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Gordon K, Jhe G, Adhikari R, Matthews A, Freizinger M, Richmond T, Lin JA. Treatment adherence and nasogastric tube use in hospitalized youth with anorexia nervosa and premorbid overweight/obesity. Eat Disord 2024:1-9. [PMID: 39054888 DOI: 10.1080/10640266.2024.2379158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Youth with restrictive-eating disorders (EDs) often experience significant distress and difficulty with treatment adherence during nutritional rehabilitation. This study assessed whether youth with restrictive EDs and premorbid overweight/obesity admitted for inpatient nutritional rehabilitation experience greater psychological distress and difficulty with treatment adherence than youth with premorbid BMI <85th percentile. A retrospective chart review examined 150 youth hospitalized for medical complications of restrictive EDs. Rates of nasogastric tube (NGT; used when youth could not complete meals), agitation medication use, and disposition recommendation were compared across premorbid BMI groups. Patients with premorbid overweight/obesity were three times more likely to require NGT feeds. These findings suggest greater challenges with nutritional rehabilitation, specifically consuming nutrition orally, in patients with premorbid overweight/obesity, highlighting the need for early and individualized psychological support for this vulnerable patient population.
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Affiliation(s)
- Katelyn Gordon
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Grace Jhe
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Richa Adhikari
- Department of Public Health, California State University, Los Angeles, California, USA
| | - Abigail Matthews
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Melissa Freizinger
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Tracy Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Jessica A Lin
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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2
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Li J, Wilczynska D, Lipowska M, Łada-Maśko AB, Radtke BM, Sajewicz-Radtke U, Izydorczyk B, Liu T, Wang Z, Lu J, Lipowski M. Predictive Model of the Relationship between Appearance, Eating Attitudes, and Physical Activity Behavior in Young People amid COVID-19. Nutrients 2024; 16:2065. [PMID: 38999813 PMCID: PMC11242963 DOI: 10.3390/nu16132065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
This cross-sectional study conducted in Poland explored the relationship between the fear of negative appearance evaluations, eating disorders, and physical activity objectives, particularly during the COVID-19 pandemic. The Fear of Negative Appearance Evaluation Scale (FNAES), the Eating Attitude Test (EAT-26), and the Physical Activity Goals Inventory (IPAO) were administered to 644 participants (455 males with a mean age of 35.2 ± 6.2 years and 189 females with a mean age of 30.18 ± 5.7 years). This study explored the effects of gender, age, and body mass index (BMI) on FNAES, EAT-26, and IPAO scores. The results of this study demonstrated that females scored higher on fear of negative appearance, peaking at 41-50 years of age. Distinct BMI categories were associated with different negative appearance fear scores, eating attitudes, and physical activity objectives. Significant correlations were also found between the fear of negative appearance, dietary attitudes, and physical activity goals. Eating attitudes completely moderated the relationship between the fear of negative appearance and physical activity objectives. A significant interaction effect of age and body mass index on physical activity objectives was also revealed. These results highlight the relevance of considering gender, age, and body mass index when examining the associations between the fear of negative appearance, eating attitudes, and physical activity objectives.
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Affiliation(s)
- Jianye Li
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport, Górskiego 1, 80-336 Gdansk, Poland; (D.W.); (Z.W.); (J.L.)
| | - Dominika Wilczynska
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport, Górskiego 1, 80-336 Gdansk, Poland; (D.W.); (Z.W.); (J.L.)
| | - Małgorzata Lipowska
- Institute of Psychology, University of Gdańsk, Bażyńskiego 8 Street, 80-309 Gdansk, Poland; (M.L.)
| | - Ariadna Beata Łada-Maśko
- Institute of Psychology, University of Gdańsk, Bażyńskiego 8 Street, 80-309 Gdansk, Poland; (M.L.)
| | - Bartosz M. Radtke
- Laboratory of Psychological and Educational Tests, 80-239 Gdansk, Poland (U.S.-R.)
| | | | | | - Taofeng Liu
- Physical Education Institute (Main Campus), Zhengzhou University, Zhengzhou 450001, China;
| | - Zitong Wang
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport, Górskiego 1, 80-336 Gdansk, Poland; (D.W.); (Z.W.); (J.L.)
| | - Junyu Lu
- Faculty of Physical Education, Gdańsk University of Physical Education and Sport, Górskiego 1, 80-336 Gdansk, Poland; (D.W.); (Z.W.); (J.L.)
| | - Mariusz Lipowski
- Faculty of Social and Humanities, WSB Merito University Gdansk, 80-226 Gdańsk, Poland;
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Williams BM, Brown ML, Levinson CA. State mechanisms of change in eating disorder symptoms and fears during an online imaginal exposure treatment for eating disorders. J Affect Disord 2024; 351:499-506. [PMID: 38309481 DOI: 10.1016/j.jad.2024.01.265] [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: 09/24/2023] [Revised: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
Anxiety and fear are key characteristics of eating disorders (EDs). Exposure therapy is a specific type of intervention aimed at reducing fear and anxiety and is efficacious in treating a variety of anxiety and related disorders. A growing body of research suggests that exposure therapy is also efficacious for the treatment of EDs. However, there is currently little research investigating mechanisms of change during exposure therapy for EDs. The current study (N = 143) expanded on an open series trial of imaginal exposure for EDs that found significant reductions in ED symptoms and core ED fears. In the current study we investigated change in state drive for thinness, body dissatisfaction, and anxiety as mechanisms underpinning change in ED symptoms and core ED fears during four sessions of online imaginal exposure treatment for EDs. We found that state body dissatisfaction, but not state drive for thinness or anxiety, was a mechanism of change for ED symptoms and some core ED fears. Our findings suggest that body dissatisfaction may be a mechanism driving change during exposure therapy for EDs. Optimizing exposure treatments to focus on body dissatisfaction may improve treatment outcomes for EDs.
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Affiliation(s)
- Brenna M Williams
- Department of Psychological & Brain Sciences, University of Louisville, United States of America
| | - Mackenzie L Brown
- Department of Psychological & Brain Sciences, University of Louisville, United States of America
| | - Cheri A Levinson
- Department of Psychological & Brain Sciences, University of Louisville, United States of America.
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Essayli JH, Forrest LN, Zickgraf HF, Stefano EC, Keller KL, Lane-Loney SE. The impact of between-session habituation, within-session habituation, and weight gain on response to food exposure for adolescents with eating disorders. Int J Eat Disord 2023; 56:637-645. [PMID: 36626314 PMCID: PMC9992286 DOI: 10.1002/eat.23894] [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: 09/13/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Exposure therapy is a promising treatment for eating disorders (EDs). However, questions remain about the effectiveness of exposure to feared foods during the weight restoration phase of treatment, and the importance of between-session and within-session habituation. METHOD We recruited 54 adolescents from a partial hospitalization program (PHP) for EDs which included daily food exposure. Throughout treatment, participants provided subjective units of distress (SUDS) ratings before and after eating a feared food, and completed measures of ED symptomatology. RESULTS Multilevel models found that pre-exposure SUDS decreased over time, providing some evidence that between-session habituation occurred. In contrast, the difference between pre-exposure and post-exposure SUDS did not decrease over time, indicating that within-session habituation did not occur. Weight gain predicted greater between-session habituation to feared foods, but did not predict within-session habituation. Between-session habituation, but not within-session habituation, predicted favorable treatment outcomes, including weight gain and improvements on the Children's Eating Attitudes Test and Fear of Food Measure. DISCUSSION Partial hospitalization programs that include daily exposure to feared foods may be effective at decreasing anxiety about foods for adolescents with EDs who are experiencing weight restoration. Further research is warranted to replicate our findings challenging the importance of within-session habituation, and to better understand between-session habituation and inhibitory learning as mechanisms of change when conducting food exposure for EDs. PUBLIC SIGNIFICANCE This study provides some evidence that PHPs that include food exposure may be useful for adolescents with EDs who are experiencing weight restoration. Between-session habituation, but not within-session habituation, predicted favorable treatment outcomes. Further research is needed to determine whether clinicians can disregard within-session habituation when conducting food exposure for EDs, and understand the importance of between-session habituation as a potential mechanism of food exposure.
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Affiliation(s)
- Jamal H Essayli
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Lauren N Forrest
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hana F Zickgraf
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Emily C Stefano
- Bariatric and Weight Management Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kathleen L Keller
- Department of Nutritional Sciences, Pennsylvania State University, Pennsylvania, USA
- Department of Food Science, Pennsylvania State University, Pennsylvania, USA
| | - Susan E Lane-Loney
- Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Virtual Rejection and Overinclusion in Eating Disorders: An Experimental Investigation of the Impact on Emotions, Stress Perception, and Food Attitudes. Nutrients 2023; 15:nu15041021. [PMID: 36839379 PMCID: PMC9965581 DOI: 10.3390/nu15041021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
(1) Background: the investigation of how interpersonal functioning affects eating psychopathology has been receiving increasing attention in the last decade. This study evaluates the impact of virtual social inclusion or ostracism on emotions, perceived stress, eating psychopathology, and the drive to binge or restrict in patients across the eating disorder spectrum. (2) Methods: a group of 122 adolescent and adult females with different eating disorder diagnoses were compared to 50 healthy peers with regards to their performance on, and responses to the Cyberball task, a virtual ball-tossing game. Each participant was randomly assigned to playing a social inclusion or a social exclusion block of the Cyberball task and completed self-report assessments of emotions, perceived stress and urge to restrict/binge before and after the task. (3) Results: patients with anorexia nervosa showed a more negative impact on psychological well-being evaluated with the need threat scale after the excluding block, while patients with bulimia nervosa reported more negative effects after the overincluding condition. Patients with binge eating disorder showed a reduction in specific negative emotions after the overincluding block, unlike all other participants. (4) Conclusions: findings show significant correlations between restraint thoughts in patients with bulimia nervosa and binge thoughts in patients with binge eating disorder after being exposed to the inclusion condition. Different reactions in cognitive and emotional states of patients with eating disorders after different interpersonal scenarios confirm the impact of inclusive or exclusive relationships on eating psychopathology, with specific and different responses across the eating disorder spectrum, that have been discussed, linked to their eating behavioral cognition.
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Simonazzi C, Natali L, Valmaggia L, Rowlands K, Meregalli V, Rabarbari E, De Luca Comandini A, Favaro A, Fontana F, Treasure J, Cardi V. Food-related aversion in a female sample of people with anorexia nervosa: Cognitive-behavioural correlates, somatic and subjective anxiety, and early experiences. Appetite 2023; 180:106366. [PMID: 36356912 DOI: 10.1016/j.appet.2022.106366] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/11/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Food-related anxiety and avoidance are key features of anorexia nervosa, and among the most arduous maintaining processes to address in treatment. This study gathered information on the behavioural and cognitive correlates of food-related anxiety, including their associations with early experiences of aversive learning related to food, and more general anxiety. METHODS One-hundred and forty-four patients with anorexia nervosa were recruited from clinical services in Italy. They completed online questionnaires to assess food-related anxiety, eating disorder psychopathology, eating disorder safety behaviours and threat cognitions, early experience of aversive learning related to food, and somatic anxiety. RESULTS Experiences of food-related aversive learning were recalled by the majority of the sample (87.86%), with negative psychological consequences following eating being the most often reported (75%). Safety behaviours and threat cognitions related to the consequences of eating were also reported (14.29%-87.86%, and 36.43-90% respectively, depending on the behaviour/cognition). Eating disorder psychopathology was predicted by both somatic anxiety and negative psychological consequences following eating, whereas self-reported food anxiety was only predicted by somatic anxiety. CONCLUSION Findings validate an anxiety-based model of anorexia nervosa which establishes the role of safety behaviours, threat cognitions, early aversive learning experiences, and anxiety in the psychopathology of the illness. Exposure-based interventions have the potential to target these factors, and inhibit food-related fear.
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Affiliation(s)
| | - Ludovica Natali
- University of Padova, Department of General Psychology, Padova, Italy.
| | - Lucia Valmaggia
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, United Kingdom; South London and Maudsley NHS Foundation Trust, London, BR3 3BX, United Kingdom; KU Leuven, Department of Psychiatry, Belgium.
| | - Katie Rowlands
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, United Kingdom.
| | - Valentina Meregalli
- University of Padova, Department of Neuroscience, Padova, Italy; University of Padova, Padova Neuroscience Center, Padova, Italy.
| | - Elisa Rabarbari
- University of Padova, Department of General Psychology, Padova, Italy.
| | | | - Angela Favaro
- University of Padova, Department of Neuroscience, Padova, Italy; University of Padova, Padova Neuroscience Center, Padova, Italy.
| | - Francesca Fontana
- Centro Provinciale di Treviso per i Disturbi del Comportamento Alimentare, Aulss2 Marca Trevigiana, Treviso, Italy.
| | - Janet Treasure
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, United Kingdom.
| | - Valentina Cardi
- University of Padova, Department of General Psychology, Padova, Italy; King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, United Kingdom.
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De Pasquale C, Morando M, Platania S, Sciacca F, Hichy Z, Di Nuovo S, Quattropani MC. The Roles of Anxiety and Self-Esteem in the Risk of Eating Disorders and Compulsive Buying Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16245. [PMID: 36498319 PMCID: PMC9735669 DOI: 10.3390/ijerph192316245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
In contemporary society, following the sudden changes that occur, different forms of addiction are becoming popular. Of note are the new addictions and concepts of poly-dependencies that involve common behaviors and trap people who suffering from them in a vicious circle. The main goal of this study is to investigate the possible mediating role that self-esteem had between trait anxiety and two specific new addictions: compulsive buying behavior and eating disorders. Furthermore, it was verified through a multigroup analysis that trait anxiety had a greater effect on eating disorders in a group of compulsive consumers. Three-hundred and fifty-two participants (67.9% women) were enrolled to participate in this study. The results showed that there was a direct effect of trait anxiety on eating disorders and on compulsive buying behavior; self-esteem mediated the effect of trait anxiety on eating disorders and compulsive buying behavior with specific differences; multi-group analysis showed differences in anxiety's effect on eating disorders between compulsive and non-compulsive consumers; the group of compulsive consumers revealed a significant and stronger effect of trait anxiety on eating disorders in all domains identified. Further research is recommended to better understand the predictors of these disorders and to contribute to a more effective preventive intervention.
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Affiliation(s)
- Concetta De Pasquale
- Section Philosophy and Social Sciences, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Martina Morando
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Silvia Platania
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Federica Sciacca
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Zira Hichy
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Santo Di Nuovo
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Maria Catena Quattropani
- Section Psychology, Department of Educational Sciences, University of Catania, 95124 Catania, Italy
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Inpatient Weight Restoration Treatment Is Associated with Decrease in Post-Meal Anxiety. J Pers Med 2021; 11:jpm11111079. [PMID: 34834431 PMCID: PMC8621034 DOI: 10.3390/jpm11111079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: Anorexia nervosa (AN) is characterized by weight loss, distorted body image with fear of becoming fat and associated with anxiety, especially in relation to food intake. Anxiety in relation to meals and weight restoration remains a major challenge in the treatment of AN. We examined the effects of inpatient weight restoration treatment on levels of post-meal anxiety using visual analogue scale (VAS) ratings in patients with AN. Materials: Thirty-two patients with AN, all part of the PROspective Longitudinal all-comer inclusion study on Eating Disorders (PROLED) were followed over eight weeks with baseline psychometric measures and weekly VAS anxiety self-scoring. Methods: Apart from the weekly body mass index (BMI) and VAS, patients were characterized at baseline using the Eating Disorder Examination Questionnaire (EDE-Q), Eating Disorder Inventory (EDI), Symptom Check List 92 (SCL-92), Major Depression Inventory (MDI), and Autism Quotient (AQ). Results: The results showed a significant time effect, Wilks Lambda = 0.523, F = 3.12, p < 0.05 (power of 0.862), indicating a reduction in VAS scores of anxiety from baseline to week 8. There was no effect of baseline medication or scores of MDI on the results. BMI increased from a mean of 15.16 (week 1) to 17.35 (week 8). In comparison, patients dropping out after only three weeks (n = 31) also had a trend toward a reduction in VAS anxiety (ns). Conclusions: Inpatient weight restoration treatment is associated with a decrease in post-meal anxiety in AN, an effect that occurs early and becomes clinically significant in patients who stay in treatment.
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9
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Drakes DH, Fawcett EJ, Rose JP, Carter-Major JC, Fawcett JM. Comorbid obsessive-compulsive disorder in individuals with eating disorders: An epidemiological meta-analysis. J Psychiatr Res 2021; 141:176-191. [PMID: 34216946 DOI: 10.1016/j.jpsychires.2021.06.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/05/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
The present study aimed to provide a precise, meta-analytic estimate of the prevalence of obsessive-compulsive disorder (OCD) amongst those with a current primary eating disorder (ED) diagnosis, and to isolate its predictors. An online search of PubMed and PsycINFO was conducted with a Boolean search phrase incorporating keywords related to OCD, EDs, comorbidity, prevalence, and epidemiology, complemented by references coded from related review articles and contact with experts in the field. Articles were included if they (a) reported an observational study examining current ED diagnoses, (b) used a semi-structured or structured diagnostic interview for OCD and ED diagnosis, (c) applied DSM or ICD criteria, (d) included adolescent or adult samples (age > 12), (e) included patient or community samples, and (f) reported lifetime or current OCD comorbidity. From the 846 articles identified, 35 lifetime and 42 current estimates were calculated. OCD prevalence was extracted from each study for each ED diagnostic category, along with eleven additional potential moderators. Analyses revealed an aggregate lifetime OCD prevalence of 13.9% CI95% [10.4 to 18.1] and current OCD prevalence of 8.7% CI95% [5.8 to 11.8] across EDs. Moderator analyses revealed the prevalence of and risk for OCD in EDs to be greatest in anorexia nervosa binge-eating purging type (ANBP). Further, OCD is most prevalent amongst patient samples than samples recruited from the community.
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Affiliation(s)
- Dalainey H Drakes
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
| | - Emily J Fawcett
- Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Julia P Rose
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | - Jonathan M Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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10
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Levinson CA, Williams BM. Eating disorder fear networks: Identification of central eating disorder fears. Int J Eat Disord 2020; 53:1960-1973. [PMID: 32918319 DOI: 10.1002/eat.23382] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Eating-related fear and anxiety are hallmark symptoms of eating disorders (EDs). However, it is still unclear which fears are most important (e.g., food, weight gain), which has practical implications, given treatments for eating-related fear necessitate modifications based on the specific fear driving ED pathology. For example, exposure treatments should be optimized based on specific fears that maintain pathology. The current study (N = 1,622 combined clinical ED and undergraduate sample) begins to answer questions on the precise nature of ED fears and how they operate with other ED symptoms. METHOD We used network analysis to create two models of ED fears and symptoms. The first model consisted of ED fears only (e.g., fears of food, fears of weight gain) to identify which fear is most central. The second model consisted of ED fears and ED symptoms to detect how ED fears operate with ED symptoms. RESULTS We found fear of disliking how one's body feels due to weight gain, disliking eating in social situations, feeling tense around food, fear of judgment due to weight gain, and food anxiety were the most central ED fears. We also identified several bridge symptoms between ED fears and symptoms. Finally, we found that the most central ED fears predicted excessive exercise at two-month follow-up. DISCUSSION These data support the idea that consequences (i.e., judgment) associated with fears of weight gain and interoceptive fears are the most central ED fears. These data have implications for the future development of precision interventions targeted to address ED-related fear.
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Affiliation(s)
- Cheri A Levinson
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Brenna M Williams
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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11
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Katsohiraki M, Poulopoulou S, Fyrfiris N, Koutelekos I, Tsiotinou P, Adam O, Vasilopoulou E, Kapritsou M. Evaluating Preoperative Anxiety Levels in Patients Undergoing Breast Cancer Surgery. Asia Pac J Oncol Nurs 2020; 7:361-364. [PMID: 33062831 PMCID: PMC7529031 DOI: 10.4103/apjon.apjon_31_20] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/30/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Patients' anxiety and stress levels are increased after the surgery. High levels of anxiety and stress could increase postoperative complications, as well as to prolong postoperative hospitalization and postoperative morbidity. This prospective, cross-sectional study was to evaluate the preoperative stress levels in patients undergoing breast cancer surgery. METHODS In the study participated 165 female patients who underwent breast cancer surgery, in a major oncological hospital in Greece. Demographic and clinical data were collected, and anxiety and stress levels assessed using the State-Trait Anxiety Inventory (STAI) Scale, which was a self-report questionnaire consisting of 40, 4 Likert Scale questions. The first 20 questions, STAI-X-1, were concerned to how the patient felt while answering the questionnaire (anxiety as a condition) and the remaining 20 questions, STAI-X-2, based on how the patient felt overall (stress as a personality trait). Descriptive statistics and nonparametric tests were performed at a significance level alpha = 0.05. RESULTS In the present study, 165 females were enrolled who underwent breast cancer surgery. The mean age of the participants was 55.86 years, whereas the mean body mass index was 26.85. The 60.6% of patients underwent a lumpectomy and 28.5% had mastectomy. The 35.8% experienced moderate levels of anxiety, and the 17.6% experienced high levels. The two scales were positively correlated (rho = 0.643, P < 0.001), at the significance level P = 0.01. Furthermore, the Stai-X-2 Scale was negatively correlated with body height (rho = -0.1188, P = 0.016). CONCLUSIONS The present study showed that patients' personality influenced their anxiety levels. Thus, the role of the nurse is a cornerstone in their psychological support preoperatively, to reduce the anxiety and stress levels.
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Affiliation(s)
- Maria Katsohiraki
- Department of Anesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Day Care Clinic, “N. Kourkoulos”, Athens, Greece
| | - Sofia Poulopoulou
- Department of Anesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Day Care Clinic, “N. Kourkoulos”, Athens, Greece
| | - Nikolaos Fyrfiris
- Department of Anesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Day Care Clinic, “N. Kourkoulos”, Athens, Greece
| | | | - Polyxeni Tsiotinou
- Department of Anesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Day Care Clinic, “N. Kourkoulos”, Athens, Greece
| | - Olga Adam
- General Hospital “Andreas Syggros”, Athens, Greece
| | - Eleni Vasilopoulou
- Department of Anesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Day Care Clinic, “N. Kourkoulos”, Athens, Greece
| | - Maria Kapritsou
- Department of Anesthesiology, Hellenic Anticancer Institute, “Saint Savvas” Hospital, Day Care Clinic, “N. Kourkoulos”, Athens, Greece
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Examining DBT Day Treatment in Treating Mood Dysregulation Expectancy and Anxiety in Women Diagnosed with Eating Disorders. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020. [DOI: 10.1007/s10879-020-09475-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Phillipou A, Musić S, Rossell SL. Refeeding is not a treatment for the underlying symptoms of anorexia nervosa. Aust N Z J Psychiatry 2020; 54:755-756. [PMID: 32441111 DOI: 10.1177/0004867420924474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,Department of Mental Health, Austin Health, Melbourne, VIC, Australia
| | - Selma Musić
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Susan Lee Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
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Zafeiri E, Kandylaki A, Zyga S, Zarogiannis I, Panoutsopoulos GI. The Contribution of Biofeedback Brain Boy Method to the Treatment of Anxiety Disorders. Mater Sociomed 2019; 31:105-109. [PMID: 31452634 PMCID: PMC6690315 DOI: 10.5455/msm.2019.31.105-109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Anxiety management is one of the most important health issues which is being faced by humans today. Biofeedback, as a method of neurophysiology, has been added to the methods recommended for this purpose. Aim: The aim of the study was to measure the effectiveness of biofeedback method by using Brain Boy Universal Professional in the treatment of anxiety disorders. Methods: The sample of this research study consisted of 50 individuals, suffering from symptoms of anxiety, who underwent biofeedback therapy. For the purposes of this study, the self-administered questionnaire Hamilton Rating Scale for Anxiety was completed by the individuals both before the initiation of the therapy and after individuals had completed ten sessions of treatment with biofeedback. Results: Prior to biofeedback, 26% of the participants showed mild to moderate anxiety, 12% a medium severity of anxiety and the remaining 62% severe anxiety. After the completion of 10 sessions of biofeedback, 78% of the participants was found to experience mild to moderate anxiety, 12% a medium severity of anxiety and only 10% of severe anxiety. Conclusion: Biofeedback can be a therapeutic method for the treatment of anxiety disorders, giving treatment to patients who do not respond to drugs but also to patients who want to apply to undergo such treatment alongside other therapeutic methods including drugs.
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Affiliation(s)
- Eleftheria Zafeiri
- Laboratory of Physiology and Pharmacology, Department of Nursing, School of Human Movement and Quality of Life, University of Peloponnese, Greece
| | - Agapi Kandylaki
- Department Social Administration and Political Science, Democritus University of Thrace, Greece
| | - Sofia Zyga
- Laboratory of Physiology and Pharmacology, Department of Nursing, School of Human Movement and Quality of Life, University of Peloponnese, Greece
| | - Ioannis Zarogiannis
- Department of Nursing, Faculty of Health and Caring Professions, University of West Attica, Athens, Greece
| | - Georgios I Panoutsopoulos
- Laboratory of Physiology and Pharmacology, Department of Nursing, School of Human Movement and Quality of Life, University of Peloponnese, Greece
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