present article, we provide an operational framework for characterizing different domains of memory, briefly review existing ED memory research within this framework, and highlight crucial gaps in the literature. RESULTS We distinguish between three domains of memory-episodic, procedural, and working-which differ based on functional attributes and underlying neural systems. Most recent ED memory research has focused on procedural memory broadly defined (e.g., reinforcement learning), and findings within all three memory domains are highly mixed. Further, few studies have attempted to assess these different domains simultaneously, though most behavior is achieved through coordination and competition between memory systems. We, therefore, offer recommendations for how to move ED research forward within each domain of memory and how to study the interactions between memory systems, using illustrative examples from other areas of basic and clinical research. DISCUSSION A stronger and more integrated understanding of the mechanisms that connect memory of past experiences to present ED behavior may yield more comprehensive theoretical models of EDs that guide novel treatment approaches. PUBLIC SIGNIFICANCE Memories of previous eating-related experiences may contribute to the onset and maintenance of eating disorders (EDs). However, research on the role of memory in EDs is limited, and distinct domains of ED memory research are rarely connected. We, therefore, offer a framework for organizing, progressing, and integrating ED memory research, to provide a better foundation for improving ED treatment and intervention going forward.
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Affiliation(s)
- Glen Forester
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Jeffrey S. Johnson
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Erin E. Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - E. Caitlin Lloyd
- Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Emily Johnson
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
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12
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Meregalli V, Tenconi E, Cardi V, Bonifanti A, Meneguzzo P, Favaro A, Collantoni E. Strategic avoidance of food stimuli in patients with restrictive anorexia nervosa: An eye-tracking evaluation. EUROPEAN EATING DISORDERS REVIEW 2023; 31:813-821. [PMID: 37408111 DOI: 10.1002/erv.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE A biased attentional processing of food stimuli may represent a disorder maintenance factor in patients with anorexia nervosa (AN). The present study aimed at investigating the temporal course of attentional deployment towards both high-calorie and low-calorie foods in patients with AN using eye-tracking. METHOD Fifty-two patients with restrictive AN and 54 healthy controls (HC) performed a dot-probe task while their gaze was recorded with an eye-tracking system. The direction bias (percentage of trials in which the gaze was directed towards the food at first fixation, 500, and 1500 ms), and the duration bias (percentage of time spent looking at the food) were extracted. RESULTS Regarding the direction bias, a group by time interaction emerged (F = 3.29, p = 0.038): while in the control group the bias continued to increase over the course of the trial, patients with AN showed a reduction of the bias between the 500 and 1500 ms. No group differences were observed on the duration bias. CONCLUSIONS In advanced stages of attentional deployment patients with AN start to differ from HC by diverting their attention away from food stimuli, a strategic process that may contribute to food avoidance and calorie restriction.
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Affiliation(s)
- Valentina Meregalli
- Department of Neuroscience, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Valentina Cardi
- Department of General Psychology, University of Padua, Padova, Italy
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | | | - Paolo Meneguzzo
- Department of Neuroscience, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
- Department of Medicine, University of Padua, Padova, Italy
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13
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Bektas S, Natali L, Rowlands K, Valmaggia L, Di Pietro J, Mutwalli H, Himmerich H, Treasure J, Cardi V. Exploring Correlations of Food-Specific Disgust with Eating Disorder Psychopathology and Food Interaction: A Preliminary Study Using Virtual Reality. Nutrients 2023; 15:4443. [PMID: 37892518 PMCID: PMC10609698 DOI: 10.3390/nu15204443] [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: 09/13/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
The emotion of disgust is thought to play a critical role in maintaining restrictive eating among individuals with anorexia nervosa. This exploratory cross-sectional study examined correlations between food-specific trait and state disgust, eating disorder psychopathology, illness severity (body mass index: BMI), and interactions with virtual foods in people with anorexia nervosa. Food-specific trait disgust and eating disorder symptoms were measured before exposure to virtual foods in one of three virtual reality (VR) kitchens to which participants were randomly allocated. Food interactions (eye gaze and reaching towards virtual foods) were measured during the VR exposure. Food-specific state disgust ratings were collected after the VR exposure. In the entire sample, eating disorder symptoms correlated positively with food-specific trait disgust (rs (68) = 0.45, p < 0.001). We also found a significant association between food-specific state disgust and eating disorder symptoms in each virtual kitchen scenario: virtual kitchen only (rs (22) = 0.40, p = 0.05), virtual kitchen plus pet (rs (22) = 0.80, p < 0.001), and virtual kitchen plus avatar (rs (20) = 0.78, p < 0.001). No significant correlation was observed for the link between food-specific disgust measures and food-related touch. Correlations between food-specific trait disgust and food-related eye gaze differed across scenarios. The current experimental paradigm needs to be improved to draw firm conclusions. Both food-specific trait and state disgust are associated with eating disorder psychopathology, and therefore, effective strategies are warranted to attenuate food-specific disgust.
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Affiliation(s)
- Sevgi Bektas
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- Department of Psychology, Hacettepe University, Ankara 06800, Türkiye
| | - Ludovica Natali
- Department of General Psychology, University of Padova, 35122 Padova, Italy
| | - Katie Rowlands
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (L.V.); (J.D.P.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AB, UK
- Department of Psychiatry, KU Leuven, 3000 Leuven, Belgium
| | - Jerome Di Pietro
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (L.V.); (J.D.P.)
| | - Hiba Mutwalli
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AB, UK
| | - Janet Treasure
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AB, UK
| | - Valentina Cardi
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- Department of General Psychology, University of Padova, 35122 Padova, Italy
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14
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Mountjoy M, Ackerman KE, Bailey DM, Burke LM, Constantini N, Hackney AC, Heikura IA, Melin A, Pensgaard AM, Stellingwerff T, Sundgot-Borgen JK, Torstveit MK, Jacobsen AU, Verhagen E, Budgett R, Engebretsen L, Erdener U. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med 2023; 57:1073-1097. [PMID: 37752011 DOI: 10.1136/bjsports-2023-106994] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/28/2023]
Abstract
Relative Energy Deficiency in Sport (REDs) was first introduced in 2014 by the International Olympic Committee's expert writing panel, identifying a syndrome of deleterious health and performance outcomes experienced by female and male athletes exposed to low energy availability (LEA; inadequate energy intake in relation to exercise energy expenditure). Since the 2018 REDs consensus, there have been >170 original research publications advancing the field of REDs science, including emerging data demonstrating the growing role of low carbohydrate availability, further evidence of the interplay between mental health and REDs and more data elucidating the impact of LEA in males. Our knowledge of REDs signs and symptoms has resulted in updated Health and Performance Conceptual Models and the development of a novel Physiological Model. This Physiological Model is designed to demonstrate the complexity of either problematic or adaptable LEA exposure, coupled with individual moderating factors, leading to changes in health and performance outcomes. Guidelines for safe and effective body composition assessment to help prevent REDs are also outlined. A new REDs Clinical Assessment Tool-Version 2 is introduced to facilitate the detection and clinical diagnosis of REDs based on accumulated severity and risk stratification, with associated training and competition recommendations. Prevention and treatment principles of REDs are presented to encourage best practices for sports organisations and clinicians. Finally, methodological best practices for REDs research are outlined to stimulate future high-quality research to address important knowledge gaps.
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Affiliation(s)
- Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
- Games Group, International Olympic Committee, Lausanne, Switzerland
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Naama Constantini
- Sports Medicine Center, Shaare Zedek Medical Center, The Hebrew University, Jerusalem, Israel
| | - Anthony C Hackney
- Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ida Aliisa Heikura
- Canada Sport Institute Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Anna Melin
- Department of Sport Science - Swedish Olympic Committee Research Fellow, Linnaeus University, Kalmar, Sweden
| | - Anne Marte Pensgaard
- Department of Sport and Social Sciences, Norwegian School of Sports Sciences, Oslo, Norway
| | - Trent Stellingwerff
- Canada Sport Institute Pacific, Victoria, British Columbia, Canada
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | | | | | | | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Science, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Uğur Erdener
- Department of Ophthalmology, Hacettepe University, Ankara, Turkey
- World Archery, Lausanne, Switzerland
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15
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Colton E, Wilson KE, Chong TTJ, Verdejo-Garcia A. Dysfunctional decision-making in binge-eating disorder: A meta-analysis and systematic review. Neurosci Biobehav Rev 2023; 152:105250. [PMID: 37263530 DOI: 10.1016/j.neubiorev.2023.105250] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/03/2023]
Abstract
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
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Affiliation(s)
- Emily Colton
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia.
| | - Kira-Elise Wilson
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Trevor T-J Chong
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
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16
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Ackerman KE, Rogers MA, Heikura IA, Burke LM, Stellingwerff T, Hackney AC, Verhagen E, Schley S, Saville GH, Mountjoy M, Holtzman B. Methodology for studying Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the International Olympic Committee (IOC) consensus on REDs. Br J Sports Med 2023; 57:1136-1147. [PMID: 37752010 DOI: 10.1136/bjsports-2023-107359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/28/2023]
Abstract
In the past decade, the study of relationships among nutrition, exercise and the effects on health and athletic performance, has substantially increased. The 2014 introduction of Relative Energy Deficiency in Sport (REDs) prompted sports scientists and clinicians to investigate these relationships in more populations and with more outcomes than had been previously pursued in mostly white, adolescent or young adult, female athletes. Much of the existing physiology and concepts, however, are either based on or extrapolated from limited studies, and the comparison of studies is hindered by the lack of standardised protocols. In this review, we have evaluated and outlined current best practice methodologies to study REDs in an attempt to guide future research.This includes an agreement on the definition of key terms, a summary of study designs with appropriate applications, descriptions of best practices for blood collection and assessment and a description of methods used to assess specific REDs sequelae, stratified as either Preferred, Used and Recommended or Potential Researchers can use the compiled information herein when planning studies to more consistently select the proper tools to investigate their domain of interest. Thus, the goal of this review is to standardise REDs research methods to strengthen future studies and improve REDs prevention, diagnosis and care.
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Affiliation(s)
- Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Margot Anne Rogers
- Australian Institute of Sport, Bruce, South Australia, Australia
- University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australian Capital Territory, Australia
| | - Ida A Heikura
- Canadian Sport Institute-Pacific, Victoria, British Columbia, Canada
- Department of Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Louise M Burke
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Victoria, British Columbia, Canada
- Department of Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Anthony C Hackney
- Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports and Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
| | - Stacey Schley
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Grace H Saville
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Margo Mountjoy
- Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
- Games Group, International Olympic Committee, Lausanne, Switzerland
| | - Bryan Holtzman
- Wu Tsai Female Athlete Program, Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Mass General for Children, Boston, Massachusetts, USA
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17
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Quittkat HL, Voges MM, Kisker J, Schöne B, Düsing R, Vocks S. One body, two faces: How double standards influence body evaluation in women with binge-eating disorder compared to mentally healthy women with higher weight and average weight. Int J Eat Disord 2023; 56:1752-1763. [PMID: 37272205 DOI: 10.1002/eat.23998] [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: 12/21/2022] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Research has found evidence that women with anorexia nervosa (AN) and bulimia nervosa (BN) apply different standards for themselves than for others when evaluating bodies, an aspect of a disturbed body image. This study investigates whether women with binge-eating disorder (BED) likewise show self-deprecating double standards (DS). METHODS Women with BED (n = 40), women with higher weight (n = 40) and women with average weight (n = 40) viewed a presentation of different builds, including their individual ideal body, which were presented once with participants' own and once with an unknown woman's face. After each presentation, participants rated their emotional response regarding arousal and valence, and evaluated the body's attractiveness, body fat and muscle mass. DS were defined as the difference in ratings of the same body with one's own and the unknown face. RESULTS Women with BED showed a higher degree of negative emotions in response to a thin and a high-weight build, rated lower levels of body attractiveness for an athletic build, and displayed more arousal for almost all builds presented with their own compared to with another face. While women with BED showed a higher burden on measures of eating pathology and body image than the other groups, DS were not more pronounced in women with BED. DISCUSSION The findings contradict DS as a characteristic feature of BED, but underline "normative" DS for higher-weight/high-weight builds, reflecting weight stigmatization. Psychoeducation on these DS might complement cognitive-behavioral therapy in BED in order to reduce negative emotions. PUBLIC SIGNIFICANCE A bias in body evaluation has been proven in women with anorexia and BN, but no research has examined this in women with BED. This study provides evidence of DS in body evaluation in women with BED, compares the extent of DS between women with BED, higher weight, and average weight, and investigates individual body ideals in women with BED and higher weight.
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Affiliation(s)
- Hannah L Quittkat
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Mona M Voges
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Joanna Kisker
- Institute of Psychology, Department of Experimental Psychology I, Osnabrück University, Osnabrück, Germany
| | - Benjamin Schöne
- Institute of Psychology, Department of Experimental Psychology I, Osnabrück University, Osnabrück, Germany
| | - Rainer Düsing
- Institute of Psychology, Department of Research Methodology, Diagnostics and Evaluation, Osnabrück University, Osnabrück, Germany
| | - Silja Vocks
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
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18
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Meregalli V, Ambrosini E, Tenconi E, Schroeder PA, Cardi V, Veronese A, Meneguzzo P, Favaro A, Collantoni E. Food induced distractibility in restrictive anorexia nervosa: Different motor patterns for different foods as revealed by a mouse tracker evaluation. Appetite 2023; 188:106639. [PMID: 37356579 DOI: 10.1016/j.appet.2023.106639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/27/2023]
Abstract
An altered automatic processing of food stimuli may contribute to the maintenance of calorie restriction in patients with restrictive Anorexia Nervosa (AN-R). The present study aimed to assess whether task-irrelevant food distractors elicited a different interference effect in the motor actions of patients with AN-R compared to healthy controls (HC). 40 patients with acute AN-R and 40 HC performed an irrelevant distractor task in which they were required to perform a reaching movement from a starting point to a green dot, while an irrelevant distractor (a high-calorie food, low-calorie food, or neutral object) was presented in the middle of the screen. Mouse trajectories and response times (RT) were recorded. The analyses conducted on the kinematic variables revealed that while the trajectories of HC veered similarly toward the three categories of stimuli, AN-R patients showed an increased deviation toward low-calorie foods and a reduced deviation toward high-calorie foods compared to neutral objects. No significant results emerged as regards RT. The pattern of responses observed in patients with AN-R (deviation increased toward low-calorie and reduced toward high-calorie) is consistent with their eating habits and may thus represent an implicit mechanism sustaining calorie restriction in patients with AN-R.
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Affiliation(s)
- Valentina Meregalli
- Department of Neurosciences, University of Padua, Padova, Italy; Padua Neuroscience Center, University of Padua, Padova, Italy.
| | - Ettore Ambrosini
- Department of Neurosciences, University of Padua, Padova, Italy; Padua Neuroscience Center, University of Padua, Padova, Italy; Department of General Psychology, University of Padua, Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Padova, Italy; Padua Neuroscience Center, University of Padua, Padova, Italy
| | | | - Valentina Cardi
- Department of General Psychology, University of Padua, Padova, Italy
| | - Angela Veronese
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padova, Italy; Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy; Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Enrico Collantoni
- Department of Neurosciences, University of Padua, Padova, Italy; Padua Neuroscience Center, University of Padua, Padova, Italy; Department of Medicine (DIMED), University of Padova, Padova, Italy
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19
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Hilbert A. Psychological and Medical Treatments for Binge-Eating Disorder: A Research Update. Physiol Behav 2023:114267. [PMID: 37302642 DOI: 10.1016/j.physbeh.2023.114267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/23/2023] [Accepted: 06/08/2023] [Indexed: 06/13/2023]
Abstract
Binge-eating disorder (BED), characterized by recurrent binge eating in the absence of regular weight-compensatory behaviors, is the most common eating disorder, associated with pronounced mental and physical sequelae. An increasing body of research documents the efficacy of diverse approaches to the treatment of this disorder, summarized in meta-analyses. This research update narratively reviewed randomized-controlled trials (RCTs) on the psychological and medical treatment of BED published between January 2018 to November 2022, identified through a systematic literature search. A total of 16 new RCTs and 3 studies on previous RCTs providing efficacy- and safety-related data were included. Regarding psychotherapy, confirmatory evidence supported the use of integrative-cognitive therapy and, with lower effects, brief emotion regulation skills training for binge eating and associated psychopathology. Behavioral weight loss treatment was revealed to be efficacious for binge eating, weight loss, and psychopathology, but its combination with naltrexone-bupropion did not augment efficacy. New treatment approaches were explored, including e-mental-health and brain-directed treatments, mostly targeting emotion and self-regulation. Additionally, different therapeutic approaches were evaluated in complex stepped-care models. In light of these advances, future research is necessary to further optimize effects of evidence-based treatments for BED, through improvement of existing or development of new treatments, based on mechanistic and/or interventional research, and/or tailoring treatments to personal characteristics in a precision medicine approach.
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Affiliation(s)
- 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.
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20
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MacLeod C. The Attention Bias Modification Approach to Anxiety: Origins, Limitations, and Opportunities. Am J Psychiatry 2023; 180:328-330. [PMID: 37122269 DOI: 10.1176/appi.ajp.20230210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Perth
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21
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Sfärlea A, Radix AK, Schulte-Körne G, Legenbauer T, Platt B. Attention Biases for Eating Disorder-Related Stimuli Versus Social Stimuli in Adolescents with Anorexia Nervosa - An Eye-Tracking Study. Res Child Adolesc Psychopathol 2023; 51:541-555. [PMID: 36418631 PMCID: PMC10017650 DOI: 10.1007/s10802-022-00993-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/25/2022]
Abstract
Anorexia nervosa (AN) is characterized by attention biases for eating disorder-related information as well as altered attentional processing of social information. However, little is known about the interplay between the altered attentional processing of these two types of information. The present study investigates attention biases for eating disorder-related information (pictures of bodies) versus social information (pictures of faces), in adolescents with AN. Attention biases were assessed via eye-tracking during a passive-viewing task in which female bodies and faces were presented simultaneously and thus competed directly for attention. Female adolescents (13-18 years) with AN (n = 28) were compared to a clinical comparison group (adolescents with major depression; n = 20) and a comparison group of adolescents with no mental illness (n = 24). All groups looked longer at bodies than at faces, i.e., showed attention biases for bodies in maintenance of attention. These biases were more pronounced in adolescents with AN than in both comparison groups, particularly for underweight bodies, at the expense of looking less at social stimuli. The results indicate "dual" attention biases in adolescents with AN (i.e., towards bodies and away from emotional faces) which could have a twofold negative impact on eating disorder psychopathology: increased attention to eating disorder-related information might directly influence eating disorder symptoms while less attention to social information might have an indirect influence through the amplification of interpersonal difficulties.
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Affiliation(s)
- Anca Sfärlea
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Research Department, Nussbaumstr. 5, 80336, Munich, Germany.
| | - Anne Kathrin Radix
- LWL-University Clinic of the RUB Bochum, Department of Child and Adolescent Psychiatry, Psychotherapy, Psychosomatics, Hamm, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Research Department, Nussbaumstr. 5, 80336, Munich, Germany
| | - Tanja Legenbauer
- LWL-University Clinic of the RUB Bochum, Department of Child and Adolescent Psychiatry, Psychotherapy, Psychosomatics, Hamm, Germany
| | - Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Research Department, Nussbaumstr. 5, 80336, Munich, Germany
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22
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Meschberger-Annweiler FA, Ascione M, Porras-Garcia B, Ferrer-Garcia M, Moreno-Sanchez M, Miquel-Nabau H, Serrano-Troncoso E, Carulla-Roig M, Gutiérrez-Maldonado J. An Attentional Bias Modification Task, through Virtual Reality and Eye-Tracking Technologies, to Enhance the Treatment of Anorexia Nervosa. J Clin Med 2023; 12:jcm12062185. [PMID: 36983186 PMCID: PMC10054656 DOI: 10.3390/jcm12062185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Mirror exposure therapies (METs) have been shown to be effective in reducing body image disturbances through the habituation process. Virtual reality (VR) combined with eye-tracking techniques can provide innovative solutions to some of METs’ limitations reported with patients with anorexia nervosa (AN), especially the negative influence of body-related attentional bias (AB). This pilot study aimed to assess the preliminary efficacy of a new VR-based AB modification task (ABMT) among healthy women and the procedure’s user experience. AB levels towards weight- and non-weight-related body parts, using complete fixation time (CFT) and number of fixations (NF), were assessed throughout the ABMT procedure (300 trials). The user experience was evaluated at the end of the procedure. The results showed that VR-based ABMT was effective in reducing AB significantly after 150 trials for both CFT- and NF-based measures, although 225 trials were necessary to get the same result for women with an NF initially more oriented towards weight-related body parts. Overall, the software received a “C-rating” on a scale from “A” (most usable) to “F” (least usable). These results provide evidence of the opportunity to use a VR-based ABMT procedure to reduce AB and improve existing treatments for AN.
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Affiliation(s)
- Franck-Alexandre Meschberger-Annweiler
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Mariarca Ascione
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Bruno Porras-Garcia
- Department of Population Health Science, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84112, USA
| | - Marta Ferrer-Garcia
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Manuel Moreno-Sanchez
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Helena Miquel-Nabau
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
| | - Eduardo Serrano-Troncoso
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - Marta Carulla-Roig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Déu of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain
| | - José Gutiérrez-Maldonado
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035 Barcelona, Spain
- Correspondence:
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23
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House T, Graham K, Ellis B, Bould H, Attwood AS, Stephen ID, Brooks KR, Penton-Voak IS. Is body dissatisfaction related to an attentional bias towards low weight bodies in non-clinical samples of women? A systematic review and meta-analysis. Body Image 2023; 44:103-119. [PMID: 36563472 DOI: 10.1016/j.bodyim.2022.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
Body dissatisfaction is defined as the negative subjective evaluation of one's body and is considered a risk factor for, and symptom of, eating disorders. Some studies show women with high body dissatisfaction display an attentional bias towards low weight bodies; however, this finding is not consistent, and results are yet to be systematically synthesised. We conducted a qualitative and quantitative synthesis of cross-sectional studies investigating the relationship between body dissatisfaction and attentional bias to low weight bodies in non-clinical samples of women. We searched PubMed, Scopus, Web of Science, PsycINFO, ProQuest, and OpenGrey for studies up until September 2022. We identified 34 eligible studies involving a total of 2857 women. A meta-analysis of 26 studies (75 effects) found some evidence from gaze tracking studies for a positive association between body dissatisfaction and attentional bias to low weight bodies. We found no evidence for an association from studies measuring attention using the dot probe task, electroencephalogram (EEG) recording, or the modified spatial cueing task. The results together provide partial support for the positive association between body dissatisfaction and attentional bias to low weight bodies in women. These findings can be used to inform future attentional bias research.
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Affiliation(s)
- T House
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia; School of Psychological Science, University of Bristol, United Kingdom.
| | - K Graham
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, United Kingdom
| | - B Ellis
- EPSRC CDT in Digital Health and Care, University of Bristol, United Kingdom
| | - H Bould
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom; Gloucestershire Health and Care NHS Foundation Trust, Centre for Academic Mental Health, University of Bristol, United Kingdom; MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, United Kingdom
| | - A S Attwood
- School of Psychological Science, University of Bristol, United Kingdom; MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, United Kingdom
| | - I D Stephen
- NTU Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - K R Brooks
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - I S Penton-Voak
- School of Psychological Science, University of Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, United Kingdom
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24
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Langlet B, Nyberg M, Wendin K, Zandian M. The clinicians' view of food-related obstacles for treating eating disorders: A qualitative study. Food Nutr Res 2023; 67:8771. [PMID: 36794011 PMCID: PMC9899047 DOI: 10.29219/fnr.v67.8771] [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: 05/18/2022] [Revised: 12/18/2022] [Accepted: 12/18/2022] [Indexed: 01/27/2023] Open
Abstract
Background Good health requires healthy eating. However, individuals with eating disorders, such as anorexia nervosa, require treatment to modify their dietary behaviours and prevent health complications. There is no consensus on the best treatment practices and treatment outcomes are usually poor. While normalising eating behaviour is a cornerstone in treatment, few studies have focused on eating and food-related obstacles to treatment. Objective The aim of the study was to investigate clinicians' perceived food-related obstacles to treatment of eating disorders (EDs). Design Qualitative focus group discussions were conducted with clinicians involved in eating disorder treatment to get an understanding of their perceptions and beliefs regarding food and eating among eating disorder patients. Thematic analysis was used to find common patterns in the collected material. Results From the thematic analysis the following five themes were identified: (1) ideas about healthy and unhealthy food, (2) calculating with calories, (3) taste, texture, and temperature as an excuse, (4) the problems with hidden ingredients and (5) the challenges of extra food. Discussion All identified themes showed not only connections to each other but also some overlap. All themes were associated with a requirement of control, where food may be perceived as a threat, with the effects of food consumption resulting in a perceived net loss, rather than a gain. This mindset can greatly influence decision making. Conclusions The results of this study are based on experience and practical knowledge that could improve future ED treatments by enhancing our understanding the challenges certain foods pose for patients. The results may also help to improve dietary plans by including and explaining challenges for patients at different stages of treatment. Future studies could further investigate the causes and best treatment practices for people suffering from EDs and other eating disturbances.
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Affiliation(s)
- Billy Langlet
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Billy Langlet, Floor 3, Hälsovägen 7, 141 52 Huddinge, Sweden.
| | - Maria Nyberg
- Food and Meals in Everyday Life (MEAL), Department of Food and Meal Science, Kristianstad University, Kristianstad, Sweden
| | - Karin Wendin
- Food and Meals in Everyday Life (MEAL), Department of Food and Meal Science, Kristianstad University, Kristianstad, Sweden,Department of Food Science, University of Copenhagen, Copenhagen, Denmark
| | - Modjtaba Zandian
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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25
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Enouy S, Desrochers JE, Bossom IRL, Tabri N. A p-curve analysis of the emotional Stroop effect among women with eating disorders. Int J Eat Disord 2022; 55:1459-1483. [PMID: 36124885 DOI: 10.1002/eat.23807] [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: 05/12/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A recent meta-review of attentional bias research in eating disorders suggests that meta-analyses and systematic reviews include many low-quality and underpowered studies (Stott et al., 2021). As such, we examined whether published research examining the link between attentional bias, using the emotional Stroop task, and eating disorders among women with eating disorders has evidential value (ruling out selective reporting of a statistically significant effect) using a p-curve analysis. A p-curve analysis plots statisticall significant p-values onto a curve from .01 to .05 to examine its distribution. We hypothesized that the p-curve would be flat, indicating no true effect. METHOD The hypothesis, database search strategy, and data analytic approach were pre-registered. The inclusion criteria were reports that compared control and eating disorder groups, reported inferential statistics, and that used body shape/weight or general threat target words. RESULTS Fifty published reports were included in the p-curve analyses. Unexpectedly, the half and full p-curves were significantly right-skewed, indicating evidential value. However, the results were not robust to the exclusion of the seven lowest p-values and on average, reports were underpowered. There were also 18 reports with null results (they had a p-value greater than .05), which precluded their inclusion in the p-curve analyses. DISCUSSION The findings suggest that most of the evidence from research examining attentional biases using the emotional Stroop task among women with an eating disorder or with elevated eating disorder symptoms is underpowered and so should be interpreted with considerable caution. PUBLIC SIGNIFICANCE Concerns have been raised about the low quality of research examining attentional biases among women with eating disorders using the emotional Stroop task. In the current research, we observed that the evidential value of primary research reporting differences between women with and without eating disorders was equivocal and had low statistical power. These results can guide researchers towards conducting more rigorous research on attentional biases among people with eating disorders.
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Affiliation(s)
- Sarah Enouy
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
| | - Jessica E Desrochers
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
| | - Isabella R L Bossom
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
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26
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Todd J, Wilson E, Coutts-Bain D, Clarke PJF. Attentional bias variability and its association with psychological and health symptoms: A meta-analysis. Neurosci Biobehav Rev 2022; 140:104812. [PMID: 35931220 DOI: 10.1016/j.neubiorev.2022.104812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/24/2022] [Accepted: 08/01/2022] [Indexed: 01/04/2023]
Abstract
The present meta-analysis sought to assess the association between an emerging neurocognitive marker of psychopathology in attentional bias variability (ABV) and key psychological and health outcomes. A comprehensive literature review yielded 53 studies in 43 manuscripts (N = 5428). Overall, clinical and sub-clinical samples exhibited greater ABV than control samples (g = 0.462). Trauma samples showed significantly greater ABV than control samples (g = 0.782, medium-large effect), whereas social anxiety samples did not (g = 0.147). Similarly, ABV was associated with degree of trauma symptoms (r = 0.21 - 0.25). ABV was associated with some symptoms of depression and anxiety, although these were small and inconsistent. These findings suggest a specific relationship between ABV and post-traumatic stress symptoms, with evidence equivocal for other psychological difficulties (although also less research). Key recommendations for future research include investigating mechanisms underlying ABV and the importance of controlling for non-attentional processes, such as reaction time variability, to ensure the validity of ABV measures.
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Affiliation(s)
- Jemma Todd
- School of Psychology, University of Sydney, Sydney, NSW, Australia; School of Psychological Science, University of Western Australia, Perth, WA, Australia.
| | - Emily Wilson
- School of Psychology, University of Sydney, Sydney, NSW, Australia
| | | | - Patrick J F Clarke
- Cognition and Emotion Research Group, School of Population Health, Curtin University, Perth, WA, Australia
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27
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Albery IP, Shove E, Bartlett G, Frings D, Spada MM. Individual differences in selective attentional bias for healthy and unhealthy food-related stimuli and social identity as a vegan/vegetarian dissociate "healthy" and "unhealthy" orthorexia nervosa. Appetite 2022; 178:106261. [PMID: 35931214 DOI: 10.1016/j.appet.2022.106261] [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: 04/13/2022] [Revised: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 11/30/2022]
Abstract
Previous work identified the operation of an attentional bias (AB) towards healthy food related stimuli among those with increasing tendencies towards orthorexia nervosa (ON) using a modified Stroop task. The current work aimed to replicate and extend our understanding of this effect by incorporating alternative measures of AB (i.e., the dot probe task) and ON (i.e., the Teruel Orthorexia Scale [ToS]) in a sample of self-defined vegans/vegetarians. The theoretical assertion of the ToS is the conceptual broadening of orthorexia with differentiable dimensions - one characterised as a "healthy" preoccupation with healthy food/eating patterns (HeOr) and the other by a more underlying pathology (OrNe). This study also aimed to examine the pattern of responding across these two dimensions according to factors known to predict ON. Eighty-six participants (mean age = 33.0 years; 20 males, 66 females) completed measures of obsessive compulsivity, perfectionism, state/trait anxiety and ToS as well as a dot probe designed to measure AB for healthy and unhealthy-related food stimuli, threat ratings of each of words utilised and perceived identity centrality as a vegan/vegetarianism. Results showed a dissociation of predicted determinants for "healthy" ON (HeOr) and pathological ON (OrNe). HeOr was predicted by increasing identity centrality whereas OrNe was predicted by increased OCD and perfectionism, and increased interference for healthy-related food words (in particular slowed disengagement) and not unhealthy related food words. Threat-related ratings of unhealthy food words was shown to be common across both dimensions. This pattern highlights cognitive and individual differences-based correlates of pathological and non-pathological ON.
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Affiliation(s)
- Ian P Albery
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK.
| | - Emma Shove
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Georgina Bartlett
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Daniel Frings
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Marcantonio M Spada
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
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28
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Hilbert A, Witte V, Meule A, Braehler E, Kliem S. Development of the Hedonic Overeating–Questionnaire (HEDO–Q). Nutrients 2022; 14:nu14091865. [PMID: 35565829 PMCID: PMC9100100 DOI: 10.3390/nu14091865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Addictive-like eating is prevalent, but a clear conceptualization and operationalization outside of an addiction framework is lacking. By adopting a biopsychological framework of food reward, this study sought to develop and evaluate a brief self-report questionnaire for the trait assessment of hedonic overeating and dyscontrol. Items in the Hedonic Overeating–Questionnaire (HEDO–Q) were constructed following a rational approach and psychometrically evaluated in a large random sample from the German population (N = 2531). A confirmatory factor analysis supported the unidimensional nature of the six-item HEDO–Q with the three postulated components of wanting, liking, and dyscontrol. Psychometric properties were favorable with good corrected item-total correlations, acceptable item difficulty and homogeneity, and high internal consistency. Population norms were provided. The HEDO–Q revealed strict measurement invariance for sex and partial invariance for age and weight status. Discriminant validity was demonstrated in distinguishing participants with versus without eating disturbances or obesity. Associations with the established measures of eating disorder and general psychopathology supported the convergent and divergent validity of the HEDO–Q. This first evaluation indicates good psychometric properties of the HEDO–Q in the general population. Future validation work is warranted on the HEDO–Q’s stability, sensitivity to change, and predictive and construct validity.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Correspondence:
| | - Veronica Witte
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, 80336 Munich, Germany;
- Schoen Clinic Roseneck, 83209 Prien am Chiemsee, Germany
| | - Elmar Braehler
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany;
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, 55131 Mainz, Germany
| | - Soeren Kliem
- Ernst-Abbe-Hochschule, University of Applied Sciences, 07745 Jena, Germany;
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29
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Saure E, Ålgars M, Laasonen M, Raevuori A. Cognitive Behavioral and Cognitive Remediation Strategies for Managing Co-Occurring Anorexia Nervosa and Elevated Autism Spectrum Traits. Psychol Res Behav Manag 2022; 15:1005-1016. [PMID: 35480715 PMCID: PMC9035441 DOI: 10.2147/prbm.s246056] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022] Open
Abstract
Anorexia nervosa (AN) is a potentially severe eating disorder whose core characteristics include energy intake restriction leading to low body weight. Autism spectrum disorder (ASD) is a developmental disorder characterized by deficits in social interaction and communication as well as repetitive, stereotyped behavior and interests. Both high ASD traits and diagnosed ASD are overrepresented among individuals with AN, and AN and ASD appear to share certain neurocognitive features. These features are associated with the severity of eating disorder symptoms and prolongation of AN. Thus, individuals with AN and high ASD traits or ASD may benefit less from traditional treatment when compared to those with low ASD traits. No previous reviews have summarized what is known about treatment adaptations for individuals with AN and high ASD traits or ASD. The purpose of this narrative review was to investigate the feasibility of cognitive remediation therapy (CRT), cognitive remediation and emotional skill training (CREST), and cognitive behavioral therapy (CBT), and give an overview of treatment modifications for individuals with AN and co-occurring ASD or high ASD traits. We found nine studies that fulfilled our inclusion criteria. The combined results suggest that individuals with AN and high ASD traits or ASD benefit less from CRT, CREST, and CBT than those with AN and low ASD traits. However, CRT and CREST administered in individual format may be associated with improved cognitive flexibility, motivation for change, and decreased alexithymia among adults with AN and high ASD traits or ASD. Individuals with comorbid AN and ASD themselves highlight the importance of treatment adaptations that take the characteristics of ASD into account. In the future, controlled studies of the treatment strategies for individuals with AN and ASD/high ASD traits are needed in order to improve the outcome of individuals with this challenging comorbidity.
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Affiliation(s)
- Emma Saure
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- BABA Center and Department of Clinical Neurophysiology, Children’s Hospital, Helsinki, Finland
- Correspondence: Emma Saure, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, Helsinki, FI-00014, Finland, Tel +358443035828, Email
| | - Monica Ålgars
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Marja Laasonen
- Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Anu Raevuori
- Department Psychiatry, Division of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
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