1
|
Miranda-Olivos R, Agüera Z, Granero R, Jiménez-Murcia S, Puig-Llobet M, Lluch-Canut MT, Gearhardt AN, Fernández-Aranda F. The Role of Food Addiction and Lifetime Substance Use on Eating Disorder Treatment Outcomes. Nutrients 2023; 15:2919. [PMID: 37447246 DOI: 10.3390/nu15132919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/04/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Food addiction (FA) and substance use (SU) in eating disorders (ED) have been associated with a more dysfunctional clinical and psychopathological profile. However, their impact on treatment outcomes has been poorly explored. Therefore, this transdiagnostic study is aimed at examining whether the presence of FA and/or SU is associated with treatment outcomes in patients with different ED types. The results were not able to reveal significant differences in treatment outcomes between patients with and without FA and/or SU; however, the effect sizes suggest higher dropout rates in the group with both FA and SU. The predictive models of treatment outcomes showed different features associated with each group. High persistence (i.e., tendency to perseverance and inflexibility) was the personality trait most associated with poor treatment outcomes in patients without addictions. High harm avoidance and younger age at ED onset were the variables most related to poor outcomes in patients with FA or SU. Finally, in the group with both addictive behaviors (FA and SU), the younger patients presented the poorest outcomes. In conclusion, our results suggest that, regardless of presenting addictive behaviors, patients with ED may similarly benefit from treatment. However, it may be important to consider the differential predictors of each group that might guide certain treatment targets.
Collapse
Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Clinical Psychology Unit, L'Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Zaida Agüera
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-Infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
- Research Group in Mental Health, Psychosocial and Complex Nursing Care (NURSEARCH), Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Clinical Psychology Unit, L'Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| | - Montserrat Puig-Llobet
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-Infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
- Research Group in Mental Health, Psychosocial and Complex Nursing Care (NURSEARCH), Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - Maria Teresa Lluch-Canut
- Departament d'Infermeria de Salut Pública, Salut Mental i Materno-Infantil, Escola d'Infermeria, Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
- Research Group in Mental Health, Psychosocial and Complex Nursing Care (NURSEARCH), Facultat de Medicina i Ciències de la Salut, L'Hospitalet de Llobregat, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Clinical Psychology Unit, L'Hospitalet de Llobregat, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| |
Collapse
|
2
|
Leppanen J, Brown D, McLinden H, Williams S, Tchanturia K. The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach. Front Psychiatry 2022; 13:793094. [PMID: 35280172 PMCID: PMC8904925 DOI: 10.3389/fpsyt.2022.793094] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
Background Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between adaptive and maladaptive emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology. Methodology A total of 104 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted. We ran a Bayesian random effects network meta-analysis and the initial network was well-connected with each emotion regulation strategy being linked to at least one other strategy. We also conducted a network meta-regression to explore whether between-study differences in body mass index (BMI), age, and whether the sample consisted of solely female participants explained any possible network inconsistency. Results The network meta-analysis revealed that ruminations and non-acceptance of emotions were most closely associated with ED psychopathology. There was no significant network inconsistency but two comparisons approached significance and thus meta-regressions were conducted. The meta-regressions revealed a significant effect of BMI such that the associations between different emotion regulation strategies and ED symptomatology were weaker among those with low BMI. Discussion The present findings build on previous work and highlight the role of rumination and difficulties with accepting emotions as key emotion regulation difficulties in EDs. Additionally, the finding that the associations were weaker among ED patients with low BMI may point toward a complex relationship between ED behaviors and emotion regulation. Taken together, our findings call for interventions that target emotion regulation, specifically rumination and difficulties accepting emotions, in the treatment of EDs. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249996, PROSPERO, identifier: CRD42021249996.
Collapse
Affiliation(s)
- Jenni Leppanen
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
| | - Dalia Brown
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Hannah McLinden
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
- School of Education, University of Bristol, Bristol, United Kingdom
| | - Steven Williams
- Department of Neuroimaging, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley National Health Service (NHS) Foundation Trust National Eating Disorder Service, London, United Kingdom
- Psychology Department, Illia State University, Tbilisi, Georgia
| |
Collapse
|