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Neipp MC, Ruiz Á, Manchón J, León-Zarceño E, Quiles MJ, Quiles Y. Quality of Life and Clinical Impairment in Spanish Adolescent Anorexia Nervosa Patients. Eur J Investig Health Psychol Educ 2024; 14:1425-1436. [PMID: 38785592 PMCID: PMC11120447 DOI: 10.3390/ejihpe14050094] [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: 01/15/2024] [Revised: 04/30/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Eating disorders have serious physical, mental and social consequences that can affect the quality of life of the sufferer. This study aimed to evaluate the relationship between the severity of ED-related psychopathology and clinical impairment in adolescents with anorexia nervosa (AN) as well as their perception of health-related quality of life. Eighty-six Spanish young women with AN completed a set of questionnaires assessing eating disorder pathology, clinical impairment, and quality of life. The set included the following instruments: the Eating Disorder Examination Questionnaire, Clinical Impairment Assessment, Short Form-12 Item Health Survey, and the Eating Disorder-Specific Heath-Related Quality of Life instrument. Descriptive and regression analyses were applied to identify associations between variables. Higher scores on clinical impairment domains were associated with greater impairment of mental and physical health. Moreover, clinical impairment domains and concerns due to ED were related to a lower quality of life. In conclusion, adolescents with AN have a poor quality of life. Moreover, the findings suggest that the clinical features of impairment may serve as severity indicators of quality of life.
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Affiliation(s)
- Marie-Carmen Neipp
- Department of Health Psychology, University of Miguel Hernández, 03202 Elche, Spain
| | - Álvaro Ruiz
- Department of Behavioural Sciences and Health, University of Miguel Hernández, 03202 Elche, Spain; (Á.R.); (J.M.); (E.L.-Z.); (M.J.Q.); (Y.Q.)
| | - Javier Manchón
- Department of Behavioural Sciences and Health, University of Miguel Hernández, 03202 Elche, Spain; (Á.R.); (J.M.); (E.L.-Z.); (M.J.Q.); (Y.Q.)
| | - Eva León-Zarceño
- Department of Behavioural Sciences and Health, University of Miguel Hernández, 03202 Elche, Spain; (Á.R.); (J.M.); (E.L.-Z.); (M.J.Q.); (Y.Q.)
| | - María José Quiles
- Department of Behavioural Sciences and Health, University of Miguel Hernández, 03202 Elche, Spain; (Á.R.); (J.M.); (E.L.-Z.); (M.J.Q.); (Y.Q.)
| | - Yolanda Quiles
- Department of Behavioural Sciences and Health, University of Miguel Hernández, 03202 Elche, Spain; (Á.R.); (J.M.); (E.L.-Z.); (M.J.Q.); (Y.Q.)
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2
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Mason Stephens J, Iasiello M, Ali K, van Agteren J, Fassnacht DB. The Importance of Measuring Mental Wellbeing in the Context of Psychological Distress: Using a Theoretical Framework to Test the Dual-Continua Model of Mental Health. Behav Sci (Basel) 2023; 13:bs13050436. [PMID: 37232673 DOI: 10.3390/bs13050436] [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: 02/04/2023] [Revised: 03/20/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
The dual-continua model of mental health suggests that psychological distress and mental wellbeing operate on two distinct yet related continua, both uniquely contributing to overall mental health. Previous literature provides support for the dual-continua model; however, inconsistent methodologies lacking a common theoretical underpinning have led to findings that are difficult to compare across studies. Using archival data, this study aimed to test the following three theoretically derived criteria proposed to accurately examine the dual-continua model: (1) confirming independent existence, (2) disconfirming bipolarity, and (3) quantifying functional independence. METHOD In total, 2065 participants (female n = 1193; 57.8%) completed two online assessments (minimum 30 days apart) measuring psychological distress, mental wellbeing, and demographic information. RESULTS In total, 1.1% of participants experienced high distress as well as mental wellbeing confirming that psychological distress and mental wellbeing exist independently (Criterion 1). Bipolarity (Criterion 2) was partly disconfirmed: mental wellbeing consistently decreased as symptom severity increased for depression; however, anxiety and stress did not meet bipolarity requirements. Functional independence (Criterion 3) was established: longitudinal analysis found that participants reliably and simultaneously increased (2.7%) or decreased (4.2%) in distress and mental wellbeing, while cross-sectional analysis showed that psychological distress only explained 38% of the variance in mental wellbeing. DISCUSSION Findings provide further support for the dual-continua model through analysis of the proposed assessment criteria, suggesting a further need to measure the dual-continua model at the subdomain level, e.g., depression, anxiety, and stress, as opposed to global psychological distress. Validation for the proposed assessment criteria provides important methodological foundations for future studies.
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Affiliation(s)
- Jackson Mason Stephens
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
- School of Psychological Science, University of Western Australia, Crawley, WA 6009, Australia
| | - Matthew Iasiello
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
| | - Joep van Agteren
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA 5042, Australia
- Mental Health and Wellbeing Theme, South Australian Health and Medical Research, Adelaide, SA 5000, Australia
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
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3
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McAulay C, Mond J, Outhred T, Malhi GS, Touyz S. Eating disorder features in bipolar disorder: clinical implications. J Ment Health 2023; 32:43-53. [PMID: 33573438 DOI: 10.1080/09638237.2021.1875401] [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] [Indexed: 01/28/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is associated with elevated rates of eating disorders (EDs), but the nature and impact of specific ED features are unclear. AIMS This study sought to identify which ED features are common in BD, and whether these relate to quality of life (QoL) impairment and body mass index (BMI). METHOD A clinical sample of 73 adults with BD completed self-report measures of health, ED features, emotion regulation ability, impulsivity, and QoL. RESULTS Binge eating (45%), excessive dietary restriction (39%), overvaluation of weight/shape (51%), purging (16%) and driven exercise (27%) were common, and associated with a poorer clinical picture, including poorer QoL and poorer emotion regulation. Furthermore, regular binge eating episodes explained a significant proportion of variance in QoL impairment after controlling for other significant predictors. The best predictors of BMI were number of medical conditions, impulsivity and positive beliefs about binge eating. CONCLUSIONS ED features that may not meet criteria for a fully diagnosable ED - particularly overvaluation of weight/shape and binge eating - warrant greater attention, as they may still significantly worsen QoL. Future research should focus on modifying existing psychological interventions to better target ED features among individuals with BD and thereby improve clinical outcomes.
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Affiliation(s)
- Claire McAulay
- Clinical Psychology Unit, University of Sydney, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
| | - Tim Outhred
- Academic Department of Psychiatry, Northern Sydney Local Health District, Sydney, Australia.,Department of Psychiatry, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, Australia
| | - Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, Sydney, Australia.,Department of Psychiatry, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, University of Sydney, Sydney, Australia
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4
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Yesildemir O, Tek NA. RISK OF EATING DISORDERS AND BODY DISSATISFACTION AMONG GYM-GOERS IN ANKARA, TURKEY. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228042021_0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Although regular exercise is widely recommended to promote optimal health, it is thought that gym-goers are at risk for body dissatisfaction and eating disorders. Objective: This study assessed the risk of eating disorders and the prevalence of body dissatisfaction in gym-goers enrolled in a gym located in the city of Ankara, the capital of Turkey. Methods: This cross-sectional study was conducted with 206 gym-goers, 102 males (mean age of 25.8±7.86 years) and 104 females (mean age of 26.5±9.07 years), who regularly exercised at least twice a week at this gym during the years 2018 to 2019. Demographic characteristics and exercise status of the participants were collected through face-to-face interviews via a questionnaire form. The REZZY (SCOFF) questionnaire was administered to determine the risk of eating disorders and the Stunkard Figure Rating Scale was administered to determine body dissatisfaction. Results: The mean REZZY score in females (1.4±1.21) was higher than in males (0.8 ± 1.05) (p<0.01). In males, 26 out of 102 (25.5%) had a score indicating a risk of eating disorders. In females, 44 out of 104 (42.3%) had a score indicating a risk of eating disorders. The risk of eating disorders is higher in females than in males (p<0.05). While 49.0% of males stated that their current body size is greater than the ideal body size, 76.0% of females said that their current body size is greater than the ideal body size. Conclusion: Consequently, it was determined that gym-goers were a risk group in terms of eating disorders and body dissatisfaction. Level of Evidence: III; Cross-sectional study.
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5
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Rangel Paniz G, Lebow J, Sim L, Lacy BE, Farraye FA, Werlang ME. Eating Disorders: Diagnosis and Management Considerations for the IBD Practice. Inflamm Bowel Dis 2022; 28:936-946. [PMID: 34096582 DOI: 10.1093/ibd/izab138] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Graziella Rangel Paniz
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, United States
| | - Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
| | - Brian E Lacy
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States
| | - Francis A Farraye
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, United States
| | - Monia E Werlang
- Division of Gastroenterology and Liver Center, Prisma-Health-Upstate, University of South Carolina School of Medicine-Greenville, Greenville, South Carolina, United States
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6
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Validating the Danish version of the Eating Disorder Quality of Life Scale (EDQLS) in anorexia nervosa. Eat Weight Disord 2022; 27:1717-1728. [PMID: 34978053 DOI: 10.1007/s40519-021-01310-5] [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: 06/04/2020] [Accepted: 09/20/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The aim of this study was to explore the factor structure of the Danish translation of the eating disorder quality of life scale and evaluate the internal reliability and convergent validity of the scale in a Danish cohort of women with AN. METHODS The total sample comprised 211 patients diagnosed with anorexia nervosa age 13-40 years. Patients completed questionnaires assessing eating disorder psychopathology, physical and social functioning, and well-being. RESULTS Factor analyses were not able to support the current division of the scale into 12 factors. We found excellent internal consistency of the eating disorder quality-of-life scale total score. We found relevant associations between quality of life and pre-determined variables. CONCLUSION This study supports the use of the total score of the eating disorder quality of life scale in assessing quality of life in patients with anorexia nervosa. However, future studies should explore the factor structure of the scale further. LEVEL OF EVIDENCE III: Evidence obtained from cohort or case-control analytic studies.
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7
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Forney KJ, Brown TA, Crosby RD, Klein KM, Keel PK. Evaluating the predictive validity of purging disorder by comparison to bulimia nervosa at long-term follow-up. Int J Eat Disord 2022; 55:810-819. [PMID: 35366014 PMCID: PMC9167719 DOI: 10.1002/eat.23712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The current study sought to examine the predictive validity of the purging disorder diagnosis at long-term follow-up by comparing naturalistic outcomes with bulimia nervosa. METHOD Women with purging disorder (N = 84) or bulimia nervosa (N = 133) who had completed comprehensive baseline assessments as part of one of three studies between 2000 and 2012 were sought for follow-up assessment. Nearly all (94.5%) responded to recruitment materials and 150 (69% of sought sample; 83.3% non-Hispanic white; 33.40 [7.63] years old) participated at an average of 10.59 (3.71) years follow-up. Participants completed the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV, and a questionnaire battery. Diagnostic groups were compared on eating disorder (illness status, recovery status, and eating pathology) and related outcomes. Group differences in predictors of outcome were explored. RESULTS There were no significant differences in eating disorder presence (p = .70), recovery status (p = .87), and level of eating pathology (p = .17) between diagnostic groups at follow-up. Post hoc equivalence tests indicated group differences were smaller than a medium effect size (p's ≤ .005). Groups differed in diagnosis at follow-up (p = .002); diagnostic stability was more likely than cross-over to bulimia nervosa for women with baseline purging disorder (p = .004). DISCUSSION Although purging disorder and bulimia nervosa do not differ in long-term outcomes, the relative stability in clinical presentation suggests baseline group differences in clinical presentation may be useful in augmenting treatments for purging disorder. PUBLIC SIGNIFICANCE STATEMENT While purging disorder is classified as an "other specified" eating disorder, individuals who experience this disorder have comparable negative long-term outcomes as those with bulimia nervosa. This highlights the importance of screening for and treating purging disorder as a full-threshold eating disorder.
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Affiliation(s)
| | - Tiffany A. Brown
- Department of Psychological SciencesAuburn UniversityAuburnAlabamaUSA
| | - Ross D. Crosby
- Sanford Center for Biobehavioral ResearchFargoNorth DakotaUSA
- Department of Psychiatry and Behavioral ScienceUniversity of North Dakota School of Medicine and Health SciencesFargoNorth DakotaUSA
| | - Kelly M. Klein
- VA Boston Healthcare System, Brockton DivisionBrocktonMassachusettsUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Pamela K. Keel
- Department of PsychologyFlorida State UniversityTallahasseeFloridaUSA
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8
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Kambanis PE, Bottera AR, Mancuso CJ, De Young KP. Motivation to change predicts naturalistic changes in binge eating and purging, but not fasting or driven exercise among individuals with eating disorders. Eat Disord 2022; 30:279-301. [PMID: 33135984 DOI: 10.1080/10640266.2020.1823174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We examined the naturalistic relations between motivation to change and change in four specific eating disorder (ED) behaviors-binge eating (BE), purging, fasting, and driven exercise-in a community-based sample of individuals with EDs over two consecutive 6-week periods. We conducted cross-lagged generalized estimating equations using the transtheoretical model's four stages of change to predict changes in the ED behaviors 6 weeks later. Individuals reported lower pre-contemplation for behaviors typically associated with more distress (e.g., BE, purging) than they did for behaviors associated with less distress (e.g., fasting and driven exercise). Action predicted decreases in BE and purging frequencies but not fasting or driven exercise frequencies. Naturalistic relations between ED behavior severity/frequency and motivation to change these features can be detected over 6-week intervals; that is, attempts at change in individuals' natural environments can be successful over relatively brief periods of time, especially when individuals experience the motivation to change these features. The process of motivation to change ED behaviors is not linear, and our study highlights the movement between stages of change among individuals with EDs. Future research is needed to examine how much of the observed changes are sustained.
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Affiliation(s)
| | | | | | - Kyle P De Young
- Department of Psychology, University of Wyoming, Laramie, Wyoming, USA
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9
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Tan EJ, Cistullo L, Castle DJ, Rossell SL, Jenkins ZM, Phillipou A. Depression, perceived disability and unemployment are associated with reduced life satisfaction in anorexia nervosa. Eat Disord 2022; 30:323-330. [PMID: 33135579 DOI: 10.1080/10640266.2020.1836890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Life satisfaction is a core aspect of an individual's wellbeing and describes the subjective assessment of their quality of life. Reduced life satisfaction is frequently reported in anorexia nervosa (AN), but the factors contributing to this are still unclear. This study sought to extend previous work by examining 12 potential correlates of AN life satisfaction. One hundred and five female AN patients were administered questionnaires assessing life satisfaction, depression, anxiety, stress, employment status, marital status, body mass index, eating disorder symptomatology, perceived disability and readiness for change. A stepwise linear regression revealed that only depression, perceived disability and employment status were significantly associated with AN life satisfaction. The findings thus highlight prevailing mood and personal functioning as critical foci for clinical management strategies in people with AN. Addressing depressive symptoms and perceived disability while bettering employment prospects could facilitate improved AN life satisfaction.
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Affiliation(s)
- Eric Josiah Tan
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Leonardo Cistullo
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - David Jonathan Castle
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Susan Lee Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Zoe Marie Jenkins
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Mental Health, Austin Hospital, Melbourne, Australia
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10
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Akgül S, Akdemir D, Nalbant K, Derman O, Ersöz Alan B, Tüzün Z, Kanbur N. The effects of the COVID-19 lockdown on adolescents with an eating disorder and identifying factors predicting disordered eating behaviour. Early Interv Psychiatry 2022; 16:544-551. [PMID: 34263541 PMCID: PMC8444904 DOI: 10.1111/eip.13193] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/23/2021] [Accepted: 07/04/2021] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the impact of the COVID-19 lockdown on adolescents with eating disorders (ED) and identify factors predicting ED behaviour. METHOD This study took place during an age-stratified lockdown for those under 20 years in Turkey. Participants completed a survey developed to evaluate the effects of the lockdown on ED behaviour, well-being and quality of life (QoL) and additionally the eating disorder examination questionnaire (EDE-Q), and scales for depression, anxiety and obsessive-compulsive behaviour. The relationship between the EDE-Q-global score and other variables related to ED was examined. Linear regression analysis was performed to examine the predictive power of these variables on ED behaviour. RESULTS Thirty-eight ED patients with a mean age of 15.12 ± 1.56 years were included in the study. Of participants, 42.1% reported feeling an improvement in ED symptomatology, 71.0% reported none or rare conflict with parents due to eating, 39.5% reported often or always complying with their meal plan. Of participants, 92.0% agreed to 'understanding the value of being healthy' and stated realizing that 'they were in control' due to the pandemic. Of participants 36.9% scored 'bad' for both overall and ED related QoL. In the stepwise regression analysis depression score had the highest predictive value for ED behaviour. CONCLUSION Almost half of the participants felt an improvement in their ED and a majority reported rare parental conflict. However, less than half reported meal plan compliance. As depression had the highest positive predictive value for ED behaviour additional screening for depression during the pandemic maybe warranted in ED patients.
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Affiliation(s)
- Sinem Akgül
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Ersöz Alan
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Zeynep Tüzün
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Nuray Kanbur
- Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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11
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Predictors of binge eating disorder and the impact on the quality of life in patients with severe obesity before bariatric surgery. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1011364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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Dunne JP, Shindul-Rothschild J, White L, Lee CS, Wolfe BE. Mindfulness in persons with anorexia nervosa and the relationships between eating disorder symptomology, anxiety and pain. Eat Disord 2021; 29:497-508. [PMID: 31791198 DOI: 10.1080/10640266.2019.1688009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Mindfulness is useful for some psychiatric illnesses, but limited research exists among persons with anorexia nervosa (AN). This study aimed to determine the relationship between mindfulness, eating disorder symptomology and indicators of health in women with AN (n = 59) entering residential treatment. Participants completed a self-administered survey, including the Cognitive Affective Mindfulness Scale and other measures. Additional data from medical records were collected. Greater mindfulness was associated with less eating disorder symptoms (p = .049). This relationship was most profound in individuals with AN, including restrictive and binge-purge subtypes compared to individuals with atypical AN (interaction p-value = 0.044). Greater mindfulness was significantly associated with less shape (p = .023) and weight concern (p = .047). Expectedly, anxiety was inversely associated with eating disorder symptoms (p = .001). Greater pain was associated with less eating disorder symptoms (p = .024). Overall, mindfulness may be a protective factor against some eating disorder symptomology.
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Affiliation(s)
- Julie P Dunne
- W. F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.,Cambridge Eating Disorder Center, Cambridge, Massachusetts, USA
| | | | - Laura White
- W. F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Christopher S Lee
- W. F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Barbara E Wolfe
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA
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13
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Mental Pain in Eating Disorders: An Exploratory Controlled Study. J Clin Med 2021; 10:jcm10163584. [PMID: 34441880 PMCID: PMC8397208 DOI: 10.3390/jcm10163584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022] Open
Abstract
Mental pain (MP) is a transdiagnostic feature characterized by depression, suicidal ideation, emotion dysregulation, and associated with worse levels of distress. The study explores the presence and the discriminating role of MP in EDs in detecting patients with higher depressive and ED-related symptoms. Seventy-one ED patients and 90 matched controls completed a Clinical Assessment Scale for MP (CASMP) and the Mental Pain Questionnaire (MPQ). ED patients also completed the Beck Depression Inventory-II (BDI-II), Clinical Interview for Depression (CID-20), and Eating Attitudes Test (EAT-40). ED patients exhibited significantly greater severity and higher number of cases of MP than controls. Moreover, MP resulted the most important cluster predictor followed by BDI-II, CID-20, and EAT-40 in discriminating between patients with different ED and depression severity in a two-step cluster analysis encompassing 87.3% (n = 62) of the total ED sample. Significant positive associations have been found between MP and bulimic symptoms, cognitive and somatic-affective depressive symptoms, suicidal tendencies, and anxiety-related symptoms. In particular, those presenting MP reported significantly higher levels of depressive and anxiety-related symptoms than those without. MP represents a clinical aspect that can help to detect more severe cases of EDs and to better understand the complex interplay between ED and mood symptomatology.
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14
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Martín J, Anton-Ladislao A, Padierna Á, Berjano B, Quintana JM. Classification of subtypes of patients with eating disorders by correspondence analysis. World J Psychiatry 2021; 11:375-387. [PMID: 34327130 PMCID: PMC8311511 DOI: 10.5498/wjp.v11.i7.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/09/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Grouping eating disorders (ED) patients into subtypes could help improve the establishment of more effective diagnostic and treatment strategies.
AIM To identify clinically meaningful subgroups among subjects with ED using multiple correspondence analysis (MCA).
METHODS A prospective cohort study was conducted of all outpatients diagnosed for an ED at an Eating Disorders Outpatient Clinic to characterize groups of patients with ED into subtypes according to sociodemographic and psychosocial impairment data, and to validate the results using several illustrative variables. In all, 176 (72.13%) patients completed five questionnaires (clinical impairment assessment, eating attitudes test-12, ED-short form health-related quality of life, metacognitions questionnaire, Penn State Worry Questionnaire) and sociodemographic data. ED patient groups were defined using MCA and cluster analysis. Results were validated using key outcomes of subtypes of ED.
RESULTS Four ED subgroups were identified based on the sociodemographic and psychosocial impairment data.
CONCLUSION ED patients were differentiated into well-defined outcome groups according to specific clusters of compensating behaviours.
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Affiliation(s)
- Josune Martín
- Department of Research, Galdakao-Usansolo Hospital, Galdakao 48960, Spain
- Kronikgune Institute for Health Services Research, Barakaldo 48902, Spain
- Health Services Research on Chronic Diseases Network – REDISSEC, Galdakao 48960, Spain
| | - Ane Anton-Ladislao
- Department of Research, Galdakao-Usansolo Hospital, Galdakao 48960, Spain
| | - Ángel Padierna
- Health Services Research on Chronic Diseases Network – REDISSEC, Galdakao 48960, Spain
- Department of Psychiatry, Galdakao-Usansolo Hospital, Galdakao 48960, Spain
| | - Belén Berjano
- Department of Psychiatry, Galdakao-Usansolo Hospital, Galdakao 48960, Spain
| | - José María Quintana
- Department of Research, Galdakao-Usansolo Hospital, Galdakao 48960, Spain
- Health Services Research on Chronic Diseases Network – REDISSEC, Galdakao 48960, Spain
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15
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Mond J, Gorrell S. "Excessive exercise" in eating disorders research: problems of definition and perspective. Eat Weight Disord 2021; 26:1017-1020. [PMID: 33389704 PMCID: PMC8068596 DOI: 10.1007/s40519-020-01075-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
- Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia.,School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Sasha Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
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16
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Cifani C, Alboni S, Mucci A, Benatti C, Botticelli L, Brunello N, Micioni Di Bonaventura MV, Righi V. Serum metabolic signature of binge-like palatable food consumption in female rats by nuclear magnetic resonance spectroscopy. NMR IN BIOMEDICINE 2021; 34:e4469. [PMID: 33458898 DOI: 10.1002/nbm.4469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/17/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Maladaptive eating behavior is a growing public health problem and compulsively eating excessive food in a short time, or binge eating, is a key symptom of many eating disorders. In order to investigate the binge-like eating behavior in female rats, induced by intermittent food restrictions/refeeding and frustration stress, we analyzed for the first time the metabolic profile obtained from serum of rats, through nuclear magnetic resonance (NMR) spectroscopy. In this experimental protocol, rats were exposed to chow food restricting/refeeding and frustration stress manipulation. This stress procedure consists of 15 min exposure to the odor and sight of a familiar chocolate paste, without access to it, just before offering the palatable food. In this model, a "binge-eating episode" was considered the significantly higher palatable food consumption within 2 h in restricted and stressed rats (R + S) than in the other three experimental groups: rats with no food restriction and no stress (NR + NS), only stressed rats (NR + S) or only restricted rats (R + NS). Serum samples from these four different rat groups were collected. The statistical analysis of the 1 H NMR spectral profiles of the four sets of samples pointed to O- and N-acetyl glycoproteins as the main biomarkers for the discrimination of restriction effects. Other metabolites, such as threonine, glycine, glutamine, acetate, pyruvate and lactate, showed trends that may be useful to understand metabolic pathways involved in eating disorders. This study suggested that NMR-based metabolomics is a suitable approach to detect biomarkers related to binge-eating behavior.
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Affiliation(s)
- Carlo Cifani
- School of Pharmacy, Pharmacology Unit, University of Camerino, Camerino, Italy
| | - Silvia Alboni
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Adele Mucci
- Department of Chemical and Geological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Benatti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Luca Botticelli
- School of Pharmacy, Pharmacology Unit, University of Camerino, Camerino, Italy
| | - Nicoletta Brunello
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Valeria Righi
- Department for the Quality of Life Studies, University of Bologna, Rimini, Italy
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17
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Dann KM, Hay P, Touyz S. Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review. J Eat Disord 2021; 9:40. [PMID: 33781337 PMCID: PMC8008586 DOI: 10.1186/s40337-021-00392-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is increasing interest in associations between cognitive impairments and clinical symptoms in Anorexia Nervosa (AN), however, the relationship with everyday function is unclear. The current review synthesizes existing data regarding associations between scores on tests of set-shifting and central coherence and functional outcome measures for individuals with AN. METHOD A systematic electronic database search yielded 13 studies which included participants with current or lifetime AN where scores on a neuropsychological test of set-shifting or central coherence were directly or indirectly compared to a functional outcome measure. RESULTS Associations between set-shifting and central coherence performance measures and functional outcomes were limited in number and noted only in adult or mixed-age cohorts. Associations were noted at subscale level, suggesting they are specific in nature. In younger cohorts, assessments of executive functioning in everyday life appear sensitive to cognitive-behavioral flexibility issues. CONCLUSIONS Associations between cognitive performance and functional outcome have not been as systematically assessed in AN as in other psychiatric disorders. Key factors to address in future research include: (a) the use of function measures which are sensitive to both the level of impairment, and specific rather than general impairments (b) the ecological validity of measures, (c) the task impurity problem, especially in regard to cognitive flexibility assessment, and (d) the need to measure both cognitive deficits and strengths, because tests of specific cognitive processes may underestimate the ability to function in daily life due to compensatory strategies.
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Affiliation(s)
- Kelly M Dann
- School of Psychology, University of Sydney, Sydney, Australia.
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute and School of Psychology, University of Sydney, Sydney, Australia
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18
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Sfeir E, Haddad C, Salameh P, Sacre H, Hallit R, Akel M, Honein K, Akiki M, Kheir N, Obeid S, Hallit S. Binge eating, orthorexia nervosa, restrained eating, and quality of life: a population study in Lebanon. Eat Weight Disord 2021; 26:145-158. [PMID: 31849002 DOI: 10.1007/s40519-019-00831-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/09/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To assess the implication of disordered eating behaviors (DEBs) on the quality of life (QOL) of a sample of the Lebanese population, after adjustment over sociodemographic characteristics of those participants. Secondary objective aimed to assess the role of body dissatisfaction (BD) in the association of DEBs and QOL. METHODS This cross-sectional study was done between January and May 2018 and enrolled 811 participants from the community. A proportionate random sample technique was used to select the sample from all Lebanese Mohafazat. The World Health Organization Quality-of-life (WHOQOL)-BREF was used to assess the QOL and it includes four domains: physical health, psychological health, social relations, and environment. RESULTS Body dissatisfaction was found to be a major confounding factor contributing to psychological and environmental HQOL impairments in patient with restrained eating. Nevertheless, orthorexia nervosa was associated with QOL impairments in its physical and environmental domains, regardless of body dissatisfaction that was shown to be a major contributor for QOL impairments. Similarly, ON was directly correlated with QOL of life impairment in its physical and environmental domains, independently of all other risk factors. CONCLUSION When adding body dissatisfaction as a confounding variable, restrained eating and orthorexia nervosa remained significantly associated with quality-of-life impairments. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Elsa Sfeir
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Department of Pediatrics, Notre Dame des Secours University Hospital, Byblos, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon
- Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, Limoges, 87000, France
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Karl Honein
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Maria Akiki
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Nelly Kheir
- Faculty of Pedagogy, Holy Family University, Batroun, 5534, Lebanon
| | - Sahar Obeid
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
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19
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Glasofer DR, Muratore AF, Attia E, Wu P, Wang Y, Minkoff H, Rufin T, Walsh BT, Steinglass JE. Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa. J Eat Disord 2020; 8:69. [PMID: 33292619 PMCID: PMC7709230 DOI: 10.1186/s40337-020-00348-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/03/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. METHODS Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual's likelihood of maintaining inpatient treatment gains. RESULTS One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. CONCLUSIONS Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.
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Affiliation(s)
- Deborah R Glasofer
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York City, NY, 10032, USA.
| | - Alexandra F Muratore
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York City, NY, 10032, USA
| | - Evelyn Attia
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York City, NY, 10032, USA
- Center for Eating Disorders, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY, 10605, USA
| | - Peng Wu
- Department of Biostatistics, Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
| | - Yuanjia Wang
- Department of Biostatistics, Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
| | - Hillary Minkoff
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York City, NY, 10032, USA
| | - Teresa Rufin
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - B Timothy Walsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York City, NY, 10032, USA
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York City, NY, 10032, USA
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20
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Mond JM, Arrighi A. Perceived acceptability of anorexia and bulimia in women with and without eating disorder symptoms. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/j.1742-9536.2011.00033.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jonathan M. Mond
- School of Sociology, The Australian National University, Canberra, ACT, Australia
| | - Anais Arrighi
- Department of Community Safety, Queensland Government, Rockhampton, Queensland, Australia
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21
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Eating Disorders, Perfectionism, and Quality of Life: Maladaptive Perfectionism as a Mediator Between Symptoms of Disordered Eating and Quality of Life. J Nerv Ment Dis 2020; 208:771-776. [PMID: 32947453 DOI: 10.1097/nmd.0000000000001241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Individuals with disordered eating behaviors exhibit significantly impaired quality of life (QoL). Maladaptive perfectionism is consistently associated with both eating disorders (EDs) and QoL, but its role in the relationship between eating pathology and QoL has remained largely unexplored. The current study investigated whether maladaptive perfectionism mediates the ED-QoL relationship. A total of 286 university students completed an online survey that consisted of self-report questionnaires assessing ED symptomology, QoL, maladaptive perfectionism, and anxiety and depression symptoms. Maladaptive perfectionism mediated the relationship between ED symptomology and QoL, but this effect did not persist when body mass index, depression, and anxiety were controlled for. The results suggest the mediatory effect of maladaptive perfectionism is masked by depression and anxiety symptomology. Recommendations for further research are proposed to clarify the role of maladaptive perfectionism in the ED-QoL relationship and to explore the mediatory role of depression and anxiety in this relationship.
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22
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Holtzhausen N, Mannan H, Foroughi N, Hay P. Effects associated with the use of healthcare for eating disorders by women in the community: a longitudinal cohort study. BMJ Open 2020; 10:e033986. [PMID: 32859658 PMCID: PMC7454177 DOI: 10.1136/bmjopen-2019-033986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time. HYPOTHESIS We hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress. DESIGN, SETTING, PARTICIPANTS Data were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED-MHL, linear or logistic mixed-effects regression analyses were used. RESULTS 20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen's d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively. CONCLUSIONS Formal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED-MHL.
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Affiliation(s)
- Nicol Holtzhausen
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Nasim Foroughi
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
- Campbelltown Hospital Mental Health, South West Sydney Local Health District, Campbelltown, New South Wales, Australia
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23
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Children’s Physical Self-Concept and Body Image According to Weight Status and Physical Fitness. SUSTAINABILITY 2020. [DOI: 10.3390/su12030782] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Previous researchers have found that low body satisfaction may be a barrier to engaging in physical activity. Therefore, this research examines the association between self-concept, body dissatisfaction, fitness, and weight status in adolescents. The sample was formed by 303 students from primary schools, (males (n = 150) and female (n = 153)) aged 10 to 13 years (M = 11.74; SD = 0.86). Initially, participants’ BMIs, as well as waist-to-hip ratio were assessed. Later, all individuals answered a questionnaire about their perception of self-concept and body image perception. Moreover, agility run test and 6-min walking test were developed to assess children’s physical fitness. Results showed self-concept differences according to different fitness level. Moreover, some factors from self-concept emerged as relevant to explain body dissatisfaction. Finally, outcomes suggest the importance of physical fitness and the perception of competence and self-esteem in adolescent boys and girls, so these two issues might be promoted in primary school classes to improve body satisfaction.
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24
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Reilly EE, Rockwell RE, Ramirez AL, Anderson LK, Brown TA, Wierenga CE, Kaye WH. Naturalistic outcomes for a day-hospital programme in a mixed diagnostic sample of adolescents with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2020; 28:199-210. [PMID: 31925866 DOI: 10.1002/erv.2716] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/07/2019] [Accepted: 12/09/2019] [Indexed: 01/04/2023]
Abstract
Despite initial data suggesting positive treatment outcomes for adolescent eating disorder day-hospital programmes (DHPs), existing studies have included limited follow-up, small samples, and a focus on restricting-type eating disorders. To address these gaps, we explored naturalistic outcomes for an adolescent eating disorders DHP. Adolescent participants (N = 265) completed measurements at treatment admission, discharge (n = 170), and various lengths of follow-up (n = 126; Mfollow up = 278.87 days). Results from multilevel models indicated significant increases in body weight for the anorexia nervosa group throughout treatment and maintenance of increased body weight from discharge to follow-up. In bulimic spectrum disorders, binge eating and purging significantly decreased from intake to discharge and did not change from discharge to follow-up. Across the entire sample, eating disorder symptoms decreased from intake to discharge and did not change from discharge to follow-up. Further, anxiety and depression decreased over the course of treatment and continued to decrease over the follow-up period. The current investigation represents the first study to explore longitudinal DHP outcomes within adolescent bulimic spectrum eating disorders. Our findings also highlight many challenges inherent in conducting naturalistic research; it is critical that the field continue to develop solutions to the barriers inherent in conducting longitudinal research on eating disorder treatment.
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Affiliation(s)
- Erin E Reilly
- Department of Psychiatry, University of California, San Diego, CA.,Department of Psychology, Hofstra University, Hempstead, NY
| | | | - Ana L Ramirez
- Department of Psychiatry, University of California, San Diego, CA
| | | | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, CA
| | - Christina E Wierenga
- Department of Psychiatry, University of California, San Diego, CA.,VA San Diego Healthcare System, San Diego, CA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, CA
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25
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Bezzina L, Touyz S, Young S, Foroughi N, Clemes S, Meyer C, Arcelus J, Madden S, Attia E, Pike KM, Hay P. Accuracy of self-reported physical activity in patients with anorexia nervosa: links with clinical features. J Eat Disord 2019; 7:28. [PMID: 31463050 PMCID: PMC6706937 DOI: 10.1186/s40337-019-0258-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/01/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND High levels of physical activity (PA) have long been described in patients with Anorexia Nervosa (AN). Despite the importance of measuring PA in this population, there are two important factors that remain unknown. First, it is not clear how accurate self-report measures of PA are among patients. Second, little is known about how clinical characteristics are associated with the accuracy of self-reported PA. Therefore, this study aimed to examine the accuracy of self-reported PA compared to an objective measure of PA in patients with AN. It also investigated whether levels of accuracy/inaccuracy were associated with compulsive exercise, motivation to change, and psychological distress. METHOD Data were analysed from 34 adult outpatients with AN. Patients wore an accelerometer device (ActiGraph) for 4 days and completed a retrospective self-report measure of exercise (Exercise Participation Screening Questionnaire). They also completed measures of compulsive exercise (Compulsive Exercise Test), motivation to change (The Anorexia Nervosa Stages of Change Questionnaire), and psychological distress (Kessler-10). RESULTS On the self-report measure, patients accurately reported their time spent in moderate and vigorous intensity PA, however, they significantly under-reported their light physical activity (compared to the accelerometer data). Accurate reporting of total PA was positively associated with higher levels of compulsive exercise. There was evidence to suggest that clinical features, such as motivation to change and psychological distress, may be associated with inaccurate reporting at some levels of PA intensity and not others. CONCLUSIONS Results indicate that patients with AN are likely to under-report their light intensity PA. We also found preliminary evidence for how compulsive exercise, motivation to change, and distress are associated with self-reported PA accuracy. Clinical implications and directions for future research are considered. TRIAL REGISTRATION ACTRN12610000585022. Taking a LEAP forward in the treatment of anorexia nervosa: a randomized controlled trial. NHMRC grant: 634922.
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Affiliation(s)
| | | | | | - Nasim Foroughi
- School of Medicine, Western Sydney University, Sydney, Australia
| | | | | | | | | | | | | | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, South NSW 2715 Australia
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26
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Clinical management of females seeking fertility treatment and of pregnant females with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2019; 27:215-223. [DOI: 10.1002/erv.2667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/10/2019] [Accepted: 01/17/2019] [Indexed: 11/07/2022]
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27
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Purton T, Mond J, Cicero D, Wagner A, Stefano E, Rand-Giovannetti D, Latner J. Body dissatisfaction, internalized weight bias and quality of life in young men and women. Qual Life Res 2019; 28:1825-1833. [DOI: 10.1007/s11136-019-02140-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
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28
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Oliveira-Cardoso ÉA, Coimbra AC, Santos MA. Qualidade de Vida em Pacientes com Anorexia e Bulimia Nervosa. PSICOLOGIA: TEORIA E PESQUISA 2018. [DOI: 10.1590/0102.3772e34411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Este estudo teve por objetivo avaliar a qualidade de vida relacionada à saúde (QVRS) de pacientes com transtornos alimentares (TAs). A amostra foi composta por 40 pacientes consecutivos, em sua maioria mulheres jovens e adultas, com diagnóstico de Anorexia Nervosa e em tratamento ambulatorial. A coleta de dados foi realizada por meio da aplicação de um instrumento de QVRS (SF-36) e do Teste de Atitudes Alimentares (EAT-26). Os resultados evidenciaram QVRS rebaixada, especialmente nos Componentes Mentais. Constatou-se prejuízo em seis dos oito domínios de QV avaliados naqueles pacientes com maior pontuação no EAT-26, em cinco domínios nos pacientes com idade acima de 22 anos, nos domínios Estado Geral de Saúde (p = 0,02) e Saúde Mental (p = 0,03) naqueles pacientes com menos de cinco anos de tratamento e no domínio Aspectos Físicos (p = 0,02) naqueles que receberam diagnóstico de Bulimia Nervosa.
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29
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Jenkins PE, Staniford J, Luck A. Symptoms predicting psychosocial impairment in bulimia nervosa. Eat Weight Disord 2018; 23:665-671. [PMID: 28500621 DOI: 10.1007/s40519-017-0397-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 04/28/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The current study aimed to determine which particular eating disorder (ED) symptoms and related features, such as BMI and psychological distress, uniquely predict impairment in bulimia nervosa (BN). METHODS Two hundred and twenty-two adults with BN completed questionnaires assessing ED symptoms, general psychological distress, and psychosocial impairment. Regression analyses were used to determine predictors which account for variance in impairment. RESULTS Four variables emerged as significant predictors of psychosocial impairment: concerns with eating; concerns with weight and shape; dietary restraint; and general psychological distress. CONCLUSIONS Findings support previous work highlighting the importance of weight and shape concerns in determining ED-related impairment. Other ED symptoms, notably dietary restraint and concerns with eating, were also significant predictors as was psychological distress. Results suggest that cognitive aspects of EDs, in addition to psychological distress, may be more important determinants of impairment than behavioural symptoms, such as binge eating or purging.
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Affiliation(s)
- Paul E Jenkins
- Cotswold House Eating Disorders Service, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK. .,School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Jessica Staniford
- Cotswold House Eating Disorders Service, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK.,Buckinghamshire Community Eating Disorders Service, Oxford Health NHS Foundation Trust, Aylesbury, UK
| | - Amy Luck
- Buckinghamshire Community Eating Disorders Service, Oxford Health NHS Foundation Trust, Aylesbury, UK
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Mason TB, Wonderlich SA, Crosby RD, Engel SG, Mitchell JE, Crow SJ, Grange DL, Smith KE, Peterson CB. Associations among eating disorder behaviors and eating disorder quality of life in adult women with anorexia nervosa. Psychiatry Res 2018; 267:108-111. [PMID: 29886272 PMCID: PMC6760249 DOI: 10.1016/j.psychres.2018.05.077] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 05/22/2018] [Accepted: 05/27/2018] [Indexed: 11/16/2022]
Abstract
The study examined associations between eating disorder behaviors measured via ecological momentary assessment (EMA) and eating disorder quality of life (EDQOL) in anorexia nervosa (AN). Women with AN (N = 82) completed an EDQOL measure and two-weeks of EMA. Greater frequency of EMA-assessed restriction and bulimic behavior were independently related to lower EDQOL scores. Lower psychological EDQOL was associated with increased EMA dietary restriction; lower work-related EDQOL was associated with increased EMA binge eating; aspects of EDQOL were unrelated to EMA purging. Findings suggest that severity of restriction and bulimic behaviors may serve as severity indicators of EDQOL in AN.
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Affiliation(s)
- Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Stephen A. Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott G. Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - James E. Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott J. Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN,The Emily Program, St. Paul, MN
| | - Daniel Le Grange
- Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA
| | - Kathryn E. Smith
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN,The Emily Program, St. Paul, MN
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Choi HG, Lim H. Association between BMI for Obesity and Distress about Appearance in Korean Adolescents. J Korean Med Sci 2018; 33:e150. [PMID: 29760607 PMCID: PMC5944214 DOI: 10.3346/jkms.2018.33.e150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/13/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous research has related obesity to body dissatisfaction and low self-esteem. This study aimed to evaluate this relation between obesity and distress about appearance. METHODS We performed a cross-sectional study using data from the Korea Youth Risk Behavior Web-based Survey for 288,390 participants assessed from 2009 to 2012. The participants were categorized according to body mass index; obese, overweight, healthy weight, and underweight. The relation between obesity and distress was analyzed using simple and multiple logistic regression with complex sampling adjusted for age, sex, region of residence, economic level, parental education level, alcohol consumption, and smoking habits as confounders. RESULTS The adjusted odds ratio (AOR) was higher for participants with obesity (AOR for healthy weight = 1.15 [95% confidence interval {CI}, 1.08-1.22]; AOR for overweight = 1.85 [95% CI, 1.72-1.98]; AOR for obese = 2.45 [95% CI, 2.27-2.64]; reference = underweight, P < 0.001). In males, healthy weight was associated with an AOR below 1 (AOR for healthy weight = 0.92 [95% CI, 0.85-0.99]; AOR for overweight = 1.26 [95% CI, 1.14-1.38]; AOR for obese = 1.66 [95% CI, 1.50-1.84], P < 0.001). In females, higher AORs were associated with obesity (AOR for healthy weight = 1.44 [95% CI, 1.33-1.57]; AOR for overweight = 2.71 [95% CI, 2.45-2.99]; AOR for obese = 3.71 [95% CI, 3.32-4.14], P < 0.001). CONCLUSION Obesity is related to distress about appearance, and the relation is stronger in girls than in boys.
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Affiliation(s)
- Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hyoseob Lim
- Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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32
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Young S, Touyz S, Meyer C, Arcelus J, Rhodes P, Madden S, Pike K, Attia E, Crosby RD, Hay P. Relationships between compulsive exercise, quality of life, psychological distress and motivation to change in adults with anorexia nervosa. J Eat Disord 2018; 6:2. [PMID: 29441204 PMCID: PMC5799909 DOI: 10.1186/s40337-018-0188-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 01/25/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND For people with anorexia nervosa (AN), compulsive exercise is characterized by extreme concerns about the perceived negative consequences of stopping/reducing exercise, dysregulation of affect, and inflexible exercise routines. It is associated with increased eating disorder psychopathology and poor clinical outcome. However, its relationships with two important clinical issues, quality of life (QoL) and motivation to change, are currently unknown. This study aimed to assess the cross-sectional relationships between compulsive exercise, QoL, psychological distress (anxiety and depressive symptoms, and obsessive-compulsive traits) and motivation to change in patients with AN. METHOD A total of 78 adults with AN participated in this study, which was nested within a randomized controlled trial of psychological treatments for AN. At baseline (pre-treatment), participants completed questionnaires assessing compulsive exercise, eating disorder (ED) psychopathology, QoL, psychological distress and motivation to change. RESULTS Baseline correlational analyses demonstrated a moderate positive relationship between compulsive exercise and ED psychopathology, and a weak positive relationship between compulsive exercise and psychological distress. There was a moderate negative relationship between compulsive exercise and eating disorder QoL. CONCLUSIONS These results indicate compulsive exercise is moderately associated with poorer QoL and weakly associated with higher distress. Targeting compulsive exercise in the treatment of anorexia nervosa may help reduce the burden of illness and improve patients' engagement in treatment. TRIAL REGISTRATION ACTRN12610000585022. Taking a LEAP forward in the treatment of anorexia nervosa: a randomized controlled trial. NHMRC grant: 634922.
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Affiliation(s)
- Sarah Young
- Griffith Taylor Building, School of Psychology, University of Sydney, Sydney, Australia
| | - Stephen Touyz
- School of Psychology, University of Sydney, Sydney, Australia
| | - Caroline Meyer
- WMG, University of Warwick, United Kingdom & University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Jon Arcelus
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Leicestershire Adult Eating Disorders Service, Leicestershire Partnership NHS Trust, Bennion Centre, Glenfield Hospital, Leicester, UK
| | - Paul Rhodes
- School of Psychology, University of Sydney, Sydney, Australia
| | - Sloane Madden
- School of Medicine, University of Sydney, Sydney, Australia
- Eating Disorders Service at the Sydney Children’s Hospitals Network, Westmead, Australia
| | - Kathleen Pike
- Division of Behavioral Health Services and Policy Research, Columbia University, New York, USA
| | - Evelyn Attia
- Department of Psychiatry, College of Physicians and Surgeons of Columbia University, Weill Cornell Medical College, New York, USA
| | - Ross D. Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota USA
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, Australia
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Mitchison D, Rieger E, Harrison C, Murray SB, Griffiths S, Mond J. Indicators of clinical significance among women in the community with binge-eating disorder symptoms: Delineating the roles of binge frequency, body mass index, and overvaluation. Int J Eat Disord 2018; 51:165-169. [PMID: 29278426 DOI: 10.1002/eat.22812] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aimed to investigate the relative contributions of binge eating, body image disturbance, and body mass index (BMI) to distress and disability in binge-eating disorder (BED). METHOD A community sample of 174 women with BED-type symptomatology provided demographic, weight, and height information, and completed measures of overvaluation of weight/shape and binge eating, general psychological distress and impairment in role functioning. Correlation and regression analyses examined the associations between predictors (binge eating, overvaluation, BMI), and outcomes (distress, functional impairment). RESULTS Binge eating and overvaluation were moderately to strongly correlated with distress and functional impairment, whereas BMI was not correlated with distress and only weakly correlated with functional impairment. Regression analysis indicated that both overvaluation and binge eating were strong and unique predictors of both distress and impairment, the contribution of overvaluation to variance in functional impairment being particularly strong, whereas BMI did not uniquely predict functional impairment or distress. DISCUSSION The findings support the inclusion of overvaluation as a diagnostic criterion or specifier in BED and the need to focus on body image disturbance in treatment and public health efforts in order to reduce the individual and community health burden of this condition.
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Affiliation(s)
- Deborah Mitchison
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Carmel Harrison
- Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Stuart B Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Scott Griffiths
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
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34
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Reas DL, Rø Ø. Less symptomatic, but equally impaired: Clinical impairment in restricting versus binge-eating/purging subtype of anorexia nervosa. Eat Behav 2018; 28:32-37. [PMID: 29310054 DOI: 10.1016/j.eatbeh.2017.12.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/18/2017] [Accepted: 12/28/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study investigated subtype differences in eating disorder-specific impairment in a treatment-seeking sample of individuals with anorexia nervosa (AN). METHOD The Clinical Impairment Assessment (CIA) and the Eating Disorder Examination-Questionnaire (EDE-Q) were administered to 142 patients. Of these, 54.9% were classified as restricting type (AN-R) and 45.1% were classified as binge-eating/purging type (AN-B/P) based on an average weekly occurrence of binge eating and/or purging episodes (≥4 episodes/28days). RESULTS Individuals with AN-B/P exhibited higher levels of core ED psychopathology (dietary restraint, eating concern, shape/weight concerns) in addition to the expected higher frequency of binge/purge episodes. No significant differences existed between AN subtypes in the severity of ED-related impairment. Weight/shape concerns and binge eating frequency significantly predicted level of impairment. Differential associations were observed between the type of ED pathology that significantly contributed to impairment according to AN subtype. DISCUSSION Although those with AN-B/P displayed higher levels of core attitudinal and behavioral ED pathology than AN-R, no significant differences in ED-specific impairment were found between AN subtypes. Eating disorder-related impairment in AN was not related to the severity of underweight or purging behaviors, but was uniquely and positively associated with weight/shape concerns and binge eating frequency.
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Affiliation(s)
- Deborah Lynn Reas
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway.
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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Blakey SM, Reuman L, Buchholz JL, Abramowitz JS. Experiential avoidance and dysfunctional beliefs in the prediction of body image disturbance in a nonclinical sample of women. Body Image 2017; 22:72-77. [PMID: 28667898 DOI: 10.1016/j.bodyim.2017.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/07/2017] [Accepted: 06/13/2017] [Indexed: 12/01/2022]
Abstract
Body image disturbance (BID) refers to persistent dissatisfaction, distress, and dysfunction related to some aspect(s) of one's physical appearance. Cognitive models of BID highlight the importance of dysfunctional beliefs in maintaining BID. Relational Frame Theory (RFT), in contrast, posits that psychological distress is sustained by the unwillingness to experience aversive internal experiences (i.e., experiential avoidance [EA]). The present study tested the hypothesis that both dysfunctional beliefs and EA uniquely predict BID even after accounting for general distress. A nonclinical female sample (N=100) completed measures of general distress, dysfunctional beliefs about appearance, EA, and BID in addition to providing in vivo anxiety ratings after looking at their most dissatisfactory facial feature in a vanity mirror. Linear regression analyses showed that dysfunctional beliefs, but not EA, accounted for significant unique variance in BID outcomes. Implications for understanding, assessing, and treating clinically significant BID are discussed.
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Affiliation(s)
- Shannon M Blakey
- University of North Carolina at Chapel Hill, 235 E. Cameron Ave, Davie Hall (CB 3270), Chapel Hill, NC 27599-3270, United States.
| | - Lillian Reuman
- University of North Carolina at Chapel Hill, 235 E. Cameron Ave, Davie Hall (CB 3270), Chapel Hill, NC 27599-3270, United States.
| | - Jennifer L Buchholz
- University of North Carolina at Chapel Hill, 235 E. Cameron Ave, Davie Hall (CB 3270), Chapel Hill, NC 27599-3270, United States.
| | - Jonathan S Abramowitz
- University of North Carolina at Chapel Hill, 235 E. Cameron Ave, Davie Hall (CB 3270), Chapel Hill, NC 27599-3270, United States.
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36
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Carey JB, Saules KK, Carr MM. A qualitative analysis of men's experiences of binge eating. Appetite 2017; 116:184-195. [DOI: 10.1016/j.appet.2017.04.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 11/24/2022]
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37
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Martín J, Padierna A, Loroño A, Muñoz P, Quintana JM. Predictors of quality of life in patients with eating disorders. Eur Psychiatry 2017; 45:182-189. [PMID: 28957785 DOI: 10.1016/j.eurpsy.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/30/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The aims of this study were to analyse the quality of life (QoL) of a broad sample of patients with eating disorders (ED) and to identify potential factors that predict QoL. METHODS This prospective cohort study involved 528 patients diagnosed with ED and treated over a 15-year period in the Eating Disorders Outpatient Clinic. Information on sociodemographic and clinical data were gathered. Patients completed five self-administered instruments: the Eating Attitudes Test-26 (EAT-26); the Eating Disorder Diagnostic Scale (EDDS); the Hospital Anxiety and Depression Scale (HADS); the Short-Form 12 (SF-12); and the Quality of Life in ED-short form (HeRQoLED-s). Descriptive, univariate analyses and multivariate linear regression models were applied to identify factors associated with QoL. RESULTS Predictive variables for a low level of QoL in patients with anorexia nervosa (AN) included antidepressant treatment (P=0.009), substance abuse disorder, (P=0.03) and other organic comorbidities (P<0.0001). For patients with bulimia nervosa (BN), they included osteoporosis (P≤0.0001), obesity (P=0.0004) or being a student (P=0.04). For patients with eating disorders not otherwise specified (EDNOS), they included anxiolytic treatment (P=0.003), having circulatory disease (P=0.001), more years since start of ED treatment (P=0.03) and living alone (P<0.0001). CONCLUSIONS We found a significant difference in QoL between the diagnostic ED groups. With regard to the variables predicting QoL in ED patients, the findings of this study suggest that organic or psychiatric comorbidities and some data of social normality might be more relevant to QoL in ED than age, type of compensatory behaviour, BMI or number of visits to hospital emergency department.
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Affiliation(s)
- J Martín
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao, 48960 Bizkaia, Spain; Health Services Research on Chronic Diseases Network-REDISSEC, 48960 Galdakao, Spain.
| | - A Padierna
- Department of Psychiatry, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao, 48960 Bizkaia, Spain; Health Services Research on Chronic Diseases Network-REDISSEC, 48960 Galdakao, Spain
| | - A Loroño
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao, 48960 Bizkaia, Spain; Health Services Research on Chronic Diseases Network-REDISSEC, 48960 Galdakao, Spain
| | - P Muñoz
- Department of Psychiatry, Ortuella Mental Health Center, Avda. Del Minero 1, Ortuella, 48530 Bizkaia, Spain
| | - J M Quintana
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao, 48960 Bizkaia, Spain; Health Services Research on Chronic Diseases Network-REDISSEC, 48960 Galdakao, Spain
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Hamatani S, Tomotake M, Takeda T, Kameoka N, Kawabata M, Kubo H, Tada Y, Tomioka Y, Watanabe S, Inoshita M, Kinoshita M, Ohta M, Ohmori T. Influence of cognitive function on quality of life in anorexia nervosa patients. Psychiatry Clin Neurosci 2017; 71:328-335. [PMID: 27973723 DOI: 10.1111/pcn.12491] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/27/2016] [Accepted: 12/05/2016] [Indexed: 12/24/2022]
Abstract
AIM The purpose of this study was to elucidate determinants of quality of life (QOL) in anorexia nervosa (AN) patients. METHODS Twenty-one female patients with AN participated in the study. QOL was assessed with the 36-Item Short Form Health Survey (SF-36), and cognitive function was evaluated using the Wisconsin Card Sorting Test Keio version, the Rey Complex Figure Test, and the Social Cognition Screening Questionnaire. Clinical symptoms were evaluated with the Beck Depression Inventory-II, the State-Trait Anxiety Inventory-Form JYZ (STAI-JYZ), and the Maudsley Obsessive Compulsive Inventory. RESULTS The Difficulty Maintaining Set score of the Wisconsin Card Sorting Test Keio version was negatively correlated to the SF-36 Physical Component Summary. Scores of the Beck Depression Inventory-II and the STAI-JYZ State and Trait were negatively correlated to the SF-36 Mental Component Summary (MCS), and the Central Coherence Index 30-min Delayed Recall score of the Rey Complex Figure Test was positively correlated with the MCS. Stepwise regression analysis showed that the Difficulty Maintaining Set score was an independent predictor of the Physical Component Summary and scores for Central Coherence Index 30-min Delayed Recall and the STAI-JYZ Trait-predicted MCS. CONCLUSION These results suggest that not only trait anxiety but also poor central coherence and impaired ability to maintain new rule worsen AN patients' QOL.
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Affiliation(s)
- Sayo Hamatani
- Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Masahito Tomotake
- Department of Mental Health, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tomoya Takeda
- Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Naomi Kameoka
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Masashi Kawabata
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Hiroko Kubo
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Yukio Tada
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Yukiko Tomioka
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shinya Watanabe
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Masatoshi Inoshita
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Makoto Kinoshita
- Department of Psychiatry, Tokushima University Hospital, Tokushima, Japan
| | - Masashi Ohta
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Tomba E, Tecuta L, Schumann R, Ballardini D. Does psychological well-being change following treatment? An exploratory study on outpatients with eating disorders. Compr Psychiatry 2017; 74:61-69. [PMID: 28107643 DOI: 10.1016/j.comppsych.2017.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 12/06/2016] [Accepted: 01/04/2017] [Indexed: 11/20/2022] Open
Abstract
Psychological well-being changes following cognitive-behavioral therapy-based treatment were investigated in outpatients with eating disorders (ED). While it is known that CBT reduces symptomatology in EDs, less is known about how changes in positive functioning may ensue. One-hundred and eighty five ED outpatients were analyzed for pre-treatment and post-treatment changes in psychological well-being (PWB) by last observation carried forward - Wilcoxon signed rank tests. Significant gains in all PWB dimensions were found, with moderate effect size correlations in environmental mastery (r=-.418), personal growth (r=-.351) and self-acceptance (r=-.341). A subsample of patients in remission (n=51) was selected and compared to healthy controls in PWB post-treatment scores through Mann-Whitney U tests. Remitted patients showed significantly lower psychological well-being in two dimensions compared to controls: PWB-positive relations (r=-.360) and PWB-self-acceptance (r=-.288). However, more than 50% of ED outpatients in remission had PWB scores that fell below the 50th percentile of healthy controls in all psychological well-being dimensions, despite significant treatment response. Several mechanisms of psychological well-being change following CBT-based treatment are discussed. The assessment of treatment outcome in EDs may benefit from considering changes in positive functioning such as psychological well-being, in addition to the standard measurement of BMI, symptomatology and behavioral parameters. CBT-based treatment outcomes may be strengthened by promoting the development of optimal domains particularly in the interpersonal realm, such as building of quality and warm relationships and focusing on enhancing self-acceptance.
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Affiliation(s)
- Elena Tomba
- Department of Psychology, University of Bologna, Bologna, Italy.
| | - Lucia Tecuta
- Department of Psychology, University of Bologna, Bologna, Italy
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40
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Bode K, Götz von Olenhusen NM, Wunsch EM, Kliem S, Kröger C. Population-based cost-offset analyses for disorder-specific treatment of anorexia nervosa and bulimia nervosa in Germany. Int J Eat Disord 2017; 50:239-249. [PMID: 28152200 DOI: 10.1002/eat.22686] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/21/2016] [Accepted: 01/09/2017] [Indexed: 11/10/2022]
Abstract
Previous research has shown that anorexia nervosa (AN) and bulimia nervosa (BN) are expensive illnesses to treat. To reduce their economic burden, adequate interventions need to be established. Our objective was to conduct cost-offset analyses for evidence-based treatment of eating disorders using outcome data from a psychotherapy trial involving cognitive behavioral therapy (CBT) and focal psychodynamic therapy (FPT) for AN and a trial involving CBT for BN. Assuming a currently running, ideal healthcare system using a 12-month, prevalence-based approach and varying the willingness to participate in treatment, we investigated whether the potential financial benefits of AN- and BN-related treatment outweigh the therapy costs at the population level. We elaborated on a formula that allows calculating cost-benefit relationships whereby the calculation of the parameters is based on estimates from data of health institutions within the German healthcare system. Additional intangible benefits were calculated with the aid of Quality-Adjusted Life Years. The annual costs of an untreated eating disorder were 2.38 billion EUR for AN and 617.69 million EUR for BN. Independent of the willingness to participate in treatment, the cost-benefit relationships for the treatment remained constant at 2.51 (CBT) and 2.33 (FPT) for AN and 4.05 (CBT) for BN. This consistency implies that for each EUR invested in the treatment, between 2.33 and 4.05 EUR could be saved each year. Our findings suggest that the implementation of evidence-based psychotherapy treatments for AN and BN may achieve substantial cost savings at the population level.
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Affiliation(s)
- Katharina Bode
- Technical University of Brunswick, Department of Psychology, Humboldtstraße 33, Brunswick, 38106, Germany
| | | | - Eva-Maria Wunsch
- Technical University of Brunswick, Department of Psychology, Humboldtstraße 33, Brunswick, 38106, Germany
| | - Sören Kliem
- Criminological Research Institute of Lower Saxony, Lützerodestraße 9, Hannover, 30161, Germany
| | - Christoph Kröger
- Technical University of Brunswick, Department of Psychology, Humboldtstraße 33, Brunswick, 38106, Germany
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41
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Eating disorders in the context of preconception care: fertility specialists’ knowledge, attitudes, and clinical practices. Fertil Steril 2017; 107:494-501. [DOI: 10.1016/j.fertnstert.2016.10.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 01/01/2023]
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42
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Stefano EC, Wagner AF, Mond JM, Cicero DC, Latner JD. Loss of Control Over Eating Scale (LOCES): Validation in undergraduate men and women with and without eating disorder symptoms. Eat Behav 2016; 23:137-140. [PMID: 27679970 DOI: 10.1016/j.eatbeh.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022]
Abstract
The present study aimed to further validate the Loss of Control Over Eating Scale (LOCES) for use with undergraduate men and women with and without eating disorder (ED) symptoms. A total of 261 participants completed the LOCES and the Eating Disorder Examination - Questionnaire (EDE-Q) and were identified as non-clinical or having probable ED symptomatology based on previously used EDE-Q cutoff scores. Results indicated that the LOCES and its subscales were significantly associated with and a significant predictor of global ED pathology and binge episode frequency. The LOCES behavioral subscale appeared to be a stronger predictor of episode frequency compared to other subscales. The ED pathology groups reported significantly higher LOCES scores compared to the non-ED pathology groups. Binary logistic regression analyses revealed that the LOCES was able to accurately distinguish between those with ED pathology and those without ED pathology in the majority of cases. Findings from the present study suggest that the LOCES is highly predictive of ED pathology, strongly associated with ED cognitions and behaviors, and an accurate index for global eating disorder pathology. Future directions for research are discussed.
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Affiliation(s)
- Emily C Stefano
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States.
| | - Allison F Wagner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Jonathan M Mond
- Department of Psychology, Macquarie University, Sydney, Australia
| | - David C Cicero
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
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Martín J, Padierna A, Unzurrunzaga A, González N, Berjano B, Quintana JM. Predictors of change in psychosocial impairment secondary to an eating disorder. Psychiatry Res 2016; 243:161-7. [PMID: 27400219 DOI: 10.1016/j.psychres.2016.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 01/12/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
Eating disorders (ED) can significantly impair psychosocial health in patients. However, no published studies have so far used a standardized and specific instrument to evaluate predictive factors in ED-related psychosocial impairment. This prospective cohort study involved 177 patients receiving outpatient treatment for an ED at baseline and 115 patients at the 1-year follow-up. Patients completed three self-administered questionnaires: the Clinical Impairment Assessment (CIA), the Eating Attitudes Test-12 (EAT-12), and the Health-Related Quality of Life in ED-short form (HeRQoLED-s). Descriptive statistics, ANOVA, chi-square, and Fisher's exact test were applied to examine intervariable relationships. Multivariate linear regression was used to determine predictors of change in CIA scores. An improvement was reported by patients with restrictive anorexia nervosa (AN) compared to those with purgative AN. In the multivariate analysis, employment status, subtype of ED, and the bulimia and food preoccupation factor of the EAT-12 were significant predictors of change in the CIA scores.
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Affiliation(s)
- Josune Martín
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao 48960, Bizkaia, Spain; Health Services Research on Chronic Diseases Network - REDISSEC, Galdakao, Spain.
| | - Angel Padierna
- Department of Psychiatry, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao 48960, Bizkaia, Spain; Health Services Research on Chronic Diseases Network - REDISSEC, Galdakao, Spain
| | - Anette Unzurrunzaga
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao 48960, Bizkaia, Spain; Health Services Research on Chronic Diseases Network - REDISSEC, Galdakao, Spain
| | - Nerea González
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao 48960, Bizkaia, Spain; Health Services Research on Chronic Diseases Network - REDISSEC, Galdakao, Spain
| | - Belén Berjano
- Department of Psychiatry, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao 48960, Bizkaia, Spain
| | - José M Quintana
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao 48960, Bizkaia, Spain; Health Services Research on Chronic Diseases Network - REDISSEC, Galdakao, Spain
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Ágh T, Kovács G, Supina D, Pawaskar M, Herman BK, Vokó Z, Sheehan DV. A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder. Eat Weight Disord 2016; 21:353-364. [PMID: 26942768 PMCID: PMC5010619 DOI: 10.1007/s40519-016-0264-x] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/17/2016] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To perform a systematic review of the health-related quality of life (HRQoL) and economic burdens of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). METHODS A systematic literature search of English-language studies was performed in Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier, and Cochrane Library. Cost data were converted to 2014 Euro. RESULTS Sixty-nine studies were included. Data on HRQoL were reported in 41 studies (18 for AN, 17 for BN, and 18 for BED), on healthcare utilization in 20 studies (14 for AN, 12 for BN, and 8 for BED), and on healthcare costs in 17 studies (9 for AN, 11 for BN, and only 2 for BED). Patients' HRQoL was significantly worse with AN, BN, and BED compared with healthy populations. AN, BN, and BED were associated with a high rate of hospitalization, outpatient care, and emergency department visits. However, patients rarely received specific treatment for their eating disorder. The annual healthcare costs for AN, BN, and BED were €2993 to €55,270, €888 to €18,823, and €1762 to €2902, respectively. CONCLUSIONS AN, BN, and BED have a serious impact on patient's HRQoL and are also associated with increased healthcare utilization and healthcare costs. The burden of BED should be examined separately from that of BN. The limited evidence suggests that further research is warranted to better understand the differences in long-term HRQoL and economic burdens of AN, BN, and BED.
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Affiliation(s)
- Tamás Ágh
- Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary.
| | - Gábor Kovács
- Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary
| | - Dylan Supina
- Formerly of Shire, 300 Shire Way, Lexington, MA, 02421, USA
| | | | | | - Zoltán Vokó
- Syreon Research Institute, 119 Thököly Street, 1146, Budapest, Hungary.,Department of Health Policy and Health Economics, Faculty of Social Sciences, Eötvös Loránd University, 1/a Pázmány Péter Street, 1117, Budapest, Hungary
| | - David V Sheehan
- University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL, 33612, USA
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Affiliation(s)
- L Citrome
- New York Medical College, Valhalla, NY, USA.
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46
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Weigel A, König HH, Gumz A, Löwe B, Brettschneider C. Correlates of health related quality of life in anorexia nervosa. Int J Eat Disord 2016; 49:630-4. [PMID: 26841271 DOI: 10.1002/eat.22512] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/30/2015] [Accepted: 12/30/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We examined the association between disorder specific factors, comorbidity and health related quality of life (HRQoL) in anorexia nervosa (AN). METHOD HRQoL was assessed using the EuroQol-5D visual analog scale (EQ-VAS) in this cross-sectional study. Three regression models were estimated to determine the association between AN subtype (restrictive vs. binge/purge), duration of the eating disorder (ED), age (adolescents vs. adults), ED pathology (EDE-Q), Body Mass Index (BMI), depressive symptoms (PHQ-9), somatic complaints (PHQ-15), anxiety (GAD-7) and EQ-VAS. RESULTS The sample comprised 218 female AN patients (mean age = 23.3 years [SD = 8.2]; mean EQ-VAS score = 53.4 [SD = 21.4]). A lower BMI, higher levels of depressive symptoms, and somatic complaints were significantly associated with lower EQ-VAS scores. DISCUSSION Findings of the present study suggest that BMI and comorbidity might be more relevant to HRQoL impairments in AN than age, diagnostic subtype, duration of the ED or current psychopathology. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:630-634).
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Affiliation(s)
- Angelika Weigel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg- Eppendorf
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg- Eppendorf
| | - Antje Gumz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg- Eppendorf
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg- Eppendorf
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg- Eppendorf
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47
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Wagner AF, Stefano EC, Cicero DC, Latner JD, Mond JM. Eating disorder features and quality of life: Does gender matter? Qual Life Res 2016; 25:2603-2610. [PMID: 27048498 DOI: 10.1007/s11136-016-1283-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. METHODS The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). RESULTS Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. CONCLUSION This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.
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Affiliation(s)
- Allison F Wagner
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA.
| | - Emily C Stefano
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | - David C Cicero
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | - Janet D Latner
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
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48
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Javier SJ, Moore MP, Belgrave FZ. Racial comparisons in perceptions of maternal and peer attitudes, body dissatisfaction, and eating disorders among African American and White women. Women Health 2015; 56:615-33. [DOI: 10.1080/03630242.2015.1118721] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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49
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Las Hayas C, Padilla P, del Barrio AG, Beato-Fernandez L, Muñoz P, Gámez-Guadix M. Individualised Versus Standardised Assessment of Quality of Life in Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2015; 24:147-56. [PMID: 26442984 DOI: 10.1002/erv.2411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/29/2015] [Accepted: 09/01/2015] [Indexed: 11/10/2022]
Abstract
Individualised measures of quality of life (QoL) refer to instruments that encourage the respondent to actively elicit which areas of their life are most relevant for his/her QoL. The aim of this study is to compare individualised versus standard measures of QoL in a sample of patients with eating disorder (ED). The Schedule for the Evaluation of the Individual Quality of Life (SEIQoL) and a generic measure of QoL [World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF)] were applied on two occasions (one-year follow-up) to a sample of 165 patients with ED, 57 recovered patients with ED, and 349 women from the general population. The areas of 'family', 'education/career or job', 'friends', 'leisure', 'romantic partner' and 'health' were identified as the most important for their QoL for all groups, both times. The WHOQOL-BREF was more sensitive than the SEIQoL in detecting changes that occurred over time. Clinical interventions for ED should consider social components as objectives of intervention.
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Affiliation(s)
- Carlota Las Hayas
- Faculty of Psychology and Education, University of Deusto, Bilbao, Spain.,REDISSEC-Health Services Research on Chronic Patients Network, University of Deusto, Bilbao, Spain
| | - Patricia Padilla
- Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Andrés Gómez del Barrio
- Center for Biomedical Research in Mental Health (CIBERSAM), Eating Disorders Unit, Department of Psychiatry, Hospital Universitario Marqués Valdecilla, Cantabria, Spain
| | | | - Pedro Muñoz
- Department of Psychiatry, Ortuella Mental Health Center, Ortuella, Spain
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50
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Naumann E, Tuschen-Caffier B, Voderholzer U, Svaldi J. Spontaneous Emotion Regulation in Anorexia and Bulimia Nervosa. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9723-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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