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Rumination, mood, and maladaptive eating behaviors in overweight and healthy populations. Eat Weight Disord 2021; 26:273-285. [PMID: 32072571 PMCID: PMC7895787 DOI: 10.1007/s40519-020-00857-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/24/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The literature suggests that rumination (i.e., repetitive thinking about 1 or more negative concerns that is perceived as difficult to control) is linked to impaired emotional regulation and increases negative affect. Not only individuals suffering from overweight or obesity, but also healthy individuals might use emotional eating as a coping strategy to deal with negative affect caused by rumination. The aim of the present study was to determine the link between rumination and maladaptive eating strategies in participants with normal weight and overweight/obesity using trait and ecological momentary measures. METHOD In Study 1, 88 individuals from overweight/obese (N = 33) and control group (N = 50) filled in a series of questionnaires assessing trait rumination, and eating behaviors. In Study 2 momentary affect, rumination and eating behavior of 26 participants were assessed using ecological momentary assessment (EMA) methodology. RESULTS In Study 1, the moderated mediation model revealed that emotional eating mediates the link between rumination and uncontrolled eating or snacking, but only in healthy participants and not in the participants with overweight. The results of Study 2 suggest that when both momentary rumination and sad mood are entered into the model predicting momentary daily emotional eating, only rumination remains a significant predictor of emotional eating. This relationship is not modified by the fact that the participants are from healthy controls or the overweight/obese group. DISCUSSION Study 1 provided evidence on the differential role of emotional eating in participants with normal weight and with overweight. Study 2 provided initial insights into the role of momentary mood and momentary repetitive thinking in the use of emotional eating in participants' everyday lives. The differences in group effect in trait and EMA measures indicated also the importance of considering the consciousness of using rumination and emotional eating, while studying those processes in individuals with overweight. LEVEL OF EVIDENCE Level III, case-control analytic study.
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2
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Koller KA, Thompson KA, Miller AJ, Walsh EC, Bardone-Cone AM. Body appreciation and intuitive eating in eating disorder recovery. Int J Eat Disord 2020; 53:1261-1269. [PMID: 32020677 DOI: 10.1002/eat.23238] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/24/2019] [Accepted: 01/19/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Eating disorder recovery research has emphasized the absence of symptoms over the presence of adaptive aspects like positive body image and healthy eating attitudes. The current study examined how body appreciation and intuitive eating related to eating disorder recovery using a comprehensive recovery definition (physical, behavioral, and cognitive recovery). METHOD Data were collected from 66 women with an eating disorder history and 31 controls with no history of eating pathology. Participants completed an online survey followed by a phone interview. RESULTS The fully recovered group did not differ from controls on body appreciation, with both groups endorsing significantly higher levels of body appreciation than the partially recovered and current eating disorder groups. Similarly, the fully recovered group did not differ from controls on overall intuitive eating, with both groups endorsing significantly higher levels of overall intuitive eating than the partially recovered and current eating disorder groups. DISCUSSION Positive psychological constructs such as body appreciation and intuitive eating relate to eating disorder recovery status. Understanding recovery within a strengths-based framework may inform intervention and relapse prevention.
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Affiliation(s)
- Katherine A Koller
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine A Thompson
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexandra J Miller
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Emily C Walsh
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Anna M Bardone-Cone
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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3
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Vanzhula IA, Sala M, Christian C, Hunt RA, Keshishian AC, Wong VZ, Ernst S, Spoor SP, Levinson CA. Avoidance coping during mealtimes predicts higher eating disorder symptoms. Int J Eat Disord 2020; 53:625-630. [PMID: 32112594 DOI: 10.1002/eat.23254] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Eating disorders (EDs) are characterized by significant anxiety during mealtime that contributes to food avoidance and weight loss. Individuals with EDs commonly use avoidance coping (e.g., distraction) to tolerate meals and comply with meal plans. Although this strategy may be effective short term, a large body of anxiety literature suggests that avoidance can lead to worsening of psychological symptoms long term. METHOD The current study (N = 66 individuals diagnosed with ED) used ecological momentary assessment (EMA) to examine the short-term and long-term associations of avoidance coping on ED symptoms. RESULTS Distraction during meals predicted a reduction in anxiety in the short term, and both distraction and avoidance of emotions predicted increases in excessive exercise in the short term. Distraction and avoidance of emotions predicted increases in bulimic symptoms 1 month after completion of EMA. DISCUSSION These results are consistent with prior literature on avoidance and suggest that avoidance coping during meals may contribute to the increase of ED behaviors in the long term. Coping strategies that encourage approach and tolerance of difficult thoughts and emotions (e.g., acceptance-based strategies) rather that avoidance coping may promote longer-term symptom reduction.
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Affiliation(s)
- Irina A Vanzhula
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | | | - Caroline Christian
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Rowan A Hunt
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Ani C Keshishian
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Valerie Z Wong
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Sarah Ernst
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Samantha P Spoor
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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4
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Smith KE, Mason TB, Lavender JM. Rumination and eating disorder psychopathology: A meta-analysis. Clin Psychol Rev 2018; 61:9-23. [PMID: 29703429 DOI: 10.1016/j.cpr.2018.03.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 02/08/2018] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Abstract
Rumination is a cognitive process involving repetitive thoughts about negative experiences and emotions and is associated with psychopathology. Rumination has been implicated in mood and anxiety disorders, and there is a growing body of research on rumination in relation to eating disorder (ED) psychopathology. The current meta-analytic review focused on the literature addressing rumination and ED psychopathology. A comprehensive search process identified 38 studies, which primarily used cross-sectional designs with non-clinical samples. Results demonstrated that rumination was concurrently (r = 0.33) and prospectively (r = 0.22-0.23) associated with ED psychopathology, and that groups with ED psychopathology evidenced higher levels of rumination compared to non-ED control groups (g = 0.95), though no significant differences in rumination were observed when comparing anorexia nervosa to bulimia nervosa groups (g = 0.09). In addition, a narrative review of five experimental studies suggested that rumination in response to ED-related stimuli was related to increased negative affect and negative body-related cognitions across clinical and non-clinical samples. The type of rumination and sample population emerged as moderators of effect sizes, such that larger effects were observed among samples using ED-specific measures of rumination and heterogeneous samples compared to only non-clinical samples. Taken together, this literature demonstrates that rumination is a salient process in ED psychopathology, though the literature is characterized by methodological limitations and the need for more fully elaborated theories on the role of rumination in EDs. Findings are discussed in the context of existing models of rumination and ED psychopathology, with suggestions for future research in this area.
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Affiliation(s)
- Kathryn E Smith
- Neuropsychiatric Research Institute, Fargo, ND, United States; University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, ND, United States
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States.
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5
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Abstract
BACKGROUND Anorexia nervosa is a serious psychiatric illness with limited evidenced-based treatment options. Mindfulness appears useful in many conditions, but few studies focus on its use in individuals with anorexia nervosa. OBJECTIVE To examine and summarize studies of mindfulness in individuals with anorexia nervosa and identify areas for future research. DESIGN An integrated review was conducted by searching health care computerized databases. RESULTS Results were mixed among the eight studies that met inclusion criteria. Multimodal mindfulness-based therapies appear effective, while brief interventions may be equally useful or result in greater anxiety compared to distraction. Qualitative data support that some participants feel mindfulness is challenging but beneficial. CONCLUSION Mindfulness as a concurrent part of therapy and/or when routinely practiced may be more clinically useful than single-episode mindful eating interventions. Due to the complexity of the concept of mindfulness and limited existing data, additional research is needed.
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Affiliation(s)
- Julie Dunne
- 1 Julie Dunne, MSN, RN, PMHNP-BC, Boston College, Chestnut Hill, MA; The Cambridge Eating Disorder Center, Cambridge, MA, USA
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6
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Tsai A, Hughes EK, Fuller-Tyszkiewicz M, Buck K, Krug I. The Differential Effects of Mindfulness and Distraction on Affect and Body Satisfaction Following Food Consumption. Front Psychol 2017; 8:1696. [PMID: 29021770 PMCID: PMC5623713 DOI: 10.3389/fpsyg.2017.01696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/14/2017] [Indexed: 11/23/2022] Open
Abstract
This study investigated whether engaging in mindfulness following food consumption produced changes in affect and body satisfaction, as compared to a control distraction task. The moderating effects of eating pathology and neuroticism were also examined. A total of 110 female university students consumed food and water before engaging in either a mindfulness induction or a control distraction task. Participants completed trait measures of eating pathology and neuroticism at baseline, and measures of state affect and body satisfaction before and after food consumption, and after the induction. Results revealed that consuming food and water reduced positive affect. Unexpectedly, both the mindfulness group and distraction control group experienced similar improvements in negative affect and body satisfaction following the induction. Eating pathology and neuroticism did not moderate the observed changes. These findings suggest that both mindfulness and distraction may contribute to the effectiveness of treatments for disordered eating that incorporate both of these techniques, such as Dialectical Behavior Therapy.
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Affiliation(s)
- Alice Tsai
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Elizabeth K Hughes
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital, Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Kimberly Buck
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
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7
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The mediating role of rumination in the relation between attentional bias towards thin female bodies and eating disorder symptomatology. PLoS One 2017; 12:e0177870. [PMID: 28542431 PMCID: PMC5436811 DOI: 10.1371/journal.pone.0177870] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 05/04/2017] [Indexed: 01/18/2023] Open
Abstract
The present study sought to investigate the association between selective attentional processing of body images, rumination, and eating disorder symptoms in young women. Seventy-three undergraduate female students (ages 17–24) completed a modified dot-probe task to assess whether young women showed a differential attentional bias pattern towards thin and non-thin female bodies. Participants also completed self-report measures of eating disorder pathology. It was found that increased reports of dietary restraint and body dissatisfaction were associated with both greater attentional bias towards thin bodies and avoidance of non-thin bodies (as compared to neutral images), although the former relationship was stronger than the latter. The results suggest attentional vigilance to thin-ideal images plays a greater role in the potential development and/or maintenance of eating disorder symptoms, at least in a university sample of young women. Results also revealed that eating disorder-specific rumination mediated the relationship between attentional bias to thin ideal images and eating disorder symptoms. These findings build on existing research and theories, for example the impaired disengagement model of rumination, and have potential clinical applications such as specifically targeting ruminative and/or attentional processes in the prevention and/or treatment of eating disorder symptoms.
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Scaife JC, Godier LR, Reinecke A, Harmer CJ, Park RJ. Differential activation of the frontal pole to high vs low calorie foods: The neural basis of food preference in Anorexia Nervosa? Psychiatry Res 2016; 258:44-53. [PMID: 27866012 PMCID: PMC5146322 DOI: 10.1016/j.pscychresns.2016.10.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 11/26/2022]
Abstract
Neuroimaging studies in anorexia nervosa (AN) suggest that altered food reward processing may result from dysfunction in both limbic reward and cortical control centers of the brain. This fMRI study aimed to index the neural correlates of food reward in a subsample of individuals with restrictive AN: twelve currently ill, fourteen recovered individuals and sixteen healthy controls. Participants were shown pictures of high and low-calorie foods and asked to evaluate how much they wanted to eat each one following a four hour fast. Whole-brain task-activated analysis was followed by psychophysiological interaction analysis (PPI) of the amygdala and caudate. In the AN group, we observed a differential pattern of activation in the lateral frontal pole: increasing following presentation of high-calorie stimuli and decreasing in during presentation of low-calorie food pictures, the opposite of which was seen in the healthy control (HC) group. In addition, decreased activation to food pictures was observed in somatosensory regions in the AN group. PPI analyses suggested hypo-connectivity in reward pathways, and between the caudate and both somatosensory and visual processing regions in the AN group. No significant between-group differences were observed between the recovered group and the currently ill and healthy controls in the PPI analysis. Taken together, these findings further our understanding of the neural processes which may underpin the avoidance of high-calorie foods in those with AN and might exacerbate the development of compulsive weight-loss behavior, despite emaciation.
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Affiliation(s)
- Jessica C Scaife
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
| | - Lauren R Godier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Andrea Reinecke
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Catherine J Harmer
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - Rebecca J Park
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
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Seidel M, Petermann J, Diestel S, Ritschel F, Boehm I, King JA, Geisler D, Bernardoni F, Roessner V, Goschke T, Ehrlich S. A naturalistic examination of negative affect and disorder-related rumination in anorexia nervosa. Eur Child Adolesc Psychiatry 2016; 25:1207-1216. [PMID: 27033353 DOI: 10.1007/s00787-016-0844-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/14/2016] [Indexed: 01/18/2023]
Abstract
In anorexia nervosa (AN), volitional inhibition of rewarding behaviors, such as eating, involves a conflict between the desire to suppress appetite and the inherent motive to consume. This conflict is thought to have costs that carry over into daily life, e.g., triggering negative affect and/or recurring ruminations, which may ultimately impact long term outcome. Hence, increasing research effort is being dedicated to understand the link between emotional and ruminative processes in the etiology and maintenance of AN. We investigated whether affective states influence disorder-related rumination in AN applying "ecological momentary assessment", a method which allows the experimenter to gain insight into psychological processes in the natural environment and assess data in real time. Participants (AN = 37, healthy controls = 33) were given a smartphone for 14 days. A ringtone signaled at six random time-points each day to fill in a questionnaire, which gauged disorder-typical thoughts about food and weight as well as affective state. Analyses, applying hierarchical linear models confirmed that AN patients spend more time thinking about food, body shape and weight than controls (p < 0.001). Additionally, the results support the hypothesis that momentary negative affect (but not baseline depression (p = 0.56) or anxiety symptoms (p = 0.60) are positively associated with a higher amount of disorder-related rumination in patients (p < 0.001). Our findings are in line with theories which claim that ruminative thinking induces a vulnerability to negative stimuli which, in turn, fosters heightened negative affect. Thus, therapeutic interventions could be improved by implementing modules that specifically target disorder-related rumination.
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Affiliation(s)
- Maria Seidel
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Juliane Petermann
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Stefan Diestel
- International School of Management and Technical University of Dortmund, Dortmund, Germany
| | - Franziska Ritschel
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Joseph A King
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Thomas Goschke
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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10
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Effects of emotional acceptance and rumination on media-induced body dissatisfaction in anorexia and bulimia nervosa. J Psychiatr Res 2016; 82:119-25. [PMID: 27491068 DOI: 10.1016/j.jpsychires.2016.07.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/22/2016] [Accepted: 07/22/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Body dissatisfaction is an important risk and maintaining factor for eating disorders. The aim of the present study was to experimentally test the effects of two emotion regulation strategies - acceptance and rumination - on media-induced body dissatisfaction in eating disorders. METHOD After watching pictures of thin models, women with anorexia nervosa (AN; n = 39) and bulimia nervosa (BN; n = 39) were encouraged to either use emotional acceptance or rumination to cope with their feelings. Body dissatisfaction and mood were repeatedly assessed. RESULTS Acceptance significantly improved body dissatisfaction in women with BN. Rumination led to a significant increase of body dissatisfaction in both eating disorder groups. Results were independent from mood changes. DISCUSSION Findings highlight the importance ruminative thinking may have in the aggravation of dissatisfaction with the own body in AN and BN. Results suggest that emotional acceptance is a useful strategy to regulate body dissatisfaction after exposure to thin-ideal media in BN.
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11
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Dondzilo L, Rieger E, Palermo R, Byrne S, Bell J. Association between rumination factors and eating disorder behaviours in young women. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/21662630.2015.1118642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Huber J, Salatsch C, Ingenerf K, Schmid C, Maatouk I, Weisbrod M, Herzog W, Friederich HC, Nikendei C. Characteristics of Disorder-Related Autobiographical Memory in Acute Anorexia Nervosa Patients. EUROPEAN EATING DISORDERS REVIEW 2015; 23:379-89. [PMID: 26095135 DOI: 10.1002/erv.2379] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/28/2015] [Accepted: 05/24/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE First studies revealed overgeneral autobiographical memories in anorexia nervosa (AN) patients. The aim of the present study was to investigate frequency, generalization and valence of autobiographical memories in AN patients in response to eating disorder-related cue words. METHOD Autobiographical memory was examined in 21 AN patients and 21 healthy controls (HC) using a modified version of the Autobiographical Memory Test, incorporating body-related, food-related, perfectionism-related, depression-related and neutral cues. RESULTS Anorexia nervosa patients recalled fewer and more general autobiographical memories compared with HC. For eating disorder-related cues as against neutral ones, AN patients compared with HC showed fewer memories for food-related and body-related cues, an elevated overgeneralization for food-related cues, while the valence of the retrieved memories was more negative in response to body-related cues. DISCUSSION This study detects disorder-related autobiographical memory alterations in AN, which are intensified in response to symptom-related cues. The findings are discussed with regard to their maladaptive function in emotion regulation.
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Affiliation(s)
- Julia Huber
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Carmen Salatsch
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Katrin Ingenerf
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Carolin Schmid
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Matthias Weisbrod
- Department of General Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Germany
| | - Wolfgang Herzog
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, LVR-Clinic Essen, Clinics and Institute of the University Duisburg-Essen, Germany
| | - Christoph Nikendei
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
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Park RJ, Godier LR, Cowdrey FA. Hungry for reward: How can neuroscience inform the development of treatment for Anorexia Nervosa? Behav Res Ther 2014; 62:47-59. [PMID: 25151600 DOI: 10.1016/j.brat.2014.07.007] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 07/04/2014] [Accepted: 07/16/2014] [Indexed: 12/29/2022]
Abstract
Dysfunctional reward from the pursuit of thinness presents a major challenge to recovery from Anorexia Nervosa (AN). We explore the neuroscientific basis of aberrant reward in AN, with the aim of generating novel hypotheses for translational investigation, and elucidate disease mechanisms to inform the development of targeted interventions. Relevant neuroimaging and behavioural studies are reviewed. These suggest that altered eating in AN may be a consequence of aberrant reward processing combined with exaggerated cognitive control. We consider evidence that such aberrant reward processing is reflected in the compulsive behaviours characterising AN, with substantial overlap in the neural circuits implicated in reward processing and compulsivity. Drawing on contemporary neuroscientific theories of substance dependence, processes underpinning the shift from the initially rewarding pursuit of thinness to extreme and compulsive weight control behaviours are discussed. It is suggested that in AN, weight loss behaviour begins as overtly rewarding, goal-directed and positively reinforced, but over time becomes habitual and increasingly negatively reinforced. Excessive habit formation is suggested as one underlying mechanism perpetuating compulsive behaviour. Ongoing research into the behavioural and neural basis of aberrant reward in AN is required to further elucidate mechanisms. We discuss clinical and transdiagnostic implications, and propose that future treatment innovation may benefit from the development of novel interventions targeting aberrant reward processing in AN.
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Affiliation(s)
- Rebecca J Park
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom.
| | - Lauren R Godier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
| | - Felicity A Cowdrey
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
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