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Natali L, Meregalli V, Rowlands K, Di Pietro J, Treasure J, Collantoni E, Meneguzzo P, Tenconi E, Favaro A, Fontana F, Ceccato E, Sala A, Valmaggia L, Cardi V. Virtual food exposure with positive mood induction or social support to reduce food anxiety in anorexia nervosa: A feasibility study. Int J Eat Disord 2024; 57:703-715. [PMID: 38366755 PMCID: PMC11137760 DOI: 10.1002/eat.24155] [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: 10/17/2023] [Revised: 01/20/2024] [Accepted: 01/20/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Aversive emotions toward food and the consequences of eating are at the core of anorexia nervosa. Exposure therapy is effective to reduce anxiety and avoidance toward feared stimuli. Based on the inhibitory learning framework, this study examined the feasibility to induce social support or positive mood to enhance the impact of a single session virtual food exposure on food-related anxiety in anorexia nervosa. METHOD One hundred and forty-five patients were randomized to: (1) virtual food exposure (i.e., baseline condition), (2) virtual food exposure plus positive mood induction (i.e., positive mood condition), or (3) virtual food exposure plus social support (i.e., social support condition). They completed self-report assessments of anxiety toward virtual foods, general anxiety, positive mood, social support, and hunger, before and after virtual food exposure. Number of eye gazes and touches toward foods were recorded during the virtual reality exposure. RESULTS Patients had lower levels of anxiety toward virtual foods in the positive mood condition, compared to the baseline condition [F(2,141) = 4.36, p = .015; medium effect size]. They also touched food items more often in the baseline condition. No other significant changes were found. DISCUSSION Virtual food exposure enhanced by positive mood induction seems a feasible approach to strengthen the impact of food exposure in anorexia nervosa. PUBLIC SIGNIFICANCE This research contributes to the understanding of how patients with anorexia nervosa can be supported to overcome fear and anxiety around food. Virtual reality enables patients to expose themselves to difficult situations (e.g., kitchen with foods of various calorie contents) while experiencing positive stimuli, such as a loving and kind pet or a supportive avatar.
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Affiliation(s)
- Ludovica Natali
- Department of General PsychologyUniversity of PadovaPadovaItaly
| | - Valentina Meregalli
- Department of NeuroscienceUniversity of PadovaPadovaItaly
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly
| | - Katie Rowlands
- Department of Psychological MedicineInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUnited Kingdom
| | - Jerome Di Pietro
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUnited Kingdom
| | - Janet Treasure
- Department of Psychological MedicineInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUnited Kingdom
| | - Enrico Collantoni
- Department of NeuroscienceUniversity of PadovaPadovaItaly
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly
- Department of PsychiatryEating Disorders Unit, Padova University HospitalPadovaItaly
| | - Paolo Meneguzzo
- Department of NeuroscienceUniversity of PadovaPadovaItaly
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly
- Department of PsychiatryEating Disorders Unit, Padova University HospitalPadovaItaly
| | - Elena Tenconi
- Department of NeuroscienceUniversity of PadovaPadovaItaly
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly
- Department of PsychiatryEating Disorders Unit, Padova University HospitalPadovaItaly
| | - Angela Favaro
- Department of NeuroscienceUniversity of PadovaPadovaItaly
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly
- Department of PsychiatryEating Disorders Unit, Padova University HospitalPadovaItaly
| | - Francesca Fontana
- Centro Provinciale di Treviso per i Disturbi del Comportamento Alimentare (Treviso Eating Disorders Unit)ULSS2 Marca TrevigianaTrevisoItaly
| | - Enrico Ceccato
- Centro Provinciale di Vicenza per i Disturbi del Comportamento Alimentare (Vicenza Eating Disorders Unit)ULSS8 BericaVicenzaItaly
| | - Alessandra Sala
- Centro Provinciale di Vicenza per i Disturbi del Comportamento Alimentare (Vicenza Eating Disorders Unit)ULSS8 BericaVicenzaItaly
| | - Lucia Valmaggia
- Department of Psychological MedicineInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUnited Kingdom
- South London and Maudsley NHS Foundation TrustLondonUnited Kingdom
- Department of PsychiatryKU LeuvenLeuvenBelgium
| | - Valentina Cardi
- Department of General PsychologyUniversity of PadovaPadovaItaly
- Department of Psychological MedicineInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUnited Kingdom
- Department of PsychiatryEating Disorders Unit, Padova University HospitalPadovaItaly
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Meneguzzo P, Baron E, Marchesin S, Andretta AM, Nalesso L, Stella S, Todisco P. Tuning in to recovery: influence of music on emotional well-being during mealtime in inpatient facilities for eating disorders. J Eat Disord 2024; 12:7. [PMID: 38225626 PMCID: PMC10789025 DOI: 10.1186/s40337-024-00970-9] [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: 10/14/2023] [Accepted: 01/11/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND In rehabilitating eating disorders (ED), mealtimes are critical but often induce stress, both for restrictive and binge-purge disorders. Although preliminary data indicate a positive effect of music during mealtime, few studies employ an experimental approach. This study examines the influence of background music during mealtime in an inpatient ward setting, offering a real-world perspective. METHODS Fifty-one women diagnosed with ED participated in this within-subjects study. Over two weeks, during lunch and dinner, they were exposed to three randomized music conditions: no music, focus piano music, and pop music. The self-report questionnaires captured affective states, noise levels, and hunger, while trained dietitians recorded food consumption and eating rituals. RESULTS The absence of music led to an increase in uneaten food (p = 0.001) and the presence of eating rituals (p = 0.012) during mealtimes. Significantly, only silence during mealtime reduced positive emotional states, while background music maintained positive emotions (p < 0.001). No specific differences emerged between the two types of music (focus piano and pop). CONCLUSIONS These findings affirm the positive impact of background music during mealtime in real-world settings, enhancing the potential of inpatient eating rehabilitation programs for individuals with ED. More studies are needed to validate and extend these results, particularly in outpatient settings.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, 35128, Padua, Italy.
- Padova Neuroscience Center, University of Padova, Padua, Italy.
| | - Elisa Baron
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Silvia Marchesin
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Anna Maria Andretta
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Lisa Nalesso
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Sonia Stella
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Patrizia Todisco
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
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Bektas S, Natali L, Rowlands K, Valmaggia L, Di Pietro J, Mutwalli H, Himmerich H, Treasure J, Cardi V. Exploring Correlations of Food-Specific Disgust with Eating Disorder Psychopathology and Food Interaction: A Preliminary Study Using Virtual Reality. Nutrients 2023; 15:4443. [PMID: 37892518 PMCID: PMC10609698 DOI: 10.3390/nu15204443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
The emotion of disgust is thought to play a critical role in maintaining restrictive eating among individuals with anorexia nervosa. This exploratory cross-sectional study examined correlations between food-specific trait and state disgust, eating disorder psychopathology, illness severity (body mass index: BMI), and interactions with virtual foods in people with anorexia nervosa. Food-specific trait disgust and eating disorder symptoms were measured before exposure to virtual foods in one of three virtual reality (VR) kitchens to which participants were randomly allocated. Food interactions (eye gaze and reaching towards virtual foods) were measured during the VR exposure. Food-specific state disgust ratings were collected after the VR exposure. In the entire sample, eating disorder symptoms correlated positively with food-specific trait disgust (rs (68) = 0.45, p < 0.001). We also found a significant association between food-specific state disgust and eating disorder symptoms in each virtual kitchen scenario: virtual kitchen only (rs (22) = 0.40, p = 0.05), virtual kitchen plus pet (rs (22) = 0.80, p < 0.001), and virtual kitchen plus avatar (rs (20) = 0.78, p < 0.001). No significant correlation was observed for the link between food-specific disgust measures and food-related touch. Correlations between food-specific trait disgust and food-related eye gaze differed across scenarios. The current experimental paradigm needs to be improved to draw firm conclusions. Both food-specific trait and state disgust are associated with eating disorder psychopathology, and therefore, effective strategies are warranted to attenuate food-specific disgust.
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Affiliation(s)
- Sevgi Bektas
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- Department of Psychology, Hacettepe University, Ankara 06800, Türkiye
| | - Ludovica Natali
- Department of General Psychology, University of Padova, 35122 Padova, Italy
| | - Katie Rowlands
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (L.V.); (J.D.P.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AB, UK
- Department of Psychiatry, KU Leuven, 3000 Leuven, Belgium
| | - Jerome Di Pietro
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (L.V.); (J.D.P.)
| | - Hiba Mutwalli
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- Department of Clinical Nutrition, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AB, UK
| | - Janet Treasure
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- South London and Maudsley NHS Foundation Trust, London SE5 8AB, UK
| | - Valentina Cardi
- Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; (K.R.); (H.M.); (H.H.); (J.T.); (V.C.)
- Department of General Psychology, University of Padova, 35122 Padova, Italy
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Booij L, Israël M, Ferrari M, St-Hilaire A, Paquin-Hodge C, Allard M, Blaquière A, Dornik J, Freiwald S, Long SA, Monarque M, Pelletier WD, Thaler L, Yaffe M, Steiger H. Development of a transdiagnostic digital interactive application for eating disorders: psychometric properties, satisfaction, and perceptions on implementation in clinical practice. J Eat Disord 2023; 11:146. [PMID: 37644511 PMCID: PMC10466831 DOI: 10.1186/s40337-023-00871-3] [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: 03/25/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Given limited availability of informed treatments for people affected by eating disorders (EDs), there has been increasing interest in developing self-administered, technology-based ED interventions. However, many available interventions are limited to a specific ED diagnosis or assume that participants are ready to change. We developed a digital self-help application (called ASTrA) that was explicitly designed to be transdiagnostic and to help increase motivation for change. The aim of the present study was to describe the development and examine the psychometric properties, user satisfaction and rated potentials for practical use of our application. METHODS The content of our application was based on concepts derived from self-determination theory, the transtheoretical model of change, and cognitive theory. The application was developed by a multidisciplinary team of clinicians, researchers, staff members and individuals with lived ED experience, each being involved in all steps of the application's development. We tested validity, reliability, satisfaction and perceived feasibility for clinical implementation in an independent sample of 15 patients with an ED and 13 clinicians specialized in ED treatment. Psychometric properties were evaluated using descriptive statistics, correlations, content validity indices and intraclass coefficients. Differences in satisfaction ratings and perceived potential for clinical implementation of the application between clinicians and patients were examined using Mann-Whitney U tests. RESULTS The digital application showed excellent validity (mean i-CVI: .93, range: .86-.96) and internal reliability (all Cronbach alpha's > .88). Patients and clinicians both considered the application acceptable, appropriate, and feasible for use in clinical practice. CONCLUSIONS Findings suggest that our transdiagnostic interactive application has excellent psychometric properties. Furthermore, patients and clinicians alike were positive about the possible use of the application in clinical practice. The next step will be to investigate the application's effectiveness as an intervention to promote autonomous motivation and to facilitate remission in people on the waitlist for specialized ED treatment.
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Affiliation(s)
- Linda Booij
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada.
| | - Mimi Israël
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Manuela Ferrari
- Department of Psychiatry, McGill University, Montreal, Canada
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Annie St-Hilaire
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Chloé Paquin-Hodge
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Melissa Allard
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Amélie Blaquière
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Julia Dornik
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Shiri Freiwald
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Shawna A Long
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Marika Monarque
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - William D Pelletier
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Lea Thaler
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Miriam Yaffe
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Howard Steiger
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research Centre, Douglas Mental Health University Institute, Montreal, Canada.
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An Explorative Analysis of the Influence of Landscape Visual Aesthetic Quality on Food Preferences in Italy: A Pilot Study. Foods 2022; 11:foods11121779. [PMID: 35741975 PMCID: PMC9222271 DOI: 10.3390/foods11121779] [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: 03/23/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 12/04/2022] Open
Abstract
As some previous research has highlighted, landscape characteristics are useful for improving the market share of some food products and the market power of companies in the agrifood sector. The purpose of this study is to verify whether the visual aesthetic quality of the landscape can influence food preferences and the willingness to pay for agrifood products. To this end, the preferences of 64 participants for three types of juice (orange, peach and pear) were analysed through a blind tasting experiment. Each participant tasted three pairs of fruit juices, one for each type of juice. The juices belonging to each pair were the same, but before tasting, the participants were shown two photos portraying the orchards where the fruits were produced, so participants were induced to think that the juices were different. The landscape associated with each pair of photographs had a different visual aesthetic quality (high or low). Participants were asked to provide three measures while tasting the juices: their overall juice assessment using a seven-point hedonic scale, the visual aesthetic quality of the photos on a seven-point Likert scale, and their willingness to pay as a percentage variation of the price that they usually pay to buy fruit juices. According to our results, the mean overall liking score and the mean willingness to pay percentage variation for the juices associated with a preferred landscape was higher and statistically different. Despite the need for further research, our results suggest that landscape acts as a proxy for quality in the evaluation of some food products and that the use of landscape photos could be a valid marketing strategy in agribusiness.
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Reichenberger J, Schnepper R, Arend A, Richard A, Voderholzer U, Naab S, Blechert J. Emotional eating across different eating disorders and the role of body mass, restriction, and binge eating. Int J Eat Disord 2021; 54:773-784. [PMID: 33656204 PMCID: PMC8252459 DOI: 10.1002/eat.23477] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Different subtypes of eating disorders (ED) show dysfunctional eating behaviors such as overeating and/or restriction in response to emotions. Yet, systematic comparisons of all major EDs on emotional eating patterns are lacking. Furthermore, emotional eating correlates with body mass index (BMI), which also differs between EDs and thus confounds this comparison. METHOD Interview-diagnosed female ED patients (n = 204) with restrictive (AN-R) or binge-purge anorexia nervosa (AN-BP), bulimia nervosa (BN), or binge-eating disorder (BED) completed a questionnaire assessing "negative emotional eating" (sadness, anger, anxiety) and "happiness eating." ED groups were compared to BMI-matched healthy controls (HCs; n = 172 ranging from underweight to obesity) to exclude BMI as a confound. RESULTS Within HCs, higher BMI was associated with higher negative emotional eating and lower happiness eating. AN-R reported the lowest degree of negative emotional eating relative to other EDs and BMI-matched HCs, and the highest degree of happiness eating relative to other EDs. The BN and BED groups showed higher negative emotional eating compared to BMI-matched HCs. Patients with AN-BP occupied an intermediate position between AN-R and BN/BED and reported less happiness eating compared to BMI-matched HCs. DISCUSSION Negative emotional and happiness eating patterns differ across EDs. BMI-independent emotional eating patterns distinguish ED subgroups and might be related to the occurrence of binge eating versus restriction. Hence, different types of emotional eating can represent fruitful targets for tailored psychotherapeutic interventions. While BN and BED might be treated with similar approaches, AN-BP and AN-R would need specific treatment modules.
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Affiliation(s)
- Julia Reichenberger
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
| | - Rebekka Schnepper
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
| | - Ann‐Kathrin Arend
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
| | | | - Ulrich Voderholzer
- Schoen Clinic RoseneckPrien am ChiemseeGermany
- Department of Psychiatry and PsychotherapyUniversity Hospital of the LMU MunichMunichGermany
- Department of Psychiatry and PsychotherapyUniversity Hospital FreiburgFreiburgGermany
| | - Silke Naab
- Schoen Clinic RoseneckPrien am ChiemseeGermany
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive NeuroscienceParis‐Lodron‐University of SalzburgSalzburgAustria
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7
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Krishna Priya A, Applewhite B, Au K, Oyeleye O, Walton E, Norton C, Patsalos O, Cardi V, Himmerich H. Attitudes Surrounding Music of Patients With Anorexia Nervosa: A Survey-Based Mixed-Methods Analysis. Front Psychiatry 2021; 12:639202. [PMID: 34149472 PMCID: PMC8206484 DOI: 10.3389/fpsyt.2021.639202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
Anorexia nervosa (AN) is one of the main eating disorders. It has the highest mortality of all psychiatric disorders, and the success rates of current therapies are not fully satisfactory. Thus, there is a need for novel interventions. We investigated the attitudes surrounding music of 41 patients with clinically-diagnosed AN as well as their thoughts on the potential therapeutic uses of music using a questionnaire of 50 questions. Free text responses were qualitatively analyzed for reoccurring themes with NVivo 12 software. Yes/no questions and questions of best fit were analyzed using the IBM SPSS Statistics version 25. The most prevalent theme was the positive effect of music. Most patients reported that listening to music evokes varying emotions in them (83%) which may be of positive or negative nature. Similarly, patients associated certain music with particular positive, but also with particular negative memories. A majority of patients stated that music helps to distract them (85%), helps with loneliness (59%) and helps them feel more connected to others (58%). This data indicates that people with AN make nonclinical use of music which seems to elicit positive as well as negative emotions and memories. Patients felt music is beneficial with regard to important aspects of AN, such as emotional problems, loneliness, and relationship difficulties. Most of them would also like to attend music therapy.
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Affiliation(s)
- Aishwarya Krishna Priya
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Briana Applewhite
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Katie Au
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Oyenike Oyeleye
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Emma Walton
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Caroline Norton
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Olivia Patsalos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Valentina Cardi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
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8
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Glashouwer KA, Brockmeyer T, Cardi V, Jansen A, Murray SB, Blechert J, Levinson CA, Schmidt U, Tchanturia K, Wade TD, Svaldi J, Giel KE, Favaro A, Fernández-Aranda F, Friederich HC, Naumann E, Treasure JL, Tuschen-Caffier B, Vocks S, Werthmann J. Time to make a change: A call for more experimental research on key mechanisms in anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2020; 28:361-367. [PMID: 32567176 DOI: 10.1002/erv.2754] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Klaske A Glashouwer
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
- Department of Eating Disorders, Accare Child and Adolescent Psychiatry, Groningen, The Netherlands
| | - Timo Brockmeyer
- Department of Clinical Psychology and Psychotherapy, University of Goettingen, Goettingen, Germany
| | - Valentina Cardi
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anita Jansen
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Stuart B Murray
- Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Jens Blechert
- Centre for Cognitive Neuroscience, Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Cheri A Levinson
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Ulrike Schmidt
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, London, UK
- Department of Psychology, Ilia State University, Tbilisi, Georgia
| | - Tracey D Wade
- Discipline of Psychology and Orama Institute, Flinders University, Adelaide, South Australia, Australia
| | - Jennifer Svaldi
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Clinic Tübingen, Tübingen, Germany
- Competence Center for Eating Disorders, Tübingen, Germany
| | - Angela Favaro
- Department of Neuroscience, Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Hans-Christoph Friederich
- General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany
| | - Eva Naumann
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Janet L Treasure
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Institute of Psychology, Freiburg, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Jessica Werthmann
- Department of Clinical Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Institute of Psychology, Freiburg, Germany
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Treasure J, Willmott D, Ambwani S, Cardi V, Clark Bryan D, Rowlands K, Schmidt U. Cognitive Interpersonal Model for Anorexia Nervosa Revisited: The Perpetuating Factors that Contribute to the Development of the Severe and Enduring Illness. J Clin Med 2020; 9:E630. [PMID: 32120847 PMCID: PMC7141127 DOI: 10.3390/jcm9030630] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 02/07/2023] Open
Abstract
The cognitive interpersonal model was outlined initially in 2006 in a paper describing the valued and visible aspects of anorexia nervosa (Schmidt and Treasure, 2006). In 2013, we summarised many of the cognitive and emotional traits underpinning the model (Treasure and Schmidt, 2013). In this paper, we describe in more detail the perpetuating aspects of the model, which include the inter- and intrapersonal related consequences of isolation, depression, and chronic stress that accumulate in the severe and enduring stage of the illness. Since we developed the model, we have been using it to frame research and development at the Maudsley. We have developed and tested interventions for both patients and close others, refining the model through iterative cycles of model/intervention development in line with the Medical Research Council (MRC) framework for complex interventions. For example, we have defined the consequences of living with the illness on close others (including medical professionals) and characterised the intense emotional reactions and behaviours that follow. For the individual with an eating disorder, these counter-reactions can allow the eating disorder to become entrenched. In addition, the consequent chronic stress from starvation and social pain set in motion processes such as depression, neuroprogression, and neuroadaptation. Thus, anorexia nervosa develops a life of its own that is resistant to treatment. In this paper, we describe the underpinnings of the model and how this can be targeted into treatment.
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Affiliation(s)
- Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (J.T.); (V.C.); (D.C.B.); (K.R.); (U.S.)
| | - Daniel Willmott
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (J.T.); (V.C.); (D.C.B.); (K.R.); (U.S.)
| | - Suman Ambwani
- Department of Psychology, Dickinson College, Carlisle, PA17013, USA;
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (J.T.); (V.C.); (D.C.B.); (K.R.); (U.S.)
| | - Danielle Clark Bryan
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (J.T.); (V.C.); (D.C.B.); (K.R.); (U.S.)
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (J.T.); (V.C.); (D.C.B.); (K.R.); (U.S.)
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (J.T.); (V.C.); (D.C.B.); (K.R.); (U.S.)
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10
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Levinson CA, Sala M, Murray S, Ma J, Rodebaugh TL, Lenze EJ. Diagnostic, clinical, and personality correlates of food anxiety during a food exposure in patients diagnosed with an eating disorder. Eat Weight Disord 2019; 24:1079-1088. [PMID: 30847689 PMCID: PMC6732034 DOI: 10.1007/s40519-019-00669-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/01/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Eating disorders are characterized by high levels of anxiety, especially while eating. However, little is known about anxiety experienced during meals and specifically what other variables may impact such anxiety. OBJECTIVE We sought to further quantify and understand the relationship between food anxiety, eating disorders, and related correlates (e.g., comorbid diagnoses, personality). METHODS In the current study [N = 42 participants diagnosed with an eating disorder (n = 36 participants with anorexia nervosa)], we quantified anxiety before, during, and after a meal using data from a food exposure session in a partial hospital eating disorder center. We examined diagnostic, personality, and clinical factors as correlates of food anxiety. RESULTS Participants were more likely to experience higher food anxiety if they had a current diagnosis of major depression, obsessive-compulsive disorder, or post-traumatic stress disorder (PTSD). Concern over mistakes was the strongest and most consistent correlate of food anxiety regardless of time during the meal that anxiety was assessed. Other significant correlates were fear of positive evaluation, social appearance anxiety, BMI, and trust. CONCLUSIONS These findings show how diagnoses, perfectionism (concern over mistakes), and other correlates relate to anxiety during meals. Food exposure interventions may benefit from personalizations that address these factors. LEVEL OF EVIDENCE IV Evidence from a randomized control trial, but from the first session before effects of the design would be present.
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Affiliation(s)
- Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292, USA.
| | - Margarita Sala
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Stuart Murray
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Jackie Ma
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, 40292, USA
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Eric J Lenze
- Department of Psychiatry, Washington University, St. Louis, MO, USA
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11
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Ralph‐Nearman C, Achee M, Lapidus R, Stewart JL, Filik R. A systematic and methodological review of attentional biases in eating disorders: Food, body, and perfectionism. Brain Behav 2019; 9:e01458. [PMID: 31696674 PMCID: PMC6908865 DOI: 10.1002/brb3.1458] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The current systematic and methodological review aimed to critically review existing literature utilizing implicit processing, or automatic approach- and/or avoidance-related attentional biases between eating disorder (ED) and nonclinical samples, which (a) highlights how psychophysiological methods advance knowledge of ED implicit bias; (b) explains how findings fit into transdiagnostic versus disorder-specific ED frameworks; and (c) suggests how research can address perfectionism-related ED biases. METHOD Three databases were systematically searched to identify studies: PubMed, Scopus, and PsychInfo electronic databases. Peer-reviewed studies of 18- to 39-year-olds with both clinical ED and healthy samples assessing visual attentional biases using pictorial and/or linguistic stimuli related to food, body, and/or perfectionism were included. RESULTS Forty-six studies were included. While behavioral results were often similar across ED diagnoses, studies incorporating psychophysiological measures often revealed disease-specific attentional biases. Specifically, women with bulimia nervosa (BN) tend to approach food and other body types, whereas women with anorexia nervosa (AN) tend to avoid food as well as overweight bodies. CONCLUSIONS Further integration of psychophysiological and behavioral methods may identify subtle processing variations in ED, which may guide prevention strategies and interventions, and provide important clinical implications. Few implicit bias studies include male participants, investigate binge-eating disorder, or evaluate perfectionism-relevant stimuli, despite the fact that perfectionism is implicated in models of ED.
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Affiliation(s)
- Christina Ralph‐Nearman
- Laureate Institute for Brain ResearchTulsaOKUSA
- School of PsychologyUniversity of NottinghamNottinghamUK
| | | | | | - Jennifer L. Stewart
- Laureate Institute for Brain ResearchTulsaOKUSA
- Department of Community MedicineUniversity of TulsaTulsaOKUSA
| | - Ruth Filik
- School of PsychologyUniversity of NottinghamNottinghamUK
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12
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Coniglio KA, Christensen KA, Haynos AF, Rienecke RD, Selby EA. The posited effect of positive affect in anorexia nervosa: Advocating for a forgotten piece of a puzzling disease. Int J Eat Disord 2019; 52:971-976. [PMID: 31361353 PMCID: PMC7176354 DOI: 10.1002/eat.23147] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/19/2019] [Accepted: 07/18/2019] [Indexed: 01/01/2023]
Abstract
Anorexia nervosa (AN) is a complex and life-threatening eating disorder. Current models of AN onset and maintenance have largely focused on the role of negative affect, while fewer models have described the role of positive affect (PA). Given that these theoretical models have informed current treatment approaches, and that treatment remains minimally effective for adults with AN, we advocate that targeting PA is one avenue for advancing maintenance models and by extension, treatment. We specifically propose that AN may arise and be chronically and pervasively maintained as a function of dysregulated PA in response to weight loss and weight loss behaviors (e.g., restriction, excessive exercise), to a degree that is not accounted for in existing models of AN. We present evidence from multiple domains, including biological, behavioral, and self-report, supporting the hypothesis that PA dysregulation in AN contributes to the maintenance of the disorder. We conclude with several specific avenues for treatment development research as well as a call for future work elucidating the biological correlates of PA.
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Affiliation(s)
- Kathryn A. Coniglio
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kara A. Christensen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Ann F. Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Renee D. Rienecke
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Edward A. Selby
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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13
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Meule A, Richard A, Schnepper R, Reichenberger J, Georgii C, Naab S, Voderholzer U, Blechert J. Emotion regulation and emotional eating in anorexia nervosa and bulimia nervosa. Eat Disord 2019; 29:1-17. [PMID: 31345125 DOI: 10.1080/10640266.2019.1642036] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) show emotion regulation deficits. While individuals with BN use binge eating to regulate negative affect, individuals with restricting-type AN may use self-starvation for this purpose. The current study examined the emotion regulatory function of over- and undereating in response to different emotional states in women with restrictive AN (n = 54), BN (n = 47), and women without eating disorders (n = 68). Participants completed self-report measures assessing the use of emotion regulation strategies and emotional eating. Both patient groups reported using more dysfunctional and less functional emotion regulation strategies than controls. The BN group reported eating more than usual in response to negative emotions but less than usual in response to positive emotions. In contrast, the AN group reported eating more than usual in response to positive emotions and less than usual in response to negative emotions. More dysfunctional emotion regulation related to eating less in response to negative emotions in the AN group. Less functional emotion regulation related to eating less when being happy in the BN group. The current study highlights the need to differentiate between different eating outcomes and different emotional states when examining emotion effects on food intake.
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Affiliation(s)
- Adrian Meule
- a Department of Psychiatry and Psychotherapy, University Hospital of the LMU Munich , Munich , Germany
- b Schoen Clinic Roseneck , Prien am Chiemsee , Germany
| | - Anna Richard
- b Schoen Clinic Roseneck , Prien am Chiemsee , Germany
| | - Rebekka Schnepper
- c Department of Psychology, University of Salzburg , Salzburg , Austria
- d Centre for Cognitive Neuroscience, University of Salzburg , Salzburg , Austria
| | - Julia Reichenberger
- c Department of Psychology, University of Salzburg , Salzburg , Austria
- d Centre for Cognitive Neuroscience, University of Salzburg , Salzburg , Austria
| | - Claudio Georgii
- c Department of Psychology, University of Salzburg , Salzburg , Austria
- d Centre for Cognitive Neuroscience, University of Salzburg , Salzburg , Austria
| | - Silke Naab
- b Schoen Clinic Roseneck , Prien am Chiemsee , Germany
| | - Ulrich Voderholzer
- a Department of Psychiatry and Psychotherapy, University Hospital of the LMU Munich , Munich , Germany
- b Schoen Clinic Roseneck , Prien am Chiemsee , Germany
- e Department of Psychiatry and Psychotherapy, University Hospital Freiburg , Freiburg , Germany
| | - Jens Blechert
- c Department of Psychology, University of Salzburg , Salzburg , Austria
- d Centre for Cognitive Neuroscience, University of Salzburg , Salzburg , Austria
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14
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The use of a positive mood induction video-clip to target eating behaviour in people with bulimia nervosa or binge eating disorder: An experimental study. Appetite 2018; 133:400-404. [PMID: 30529607 DOI: 10.1016/j.appet.2018.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
Recent theoretical models and empirical research have indicated that momentary negative affect increases the likelihood of binge eating episodes for individuals with bulimia nervosa and binge eating disorder. However, relatively little research has explored the potential for positive mood to serve a protective effect in reducing the likelihood of overeating behaviour in bulimia nervosa and binge eating disorder. The current study included 30 women with bulimia nervosa or binge eating disorder in a within-subjects crossover design. Following exposure to a video designed to induce food craving, we found that a positive mood vodcast was associated with significantly lower levels of negative mood and food consumption in a taste test meal, when compared to a neutral vodcast (p = 0.002). These findings support a role for decreasing negative mood in reducing the likelihood of binge eating behaviour in women with bulimia nervosa and binge eating disorder.
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15
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Lloyd EC, Steinglass JE. What can food-image tasks teach us about anorexia nervosa? A systematic review. J Eat Disord 2018; 6:31. [PMID: 30410758 PMCID: PMC6211517 DOI: 10.1186/s40337-018-0217-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 09/11/2018] [Indexed: 12/24/2022] Open
Abstract
A salient feature of anorexia nervosa (AN) is the persistent and severe restriction of food, such that dietary intake is inadequate to maintain a healthy body weight. Experimental tasks and paradigms have used illness-relevant stimuli, namely food images, to study the eating-specific neurocognitive mechanisms that promote food avoidance. This systematic review, completed in accordance with PRISMA guidelines, identified and critically evaluated paradigms involving images of food that have been used to study AN. There were 50 eligible studies, published before March 10th 2018, identified from Medline and PsychINFO searches, and reference screening. Studies using food image-based paradigms were categorised into three methodologic approaches: neuropsychology, neurophysiology, and functional magnetic resonance imaging (fMRI). Paradigms were reviewed with a focus on how well they address phenomena central to AN. Across tasks, differences between individuals with AN and healthy peers have been identified, with the most consistent findings in the area of reward processing. Measuring task performance alongside actual eating behaviour, and using experimental manipulations to probe causality, may advance understanding of the mechanisms of illness in AN.
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Affiliation(s)
- E. Caitlin Lloyd
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Joanna E. Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY USA
- New York State Psychiatric Institute, New York, NY USA
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16
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Anastasiadou D, Folkvord F, Lupiañez-Villanueva F. A systematic review of mHealth interventions for the support of eating disorders. EUROPEAN EATING DISORDERS REVIEW 2018; 26:394-416. [DOI: 10.1002/erv.2609] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/09/2018] [Accepted: 05/12/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Dimitra Anastasiadou
- Department of Information and Communication Sciences; Universitat Oberta de Catalunya; Barcelona Spain
- Open Evidence Research; Universitat Oberta de Catalunya; Barcelona Spain
| | - Frans Folkvord
- Department of Information and Communication Sciences; Universitat Oberta de Catalunya; Barcelona Spain
- Open Evidence Research; Universitat Oberta de Catalunya; Barcelona Spain
- Behavioural Science Institute; Radboud University; Nijmegen The Netherlands
- Communication Science Department; Amsterdam University; Amsterdam The Netherlands
| | - Francisco Lupiañez-Villanueva
- Department of Information and Communication Sciences; Universitat Oberta de Catalunya; Barcelona Spain
- Open Evidence Research; Universitat Oberta de Catalunya; Barcelona Spain
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17
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Treasure J, Cardi V. Anorexia Nervosa, Theory and Treatment: Where Are We 35 Years on from Hilde Bruch's Foundation Lecture? EUROPEAN EATING DISORDERS REVIEW 2017; 25:139-147. [PMID: 28402069 DOI: 10.1002/erv.2511] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/13/2022]
Abstract
Hilde Bruch's foundation lecture in 1982 is a milestone from which to survey current theory and treatment for anorexia nervosa. Bruch described problems in body perception, emotion processing and interpersonal relationships as core theoretical aspects of the illness and built her theory of psychopathology on these aspects, as well as on animal studies on attachment. She also noted that many psychological problems result as consequence of starvation. In the first part of this paper, we parse Bruch's clinical descriptions into elements of psychopathology (disturbances in body perception, attachment, emotion expression, perception and regulation, social comparison, interpersonal, and family and therapeutic relationships), in order to assemble and update the theoretical evidence for a model of the illness. In the second part, we describe and extend her description of three core targets of treatment: family relationships, patient's inner confusion and nutritional restoration. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Janet Treasure
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Valentina Cardi
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
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18
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Turton R, Nazar BP, Burgess EE, Lawrence NS, Cardi V, Treasure J, Hirsch CR. To Go or Not to Go: A Proof of Concept Study Testing Food-Specific Inhibition Training for Women with Eating and Weight Disorders. EUROPEAN EATING DISORDERS REVIEW 2017; 26:11-21. [PMID: 29098749 DOI: 10.1002/erv.2566] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/11/2017] [Accepted: 10/11/2017] [Indexed: 11/11/2022]
Abstract
Inefficient food-specific inhibitory control is a potential mechanism that underlies binge eating in bulimia nervosa and binge eating disorder. Go/no-go training tools have been developed to increase inhibitory control over eating impulses. Using a within-subjects design, this study examined whether one session of food-specific go/no-go training, versus general inhibitory control training, modifies eating behaviour. The primary outcome measure was food consumption on a taste test following each training session. Women with bulimia nervosa and binge eating disorder had small non-significant reductions in high-calorie food consumption on the taste test following the food-specific compared with the general training. There were no effects on eating disorder symptomatic behaviour (i.e. binge eating/purging) in the 24 h post-training. The training task was found to be acceptable by the clinical groups. More research is needed with larger sample sizes to determine the effectiveness of this training approach for clinical populations. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Robert Turton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bruno P Nazar
- Department of Psychiatry and Mental Health, Federal University of Rio de Janeiro, Institute of Psychiatry (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - Emilee E Burgess
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.,Mental Health and Addictions Services, Nova Scotia Health Authority, Halifax, Canada
| | | | - Valentina Cardi
- 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
| | - Colette R Hirsch
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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19
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Haynos AF, Berg KC, Cao L, Crosby RD, Lavender JM, Utzinger LM, Wonderlich SA, Engel SG, Mitchell JE, Le Grange D, Peterson CB, Crow SJ. Trajectories of higher- and lower-order dimensions of negative and positive affect relative to restrictive eating in anorexia nervosa. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 126:495-505. [PMID: 27893231 DOI: 10.1037/abn0000202] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite robust support for the role of affect in the maintenance of binge eating and purging, the relationship between affect and restrictive eating remains poorly understood. To investigate the relationship between restrictive eating and affect, ecological momentary assessment data from 118 women with anorexia nervosa (AN) were used to examine trajectories of higher-order dimensions of negative affect (NA) and positive affect (PA), as well as lower-order dimensions of NA (Fear, Guilt) and PA (Joviality, Self-Assurance) relative to restrictive eating. Affect trajectories were modeled before and after restrictive eating episodes and AN subtype was examined as a moderator of these trajectories. Across the sample, Guilt significantly increased before and decreased after restrictive eating episodes. Global NA, Global PA, Fear, Joviality, and Self-Assurance did not vary relative to restrictive eating episodes across the sample. However, significant subtype by trajectory interactions were detected for PA indices. Among individuals with AN restricting subtype, Global PA, Joviality, and Self-Assurance decreased prior to and Self-Assurance increased following restrictive eating episodes. In contrast, Global PA and Self-Assurance increased prior to, but did not change following, restrictive eating episodes among individuals with AN binge eating/purging subtype. Results suggest that dietary restriction may function to mitigate guilt across AN subtypes and to enhance self-assurance among individuals with AN restricting subtype. (PsycINFO Database Record
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry, University of Minnesota Medical Center
| | - Kelly C Berg
- Department of Psychiatry, University of Minnesota Medical Center
| | - Li Cao
- Neuropsychiatric Research Institute
| | | | | | - Linsey M Utzinger
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| | | | | | | | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota Medical Center
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota Medical Center
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20
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Haynos AF, Hill B, Fruzzetti AE. Emotion regulation training to reduce problematic dietary restriction: An experimental analysis. Appetite 2016; 103:265-274. [PMID: 27105583 DOI: 10.1016/j.appet.2016.04.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/11/2016] [Accepted: 04/16/2016] [Indexed: 10/21/2022]
Abstract
Evidence suggests that emotion regulation may be a process relevant to problematic dietary restriction. However, emotion regulation has not been evaluated as an intervention target across a range of restriction severity. This study utilized an experimental design to examine whether targeting emotion regulation reduced problematic dietary restriction. Within a self-identified restrictive sample (n = 72), the effects of an emotion regulation condition (i.e., emotion regulation training) were compared to those of a control condition (i.e., nutrition information training) on dietary restriction indices (i.e., effort to reduce intake on a progressive ratio task, work towards an alternate reinforcer on a progressive ratio task, intake by dietary recall) following a stressor. Exploratory analyses of potential moderators (i.e., restraint, BMI, binge eating and purging status, emotion regulation difficulties) were conducted to examine whether these factors affected the impact of training on dietary restriction. No significant main effects of condition were detected on any outcome measure. However, results were moderated by BMI status. Participants with lower BMIs exerted less effort towards dietary restriction following the emotion regulation condition versus the control condition (p = 0.02). Results suggest that targeting emotion regulation may help to reduce problematic dietary restriction among lower weight individuals.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, MN, United States; Department of Psychology, University of Nevada, Reno, Reno, NV, United States.
| | - Bailey Hill
- Department of Psychology, University of Nevada, Reno, Reno, NV, United States
| | - Alan E Fruzzetti
- Department of Psychology, University of Nevada, Reno, Reno, NV, United States
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21
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Treasure J, Cardi V, Leppanen J, Turton R. New treatment approaches for severe and enduring eating disorders. Physiol Behav 2015; 152:456-65. [DOI: 10.1016/j.physbeh.2015.06.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 05/22/2015] [Accepted: 06/04/2015] [Indexed: 10/23/2022]
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22
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Cardi V, Leppanen J, Treasure J. The effects of negative and positive mood induction on eating behaviour: A meta-analysis of laboratory studies in the healthy population and eating and weight disorders. Neurosci Biobehav Rev 2015; 57:299-309. [DOI: 10.1016/j.neubiorev.2015.08.011] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/03/2015] [Accepted: 08/18/2015] [Indexed: 12/15/2022]
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