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Rienecke RD, Mehler PS, Duffy A, Le Grange D, Peterson CB, Blalock DV. Eating Disorder Examination-Questionnaire: Norms for Adults in Higher Levels of Care. Assessment 2024; 31:1179-1188. [PMID: 37927104 DOI: 10.1177/10731911231208386] [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] [Indexed: 11/07/2023]
Abstract
Establishing normative data for questionnaires is essential for the accurate interpretation of scores, given that these norms can vary according to different subpopulations and treatment contexts. The purpose of this study was to establish norms for the Eating Disorder Examination-Questionnaire (EDE-Q) among adults receiving higher levels of care (HLOCs) for the treatment of eating disorders. Participants were 2,283 people receiving treatment at the inpatient, residential, partial hospitalization, or intensive outpatient levels of care. The EDE-Q was completed at admission. Patients with anorexia nervosa-restricting subtype (AN-R) had the lowest EDE-Q Global scores when compared with all other eating disorder diagnoses. When compared with intensive outpatient care, only those in residential treatment had higher EDE-Q Global scores. This study is among the first to describe norms for the EDE-Q in a large sample of adults receiving various HLOCs. Programs utilizing the EDE-Q to assess treatment outcomes can use these findings to aid people in interpreting their scores.
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Affiliation(s)
- Renee D Rienecke
- Eating Recovery Center and Pathlight Mood & Anxiety Center, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
| | - Philip S Mehler
- Eating Recovery Center and Pathlight Mood & Anxiety Center, Chicago, IL, USA
- Denver Health, CO, USA
- University of Colorado, Denver, USA
| | - Alan Duffy
- Eating Recovery Center and Pathlight Mood & Anxiety Center, Chicago, IL, USA
| | - Daniel Le Grange
- University of California, San Francisco, USA
- The University of Chicago, IL, USA
| | | | - Dan V Blalock
- Durham Veterans Affairs Medical Center, NC, USA
- Duke University School of Medicine, Durham, NC, USA
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2
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Masheb RM, Snow JL, Siegel SE, Munro LF, Huggins J, Hamilton AB, Maguen S. US Military Veteran Perspectives on Eating Disorder Screening, Diagnosis, and Treatment: A Qualitative Study. Int J Eat Disord 2024. [PMID: 38989608 DOI: 10.1002/eat.24255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA). METHOD Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA's effort to address them. RESULTS Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible. DISCUSSION For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.
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Affiliation(s)
- Robin M Masheb
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer L Snow
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Sarah E Siegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Lindsay F Munro
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Joy Huggins
- San Francisco VA Health Care System, Mental Health Service, San Francisco, California, USA
| | - Alison B Hamilton
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California, USA
| | - Shira Maguen
- San Francisco VA Health Care System, Mental Health Service, San Francisco, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California-San Francisco, San Francisco, California, USA
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Quiñones IC, Selkie E, Mammel KA, Haedt-Matt A, Klump KL, Burt SA, Van Huysse JL. Disordered eating in transgender and gender non-conforming youth: A comparison to community-based and clinical samples. EUROPEAN EATING DISORDERS REVIEW 2024; 32:338-349. [PMID: 37905947 DOI: 10.1002/erv.3045] [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: 07/14/2023] [Revised: 10/03/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study investigates eating pathology in transgender and gender non-conforming (TGNC) youth compared to a community-based sample and individuals with eating disorders (EDs). METHOD Participants (ages 13-21 years) included TGNC youth from a paediatric gender clinic (N = 97), a demographically matched community-based sample of cisgender males (N = 97) and cisgender females (N = 97), and treatment-seeking patients with EDs (N = 112). The Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED cognitions and behaviours. RESULTS Transgender and gender non-conforming participants reported significantly higher EDE-Q global scores compared to the cisgender samples, but significantly lower than the ED sample. Transgender and gender non-conforming individuals reported a higher likelihood of objective binge episodes (OBEs) than the cisgender groups, albeit lower than youth with EDs. A substantial proportion of TGNC participants scored in elevated ranges on the EDE-Q global score (35% ≥ score of 3, 17% ≥ score of 4), significantly higher than cisgender males (0% ≥ score of 3, 0% ≥ score of 4) and females (9% ≥ score of 3, 3% ≥ score of 4). CONCLUSIONS Findings indicate that TGNC youth exhibit increased ED cognitions and OBEs compared to cisgender samples, highlighting the need for screening and addressing ED symptoms in this population.
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Affiliation(s)
- Isabel C Quiñones
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Ellen Selkie
- University of Wisconsin, Madison, Wisconsin, USA
| | - Kathleen A Mammel
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Alissa Haedt-Matt
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Groves V, Ridley BJ, Cornelissen PL, Maalin N, Mohamed S, Kramer RSS, McCarty K, Tovée MJ, Cornelissen KK. Men's perception of current and ideal body composition and the influence of media internalization on body judgements. Front Psychol 2023; 14:1116686. [PMID: 37205060 PMCID: PMC10185840 DOI: 10.3389/fpsyg.2023.1116686] [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: 12/05/2022] [Accepted: 03/31/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction To determine men's body ideals and the factors that influence these choices, this study used a matrix of computer generated (CG) male bodies (based on an analysis of 3D scanned real bodies) which independently varied in fat and muscle content. Methods Two hundred and fifty-eight male participants completed a range of psychometric measures to index body concerns and body ideal internalization and then chose the CG body that best reflected their own current body, as well as the body that reflected their personal ideal. A subset of participants was then retested to check that these judgements were stable over time. Results While judgements of the ideal body seem to be influenced by a shared appearance ideal, the degree to which this ideal was internalized showed significant variability between participants. The effect of this internalization was reflected in the difference between the estimated current body and the ideal. Discussion Higher internalization led to a preference for higher muscle and lower fat content. This preference was most marked for fat content, although reducing adiposity also made the underlying musculature more salient. Additionally, the ideal body composition was modulated by the composition the participant believed his current body had (i.e., it seemed that a participant's ideal body was anchored by what they believed to be their current body and what change was possible from this starting point).
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Affiliation(s)
- Vicki Groves
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bethany J. Ridley
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Piers L. Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Nadia Maalin
- Department of Psychology, Birmingham City University, Birmingham, United Kingdom
| | - Sophie Mohamed
- Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, United Kingdom
| | | | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Martin J. Tovée
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katri K. Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
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Ruby F, Costa da Silva L, Tait N, Rashid A, Singleton R, Atkins L, Marriot S, Dalzell K, Labno A, Edbrooke-Childs J, Jacob J. Children and young people's mental health outcome measures in paediatrics. Arch Dis Child 2023; 108:271-275. [PMID: 35680404 DOI: 10.1136/archdischild-2020-320852] [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: 07/14/2021] [Accepted: 05/13/2022] [Indexed: 11/03/2022]
Abstract
Paediatricians are increasingly likely to encounter children and young people with mental health difficulties, either as primary presentations or as comorbidities linked with chronic illnesses. However, paediatricians may have limited training or experience regarding the tools available to identify mental health needs and how to use these tools. The current paper aims to provide a go-to guide for paediatricians when considering the use of mental health and well-being outcome measures, including how to select, administer and interpret measures effectively. It also provides practical guidance on the most common mental health outcome measures used in children and young people's mental health services across the UK and elsewhere, which paediatricians are likely to encounter in their practice. Paediatricians may also find these measures useful in their own practice to screen for potential mental health difficulties, monitor the impact of chronic health conditions on a young person's mental health and well-being, or to provide evidence when referring young people to mental health services.
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Affiliation(s)
- Florence Ruby
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | | | - Nick Tait
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | - Anisatu Rashid
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | - Rosie Singleton
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | - Lee Atkins
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | - Sally Marriot
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | - Kate Dalzell
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
| | - Angelika Labno
- Evidence Based Practice Unit, Anna Freud Centre and UCL, London, UK
| | - Julian Edbrooke-Childs
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
- Evidence Based Practice Unit, Anna Freud Centre and UCL, London, UK
| | - Jenna Jacob
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK
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Examining the relationship of eating disorder symptoms and perfectionism in men and women using two assessments of eating pathology. Eat Behav 2023; 48:101704. [PMID: 36724674 DOI: 10.1016/j.eatbeh.2023.101704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/14/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Eating disorder (ED) pathology in men is not as well understood or studied as ED pathology in women. One potential reason for this is that most of the traditional assessments used for EDs were developed for and validated with exclusively female samples, meaning that symptoms in men are not as well represented or measured. There are consistent associations between perfectionism and ED symptoms in women, but less is known regarding how these relationships function in men. This study examined whether the relationship of perfectionism to ED symptoms varies by gender using the Eating Disorder Examination-Questionnaire (EDE-Q) and the Eating Pathology Symptom Inventory (EPSI). The EPSI has multiple dimensions that may better capture the presentation of ED symptoms in men. Participants were recruited from a large public university and through Amazon MechanicalTurk. Participants completed a survey battery that included the two eating measures and the self-oriented perfectionism scale from the Hewitt and Flett Multidimensional Perfectionism Scale. Data were analyzed using independent samples t-tests and structural equation modeling. There were significant positive associations between self-oriented perfectionism and all dimensions measured by the EDE-Q and the EPSI. The models were invariant across gender. Implications for further research were discussed.
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Kim BR, Mackert M. Social media use and binge eating: An integrative review. Public Health Nurs 2022; 39:1134-1141. [PMID: 35294990 DOI: 10.1111/phn.13069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 11/28/2022]
Abstract
Despite binge eating being important to public health, no recent reviews have been conducted to produce a comprehensive synthesis of current literature on the relationship between social media use and binge eating. The aims of this review were: (1) to standardize the measurement of social media use in recent research, (2) to identify eating types that include binge-eating concepts, and (3) to identify the relationships between social media use and binge eating. This is an integrative review of studies conducted from 2016 to 2021 on binge eating and social media use. Searches were conducted in PubMed, PsycInfo, and Web of Science; eight studies were included in this integrative review. Included studies found direct or indirect effects of social media use on binge eating. The more participants use social media, the more likely they are to have increased appetite or intention to eat, which can lead to binge eating. The recent binge-eating studies indicated a significant relationship between social media use and binge eating. Interventions for binge eating should be developed with an understanding of individuals' social media use.
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Affiliation(s)
- Bo Ra Kim
- School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Michael Mackert
- Center for Health Communication, The University of Texas at Austin, Austin, Texas
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Efficacy of Eat Breathe Thrive: A randomized controlled trial of a yoga-based program. Body Image 2022; 42:427-439. [PMID: 35985168 DOI: 10.1016/j.bodyim.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022]
Abstract
Evidence positions yoga as a promising intervention for enhancing positive embodiment and supporting the prevention of, and recovery from, eating disorders (EDs) by reducing ED symptomatology and building skills that facilitate an ongoing, embodied sense of wellbeing. However, yoga-based programs are few and rigorous literature on their efficacy is limited. This study examined the efficacy and feasibility of a yoga-based program called Eat Breathe Thrive (EBT) which aims to prevent EDs and support embodiment. Participants (N = 168, 93.5 % women) from a community sample in the United States and United Kingdom, ages 18-65, were randomly allocated to a 2-h, 7-week EBT program or waitlist-control condition. Compared to controls, EBT participants experienced significant decreases in ED behaviors, depression, and difficulties regulating emotions. They reported significantly greater use of mindfulness skills, such as interoceptive awareness, mindful self-care, and mindful eating. After a single session, participants reported immediate improvement in their sense of well-being, indicating increased state positive embodiment. Most effects were sustained at 6-month follow-up. The majority of individuals attended most sessions. Self-reported treatment integrity was excellent. Directions for future research are proposed. Results support the efficacy and feasibility of an integrated yoga intervention that fosters positive ways of inhabiting the body.
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Bryant E, Spielman K, Le A, Marks P, Touyz S, Maguire S, Brennan L, Bryant E, Byrne S, Caldwell B, Calvert S, Carroll B, Castle D, Caterson I, Chelius B, Chiem L, Clarke S, Conti J, Crouch L, Dammery G, Dzajkovski N, Fardouly J, Feneley J, Foroughi N, Fuller-Tyszkiewicz M, Fursland A, Gonzalez-Arce V, Gouldthorp B, Griffin K, Griffiths S, Hambleton A, Hannigan A, Hart M, Hart S, Hay P, Hickie I, Kay-Lambkin F, King R, Kohn M, Koreshe E, Krug I, Le A, Linardon J, Long R, Long A, Madden S, Maguire S, Maloney D, Marks P, McLean S, Meddick T, Miskovic-Wheatley J, Mitchison D, O’Kearney R, Paterson R, Paxton S, Pehlivan M, Pepin G, Phillipou A, Piccone J, Pinkus R, Raykos B, Rhodes P, Rieger E, Rodan S, Rockett K, Russell J, Russell H, Salter F, Sawyer S, Shelton B, Singh U, Smith S, Smith E, Spielman K, Squire S, Thomson J, Tiggemann M, Touyz S, Utpala R, Vartanian L, Wallis A, Ward W, Wells S, Wertheim E, Wilksch S, Williams M, Touyz S, Maguire S. Screening, assessment and diagnosis in the eating disorders: findings from a rapid review. J Eat Disord 2022; 10:78. [PMID: 35672777 PMCID: PMC9175461 DOI: 10.1186/s40337-022-00597-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/21/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Limited screening practices, minimal eating disorder training in the healthcare professions, and barriers related to help-seeking contribute to persistent low rates of eating disorder detection, significant unmet treatment need, and appreciable associated disease burden. The current review sought to broadly summarise the literature and identify gaps relating to the screening, assessment, and diagnosis of eating disorders within Western healthcare systems. METHODS This paper forms part of a Rapid Review series scoping the evidence base for the field of eating disorders, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for studies published between 2009 and mid 2021 in English. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised through purposive sampling. Data from selected studies relating to Screening, Assessment and Diagnosis of eating disorders were synthesised and are disseminated in the current review. RESULTS Eighty seven studies were identified, 38% relating to screening and 62% to assessment and diagnosis. The majority of screening studies were conducted in university student samples, showing high prevalence but only modest improvements in help-seeking in those studies that followed up post-screen. In healthcare settings, clinicians continue to have difficulty identifying eating disorder presentations, particularly Binge Eating Disorder, Other Specified Feeding or Eating Disorders, and sub-threshold eating disorders. This is preceded by inadequate and frequently homogenous screening mechanisms and exacerbated by considerable personal and health-system barriers, including self-stigma and lack of resourcing. While all groups are at risk of delayed or no diagnosis, those at particular risk include LGBTQ+ and gender diverse individuals, individuals living in larger bodies, and males. CONCLUSIONS A majority of individuals with eating disorders remain undiagnosed and untreated despite a high prevalence of these conditions and increased advocacy in recent years. Research into improving detection and clinician diagnostic skill is extremely limited. Innovative empirical research is strongly recommended to address significant individual and health-system barriers currently preventing appropriate and timely intervention for many. Limited screening in healthcare settings and low rates of eating disorder training in the healthcare professions are just some of the barriers to help-seeking which may contribute to delayed intervention and diagnosis in the eating disorders. This has significant impacts, prolonging treatment when it is finally received, and increasing healthcare costs for both the individual and the healthcare system. The current review is part of a larger Rapid Review series conducted to inform the development of Australia's National Eating Disorders Research and Translation Strategy 2021-2031. A Rapid Review is designed to comprehensively summarise a body of literature in a short timeframe, often to guide policy-making and address urgent health concerns. The Rapid Review synthesises the current evidence-base and identifies gaps in eating disorder research and care, in order to guide decision making and address urgent health concerns. This paper gives a critical overview of the scientific literature relating to the current state of screening, assessment, and diagnosis of eating disorders within Western healthcare systems that may inform health policy and research in an Australian context. It covers screening initiatives in both general and high-risk populations; personal, clinician and healthcare system challenges relating to help-seeking; and obstacles to accurate and timely clinical diagnosis across the eating disorders.
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Affiliation(s)
- Emma Bryant
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Karen Spielman
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, VIC, Australia
| | - Peta Marks
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | | | - Stephen Touyz
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, New South Wales Health, Sydney, Australia
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Contreras-Valdez JA, Freyre MÁ, Mendoza-Flores E. The eating disorder examination questionnaire for adults from the Mexican general population: Reliability and validity. PLoS One 2022; 17:e0266507. [PMID: 35390074 PMCID: PMC8989200 DOI: 10.1371/journal.pone.0266507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
The Eating Disorder Examination Questionnaire is a widely used self-report questionnaire for eating disorders. An Eating Disorder Examination Questionnaire model that is not lacking in relevant content has been supported in three different samples, but existing studies on this model present shortcomings regarding generalizations to the general population. Therefore, the general purpose of the current research was to test the reliability and interpretation validity of the Eating Disorder Examination Questionnaire 6.0 scores in adults of both sexes from the Mexican general population. After translating, adapting, and assessing the Eating Disorder Examination Questionnaire 6.0 in the target population through three pilot studies, we conducted two independent studies. In Study 1, 684 women and 433 men aged 18–83 participated, whereas in Study 2, 591 women and 382 men aged 18–86 did it. They answered the Eating Disorder Examination Questionnaire 6.0 and a measure of either body dissatisfaction (Study 1) or self-esteem (Study 2). According to confirmatory factor analyses, the 14-item Eating Disorder Examination Questionnaire model that we tested fit acceptably for the four samples (two female, two male) and was invariant across sex. All 14-item Eating Disorder Examination Questionnaire 6.0 scores were reliable according to Cronbach’s alpha and McDonald’s omega, except for only one factor score in men. Pearson’s correlations of the 14-item Eating Disorder Examination Questionnaire 6.0 scores with body dissatisfaction and self-esteem were positive and negative, respectively. This new Latin American Spanish translation of the Eating Disorder Examination Questionnaire 6.0 works broadly as expected and provides evidence to extend the generalization of previous studies to the general population. Thus, the present translation of the Eating Disorder Examination Questionnaire 6.0 may be a valuable tool in the field of eating disorders for researchers and practitioners studying or serving Latin American Spanish speakers of either sex from the general population.
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Affiliation(s)
| | - Miguel-Ángel Freyre
- Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Rica R, Solar M, Compte EJ, Sepúlveda AR. Establishing the optimal male cut-off point: confirmatory factor analysis of the eating disorder examination-questionnaire (EDE-Q) in a representative sample of Spanish university students. Eat Weight Disord 2022; 27:969-977. [PMID: 34089512 DOI: 10.1007/s40519-021-01234-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/29/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Although the EDE-Q is derived from the "gold standard" for the assessment of eating disorders (ED), its factor structure is controversial, particularly in male samples. The aim of the study was to examine the psychometric properties and factor structure of the EDE-Q, as well as to establish a sensitive and specific cut-off point validated by EDE clinical interview. METHODS A series of Confirmatory Factor Analyses were performed among a representative sample of 796 male university students, of whom 139 were interviewed. Sensitivity and specificity were calculated by receiver-operating characteristic (ROC) analysis to determinate the most appropriate cut-off value. RESULTS The original factor structure was not confirmed, showing a better fit with a 2-factor solution. For the Spanish male sample, a cut-off ≥ 1.09 for at-risk of ED cases and ≥ 2.41 for clinical cases presents an optimal balance between sensitivity and specificity. CONCLUSIONS The establishment of specific cut-off points for males may help to reduce the under-diagnosis of ED in this population. LEVEL OF EVIDENCE III: evidence obtained from well-designed case-control study.
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Affiliation(s)
- Robin Rica
- Faculty of Psychology. Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid (UAM), Madrid, Spain
| | - María Solar
- Faculty of Psychology. Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Emilio J Compte
- Eating Behavior Research Center School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Ana R Sepúlveda
- Faculty of Psychology. Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid (UAM), Madrid, Spain.
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Potential Low Energy Availability (LEA) Risk Amongst Amateur and Recreational Athletes in Singapore. PHYSICAL ACTIVITY AND HEALTH 2021. [DOI: 10.5334/paah.120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kahn L, Sutton B, Winston HR, Abosch A, Thompson JA, Davis RA. Deep Brain Stimulation for Obsessive-Compulsive Disorder: Real World Experience Post-FDA-Humanitarian Use Device Approval. Front Psychiatry 2021; 12:568932. [PMID: 33868034 PMCID: PMC8044872 DOI: 10.3389/fpsyt.2021.568932] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: While case series have established the efficacy of deep brain stimulation (DBS) in treating obsessive-compulsive disorder (OCD), it has been our experience that few OCD patients present without comorbidities that affect outcomes associated with DBS treatment. Here we present our experience with DBS therapy for OCD in patients who all have comorbid disease, together with the results of our programming strategies. Methods: For this case series, we assessed five patients who underwent ventral capsule/ventral striatum (VC/VS) DBS for OCD between 2015 and 2019 at the University of Colorado Hospital. Every patient in this cohort exhibited comorbidities, including substance use disorders, eating disorder, tic disorder, and autism spectrum disorder. We conducted an IRB-approved, retrospective study of programming modifications and treatment response over the course of DBS therapy. Results: In addition to patients' subjective reports of improvement, we observed significant improvement in the Yale-Brown Obsessive-Compulsive Scale (44%), the Montgomery-Asberg Depression Rating Scale (53%), the Quality of Life Enjoyment and Satisfaction Questionnaire (27%), and the Hamilton Anxiety Rating scales (34.9%) following DBS. With respect to co-morbid disease, there was a significant improvement in a patient with tic disorder's Total Tic Severity Score (TTSS) (p = 0.005). Conclusions: DBS remains an efficacious tool for the treatment of OCD, even in patients with significant comorbidities in whom DBS has not previously been investigated. Efficacious treatment results not only from the accurate placement of the electrodes by the surgeon but also from programming by the psychiatrist.
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Affiliation(s)
- Lora Kahn
- Department of Neurosurgery, Ochsner Health, Tulane University-Ochsner Health Neurosurgery Program, New Orleans, LA, United States
| | - Brianne Sutton
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Helena R. Winston
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Aviva Abosch
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, United States
| | - John A. Thompson
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Rachel A. Davis
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Pritchett K, DiFolco A, Glasgow S, Pritchett R, Williams K, Stellingwerff T, Roney P, Scaroni S, Broad E. Risk of Low Energy Availability in National and International Level Paralympic Athletes: An Exploratory Investigation. Nutrients 2021; 13:nu13030979. [PMID: 33803566 PMCID: PMC8002867 DOI: 10.3390/nu13030979] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 12/25/2022] Open
Abstract
(1) Background: The purpose of this study was to examine the symptoms of low energy availability (LEA) and risk of relative energy deficiency in sport (RED-S) symptoms in para-athletes using a multi-parameter approach. (2) Methods: National level para-athletes (n = 9 males, n = 9 females) completed 7-day food and activity logs to quantify energy availability (EA), the LEA in Females Questionnaire (LEAF-Q), dual energy X-ray absorptiometry (DXA) scans to assess bone mineral density (BMD), and hormonal blood spot testing. (3) Results: Based on EA calculations, no athlete was at risk for LEA (females < 30 kcal·kg−1 FFM·day−1; and males < 25 kcal·kg−1 FFM·day−1; thresholds for able-bodied (AB) subjects). Overall, 78% of females were “at risk” for LEA using the LEAF-Q, and 67% reported birth control use, with three of these participants reporting menstrual dysfunction. BMD was clinically low in the hip (<−2 z-score) for 56% of female and 25% of male athletes (4) Conclusions: Based on calculated EA, the risk for RED-S appears to be low, but hormonal outcomes suggest that RED-S risk is high in this para-athlete population. This considerable discrepancy in various EA and RED-S assessment tools suggests the need for further investigation to determine the true prevalence of RED-S in para-athlete populations.
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Affiliation(s)
- Kelly Pritchett
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (A.D.); (S.G.); (R.P.); (K.W.)
- Correspondence:
| | - Alicia DiFolco
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (A.D.); (S.G.); (R.P.); (K.W.)
| | - Savannah Glasgow
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (A.D.); (S.G.); (R.P.); (K.W.)
| | - Robert Pritchett
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (A.D.); (S.G.); (R.P.); (K.W.)
| | - Katy Williams
- Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA; (A.D.); (S.G.); (R.P.); (K.W.)
| | - Trent Stellingwerff
- Canadian Sport Institute-Pacific, Victoria, BC V9E 2C5, Canada;
- Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC V8P 5C2, Canada
- Athletics Canada, Ottawa, ON K1G 6C9, Canada;
| | | | - Susannah Scaroni
- Division of Nutrition Sciences, University of Illinois Urbana-Champaign, Champaign, IL 61801, USA;
| | - Elizabeth Broad
- United States Olympic and Paralympic Committee, Chula Vista, CA 91915, USA;
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15
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Kan C, Hawkings YR, Cribben H, Treasure J. Length of stay for anorexia nervosa: Systematic review and meta-analysis. EUROPEAN EATING DISORDERS REVIEW 2021; 29:371-392. [PMID: 33548148 DOI: 10.1002/erv.2820] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 11/23/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Evidence regarding global trends in length of stay for patients with anorexia nervosa is limited. The aim of this study is to conduct a meta-analysis examining the length of stay for anorexia nervosa patients globally, and to investigate moderators of the variance. METHOD Medline, EMBASE and PsycINFO were searched for studies published up to January 2019. Two independent reviewers assessed the eligibility of each report based on predefined inclusion criteria. A meta-analysis was performed to calculate a pooled mean length of stay using the random-effects model. Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity between studies. RESULTS Of 305 abstracts reviewed, 71 studies met the inclusion criteria, generating 111 datasets. The pooled mean length of stay (95% confidence interval) was 76.3 days (73.3, 79.4) using the random-effects model, with marked variation across countries and time. Heterogeneity between studies was explained by age and admission body mass index. CONCLUSIONS This meta-analysis found that although clinical features do contribute to length of admissions for anorexia nervosa, there are also global and temporal variations. Future research should provide an in-depth analysis of why and how this variation exists and what the impact is on the well-being of people with anorexia nervosa.
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Affiliation(s)
- Carol Kan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Hannah Cribben
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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16
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Lewis-Smith H, Garbett KM, Chaudhry A, Uglik-Marucha N, Vitoratou S, Dhillon M, Shroff H, Diedrichs PC. Adaptation and validation of the Eating Disorder Examination-Questionnaire in English among urban Indian adolescents. Int J Eat Disord 2021; 54:187-202. [PMID: 33305881 DOI: 10.1002/eat.23431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Eating pathology is a salient issue in India, with clinical features reported among adults and adolescents. However, there are currently no validated measures of disordered eating in the Indian context. The present study therefore aimed to validate a culturally appropriate English language version of the Eating Disorder Examination Questionnaire (EDE-Q), a widely used measure, among adolescents in India. METHOD We adapted and examined the factor structure, reliability, and construct validity of the EDE-Q among an urban sample of 1,413 Indian adolescents (mean age = 13 years; 45% girls). RESULTS In contrast to the original four-factor model, exploratory factor analysis identified a two-factor solution for girls and boys, which was verified by confirmatory factor analysis; a "Preoccupation and Control" subscale and a "Weight and Shape Concerns" subscale. The total scale comprised 15 items for girls and 18 items for boys. Test-retest reliability and internal consistency were satisfactory for the girls' and boys' scales (Cronbach's α = .91 for both) and their comprising subscales (αs ≥ .80). Concurrent validity was established through medium-high significant correlations with measures of body image and internalization of appearance ideals. Combining items common to both versions of the scale led to a psychometrically acceptable model which was largely invariant across both genders, thus facilitating gendered comparison. DISCUSSION Findings indicate the reliability and validity of the EDE-Q among English-speaking urban Indian adolescents. This will facilitate further research examining the prevalence and nature of eating pathology among adolescents in India.
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Affiliation(s)
- Helena Lewis-Smith
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | | | | | | | - Megha Dhillon
- Lady Shri Ram College, University of Delhi, New Delhi, India
| | - Hemal Shroff
- Tata Institute of Social Sciences, Mumbai, India
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17
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Factor structure of the Eating Disorder Examination - Questionnaire among heterosexual and sexual minority males. Eat Behav 2020; 38:101403. [PMID: 32540716 DOI: 10.1016/j.eatbeh.2020.101403] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 05/13/2020] [Accepted: 05/26/2020] [Indexed: 11/20/2022]
Abstract
Eating disorder (ED) pathology is increasingly recognized among males; however, presentations within males differ from traditional descriptions of ED pathology in females. Additionally, experiences of ED pathology differ between sexual minority (SM) and heterosexual males. These differences suggest that existing ED assessments, which are primarily based on female samples, do not adequately capture ED pathology in SM and heterosexual males. The Eating Disorder Examination-Questionnaire (EDE-Q) is a commonly used assessment of ED pathology; however, at present the factor structure of this instrument in SM and heterosexual males is unclear. This study aimed to determine the most appropriate factor structure of the EDE-Q by evaluating proposed factor structures in a large, non-clinical sample consisting of heterosexual and SM men. Additionally, this study examined differences in the factor structures and severities of ED pathology between SM and heterosexual males. Confirmatory Factor Analyses examining existing factor structures of the EDE-Q indicated that the brief three-factor model was the best fitting model for both heterosexual and SM males. Subsequent comparisons of factor scores between groups indicated that SM males in our sample experienced higher levels of dietary restraint, overvaluation of shape and weight, and body dissatisfaction than heterosexual males. Results provide preliminary support for the use of the brief three-factor model of the EDE-Q when assessing ED pathology among SM and heterosexual males in non-clinical research settings.
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18
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Jaworski M, Panczyk M, Śliwczyński A, Brzozowska M, Janaszek K, Małkowski P, Gotlib J. Eating Disorders in Males: An 8-Year Population-Based Observational Study. Am J Mens Health 2020; 13:1557988319860970. [PMID: 31268395 PMCID: PMC6610443 DOI: 10.1177/1557988319860970] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was the realistic evaluation of the prevalence of
eating disorders (ED) among Polish men who sought treatment through the National
Health Fund (NFZ) in the years 2010–2017. According to ICD-10, four types of ED
were analyzed: anorexia nervosa—AN (F50.0), atypical anorexia nervosa (F50.1),
bulimia nervosa—BN (F50.2), and atypical bulimia nervosa (F50.3). The NFZ database was used. The ED groups were defined according to ICD-10 codes.
Demographic data were collected from the web page of Statistics Poland (GUS).
The annual prevalence of EDs was estimated, and the age groups were categorized
into nine groups. For the incidence of EDs in male patients in the years
2010–2017, relative risk (RR) with 95% confidence interval (95% CI) was
calculated. The frequency trend of AN in males remains relatively stable. AN occurred mainly
in young men (between 11 and 30 years). It was noted that AN affected
approximately 100 men in each year of observation, while atypical anorexia
nervosa affected about 40 men. In 2017, the RR for EDs in young males was 0.041
(95% CI [0.033, 0.051]). Bulimia was relatively rare (about 35 males each
year). The incidence of EDs in males is a relatively constant phenomenon. The real
number of male patients with EDs may be higher. The current conceptualizations
of ED pathology should be modified and better adapted to men. Clinical
guidelines for specialists working with males with EDs should be developed.
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Affiliation(s)
- Mariusz Jaworski
- 1 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland
| | - Mariusz Panczyk
- 1 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland
| | - Andrzej Śliwczyński
- 2 Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Melania Brzozowska
- 2 Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Katarzyna Janaszek
- 2 Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Piotr Małkowski
- 3 Department of Surgical and Transplant Nursing and Extracorporeal Treatment, Medical University of Warsaw, Poland
| | - Joanna Gotlib
- 1 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland
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19
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The Sum Is Greater than its Parts: Intersectionality and Measurement Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in Latinx Undergraduates in the United States. SEX ROLES 2020. [DOI: 10.1007/s11199-020-01149-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Terhoeven V, Nikendei C, Bärnighausen T, Bountogo M, Friederich H, Ouermi L, Sié A, Harling G. Eating disorders, body image and media exposure among adolescent girls in rural Burkina Faso. Trop Med Int Health 2020; 25:132-141. [PMID: 31710750 PMCID: PMC8609432 DOI: 10.1111/tmi.13340] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Body dissatisfaction and eating disorders (ED) among young females may increase in limited-resource settings as exposure to media and higher-resource cultures increases. We examined ED prevalence and its predictors among adolescent girls in rural north-western Burkina Faso. METHODS Fieldworkers interviewed 696 female adolescents aged 12-20 years in the Nouna Health and Demographic Surveillance System (HDSS). ED were evaluated using the Structured Clinical Interview for DSM-5 (SCID-5), self-perceived appearance and body ideal were measured using Thompson and Gray's Contour Drawing Rating Scale (CDRS) and eating disorder predictors by the Eating Disorder Examination Questionnaire (EDE-Q). We assessed media exposure to magazines, radio, television, and the internet. RESULTS 16% of respondents had a BMI below WHO age-standardised 5th percentile, while 4% were above the 85th percentile; most respondents wanted to be larger. DSM-5 criteria for anorexia nervosa (AN) were fulfilled by four of 696 respondents (0.6%), those for bulimia nervosa by none, and those for binge eating disorder by two (0.3%). In multivariable regression, more AN symptoms were associated with greater EDE-Q body dissatisfaction, desiring a thinner body and a history of sexual harassment or assault, but not with media exposure. A thinner desired body was associated with greater media exposure, higher BMI z-score and greater EDE-Q disordered eating. CONCLUSION ED were very rare in rural Burkinabé female adolescents, but factors predictive of ED in higher-resource settings were also predictive of ED precursor symptoms here. Our findings suggest that increasing media exposure in resource-limited settings may lead to increased body dissatisfaction, and potentially to increased future ED prevalence.
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Affiliation(s)
- Valentin Terhoeven
- Centre for Psychosocial MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Christoph Nikendei
- Centre for Psychosocial MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Till Bärnighausen
- Institute for Global HealthUniversity College LondonLondonUK
- Heidelberg Institute of Global Health (HIGH)University of HeidelbergHeidelbergGermany
- Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMAUSA
- Africa Health Research Institute (AHRI)Somkhele and DurbanSouth Africa
| | | | | | - Lucienne Ouermi
- Centre de Recherche en Santé de Nouna (CRSN)NounaBurkina Faso
| | - Ali Sié
- Centre de Recherche en Santé de Nouna (CRSN)NounaBurkina Faso
| | - Guy Harling
- Institute for Global HealthUniversity College LondonLondonUK
- Africa Health Research Institute (AHRI)Somkhele and DurbanSouth Africa
- Department of Epidemiology & Harvard Center for Population and Development StudiesHarvard T.H. Chan School of Public HealthBostonMAUSA
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21
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Perko VL, Forbush KT, Siew CSQ, Tregarthen JP. Application of network analysis to investigate sex differences in interactive systems of eating-disorder psychopathology. Int J Eat Disord 2019; 52:1343-1352. [PMID: 31608479 DOI: 10.1002/eat.23170] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 08/09/2019] [Accepted: 08/13/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Although men comprise 25% of persons with eating disorders (EDs), most research has focused on understanding EDs in women. The theoretical framework underlying common ED treatment has not been rigorously tested in men. The purpose of this study was to compare the interconnectivity among ED symptoms in men versus women. METHOD Participants (N = 1,348; 50% men) were individuals with anorexia nervosa, bulimia nervosa, binge-eating disorder, or other specified feeding or eating disorder who were users of Recovery Record, a smartphone app for monitoring ED symptoms. Participants were matched on age and duration of illness. Network analysis was used to create networks of symptoms for both sexes. Strength centrality, network stability, and bootstrapped centrality differences were tested. The network comparison test (NCT) was used to identify sex differences between networks. Key players analysis was used to compare fragmentation of each network. RESULTS For both sexes, items related to binge eating and restricting emerged as highest in strength centrality. The NCT identified significant differences global strength (p = .03) but not network invariance (p = .06) suggesting that although the structure of the networks was not statistically different, the strength of the connections within the network was greater for women. Key players analysis indicated that both networks were similarly disrupted when important nodes within the network were removed. DISCUSSION Findings suggested that there are more similarities than differences in networks of EDs in men and women. Results have important clinical implications by supporting theoretical underpinnings of cognitive-behavioral models of EDs in both men and women.
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Affiliation(s)
- Victoria L Perko
- Department of Psychology, University of Kansas, Lawrence, Kansas
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas
| | - Cynthia S Q Siew
- Department of Psychology, National University of Singapore, Singapore
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22
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Ortiz S, Knauft K, Smith A, Kalia V. Expressive suppression mediates the relation between disordered eating and suicidal ideation. J Clin Psychol 2019; 75:1943-1958. [PMID: 31332800 DOI: 10.1002/jclp.22830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Although disordered eating is robustly associated with suicidal thoughts, it is not well understood why these conditions relate to each other. Emotion dysregulation is a shared risk factor for disordered eating and suicidal thoughts. Individuals with dysregulated emotions struggle to select appropriate strategies to modulate emotions and the strategies they use might explain some of the shared variances. Thus, we examined whether emotion regulation strategies mediated the relationship between disordered eating and suicidal ideation. METHOD Adult participants (N = 230) completed questionnaires on current disordered eating symptoms, emotion regulation strategies, and current suicidal ideation. RESULTS Disordered eating symptoms positively associated with suicidal ideation. In addition, expressive suppression mediated the relation between disordered eating symptoms and current suicidal ideation. No relation was found for cognitive reappraisal. CONCLUSIONS The use of expressive suppression as an emotion regulation strategy may be related to increased suicidal ideation in individuals who express concerns about eating.
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Affiliation(s)
- Shelby Ortiz
- Department of Psychology, Miami University, Oxford, Ohio
| | | | - April Smith
- Department of Psychology, Miami University, Oxford, Ohio
| | - Vrinda Kalia
- Department of Psychology, Miami University, Oxford, Ohio
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23
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Knauft K, Ortiz S, Velkoff E, Smith A, Kalia V. Keep Calm and Carry On? Grit Buffers Against Disordered Eating Unless Expressive Suppression is Used to Regulate Emotions. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.4.321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Grit is a personality trait that affords individuals the ability to push through challenging circumstances, suggesting tolerance of negative affect. In contrast, individuals with disordered eating are motivated to avoid negative affect. We speculated whether grit would buffer against disordered eating attitudes and behaviors, and conducted two studies to address this query. Method: Study 1 (N = 137) had participants from eating disorder treatment centers (n = 52) and adults from the community (n = 85). Disordered eating was assessed using the Eating Disorder Inventory. In Study 2, we tested whether emotion regulation strategy (i.e., cognitive reappraisal and expressive suppression) as an individual differences variable influenced the relation between grit and disordered eating within a community sample (N = 212). Disordered eating was assessed via the Eating Disorder Examination Questionnaire. In both studies, Grit-Consistency and Grit-Perseverance were measured using the Short Grit Scale. Results: Study 1 revealed that Grit–Consistency, not Grit–Perseverance, was associated with lower bulimia and body dissatisfaction scores. Further, moderation analysis indicated that this relation was consistent for both the clinical and community samples. Findings from Study 2 demonstrated that Grit–Consistency was inversely correlated with shape and weight concerns. Moderation regression analysis showed that elevated levels of expressive suppression attenuated the relation between Grit-Consistency and disordered eating. Discussion: Our work provides evidence that Grit-Consistency buffers against disordered eating. But elevated use of expressive suppression, a maladaptive emotion regulation strategy, eliminates the benefits of grit.
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24
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Schaefer LM, Smith KE, Leonard R, Wetterneck C, Smith B, Farrell N, Riemann BC, Frederick DA, Schaumberg K, Klump KL, Anderson DA, Thompson JK. Identifying a male clinical cutoff on the Eating Disorder Examination-Questionnaire (EDE-Q). Int J Eat Disord 2018; 51:1357-1360. [PMID: 30480321 PMCID: PMC6310481 DOI: 10.1002/eat.22972] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Evidence suggests that eating disorders (EDs) may be under-detected in males. Commonly used measures of EDs such as the Eating Disorder Examination-Questionnaire (EDE-Q) were initially developed within female samples, raising concern regarding the extent to which these instruments may be appropriate for detecting EDs in males. The current study used receiver operating characteristic curve analysis to (a) examine the accuracy of the EDE-Q global score in correctly classifying males with and without clinically significant ED pathology, and (b) establish the optimal EDE-Q global clinical cutoff for males. METHOD Participants were a clinical sample of 245 male ED patients and a control sample of 205 male undergraduates. RESULTS Eating Disorder Examination-Questionnaire global scores demonstrated moderate-high accuracy in predicting ED status (area under the curve = 0.85, 95% CI: 0.82-0.89). The optimal cutoff of 1.68 yielded a sensitivity of 0.77 and specificity of 0.77. DISCUSSION Overall, results provide preliminary support for the discriminant validity of EDE-Q scores among males. However, concerns remain regarding the measure's ability to comprehensively assess domains of disordered eating most relevant to males. Therefore, careful attention to the possibility for measurement bias and continued evaluation of the scale in males is encouraged.
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Affiliation(s)
| | - Kathryn E. Smith
- Sanford Research, Fargo, North Dakota, USA,University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, North Dakota, USA
| | | | | | - Brad Smith
- Rogers Memorial Hospital, Oconomowoc, Wisconsin, USA
| | | | | | | | - Katherine Schaumberg
- University of Wisconsin-Madison, Department of Psychiatry, Madison, Wisconsin, USA
| | - Kelly L. Klump
- Michigan State University, Department of Psychology, East Lansing, Michigan, USA
| | - Drew A. Anderson
- University at Albany-State University of New York, Department of Psychology, Albany, New York, USA
| | - J. Kevin Thompson
- University of South Florida, Department of Psychology, Tampa, Florida, USA
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Preston C, Ehrsson HH. Implicit and explicit changes in body satisfaction evoked by body size illusions: Implications for eating disorder vulnerability in women. PLoS One 2018; 13:e0199426. [PMID: 29928005 PMCID: PMC6013093 DOI: 10.1371/journal.pone.0199426] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 06/07/2018] [Indexed: 11/18/2022] Open
Abstract
Dissatisfaction with one's body is a widespread issue in modern society and has been linked to vulnerability for developing eating disorders. Recent studies have demonstrated a direct relationship between body perception and body satisfaction by manipulating perceived body size using multisensory body illusions. However, how these body size illusions influence implicit affective experience has not previously been examined. The current experiment used an established full-body ownership illusion paradigm to induce feelings of illusory obesity in male and female participants. The effects of illusory obesity on explicit and implicit body satisfaction were measured in naïve participants across two separate experiments. In terms of explicit measures, owning an obese body decreased body satisfaction, and owning a slimmer body increased body satisfaction in females but not in males. However, implicit feelings regarding the body were only influenced by the synchrony of the touch and not the size of the body in the illusion. These results suggest that implicit and explicit affective experiences of the body may be mediated by different factors. In addition, these findings may have clinical implications because both implicit and explicit changes in affective experience of the body were related to behaviours and thoughts associated with disordered eating in a non-clinical sample.
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Affiliation(s)
- Catherine Preston
- Psychology Department, University of York, York, United Kingdom
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - H. Henrik Ehrsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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26
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Jennings KM, Phillips KE. Eating Disorder Examination-Questionnaire (EDE-Q): Norms for Clinical Sample of Female Adolescents with Anorexia Nervosa. Arch Psychiatr Nurs 2017; 31:578-581. [PMID: 29179824 PMCID: PMC5728684 DOI: 10.1016/j.apnu.2017.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/28/2017] [Accepted: 08/01/2017] [Indexed: 01/14/2023]
Affiliation(s)
- Karen M Jennings
- The University of Chicago, Psychiatry & Behavioral Neuroscience, 5841 S. Maryland Avenue, Chicago, IL 06824, United States.
| | - Kathryn E Phillips
- Fairfield University, 1073 N. Benson Road, Fairfield, CT 06825, United States.
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Smith KE, Mason TB, Murray SB, Griffiths S, Leonard RC, Wetterneck CT, Smith BER, Farrell NR, Riemann BC, Lavender JM. Male clinical norms and sex differences on the Eating Disorder Inventory (EDI) and Eating Disorder Examination Questionnaire (EDE-Q). Int J Eat Disord 2017; 50:769-775. [PMID: 28436086 PMCID: PMC5741972 DOI: 10.1002/eat.22716] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/22/2017] [Accepted: 03/29/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Evidence indicates that males account for a significant minority of patients with eating disorders (EDs). However, prior research has been limited by inclusion of small and predominantly non-clinical samples of males. This study aimed to (1) provide male clinical norms for widely used ED measures (Eating Disorder Examination Questionnaire [EDE-Q] and Eating Disorder Inventory-3 [EDI-3]) and (2) examine sex differences in overall ED psychopathology. METHOD Participants were 386 male and 1,487 female patients with an ED diagnosis aged 16 years and older who completed the EDE-Q and EDI-3 upon admission to a residential or partial hospital ED treatment program. RESULTS Normative data were calculated for the EDE-Q (global and subscales) and the EDI-3 (drive for thinness, body dissatisfaction, and bulimia). Analyses of variance (ANOVAs) used to examine sex, ED diagnosis, and their interaction in relation to overall ED psychopathology revealed a consistent pattern of greater severity among females for ED psychopathology. DISCUSSION This study provides clinical norms on the EDE-Q and the EDI-3 for males with clinically diagnosed EDs. It is unclear whether the greater severity observed in females reflects qualitative differences in ED presentation or true quantitative differences in ED severity. Additional research examining the underlying nature of these differences and utilizing male-specific ED measures with clinical samples is warranted.
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Affiliation(s)
- Kathryn E. Smith
- Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Tyler B. Mason
- Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Stuart B. Murray
- School of Medicine, University of California San Francisco, San Francisco, California
| | - Scott Griffiths
- Research School of Psychology, Australian National University, Australia,Centre for Applied Psychology, University of Canberra, Australia,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | | | | | | | | | | | - Jason M. Lavender
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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