1
|
Smith KE, Goldschmidt AB. Treatment of Binge-Eating Disorder Across the Lifespan: An Updated Review of the Literature and Considerations for Future Research. Curr Obes Rep 2024; 13:195-202. [PMID: 38363468 PMCID: PMC11150297 DOI: 10.1007/s13679-024-00553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW The present review describes the recent literature on treatment for binge-eating disorder (BED) in adults and youth, with a particular focus on research gaps, emerging treatments, and future research directions. RECENT FINDINGS Evidence supports the efficacy of several treatment modalities in adults, including self-help treatment, clinician-led psychotherapy, and pharmacotherapy; the largest effect sizes have been found for psychotherapies, most of which were cognitive-behavioral in orientation. Adapted psychotherapies for youth also show promise but lack a robust body of evidence. Predictors, moderators, and mediators of treatment outcome remain poorly understood; individuals with BED continue to experience significant barriers to treatment; and research is needed to address suboptimal treatment response. Recent work has highlighted the potential of adaptive interventions and investigation of novel mechanisms to address these gaps. Research on BED treatment continues to grow, though critical questions must be answered to improve treatment efficacy across the lifespan.
Collapse
Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar St #2200, Los Angeles, CA, 90033, USA.
| | - Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
2
|
Timko CA, Schnabel J, Orloff NC. The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy. Int J Eat Disord 2024; 57:1109-1118. [PMID: 38333943 DOI: 10.1002/eat.24164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Inefficiencies in executive functioning (EF), more specifically cognitive flexibility and an overly detailed processing style, are frequently observed in individuals with Anorexia Nervosa (AN) and have been identified as potential targets in treatment. Cognitive Remediation Therapy (CRT) is an adjunctive treatment approach specifically designed to have a positive impact on EF. Mainly evaluated in adults, CRT has been criticized for its perceived ineffectiveness in promoting weight restoration or directly reducing eating disorder symptoms. METHOD We argue that we need to refocus our conceptual framework for using CRT as an adjunctive treatment and specifically explore its potential benefit in adolescents. RESULTS Adolescence is a critical window for EF development during which CRT has the potential to have the most impact. While it may not specifically ameliorate eating disorder symptoms and directly improve weight gain, CRT may mitigate the impact of malnutrition on adolescent brain development, reduce attrition rates in treatment, and improve cognitive flexibility and (indirectly) other maintaining factors, thereby improving global functioning. DISCUSSION More research needs to be done to understand the development of EF in adolescents with AN and how best to employ CRT as an adjunctive treatment to support development and target maintaining factors. The current article broadly reviews findings on executive functioning inefficiencies in adolescents with AN and discusses the purpose and role of CRT in treating AN. Finally, we highlight key critiques of using CRT and pose questions for future research. PUBLIC SIGNIFICANCE Treatments targeting executive functioning in adolescents with AN are limited. We need to better understand how CRT can benefit adolescents in treatment. Increasing treatment options, including adjunctive treatments, is necessary to reduce the long-term impact of AN.
Collapse
Affiliation(s)
- C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jiana Schnabel
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
| | - Natalia C Orloff
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Equip Health, Carlsbad, California, USA
| |
Collapse
|
3
|
Goldschmidt AB, Goldstein SP, Schmiedek F, Stalvey E, Irizarry B, Thomas JG. State-level working memory and dysregulated eating in children and adolescents: An exploratory ecological momentary assessment study. Int J Eat Disord 2024; 57:93-103. [PMID: 37888341 PMCID: PMC10872824 DOI: 10.1002/eat.24087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait-level working memory (WM), which may limit adaptive responding to intra- and extra-personal cues related to eating. Understanding of how WM performance relates to eating behavior in real-time is currently limited. METHODS We studied 32 youth (ages 10-17 years) with LOC eating and overweight/obesity (LOC-OW; n = 9), overweight/obesity only (OW; n = 16), and non-overweight status (NW; n = 7). Youth completed spatial and numerical WM tasks requiring varying degrees of cognitive effort and reported on their eating behavior daily for 14 days via smartphone-based ecological momentary assessment. Linear mixed effects models estimated group-level differences in WM performance, as well as associations between contemporaneously completed measures of WM and dysregulated eating. RESULTS LOC-OW were less accurate on numerical WM tasks compared to OW and NW (ps < .01); groups did not differ on spatial task accuracy (p = .41). Adjusting for between-subject effects (reflecting differences between individuals in their mean WM performance and its association with eating behavior), within-subject effects (reflecting variations in moment-to-moment associations) revealed that more accurate responding on the less demanding numerical WM task, compared to one's own average, was associated with greater overeating severity across the full sample (p = .013). There were no associations between WM performance and LOC eating severity (ps > .05). CONCLUSIONS Youth with LOC eating and overweight/obesity demonstrated difficulties mentally retaining and manipulating numerical information in daily life, replicating prior laboratory-based research. Overeating may be related to improved WM, regardless of LOC status, but temporality and causality should be further explored. PUBLIC SIGNIFICANCE STATEMENT Our findings suggest that youth with loss of control eating and overweight/obesity may experience difficulties mentally retaining and manipulating numerical information in daily life relative to their peers with overweight/obesity and normal-weight status, which may contribute to the maintenance of dysregulated eating and/or elevated body weight. However, it is unclear whether these individual differences are related to eating behavior on a moment-to-moment basis.
Collapse
Affiliation(s)
- Andrea B. Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine/Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | - Stephanie P. Goldstein
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Florian Schmiedek
- Department of Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
| | - Erin Stalvey
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Bailey Irizarry
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| |
Collapse
|
4
|
Eichen DM, Strong DR, Twamley EW, Boutelle KN. Adding executive function training to cognitive behavioral therapy for binge eating disorder: A pilot randomized controlled trial. Eat Behav 2023; 51:101806. [PMID: 37660487 PMCID: PMC10840715 DOI: 10.1016/j.eatbeh.2023.101806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 08/04/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
Abstract
Evidence-based treatments for binge eating disorder (BED), such as cognitive behavioral therapy (CBT) lead to successful outcomes only about half the time. Individuals with BED often have measurable deficits in executive function (EF) that may challenge adherence to or impact of cognitive behavioral intervention components. The aim of this study was to evaluate the impact of adding EF training to CBT by combining CBT with a compensatory cognitive training approach (EF-CBT). Participants were 32 adults with BED, overweight/obesity, and comorbid anxiety or depression who were randomly assigned to four months of group treatment in either standard CBT or EF-CBT. Outcomes were assessed at baseline, post-treatment, and at 2-month follow-up. Results showed that EF-CBT was feasible and acceptable, comparable to CBT. Both groups significantly decreased loss of control (LOC) days, clinical impairment, and depression at post-treatment and 2-month follow-up; though there were no differences between groups. Neither group significantly reduced anxiety or weight. Exploratory analyses found that participants with lower EF treated with EF-CBT were less likely to have LOC at post-treatment than those with lower EF treated with CBT. Higher self-monitoring rates during treatment were associated with lower LOC at post-treatment and participants with lower EF were more likely to self-monitor in the EF-CBT arm relative to the CBT arm. These findings suggest that EF-CBT is feasible, acceptable and efficacious, although larger scale research is needed. EF-CBT may be particularly suited for individuals with BED who have lower EF.
Collapse
Affiliation(s)
- Dawn M Eichen
- University of California San Diego, Department of Pediatrics, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - David R Strong
- University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Elizabeth W Twamley
- University of California San Diego, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA 92093, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA 92161, USA
| | - Kerri N Boutelle
- University of California San Diego, Department of Pediatrics, 9500 Gilman Drive, La Jolla, CA 92093, USA; University of California San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, 9500 Gilman Drive, La Jolla, CA 92093, USA; University of California San Diego, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA 92093, USA
| |
Collapse
|
5
|
Lozano-Madrid M, Granero R, Lucas I, Sánchez I, Sánchez-González J, Gómez-Peña M, Moragas L, Mallorquí-Bagué N, Tapia J, Jiménez-Murcia S, Fernández-Aranda F. Impulsivity and compulsivity in gambling disorder and bulimic spectrum eating disorders: Analysis of neuropsychological profiles and sex differences. Eur Psychiatry 2023; 66:e91. [PMID: 37855168 PMCID: PMC10755579 DOI: 10.1192/j.eurpsy.2023.2458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains. METHODS Using self-reported and neurocognitive measures, we assessed different impulsive-compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls. RESULTS We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs. CONCLUSIONS Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.
Collapse
Affiliation(s)
- María Lozano-Madrid
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Isabel Sánchez
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jéssica Sánchez-González
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Nuria Mallorquí-Bagué
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Department of Psychiatry, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Javier Tapia
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
6
|
Colton E, Wilson KE, Chong TTJ, Verdejo-Garcia A. Dysfunctional decision-making in binge-eating disorder: A meta-analysis and systematic review. Neurosci Biobehav Rev 2023; 152:105250. [PMID: 37263530 DOI: 10.1016/j.neubiorev.2023.105250] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/03/2023]
Abstract
Binge-Eating Disorder (BED) involves anticipatory craving and urges, subjective loss-of-control during binge-eating episodes, and post-feeding psychological distress and guilt. Evidence indicates neurocognitive dysfunctions contribute to BED onset, maintenance, and treatment response. However, an integrated understanding of how cognitive processes underpin BED symptomology is lacking. We utilised a multi-stage decision-making model defining ten cognitive processes underpinning Preference Formation, Choice Implementation, Feedback Processing, and Flexibility/Shifting, to comprehensively review research published since 2013. We used preregistered PICOS criteria to assess 1966 articles identified from PubMed, PsycInfo, and Scopus database searches. This yielded 50 studies reporting behavioural cognitive tasks outcomes, comparing individuals with BED to controls with normal and higher weight. Meta-analyses revealed a unique profile of cognitive dysfunctions that spanned all decision-making stages. Significant deficits were evident in Uncertainty Evaluation, Attentional Inhibition, Choice Consistency, and Cognitive Flexibility/Set-shifting. We propose a novel model of dysfunctional decision-making processes in BED and describe their role in binge-eating behaviour. We further highlight the potential for cognitive interventions to target these processes and address the significant treatment gap in BED.
Collapse
Affiliation(s)
- Emily Colton
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia.
| | - Kira-Elise Wilson
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Trevor T-J Chong
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| | - Antonio Verdejo-Garcia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC 3800, Australia
| |
Collapse
|
7
|
Naets T, Vermeiren E, Vervoort L, Van Eyck A, Ysebaert M, Verhulst S, De Winter B, Van Hoorenbeeck K, Bruyndonckx L, Tanghe A, De Guchtenaere A, Verbeken S, Braet C. Self-control training supplementing inpatient multidisciplinary obesity treatment in children and adolescents. Behav Res Ther 2023; 167:104335. [PMID: 37327533 DOI: 10.1016/j.brat.2023.104335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023]
Abstract
Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT). Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data. Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.
Collapse
Affiliation(s)
- Tiffany Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
| | - Eline Vermeiren
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Leentje Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium; Department of Developmental Psychology, Radboud University, Nijmegen, the Netherlands
| | - Annelies Van Eyck
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | | | - Stijn Verhulst
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Benedicte De Winter
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Kim Van Hoorenbeeck
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Luc Bruyndonckx
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | | | | | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| |
Collapse
|
8
|
Chew KK, Temples HS. Adolescent Eating Disorders: Early Identification and Management in Primary Care. J Pediatr Health Care 2022; 36:618-627. [PMID: 37855407 DOI: 10.1016/j.pedhc.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 11/24/2022]
Abstract
Eating disorders are complex, potentially life-threatening conditions characterized by disruptive eating behaviors that significantly impact physical and psychosocial functioning. The adolescent population is at an increased risk of developing eating disorders because of developmental changes affecting their perception. Eating disorders are associated with devastating medical complications and high mortality rates if left untreated. As the prevalence of eating disorders among adolescents continues to increase, it is important that clinicians are knowledgeable about early signs of disordered eating and facilitate timely evaluation and care coordination. Newly released clinical guidelines from the American Academy of Pediatrics are reviewed for early identification and management of eating disorders in children and adolescents. The epidemiology, risk factors, and medical complications for common eating disorders in primary care such as anorexia nervosa, bulimia nervosa, and binge eating disorder, are presented. An approach to screening for eating disorders, clinical assessment, and treatment options are outlined.
Collapse
|
9
|
Integrative review on psychological and social risk and prevention factors of eating disorders including anorexia nervosa and bulimia nervosa: seven major theories. Heliyon 2022; 8:e11422. [DOI: 10.1016/j.heliyon.2022.e11422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/16/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022] Open
|
10
|
MacNeil BA, Leung PC. Evaluating thinking styles in adults with an eating disorder: Associations with life satisfaction, psychological symptoms, and treatment engagement. J Psychiatr Res 2022; 153:30-36. [PMID: 35793577 DOI: 10.1016/j.jpsychires.2022.06.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/18/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022]
Abstract
Cognitive weaknesses have been implicated as a vulnerability factor in the development and maintenance of eating disorders. Despite this, cognitive styles are not routinely assessed in adult outpatient eating disorder programs and little is known about how they may impact patients' functional outcomes, psychological symptoms, or treatment engagement. The aim of this study was to evaluate thinking styles (i.e., cognitive rigidity and attention to detail) among adults attending specialized outpatient treatment for an eating disorder and assess whether such styles were associated with participants' satisfaction with life, psychological symptoms, and engagement in the outpatient group therapy program. Demographic and physical health information was collected from 95 adults who were eligible for an outpatient program. Participants completed the Detail and Flexibility Questionnaire, Satisfaction with Life Scale, Beck Depression Inventory second edition, and Beck Anxiety Inventory. Elevated scores for cognitive rigidity and attention to detail were transdiagnostic rather than specific to eating disorder diagnoses. Cognitive rigidity and attention to detail were associated with lower satisfaction with life, and increased anxiety and depression. Cognitive styles of cognitive rigidity and attention to detail were not associated with engagement in treatment or treatment completion. Cognitive patterns may be important for clinicians to evaluate as part of routine outpatient care given that they occur transdiagnostically and are linked with psychological symptoms and functional outcomes for adults struggling with an eating disorder.
Collapse
Affiliation(s)
- Brad A MacNeil
- College of Health Sciences, Department of Behavioral Sciences, Doctoral Clinical Psychology Program, Midwestern University, 19555 N 59th Ave, Glendale, AZ, 85308, USA.
| | - Pauline C Leung
- Forensic Program, Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, Whitby, ON, L1N 5S9, Canada
| |
Collapse
|
11
|
Solier-López L, González-González R, Caracuel A, Kakoschke N, Lawrence N, Vilar-López R. A Program for the Comprehensive Cognitive Training of Excess Weight (TRAINEP): The Study Protocol for A Randomized, Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148447. [PMID: 35886296 PMCID: PMC9324504 DOI: 10.3390/ijerph19148447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 02/06/2023]
Abstract
Background: The available treatments for people with excess weight have shown small effects. Cognitive training has shown promising results, but most of the research focused on normal-weight university students and reported immediate results after a single training session. This parallel group, randomized, controlled trial aims to study the efficacy of a program for the comprehensive cognitive treatment of excess weight. Methods and Analysis: Participants will be 150 people with excess weight recruited through social media, who will be randomized into three groups: cognitive intervention, sham cognitive intervention, and treatment as usual. All assessment and intervention sessions will be online in groups of 5–6 participants. The three groups will attend a motivational interviewing session, and they will receive individualized diet and physical exercise guidelines throughout the program. The cognitive training will consist of four weekly sessions of approximately 60–90 min, each based on approach–avoidance bias training, inhibitory control training, implementation of intentions, and episodic future thinking, respectively. The main outcome measure will be a change in Body Mass Index (kg/m2). Secondary outcomes include changes in cognitive measures, eating and physical exercise behaviors, and anthropometric measures. Assessments will be conducted up to 6 months after the end of the program. In addition, data on the use of the health system will be collected to analyze the cost-effectiveness and the cost-utility of training. Linear mixed models will be used for statistical analysis. Findings of this study will expand the available evidence on cognitive interventions to reduce excess weight.
Collapse
Affiliation(s)
- Lucía Solier-López
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18070 Granada, Spain; (L.S.-L.); (R.G.-G.); (R.V.-L.)
| | - Raquel González-González
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18070 Granada, Spain; (L.S.-L.); (R.G.-G.); (R.V.-L.)
| | - Alfonso Caracuel
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18070 Granada, Spain; (L.S.-L.); (R.G.-G.); (R.V.-L.)
- Correspondence:
| | - Naomi Kakoschke
- Nutrition and Health Program (Health & Biosecurity) at CSIRO, Adelaide, SA 5000, Australia;
| | - Natalia Lawrence
- Department of Psychology, University of Exeter, Exeter EX4 4PY, UK;
| | - Raquel Vilar-López
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18070 Granada, Spain; (L.S.-L.); (R.G.-G.); (R.V.-L.)
| |
Collapse
|
12
|
Giel KE, Bulik CM, Fernandez-Aranda F, Hay P, Keski-Rahkonen A, Schag K, Schmidt U, Zipfel S. Binge eating disorder. Nat Rev Dis Primers 2022; 8:16. [PMID: 35301358 PMCID: PMC9793802 DOI: 10.1038/s41572-022-00344-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/30/2022]
Abstract
Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018-2020 is estimated to be 0.6-1.8% in adult women and 0.3-0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging treatment approaches. Psychotherapy is the first-line treatment for BED. Recognition and research on BED has increased since its inclusion into DSM-5; however, continuing efforts are needed to understand underlying mechanisms of BED and to improve prevention and treatment outcomes for this disorder. These efforts should also include screening, identification and implementation of evidence-based interventions in routine clinical practice settings such as primary care and mental health outpatient clinics.
Collapse
Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany.
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | | | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| |
Collapse
|
13
|
Lanoye A, Adams E, Fuemmeler BF. Obesity and Attention-Deficit Hyperactivity Disorder. Curr Top Behav Neurosci 2022; 57:221-241. [PMID: 35505058 DOI: 10.1007/7854_2022_337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
An association between ADHD and obesity has been established throughout the past 20 years via animal model experiments and both correlational and longitudinal studies in humans. However, much remains to be determined regarding causality, developmental course, and effective treatments targeting both conditions. This chapter provides an overview and update on the current state of the science on the relationship between obesity and ADHD; expands the scope of the connection between obesity and ADHD to include behavioral components important to weight regulation - i.e., physical activity, eating behaviors, and sleep; and presents applications of these findings to treatment approaches and future directions.
Collapse
Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
- Research Center for Child Well-Being, University of South Carolina, Columbia, SC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
14
|
Busch N, Schmidt R, Hilbert A. Executive Functions of Adults with Binge-Eating Disorder: The Role of Weight Status and Psychopathology. Brain Sci 2021; 12:6. [PMID: 35053750 PMCID: PMC8773845 DOI: 10.3390/brainsci12010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
Findings on executive functions (EFs) in binge-eating disorder (BED) are inconsistent and possibly biased by associated comorbidities. This study aimed to identify whether distinct levels of physical and mental comorbidity are related to EFs in BED. General and food-specific EFs in n = 77 adults with BED were compared to population-based norms and associations with weight status, depressive symptoms, and eating disorder psychopathology were analyzed. To detect within-sample patterns of EF performance, k-means clustering was applied. The results indicated that participants' general EFs were within the average range with slight deficits in alertness. While depression and eating disorder psychopathology were unrelated to EFs, weight status was associated with food-specific attentional bias that was significantly higher in obesity class 2 than in overweight/obesity class 1 and obesity class 3. Four meaningful clusters with distinct strengths and impairments in general and food-specific EFs but without differences in clinical variables were identified. Altogether, adults with BED showed few specific deficits compared to normative data. Performance was unrelated to depression and eating disorder psychopathology, while weight status was associated with food-specific EFs only. The results highlight the need for longitudinal studies to evaluate the relevance of EFs in BED development and maintenance in neurologically healthy adults.
Collapse
Affiliation(s)
| | | | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany; (N.B.); (R.S.)
| |
Collapse
|
15
|
Heriseanu AI, Hay P, Touyz S. A cross-sectional examination of executive function and its associations with grazing in persons with obesity with and without eating disorder features compared to a healthy control group. Eat Weight Disord 2021; 26:2491-2501. [PMID: 33515403 DOI: 10.1007/s40519-021-01105-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/09/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The current study aimed to investigate associations between grazing and different facets of executive functioning in persons with obesity with and without significant eating disorder psychopathology, compared to a healthy-weight control group. METHODS Eighty-nine participants (of which 20 had obesity and marked eating disorder symptomatology, 25 had obesity but without marked eating disorder symptoms, and 44 were healthy-weight age- and sex-matched participants; N = 89; 66.3% female, age = 28.59 (8.62); 18.18-58.34 years) completed a battery of neuropsychological tests and demographic and eating disorder-related questionnaires. Poisson, Negative Binomial, and Ordinary Least Squares regressions were performed to examine group differences and the associations of grazing with executive functioning within the three groups. RESULTS Significantly lower inhibitory control and phonemic fluency were observed for the obesity group without ED features compared to healthy-weight controls. Increasing grazing severity was associated with improved performance in inhibitory control in both groups with obesity, and with phonemic fluency in the obesity group with marked eating disorder features. CONCLUSION Although there is mounting evidence that specific cognitive domains, especially inhibition, are affected in obesity, evidence of further detrimental effects of eating disorder psychopathology remains mixed; additionally, for persons with obesity, there may be a weak but positive link between executive functioning and grazing behaviour. LEVEL OF EVIDENCE III, comparative cross-sectional observational study with a concurrent control group.
Collapse
Affiliation(s)
- Andreea I Heriseanu
- eCentreClinic, Department of Psychology, Macquarie University, Macquarie Park, NSW, 2109, Australia.
- Clinical Psychology Unit, School of Psychology, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Campbelltown Hospital, South West Sydney Local Health District (SWSLHD), PO Box 149, Campbelltown, NSW, 2560, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, School of Psychology, University of Sydney, Level 3 M02F, 94 Mallett Street, Camperdown, NSW, 2050, Australia
- InsideOut Institute, Level 2, Charles Perkins Centre, University of Sydney, Johns Hopkins Drive, Camperdown, NSW, 2006, Australia
| |
Collapse
|
16
|
Daniela Mercado, Robinson L, Gordon G, Werthmann J, Campbell IC, Schmidt U. The outcomes of mindfulness-based interventions for Obesity and Binge Eating Disorder: A meta-analysis of randomised controlled trials. Appetite 2021; 166:105464. [PMID: 34146647 DOI: 10.1016/j.appet.2021.105464] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/11/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mindfulness Based Interventions (MBIs) for weight loss and overeating-related behaviours have recently gained popularity. Previous systematic reviews and meta-analyses included studies of variable quality, which hinders interpretation of results. This meta-analysis examined only randomised controlled trials (RCTs) comparing the efficacy of MBIs with control groups primarily encouraging either dietary or exercise-based behavioural change in individuals with overweight/obesity and/or binge eating disorder (BED). METHODS Using PRISMA guidelines, we systematically reviewed relevant articles in Medline, Psychinfo and EMBASE. Twelve eligible RCTs were identified, with three random-effects meta-analyses conducted on primary outcome measures of body mass (N = 11), mindfulness (N = 7) and BED symptoms (N = 3). RESULTS MBIs were more efficacious than control in increasing mindfulness scores and decreasing BED symptoms from pre-to post-treatment. However, they were no more efficacious than control in reducing body mass which may be attributed to variability in the duration of interventions. Based on intervention duration, exploratory cumulative meta-analyses revealed that while shorter interventions (i.e., 6 weeks) showed greater reductions in body mass compared to longer interventions (i.e., 24 weeks), longer interventions led to greater improvements in mindfulness scores and BED symptoms. CONCLUSIONS These results highlight the potential of MBIs to improve obesity-related behaviours compared to lifestyle interventions, but their effects on short-term weight loss remain unclear. Future research with a rigorous methodology should consider long-term follow-ups including body mass and mindfulness-related outcome measures in order to establish the clinical potential of MBIs.
Collapse
Affiliation(s)
- Daniela Mercado
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Section of Eating Disorders, UK.
| | - Lauren Robinson
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Section of Eating Disorders, UK.
| | - Gemma Gordon
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Section of Eating Disorders, UK.
| | - Jessica Werthmann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs University of Freiburg, Germany.
| | - Iain C Campbell
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Section of Eating Disorders, UK.
| | - Ulrike Schmidt
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Section of Eating Disorders, UK; South London and Maudsley NHS Foundation Trust, London, UK.
| |
Collapse
|
17
|
Haynos AF, Anderson LM, Askew AJ, Craske MG, Peterson CB. Adapting a neuroscience-informed intervention to alter reward mechanisms of anorexia nervosa: a novel direction for future research. J Eat Disord 2021; 9:63. [PMID: 34039415 PMCID: PMC8152047 DOI: 10.1186/s40337-021-00417-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/04/2021] [Indexed: 01/16/2023] Open
Abstract
Accumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.
Collapse
Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA.
| | - Lisa M Anderson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA
| | - Autumn J Askew
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA
| | - Michelle G Craske
- Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2450 Riverside Ave., Minneapolis, MN, 55454, USA
| |
Collapse
|
18
|
Haynos AF, Camchong J, Pearson CM, Lavender JM, Mueller BA, Peterson CB, Specker S, Raymond N, Lim KO. Resting State Hypoconnectivity of Reward Networks in Binge Eating Disorder. Cereb Cortex 2021; 31:2494-2504. [PMID: 33415334 DOI: 10.1093/cercor/bhaa369] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
The clinical presentation of binge eating disorder (BED) and data emerging from task-based functional neuroimaging research suggests that this disorder may be associated with alterations in reward processing. However, there is a dearth of research investigating the functional organization of brain networks that mediate reward in BED. To address this gap, 27 adults with BED and 21 weight-matched healthy controls (WMC) completed a multimodel assessment consisting of a resting functional magnetic resonance imaging scan, behavioral tasks measuring reward-based decision-making (i.e., delay discounting and reversal learning), and self-report assessing clinical symptoms. A seed-based approach was employed to examine the resting state functional connectivity (rsFC) of the striatum (nucleus accumbens [NAcc] and ventral and dorsal caudate), a collection of regions implicated in reward processing. Compared with WMC, the BED group exhibited lower rsFC of striatal seeds, with frontal regions mediating executive functioning (e.g., superior frontal gyrus [SFG]) and posterior, parietal, and temporal regions implicated in emotional processing. Lower NAcc-SFG rsFC was associated with more difficulties with reversal learning and binge eating frequency in the BED group. Results suggest that hypoconnectivity of striatal networks that integrate self-regulation and reward processing may promote the clinical phenomenology of BED. Interventions for BED may benefit from targeting these circuit-based disturbances.
Collapse
Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Jazmin Camchong
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Carolyn M Pearson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, 20814 MD, USA.,Metis Foundation, San Antonio, 78205 TX, USA
| | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Sheila Specker
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA
| | - Nancy Raymond
- Department of Psychiatry, University of Wisconsin, Madison, 53719 WI, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, 55454 MN, USA.,Minneapolis VA Health Care System, Minneapolis, 55417 MN, USA
| |
Collapse
|
19
|
Vervoort L, Braun M, De Schryver M, Naets T, Koster EHW, Braet C. A Pictorial Dot Probe Task to Assess Food-Related Attentional Bias in Youth With and Without Obesity: Overview of Indices and Evaluation of Their Reliability. Front Psychol 2021; 12:644512. [PMID: 33746859 PMCID: PMC7965983 DOI: 10.3389/fpsyg.2021.644512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022] Open
Abstract
Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias toward or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores, and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and without obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample.
Collapse
Affiliation(s)
- Leentje Vervoort
- Department of Developmental Psychology, Radboud University, Nijmegen, Netherlands.,Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Maya Braun
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Maarten De Schryver
- Faculty of Psychology and Educational Sciences, Faculty Research Support Office, Ghent University, Ghent, Belgium
| | - Tiffany Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.,Department Health Care (Dietetics), Odisee University College, Ghent, Belgium
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| |
Collapse
|
20
|
Juchacz K, Kłos P, Dziedziejko V, Wójciak RW. The Effectiveness of Supportive Psychotherapy in Weight Loss in a Group of Young Overweight and Obese Women. Nutrients 2021; 13:nu13020532. [PMID: 33562001 PMCID: PMC7914739 DOI: 10.3390/nu13020532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 01/20/2023] Open
Abstract
Overweight and obesity are among the most widespread health problems worldwide. The primary cause of obesity is an inability to control overeating. Therefore, today, obesity needs to be treated more as an eating disorder, i.e., a mental disorder, and thus, it should be approached as such. Taking the above together, this study aimed to assess the impact of supportive psychotherapy on reducing body weight in young overweight and obese women who attempted slimming therapy and, additionally, the possibility of maintaining the weight-loss effect in the long term. Sixty young women aged 20–30 were randomized into three groups that differed in therapeutic management. With the help of an individually selected diet plan, the highest effectiveness in weight loss was demonstrated in people whose weight reduction was supported by goal-oriented psychotherapy. In this group, a sustained effect of slimming and even further weight loss were observed six months following the discontinuation of the therapy. In conclusion, traditional slimming therapies using an individual diet plan and a dietitian’s care are effective; however, supportive psychotherapeutic work provides more beneficial results and maintains the change from a long-term perspective.
Collapse
Affiliation(s)
- Krzysztof Juchacz
- Department of Clinical Psychology, Poznan University of Medical Study, 60-812 Poznań, Poland;
| | - Patrycja Kłos
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland;
- Correspondence: (P.K.); (R.W.W.); Tel.: +48-91-466-15-15 (P.K.); +48-61-854-72-74 (R.W.W.)
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Rafał W. Wójciak
- Department of Clinical Psychology, Poznan University of Medical Study, 60-812 Poznań, Poland;
- Correspondence: (P.K.); (R.W.W.); Tel.: +48-91-466-15-15 (P.K.); +48-61-854-72-74 (R.W.W.)
| |
Collapse
|
21
|
Nobile B, Maimoun L, Jaussent ID, Seneque M, Dupuis-Maurin K, Lefebvre P, Courtet P, Renard E, Guillaume S. Effects of Hormonal Contraception Use on Cognitive Functions in Patients With Bulimia Nervosa. Front Psychiatry 2021; 12:658182. [PMID: 34079484 PMCID: PMC8165222 DOI: 10.3389/fpsyt.2021.658182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Growing evidences indicate that sex hormones have an effect on cognitive functions, and that Bulimia Nervosa (BN) is associated with cognitive impairment. The aim of this study was to determine the effect of hormonal contraception (HC) use on four cognitive functions that are impaired in patients with BN. Methods: This retrospective exploratory study included 103 women with a diagnosis of BN based on the DSM-5 criteria. Their age ranged from 15 to 45 years, and 46.6% were taking HC (oral, transdermal, or intrauterine). Cognition was assessed with the d2 test (attention), Iowa gambling task (IGT; decision making), Brixton spatial anticipation test (set shifting), and Rey-Osterrieth complex figure test (central coherence). Data were analyzed with logistic regression models to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of HC effect on the neuropsychological test scores. Results: In the multivariate model, HC use was significantly associated with better scores for two d2 test indices: F-score [OR = 0.98, 95% CI = (0.95; 0.99)] and final total score ratio [OR = 0.87, 95% CI = (0.77; 0.99)]. HC was also associated with a better understanding of the IGT explicit rules. No difference between the two groups (HC and non-HC use) was detected for set shifting and central coherence. Conclusions: This exploratory study suggests that HC could have effects on the sustained attention and concentration in women with BN. More studies are needed to confirm these results.
Collapse
Affiliation(s)
- Benedicte Nobile
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Laurent Maimoun
- Department of Nuclear Medicine, CHRU Montpellier, Montpellier, France.,INSERM U1046, UMR9214 CNRS, Physiology and Experimental Medicine of the Heart and Muscles, University of Montpellier, CHRU Montpellier, Montpellier, France
| | | | - Maude Seneque
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France
| | - Kathlyne Dupuis-Maurin
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France
| | - Phillippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, CHRU Montpellier, Montpellier, France.,UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, Montpellier, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, Montpellier, France.,Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| |
Collapse
|
22
|
Luis-Ruiz S, Caldú X, Sánchez-Castañeda C, Pueyo R, Garolera M, Jurado MÁ. Is cognitive training an effective tool for improving cognitive function and real-life behaviour in healthy children and adolescents? A systematic review. Neurosci Biobehav Rev 2020; 116:268-282. [PMID: 32565174 DOI: 10.1016/j.neubiorev.2020.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/09/2023]
Abstract
Computerised cognitive training (CCT) has been applied to improve cognitive function in pathological conditions and in healthy populations. Studies suggest that CCT produces near-transfer effects to cognitive functions, with less evidence for far-transfer. Newer applications of CTT in adults seem to produce certain far-transfer effects by influencing eating behaviour and weight loss. However, this is more unexplored in children and adolescents. We conducted a systematic review of 16 studies with randomised controlled design to assess the impact of CCT on cognitive functioning and real-life outcomes, including eating behaviour, in children and adolescents with typical development (PROSPERO registration number: CRD42019123889). Results show near-transfer effects to working memory, with inconsistent results regarding far-transfer effects to other cognitive functions and real-life measures. Long-term effects show the same trend. Far-transfer effects occurred after cue-related inhibitory control and attentional training, although effects seem not to last. CCT may be a potential weight-loss treatment option but more research is needed to determine the specific characteristics to enhance treatment outcomes.
Collapse
Affiliation(s)
- Sandra Luis-Ruiz
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Cristina Sánchez-Castañeda
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Maite Garolera
- Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Unitat de Neuropsicologia, Consorci Sanitari de Terrassa, Carretera de Torrebonica, S/N, 08227, Terrasa, Barcelona, Spain; Brain, Cognition and Behaviour Clinical Research Group, Consorci Sanitari de Terrassa, Carretera de Torrebonica, S/N, 08227, Terrasa, Barcelona, Spain
| | - María Ángeles Jurado
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
| |
Collapse
|
23
|
Affiliation(s)
- James E Mitchell
- From the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo (J.E.M.); and the Department of Psychiatry and Behavioral Sciences, University of Minnesota School of Medicine, Minneapolis (C.B.P.)
| | - Carol B Peterson
- From the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo (J.E.M.); and the Department of Psychiatry and Behavioral Sciences, University of Minnesota School of Medicine, Minneapolis (C.B.P.)
| |
Collapse
|
24
|
Abstract
Eating disorders are disabling, deadly, and costly mental disorders that considerably impair physical health and disrupt psychosocial functioning. Disturbed attitudes towards weight, body shape, and eating play a key role in the origin and maintenance of eating disorders. Eating disorders have been increasing over the past 50 years and changes in the food environment have been implicated. All health-care providers should routinely enquire about eating habits as a component of overall health assessment. Six main feeding and eating disorders are now recognised in diagnostic systems: anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant-restrictive food intake disorder, pica, and rumination disorder. The presentation form of eating disorders might vary for men versus women, for example. As eating disorders are under-researched, there is a great deal of uncertainty as to their pathophysiology, treatment, and management. Future challenges, emerging treatments, and outstanding research questions are addressed.
Collapse
Affiliation(s)
- Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Tiago Antunes Duarte
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Serviço de Psiquiatria e Saúde Mental, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
25
|
Mercado D, Werthmann J, Campbell IC, Schmidt U. Study protocol of a randomised controlled feasibility study of food-related computerised attention training versus mindfulness training and waiting-list control for adults with overweight or obesity. Trials 2020; 21:66. [PMID: 31924255 PMCID: PMC6954613 DOI: 10.1186/s13063-019-3932-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/24/2019] [Indexed: 12/19/2022] Open
Abstract
Background Obesity is a highly prevalent condition with multiple adverse health consequences. Widely available first-line treatments for obesity, such as dietary and other lifestyle interventions, typically have only short-term effects. Thus, new treatment approaches are needed. Novel interventions such as Attention Bias Modification Training (ABMT) and mindfulness-based interventions focus on modifying different maladaptive cognitive patterns typically present in people with obesity (e.g. attention bias to food cues); however, their mechanisms of action remain largely unknown. We describe the theoretical basis and the rationale for a study protocol of a feasibility randomised controlled trial (RCT) comparing two attention trainings (ABMT vs Mindfulness Training [MT]) in people with overweight or obesity. The aim of this study is to inform the development of a large-scale RCT in relation to acceptability and attendance rates and to identify preliminary evidence for the interventions’ clinical efficacy and potential underlying mechanisms. Design Forty-five adults who are either overweight or obese (minimum body mass index of 25 kg/m2) will be randomly allocated to receive eight sessions over eight weeks of either computerised ABMT or MT or be on a waiting list. Clinical and cognitive outcomes will be assessed at baseline, post-treatment (8 weeks) and follow-up (12 weeks post-randomisation). These include mood, body composition and attention biases. Credibility and acceptability of the trainings will be assessed using questionnaires, and recruitment and retention rates will be recorded. Discussion Findings will inform the feasibility of developing a large-scale RCT that takes into consideration effect sizes for primary outcome measures and the acceptability of the design. The study will also provide preliminary evidence on the clinical efficacy of two different attention trainings for people with obesity and associated underlying mechanisms. Trial registration ISRCTN Registry, ISRCTN15745838. Registered on 22 May 2018.
Collapse
Affiliation(s)
- Daniela Mercado
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Jessica Werthmann
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs University of Freiburg, Freiburg im Breisgau, Germany
| | - Iain C Campbell
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK. .,South London and Maudsley NHS Foundation Trust, London, UK.
| |
Collapse
|
26
|
Lavender JM, King WC, Kalarchian MA, Devlin MJ, Hinerman A, Gunstad J, Marcus MD, Mitchell JE. Examining emotion-, personality-, and reward-related dispositional tendencies in relation to eating pathology and weight change over seven years in the Longitudinal Assessment of Bariatric Surgery (LABS) study. J Psychiatr Res 2020; 120:124-130. [PMID: 31670260 PMCID: PMC6901114 DOI: 10.1016/j.jpsychires.2019.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/01/2019] [Accepted: 10/17/2019] [Indexed: 12/28/2022]
Abstract
This study examined dispositional emotion-, personality/temperament-, and reward-related variables in relation to post-surgery eating pathology and weight-change among 107 adults who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB). As part of a prospective cohort study, annual post-surgical assessments were conducted to evaluate eating pathology, using the Eating Disorder Examination-Bariatric Surgery Version, and percent weight change from pre-surgery. Dispositional measures were administered at the 6- or 7-year assessment and included the Affect Intensity Measure, Difficulties in Emotion Regulation Scale, UPPS-P Impulsive Behavior Scale, Adult Temperament Questionnaire-Effortful Control Scale, and Sensitivity to Punishment/Sensitivity to Reward Questionnaire. Results from a series of linear mixed models revealed significant associations of emotion dysregulation, affect intensity, positive and negative urgency, effortful control, and reward sensitivity with eating pathology severity across 7 years; additionally, all but two of the subscales comprising the total scores were also significantly associated. Fewer statistically significant results were found in relation to weight change; emotion dysregulation and affect intensity (along with several subscales) were significantly associated with lower percent weight change (i.e., less weight loss), but of the reward-related and personality/temperament variables, only total effortful control emerged as significant. However, the associations of the other variables with both outcomes were consistently in the expected direction. Associations also appeared consistent across surgical procedures. Taken together, findings suggest that certain dispositional tendencies may relate to less optimal long-term outcomes following bariatric surgery and thus may be useful to assess in pre-surgical or early post-surgical evaluations to inform targeted recommendations.
Collapse
Affiliation(s)
- Jason M Lavender
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Military Cardiovascular Outcomes Research Program (MiCOR), Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Metis Foundation, San Antonio, TX, USA.
| | - Wendy C King
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Michael J Devlin
- Columbia University Vagelos College of Physicians and Surgeons / New York State Psychiatric Institute, New York, NY, USA
| | - Amanda Hinerman
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | |
Collapse
|
27
|
Legenbauer T, Preuss H. Verbesserung der Impuls- und Emotionsregulation bei Binge-Eating-Störungen. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Impulsivität beeinflusst die Verarbeitung von störungsspezifischen Reizen und die Handlungskompetenz hinsichtlich der Nahrungsaufnahme. Neuere Studien adressieren daher unterschiedliche Facetten impulsiven Erlebens und Verhaltens, um eine Reduktion von Essanfällen und des Körpergewichts bei der Binge-Eating-Störung (BES) zu erzielen. ImpulsE ist ein Therapieprogramm zur Verbesserung der Impuls- und Emotionsregulationsfertigkeiten, welches mit einem computergestützten nahrungsbezogenen Inhibitionstraining kombiniert und mit einer Standardbehandlung (TAU) verglichen wurde. N = 31 Personen mit BES nahmen teil (n = 22 ImpulsE, n = 9 TAU). Die Ergebnisse zeigten Verbesserungen in der nahrungsbezogenen Verhaltensinhibition und der allgemeinen Essstörungspathologie in beiden Gruppen, während sich die Anzahl von Essanfällen nur bei ImpulsE signifikant senkte. Die Ergebnisse stellen erste Hinweise auf die Wirksamkeit eines solchen Trainings dar. Eine Adaption an Jugendliche erscheint sinnvoll.
Collapse
Affiliation(s)
- Tanja Legenbauer
- LWL-Universitätsklinik Hamm für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik Hamm, Ruhr-Universität Bochum
| | - Hanna Preuss
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz
| |
Collapse
|
28
|
Maternal executive function and the family food environment. Appetite 2019; 137:21-26. [DOI: 10.1016/j.appet.2019.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/07/2019] [Accepted: 02/10/2019] [Indexed: 02/03/2023]
|
29
|
Abstract
The authors present the theoretic model, structure of treatment, and preliminary evidence for several emerging treatments that are increasingly being used and studied in eating disorders treatment, including dialectical behavior therapy, acceptance and commitment therapy, integrative cognitive-affective therapy, and neuromodulation. In addition, the article discusses treatments that address mindfulness, interpersonal factors, and habit.
Collapse
Affiliation(s)
- Emily M Pisetsky
- Department of Psychiatry, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Lauren M Schaefer
- Sanford Center for Biobehavioral Research, 120 South Eighth Street, Fargo, ND 58103, USA
| | - Stephen A Wonderlich
- Sanford Center for Biobehavioral Research, 120 South Eighth Street, Fargo, ND 58103, USA; University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA
| |
Collapse
|
30
|
Iceta S, Benoit J, Cristini P, Lambert-Porcheron S, Segrestin B, Laville M, Poulet E, Disse E. Attentional bias and response inhibition in severe obesity with food disinhibition: a study of P300 and N200 event-related potential. Int J Obes (Lond) 2019; 44:204-212. [PMID: 30967609 DOI: 10.1038/s41366-019-0360-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 02/05/2019] [Accepted: 02/24/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVE In obesity there is growing evidence for common mechanism between food intake regulation and substance use disorders, especially more attentional bias and less cognitive control. In the present study we investigated whether severely obese subjects with or without disordered eating exhibit electroencephalographic (EEG) event-related potential (ERP) modifications as observed in substance abusers. SUBJECTS/METHODS A total of 90 women were included; 30 in the normal-weight (NW) group (18.5 < BMI < 24.5 kg/m2; no food disinhibition or restriction on the Three-Factor Eating Questionnaire) and 60 participants with BMI ≥ 35 kg/m2 were separated into two groups (n = 30): without food disinhibition (disinhibition score ≤8; ObFD- group) and with food disinhibition (score >8; ObFD+). Clinical and metabolic parameters as well as compartmental aspects (Eating Disorders Inventory-2, EDI-2) were assessed. Participants underwent an ERP recording with an auditory oddball paradigm. RESULTS The mean ± SD P300 amplitudes in Pz were significantly (p < 0.05) lower in ObFD- (12.4 ± 4.6) and ObFD+ (12.5 ± 4.4) groups than in the NW group (15.8 ± 5.9). The mean ± SD N200 amplitude in Cz was significantly lower in the ObFD- group (-2.0 ± 5.4) than in the NW group (-5.2 ± 4.2 vs; p = 0.035). N200 Cz amplitude was correlated with EDI-2 Binge eating risk score (ρ = 0.331; p = 0.01), EDI-2 Body Dissatisfaction score (ρ = 0.351; p = 0.007), and Drive for Thinness score (ρ = 0.26; p = 0.05). CONCLUSIONS The present study provides evidence for reduction of P300 and N200 amplitude in obese women and that N200 amplitude may be related to more disordered eating and eating disorder risk. This leads to consider attentional bias and response inhibition as core mechanisms in obesity and as possible targets for new therapeutic strategy.
Collapse
Affiliation(s)
- Sylvain Iceta
- Centre Référent pour l'Anorexie et les Troubles du Comportement Alimentaire (CREATYON), Hospices Civils de Lyon, Lyon, France. .,INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon (CRNL), Equipe PSYR2 Centre Hospitalier Le Vinatier, Lyon, France. .,Centre Intégré de l'Obésité Rhône-Alpes; Fédération Hospitalo-Universitaire DO-iT, Service Endocrinologie-Diabète-Nutrition, Université de Lyon, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.
| | - Julien Benoit
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ-Lyon, CarMeN Laboratory, Université Claude Bernard Lyon1, Hospices Civils de Lyon, CENS, FCRIN/FORCE Network, Pierre Benite, France
| | - Philippe Cristini
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ-Lyon, CarMeN Laboratory, Université Claude Bernard Lyon1, Hospices Civils de Lyon, CENS, FCRIN/FORCE Network, Pierre Benite, France
| | - Stéphanie Lambert-Porcheron
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ-Lyon, CarMeN Laboratory, Université Claude Bernard Lyon1, Hospices Civils de Lyon, CENS, FCRIN/FORCE Network, Pierre Benite, France
| | - Bérénice Segrestin
- Centre Référent pour l'Anorexie et les Troubles du Comportement Alimentaire (CREATYON), Hospices Civils de Lyon, Lyon, France.,Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ-Lyon, CarMeN Laboratory, Université Claude Bernard Lyon1, Hospices Civils de Lyon, CENS, FCRIN/FORCE Network, Pierre Benite, France
| | - Martine Laville
- Centre Intégré de l'Obésité Rhône-Alpes; Fédération Hospitalo-Universitaire DO-iT, Service Endocrinologie-Diabète-Nutrition, Université de Lyon, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ-Lyon, CarMeN Laboratory, Université Claude Bernard Lyon1, Hospices Civils de Lyon, CENS, FCRIN/FORCE Network, Pierre Benite, France
| | - Emmanuel Poulet
- INSERM U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon (CRNL), Equipe PSYR2 Centre Hospitalier Le Vinatier, Lyon, France
| | - Emmanuel Disse
- Centre Intégré de l'Obésité Rhône-Alpes; Fédération Hospitalo-Universitaire DO-iT, Service Endocrinologie-Diabète-Nutrition, Université de Lyon, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France.,Centre de Recherche en Nutrition Humaine Rhône-Alpes, Univ-Lyon, CarMeN Laboratory, Université Claude Bernard Lyon1, Hospices Civils de Lyon, CENS, FCRIN/FORCE Network, Pierre Benite, France
| |
Collapse
|
31
|
Abstract
Well-being requires the maintenance of energy stores, water, and sodium within permissive zones. The brain, as ringleader, orchestrates their homeostatic control. It senses disturbances, decides what needs to be done next, and then restores balance by altering physiological processes and ingestive drives (i.e., hunger, thirst, and salt appetite). But how the brain orchestrates this control has been unknown until recently — largely because we have lacked the ability to elucidate and then probe the underlying neuronal “wiring diagrams.” This has changed with the advent of new, transformative neuroscientific tools. When targeted to specific neurons, these tools make it possible to selectively map a neuron’s connections, measure its responses to various homeostatic challenges, and experimentally manipulate its activity. This review examines these approaches and then highlights how they are advancing, and in some cases profoundly changing, our understanding of energy, water, and salt homeostasis and the linked ingestive drives.
Collapse
Affiliation(s)
- Bradford B Lowell
- From the Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center, and the Program in Neuroscience, Harvard Medical School - both in Boston
| |
Collapse
|
32
|
Smith KE, Mason TB, Johnson JS, Lavender JM, Wonderlich SA. A systematic review of reviews of neurocognitive functioning in eating disorders: The state-of-the-literature and future directions. Int J Eat Disord 2018; 51:798-821. [PMID: 30102781 PMCID: PMC6594106 DOI: 10.1002/eat.22929] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE In recent years there has been increasing clinical and empirical interest in neurocognitive functioning in eating disorders (EDs), which has resulted in numerous quantitative and qualitative reviews. However, there has yet to be a comprehensive synthesis or critical review of this literature to identify future directions to advance the field in this area. Therefore the aim of this systematic review of systematic reviews was to (a) characterize the existing literature on neurocognitive functioning in EDs based on recent reviews (i.e., published since 2010), (b) describe related limitations, and (c) suggest avenues for future research to address gaps in the current literature. METHOD Electronic databases were queried for reviews of neurocognitive domains (i.e., inhibitory control, decision-making, central coherence, set-shifting, working memory, and attention bias) in EDs, which identified 28 systematic and meta-analytic reviews. RESULTS Broadly, the literature indicates deficits across these neurocognitive domains in EDs, though heterogeneity was noted in the magnitude of these effects, which varied to some extent across ED subtypes, sample characteristics, and methodological approaches. DISCUSSION While these reviews have generally suggested varying patterns of neurocognitive deficits across EDs, there remain critical limitations regarding the methodological quality of these studies (e.g., the lack of prospective designs, consideration of confounding influences, or examination of interrelationships between neurocognitive domains and relationships between neurocognition and other relevant behavioral constructs). Specifically, we outline 10 key areas that are imperative to address in future research in this area in order to move our field forward.
Collapse
Affiliation(s)
- Kathryn E Smith
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Jeffrey S Johnson
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychology, North Dakota State University, North Dakota
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, California
| | - Stephen A Wonderlich
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota
| |
Collapse
|
33
|
Matheson BE, Eichen DM. A Review of Childhood Behavioral Problems and Disorders in the Development of Obesity: Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Beyond. Curr Obes Rep 2018; 7:19-26. [PMID: 29411333 DOI: 10.1007/s13679-018-0293-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Given the high rates of pediatric and adult obesity, it is imperative to identify early risk factors that might contribute to excess weight gain. This review aims to investigate the relationship between childhood behavioral problems with the development and persistence of obesity. Specifically, this review highlights the association of obesity with (1) neurocognitive constructs, such as executive functioning and inhibition/impulsivity, and (2) disorders commonly diagnosed in childhood, including attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). RECENT FINDINGS Consistent evidence supports a relationship between childhood behavioral problems, executive functioning, inhibition/impulsivity, ADHD, and ASD with obesity across the lifespan. Longitudinal studies suggest behavior problems, neurocognitive functioning deficits, and ADHD symptoms in childhood predict weight gain over time. Identifying risk factors in childhood that promote obesity may help develop targeted intervention and prevention programs. Additional research should elucidate mechanisms that account for these relationships.
Collapse
Affiliation(s)
- Brittany E Matheson
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, 6363 Alvarado Court, San Diego, CA, 92120, USA.
- Department of Psychiatry, University of California, San Diego, 8950 Villa La Jolla Dr. Suite C-203, San Diego, CA, 92037, USA.
| | - Dawn M Eichen
- Department of Pediatrics, University of California, San Diego, 8950 Villa La Jolla Dr. Suite C-203, San Diego, CA, 92037, USA
| |
Collapse
|
34
|
Abstract
PURPOSE OF REVIEW Obesity is a chronic illness and its prevalence is growing worldwide and numerous factors play a role in the regulation of food intake. The prefrontal cortex (PFC) is involved in high-order executive function, regulation of limbic reward regions, and the inhibition of impulsive behaviors. Understanding the role of the PFC in the control of appetite regulation may contribute to a greater understanding of the etiology of obesity and could improve weight loss outcomes. RECENT FINDINGS Neuroimaging studies have identified lower activation in the left dorsolateral PFC (DLPFC) in obese compared to lean individuals and others have focused on efforts to improve cognitive control in this area of the brain. The DLPFC is a critical brain area associated with appetitive control, food craving, and executive functioning, indicating a candidate target area for treatment. Further studies are needed to advance our understanding of the relationship between obesity, appetite, and the DLPFC and provide validation for the effectiveness of novel treatments in clinical populations.
Collapse
Affiliation(s)
- Marci E Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA.
| | - Pooja Viswanath
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA
| | - Emma J Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Room 541, Phoenix, AZ, 85016, USA
| |
Collapse
|