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Frank GKW, Stoddard JJ, Brown T, Gowin J, Kaye WH. Weight gained during treatment predicts 6-month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning. Int J Eat Disord 2024; 57:1653-1667. [PMID: 38610100 DOI: 10.1002/eat.24208] [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: 11/13/2023] [Revised: 03/22/2024] [Accepted: 03/24/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. METHODS Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data available for a 6-month follow-up analysis. Participants were treated in a 6-day-per-week partial-hospital program. Participants were assessed for eating disorder-specific and non-specific psychopathology. The analyses used established machine learning procedures combined in an ensemble model from support vector machine learning, random forest prediction, and the elastic net regularized regression with an exploration (training; 75%) and confirmation (test; 25%) split of the data. RESULTS The models predicting body mass index (BMI) at 6-month follow-up explained a 28.6% variance in the training set (n = 120). The model had good performance in predicting 6-month BMI in the test dataset (n = 40), with predicted BMI significantly correlating with actual BMI (r = .51, p = 0.01). The change in BMI from admission to discharge was the most important predictor, strongly correlating with reported BMI at 6-month follow-up (r = .55). Behavioral variables were much less predictive of BMI outcome. Results were similar for z-transformed BMI in the adolescent-only group. Length of stay was most predictive of weight gain in treatment (r = .56) but did not predict longer-term BMI. CONCLUSIONS This study, using an agnostic ensemble machine learning approach in the largest to-date sample of individuals with anorexia nervosa, suggests that achieving weight gain goals in treatment predicts longer-term weight-related outcomes. Other potential predictors, personality, mood, or eating disorder-specific symptoms were relatively much less predictive. PUBLIC SIGNIFICANCE The results from this study indicate that the amount of weight gained during treatment predicts BMI 6 months after discharge from a high level of care. This suggests that patients require sufficient time in a higher level of care treatment to meet their specific weight goals and be able to maintain normal weight.
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Affiliation(s)
- Guido K W Frank
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Joel J Stoddard
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tiffany Brown
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Josh Gowin
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
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Longo P, Scaliti E, Panero M, Toppino F, Brustolin A, Salis B, Lacidogna MC, Abbate-Daga G, Martini M. A quantitative study on peripersonal space in anorexia nervosa and healthy subjects: Role of social variables and association with psychopathology. Int J Clin Health Psychol 2024; 24:100476. [PMID: 39035050 PMCID: PMC11257834 DOI: 10.1016/j.ijchp.2024.100476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/31/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives This study investigates peripersonal space (PPS) modulation in patients with anorexia nervosa (AN) versus healthy controls (HCs) and explores associations between PPS, eating-related, and general psychopathology. Method Forty-six patients and 42 HCs completed a computer-based task observing videos of an approaching actor (male or female) displaying different facial expressions along with a non-social condition. Then, participants completed self-report questionnaires assessing eating-related and general psychopathology. Results Mixed-models revealed that both groups adjusted PPS based on task conditions, with a gender effect favoring closer proximity to female actor. HCs reduced PPS amplitude progressively during the task, while patients did not show this effect. In patients, wider PPS correlated with lower self-esteem and facial expression identification accuracy, while in HCs, PPS was associated to body dissatisfaction and anxiety symptoms. Conclusion These findings enhance understanding of bodily self-consciousness, suggesting PPS consideration in therapeutic interactions with patients with AN and as a potential target in treatments addressing social impairment.
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Affiliation(s)
- Paola Longo
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Eugenio Scaliti
- Human Science and Technologies, University of Turin, Italy
- Department of Management “Valter Cantino”, University of Turin, Italy
| | - Matteo Panero
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Federica Toppino
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Annalisa Brustolin
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Benedetta Salis
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Maria Carla Lacidogna
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
| | - Matteo Martini
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Via Cherasco 11, 10126, Turin, Italy
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Longo P, Bevione F, Amodeo L, Martini M, Panero M, Abbate-Daga G. Perfectionism in anorexia nervosa: Associations with clinical picture and personality traits. Clin Psychol Psychother 2023. [PMID: 37970961 DOI: 10.1002/cpp.2931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023]
Abstract
Although many researchers addressed the topics, no consistent data are currently available regarding the relationship between perfectionism and personality traits in anorexia nervosa (AN). The present study aimed to assess differences between high- and low-perfectionism groups of patients with AN and to identify which variables show the strongest association with perfectionism. A group of inpatients with AN (n = 193) was recruited and completed a battery of self-report questionnaires regarding eating-related and general psychopathology, perfectionism, and personality. On the basis of perfectionism scores, patients were divided into high- and low-perfectionism groups. High-perfectionist patients displayed higher eating-related and general psychopathology; higher depressive, cyclothymic, irritable and anxious temperament, and lower self-directedness, cooperativeness and self-esteem. Perfectionism was associated with the drive for thinness, cooperativeness, self-esteem and anxious temperament. On the basis of the two personality traits most strongly correlated with perfectionism (i.e., cooperativeness and anxious temperament), patients could be correctly assigned to the high- or low-perfectionism group by an algorithm. The study suggests that perfectionism in AN is related to eating psychopathology, especially of restrictive type, and personality features such as cooperativeness and anxious temperament. These findings confirm the important role of perfectionism in AN, not only concerning eating behaviour but personality as well.
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Affiliation(s)
- Paola Longo
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Francesco Bevione
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Laura Amodeo
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Matteo Martini
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Matteo Panero
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
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Colle L, Hilviu D, Boggio M, Toso A, Longo P, Abbate-Daga G, Garbarini F, Fossataro C. Abnormal sense of agency in eating disorders. Sci Rep 2023; 13:14176. [PMID: 37648816 PMCID: PMC10469170 DOI: 10.1038/s41598-023-41345-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023] Open
Abstract
The feeling of controlling one's own actions and, through them, impacting the external environment (i.e. Sense of Agency-SoA) can be relevant in the eating disorders (EDs) symptomatology. Yet, it has been poorly investigated. This study aims to implicitly assess SoA exploiting the Sensory Attenuation paradigm in two groups of EDs patients (Anorexia Nervosa Restrictive and Anorexia Nervosa Binge-Purging or Bulimia Nervosa) compared to a control group. We find that controls perceive self-generated stimuli as less intense than other-generated ones showing the classic pattern of sensory attenuation. By contrast, EDs patients show the opposite pattern, with self-generated perceived as more intense than other-generated stimuli. This result indicates an alteration of the implicit component of the feeling of control in EDs patients, thus suggesting a potential implication of these results for the clinical practice and the treatment of EDs symptomatology.
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Affiliation(s)
- Livia Colle
- Department of Psychology, University of Turin, Turin, Italy
| | - Dize Hilviu
- Department of Psychology, University of Turin, Turin, Italy
| | - Monica Boggio
- Department of Psychology, University of Turin, Turin, Italy
| | - Alessandra Toso
- Department of Neuroscience, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
| | - Paola Longo
- Department of Neuroscience, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
| | - Giovanni Abbate-Daga
- Department of Neuroscience, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
| | | | - Carlotta Fossataro
- MANIBUS Lab, Department of Psychology, University of Turin, Turin, Italy.
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Meshkova TA, Mitina OV, Aleksandrova RV. Risk factors of disordered eating in adolescent girls from a community sample: a multidimensional approach. CONSORTIUM PSYCHIATRICUM 2023; 4:21-39. [PMID: 38250642 PMCID: PMC10795956 DOI: 10.17816/cp6132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Eating disorders (ED) are severe, chronic, and complex in nature mental illnesses that are difficult to treat. One of the ways to stave off EDs is by screening among adolescents to preempt the development of clinical forms of ED in risk groups. AIM 1) to investigate the prevalence of ED risk among adolescent girls and compare subgroups at high and low risk of ED; 2) to investigate using a multidimensional approach those variables that can interact with temperament and character traits to predict ED symptomatology. METHODS The cross-sectional observational self-report study of a community sample of adolescent girls 1217 years old (n=298; M=14.771.13) was carried out in the city of Ryazan, Russia. The Russian versions of Eating Attitudes Test and Cloningers Temperament and Character Inventory-Revised were used. In addition, an original questionnaire (Risk Factors of Eating Disorders) was developed. Regression models (to test for significant moderation) and path analysis (to test for significant mediations) were used. RESULTS Girls at risk of developing EDs are characterized by a heightened level of concern about weight and dissatisfaction with their body, tend to suffer from low self-directedness, higher novelty seeking and tendency to higher harm avoidance, display high alexithymia, experience self-distrust, negative emotionality and are dissatisfied with family relationships. They also suffer from low self-esteem and tend to be perfectionism and engage in risk behavior. Significant moderating effects were uncovered between the following ED risk factors: (1) self-distrust/risk behavior and BMI; (2) alexithymia/negative emotionality/self-esteem and cooperativeness; and (3) negative emotionality/risk behavior and self-transcendence. Family relationship dissatisfaction mediates the association between self-directedness/cooperativeness/self-transcendence and disordered eating. CONCLUSION There are various mutual influences between the numerous ED risk and prevention factors, which all together determine the paths between the predictors and final outcome.
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Affiliation(s)
| | | | - Roza V. Aleksandrova
- Research Educational Center of Applied Psychology and Psychological Services of S. Yesenin Ryazan State University
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Sfeir M, Rahme C, Obeid S, Hallit S. The mediating role of anxiety and depression between problematic social media use and bulimia nervosa among Lebanese university students. J Eat Disord 2023; 11:52. [PMID: 36991483 PMCID: PMC10052263 DOI: 10.1186/s40337-023-00776-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Background Bulimia nervosa (BN) is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight. The aim of this study was to evaluate the mediating role of anxiety and depression between problematic social media use (PSMU) and BN among a sample of Lebanese university students. Methods This cross-sectional study was carried out between July and September 2021; a total of 363 university students was recruited through convenience sampling. The PROCESS SPSS Macro version 3.4, model four was used to test the indirect effect and calculate three pathways. Pathway A determined the regression coefficient for the effect of PSMU on mental health issues (depression/anxiety); Pathway B examined the association between mental health issues on BN, and Pathway C’ estimated the direct effect of PSMU on BN. Pathway AB was used to calculate the indirect effect of PSMU on BN via depression/anxiety. Results Results showed that depression and anxiety partially mediated the association between PSMU and BN. Higher levels of PSMU were associated with more depression and anxiety; higher depression and anxiety were associated with more BN. PSMU was directly and significantly associated with more BN. When entering anxiety (M1) then depression (M2) as consecutive mediators in a first model, the results showed that only depression mediated the association between PSMU and bulimia. When taking depression (M1) then anxiety (M2) as consecutive mediators in a second model, the results showed that the mediation PSMU → Depression → Anxiety → Bulimia was significant. Higher PSMU was significantly associated with more depression, which was significantly associated with more anxiety, which was significantly associated with more bulimia. Finally, higher PSMU was directly and significantly associated with more bulimia Conclusion The current paper highlights the relationship that social media use has on BN and other aspects of mental health such as anxiety and depression in Lebanon. Future studies should replicate the mediation analysis conducted in the current study while taking into account other eating disorders. Additional investigations of BN and its correlates must strive to improve the comprehension of these associations’ pathways through designs that allow to draw temporal frameworks, in order to efficiently treat this eating disorder and prevent its negative outcomes. Bulimia nervosa, an eating disorder, is characterized by an impulsive consumption of food in a short period of time, followed by behaviors that compensate the eating such as vomiting or excessive exercise in order to avoid weight gain. Individuals with problematic social media use were found to have higher levels of bulimia symptoms. Symptoms of bulimia can also be associated with both depression and anxiety. The aim of the current study was to examine the mediating role of anxiety and depression between problematic social media use and bulimia nervosa. The results of our study found that problematic social media use was directly associated with more bulimia nervosa and also associated with higher depression and anxiety, both of which were associated with bulimia nervosa. Tackling associated disorders may help reduce symptoms of bulimia nervosa. Clinicians should carefully examine these associations while assessing and implementing treatment plans.
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Affiliation(s)
- Michel Sfeir
- grid.8364.90000 0001 2184 581XDepartment of Clinical Psychology, University of Mons, Mons, Belgium
- grid.9851.50000 0001 2165 4204Institute of Psychology (IP), Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Clara Rahme
- grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- grid.411423.10000 0004 0622 534XApplied Science Research Center, Applied Science Private University, Amman, Jordan
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