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Wallace C, Krugman R. More Than What You Eat: A Review on the Association Between Childhood Maltreatment and Elevated Adult BMI. Curr Nutr Rep 2024:10.1007/s13668-024-00558-4. [PMID: 38922364 DOI: 10.1007/s13668-024-00558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE OF REVIEW Obesity is an overwhelmingly common medical entity seen in the adult population. A growing body of research demonstrates that there is a significant relationship between child maltreatment and adult obesity. RECENT FINDINGS Emerging research demonstrates a potential dose-response relationship between various types of child abuse and adulthood BMI. Recent work also explores the potential role of the hypothalamic-pituitary-adrenal (HPA) axis, and other hormonal mediators such as sex-hormone binding globulin and leptin. There are also studies that suggest factors such as depression and socioeconomic and environmental influences mediate this relationship. Comorbidities that have been reported include cardiovascular and metabolic disease, diabetes, and insulin resistance. Preliminary work also demonstrates potential gender and racial disparities in the effect of abuse on adulthood obesity. In this narrative review, we summarize the existing work describing the different child maltreatment types (physical, sexual, emotional, verbal, and child neglect) and their relation to adult obesity, what is known about a potential dose-response relationship, potential mediators and pathophysiology, comorbidities, and preliminary work on gender and racial/ethnic disparities. We review the limited data on interventions that have been studied, and close with a discussion of implications and suggestions for clinicians who treat adult obesity, as well as potential future research directions.
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Affiliation(s)
- Carmelle Wallace
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
- Section of Emergency Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Richard Krugman
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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Ferreira P, Fraga S, Oliveira A. Association of adverse childhood experiences with dietary patterns of school-age children: evidence from the birth cohort Generation XXI. Am J Clin Nutr 2024:S0002-9165(24)00525-2. [PMID: 38857694 DOI: 10.1016/j.ajcnut.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have been associated with health-risk behaviors and several chronic diseases in adulthood. However, the relationship between exposure to ACEs and dietary patterns at school age is unknown. OBJECTIVES To investigate the association between ACEs and dietary patterns of 10-year-olds. METHODS The study included 5034 children from the Generation XXI cohort, recruited in 2005/2006 in Porto, Portugal. ACEs were assessed through a self-administered questionnaire covering the first 10 years (y) of life, quantified and grouped into 5 dimensions: "abuse," "school problems," "death/severe disease," "life changes," and "household dysfunction." Dietary patterns were identified by latent class analysis using data collected with a validated food frequency questionnaire. Five dietary patterns were studied: "low consumption," "energy-dense foods," "snacking," "intermediate consumption," and "healthier" (used as reference). Multinomial regression analyses were conducted, adjusted for the child's sex, household income, family structure, and mother's age [odds ratio (OR) and 99% confidence intervals (CIs)]. RESULTS Most children were exposed to ≥1 ACE (96%), and ∼27% had reported 6 or more ACEs throughout life. Those reporting 4-5 and ≥6 ACEs were more likely to follow the "Energy-dense foods" dietary pattern compared with those with no ACEs (OR: 2.41; 99% CI: 1.00, 5.77 and OR: 2.65; 99% CI: 1.10, 6.39, respectively). Children exposed to "abuse" in the first 10 y showed 28% higher odds of following the "low consumption" dietary pattern when compared to children with no reported ACEs and using the "healthier" dietary pattern as a reference (OR: 1.28; 99% CI: 1.00, 1.63). CONCLUSIONS Exposure to ACEs was associated with less healthy dietary patterns in school-aged children. Results suggest a cumulative effect of the adverse experiences resulting in a dietary pattern higher in energy-dense foods. Children with ACEs reported under the dimension of "abuse" seemed to have reduced food consumption.
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Affiliation(s)
- Pedro Ferreira
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto (Epidemiology Research Unit, Institute of Public Health, University of Porto), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Sílvia Fraga
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto (Epidemiology Research Unit, Institute of Public Health, University of Porto), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto (Epidemiology Research Unit, Institute of Public Health, University of Porto), Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.
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Rania M, Caroleo M, Carbone EA, Ricchio M, Pelle MC, Zaffina I, Condoleo F, de Filippis R, Aloi M, De Fazio P, Arturi F, Segura-Garcia C. Reactive hypoglycemia in binge eating disorder, food addiction, and the comorbid phenotype: unravelling the metabolic drive to disordered eating behaviours. J Eat Disord 2023; 11:162. [PMID: 37726785 PMCID: PMC10507855 DOI: 10.1186/s40337-023-00891-z] [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: 06/06/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Impaired metabolic response such as blood glucose fast fluctuations may be hypothesized in binge eating disorder (BED) and food addiction (FA) by virtue of the repetitive consumption of highly processed food. Conversely, rapid changes in plasma glucose (i.e., hypoglycemia) may trigger craving for the same food products. The investigation of early glycemic disturbances in BED and FA could enhance the understanding of the metabolic mechanisms involved in the maintenance of the disorders. Present study investigated hypoglycemia events during a 5-h-long oral glucose tolerance test (OGTT) in people with BED, FA, and the comorbid phenotype. Further, the association between the severity of eating psychopathology and the variability in hypoglycaemia events was explored. METHODS Two-hundred participants with high weight and no diabetes completed the extended OGTT and were screened for BED, FA, BED-FA, or no-BED/FA. The four groups were compared in hypoglycemia events, OGTT-derived measures, and eating psychopathology. The association between predictors (eating psychopathology), confounders (demographics, metabolic features), and the outcomes (hypoglycemia, early/late hypoglycemia, severe hypoglycemia, reactive hypoglycemia) was examined through logistic regression. RESULTS Hypoglycemia in general, and reactive hypoglycemia were highly frequent (79% and 28% of the sample, respectively). Hypoglycemia events (< 70 mg/dL) were equally experienced among groups, whilst severe hypoglycemia (< 54 mg/dL) was more frequent in BED at the late stage of OGTT (5 h; χ2 = 1.120, p = .011). The FA and BED groups exhibited significantly higher number of reactive hypoglycemia (χ2 = 13.898, p = .003), in different times by diagnosis (FA: 210'-240'; BED: at the 270'). FA severity was the only predictor of early and reactive hypoglycemia. CONCLUSIONS People with BED or FA are prone to experiencing reactive hypoglycemia; FA severity may predict early and symptomatic hypoglycemia events. This can further reinforce disordered eating behaviours by promoting addictive responses, both biologically and behaviourally. These results inform professionals dealing with eating disorders about the need to refer patients for metabolic evaluation. On the other hand, clinicians dealing with obesity should screen for and address BED and FA in patients seeking care for weight loss.
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Affiliation(s)
- Marianna Rania
- Psychiatry Unit, Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy.
| | | | - Elvira Anna Carbone
- Psychiatry Unit, Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Marco Ricchio
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Internal Medicine Unit, Outpatient Unit for the Treatment of Obesity, University Hospital "Renato Dulbecco", Catanzaro, Italy
| | - Maria Chiara Pelle
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Internal Medicine Unit, Outpatient Unit for the Treatment of Obesity, University Hospital "Renato Dulbecco", Catanzaro, Italy
| | - Isabella Zaffina
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Internal Medicine Unit, Outpatient Unit for the Treatment of Obesity, University Hospital "Renato Dulbecco", Catanzaro, Italy
| | - Francesca Condoleo
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Internal Medicine Unit, Outpatient Unit for the Treatment of Obesity, University Hospital "Renato Dulbecco", Catanzaro, Italy
| | - Renato de Filippis
- Psychiatry Unit, Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Internal Medicine Unit, Outpatient Unit for the Treatment of Obesity, University Hospital "Renato Dulbecco", Catanzaro, Italy
| | - Cristina Segura-Garcia
- Psychiatry Unit, Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, Catanzaro, Italy
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Römer SS, Bliokas V, Teo JT, Thomas SJ. Food addiction, hormones and blood biomarkers in humans: A systematic literature review. Appetite 2023; 183:106475. [PMID: 36716820 DOI: 10.1016/j.appet.2023.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/15/2023] [Accepted: 01/23/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND Food addiction may play a role in rising obesity rates in connection with obesogenic environments and processed food availability, however the concept of food addiction remains controversial. While animal studies show evidence for addictive processes in relation to processed foods, most human studies are psychologically focussed and there is a need to better understand evidence for biological mechanisms of food addiction in humans. Several key hormones are implicated in models of food addiction, due to their key roles in feeding, energy metabolism, stress and addictive behaviours. This systematic literature review examines evidence for relationships between food addiction, hormones and other blood biomarkers. METHODS A series of literature searches was performed in Scopus, PsychInfo, MedLine, ProQuest, CINAHL and Web of Science. A total of 3111 articles were found, of which 1045 were duplicates. Articles were included if they contained a psychometric measurement of food addiction, such as the Yale Food Addiction Scale, as well as addressed the association between FA and hormones or blood biomarkers in humans. Articles were assessed for eligibility by two independent reviewers. RESULTS Sixteen studies were identified that examined relationships between food addiction and blood biomarkers, published between 2015 and 2021. Significant findings were reported for leptin, ghrelin, cortisol, insulin and glucose, oxytocin, cholesterol, plasma dopamine, thyroid stimulating hormone (TSH), haemoglobin A1c (HbA1c), triglyceride (TG), amylin, tumour necrosis factor alpha (TNF- α) and cholecystokinin (CCK). Methodological issues included small sample sizes and variation in obesity status, sex and mental health-related comorbidities. Due to methodological limitations, definite connections between FA, hormones and other blood biomarkers cannot yet be determined. CONCLUSION This systematic review identified preliminary evidence linking FA symptoms to hormones and other blood biomarkers related to feeding, addiction, and stress. However, due to the small number of studies and methodological limitations, further research is needed to evaluate biopsychosocial models of FA and to resolve controversies.
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Affiliation(s)
- Stephanie Sophie Römer
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Australia.
| | - Vida Bliokas
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, 2522, Australia.
| | - Jillian Terese Teo
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Australia.
| | - Susan J Thomas
- Illawarra Health and Medical Research Institute, University of Wollongong, 2522, Australia; Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Australia.
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Dissociative experiences of compartmentalization are associated with food addiction symptoms: results from a cross-sectional report. Eat Weight Disord 2023; 28:28. [PMID: 36867281 PMCID: PMC9984353 DOI: 10.1007/s40519-023-01555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/04/2022] [Indexed: 03/04/2023] Open
Abstract
PURPOSE Studies have shown significant associations of dissociative symptoms with both eating and addictive disorders; however, the different forms of dissociation have been relatively understudied in relation to food addiction (FA). The main aim of this study was to investigate the association of certain forms of dissociative experiences (i.e., absorption, detachment and compartmentalization) with FA symptoms in a nonclinical sample. METHODS Participants (N = 755; 543 women; age range: 18-65; mean age: 28.22 ± 9.99 years) were evaluated using self-report measures of FA, dissociation, eating disturbances, and general psychopathology. RESULTS Compartmentalization experiences (defined as pathological over-segregation of higher mental functions) were independently associated with FA symptoms (β = 0.174; p = 0.013; CI = [0.008; 0.064]) even when confounding factors were controlled for. CONCLUSION This finding suggests that compartmentalization symptoms can have a role in the conceptualization of FA, with such two phenomena possibly sharing common pathogenic processes. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Wattick RA, Olfert MD, Claydon E, Hagedorn-Hatfield RL, Barr ML, Brode C. Early life influences on the development of food addiction in college attending young adults. Eat Weight Disord 2023; 28:14. [PMID: 36807705 PMCID: PMC9940052 DOI: 10.1007/s40519-023-01546-3] [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: 07/13/2022] [Accepted: 01/25/2023] [Indexed: 02/23/2023] Open
Abstract
PURPOSE There is little investigation into the causes of food addiction. The aim of this study was to determine the impact of early life influences on the development of food addiction in college-attending young adults aged 18-29. METHODS This study utilized a sequential explanatory mixed-methods research design. College-attending young adults were invited to complete an online survey measuring Adverse Childhood Experiences (ACEs), food addiction, depression, anxiety, stress, and demographic information. Correlations between food addiction and the other variables were analyzed and significant variables were placed into a nominal logistic regression model to predict the development of food addiction. Participants who met the criteria for food addiction were invited to participate in interviews to examine their childhood eating environment and when their symptoms emerged. Interviews were transcribed and thematically analyzed. Quantitative analysis was conducted using JMP Pro Version 16.0 and qualitative analysis was conducted using NVIVO Software Version 12.0. RESULTS Survey respondents (n = 1645) had an overall 21.9% prevalence of food addiction. Significant correlations were observed between food addiction and ACEs, depression, anxiety, stress, and sex (p < .01 for all). Depression was the only significant predictor of the development of food addiction (OR = 3.33 95% CI 2.19, 5.05). The most common eating environment described by interview participants (n = 36) was an emphasis on diet culture, ideal body image, and restrictive environments. Symptoms frequently emerged after transitioning into college and having the ability to make their own food choices. CONCLUSION These results show the impact of early life eating environments and young adulthood mental health on the development of food addiction. These findings contribute to the understanding of underlying causes of food addiction. LEVEL OF EVIDENCE Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
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Affiliation(s)
- Rachel A Wattick
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources, and Design, West Virginia University, G25 4100 Agricultural Sciences Building, 1194 Evansdale Dr., P.O. Box 6108, Morgantown, WV, 26505-6108, USA
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources, and Design, West Virginia University, G25 4100 Agricultural Sciences Building, 1194 Evansdale Dr., P.O. Box 6108, Morgantown, WV, 26505-6108, USA.
| | - Elizabeth Claydon
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, 64 Medical Center Dr., Morgantown, WV, 26505-9190, USA
| | - Rebecca L Hagedorn-Hatfield
- Department of Nutrition, Health and Human Performance, School of Education Health and Human Sciences, Meredith College, 3800 Hillsborough Street, Raleigh, NC, 27607-5298, USA
| | - Makenzie L Barr
- Department of Dietetics and Human Nutrition, University of Kentucky, 212 Funkhouser Building, Lexington, KY, 40514, USA
| | - Cassie Brode
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, WV, USA
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Legendre M, Sabourin S, Bégin C. Childhood sexual abuse and food addiction severity in a clinical sample of individuals with overweight or obesity. Eat Weight Disord 2022; 27:3737-3742. [PMID: 35994206 DOI: 10.1007/s40519-022-01441-3] [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: 03/07/2022] [Accepted: 06/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE A higher risk of food addiction (FA) in individuals reporting childhood sexual abuse (CSA) has been well demonstrated with community samples, but studies including clinical samples failed to replicate this relation. This study examined, among individuals presenting eating and weight disorders, the risk of FA for those reporting CSA while considering the severity of CSA and other types of traumas. METHODS Participants (N = 187) completed a DSM-5 diagnosis assessment and questionnaires on LimeSurvey evaluating FA, interpersonal traumas, depressive level, body esteem, dieting/weight preoccupations, and body mass index (BMI). Logistic regressions were used to calculate the odds ratio (OR) of FA using interpersonal traumas as risk factors, and t tests were used to compare individuals with FA and CSA and those with FA without CSA. RESULTS Of all interpersonal traumas, CSA was associated with the highest risk of FA, with ORs of 1.73 (p = 0.094) and 2.07 (p = 0.034). The relationship with the abuser, the type of sexual abuse and the number of abuses were significant or marginally significant risk factors, with ORs ranging from 1.26 to 1.50. Finally, no significant difference was found between FA with CSA and FA without CSA. CONCLUSION Using a clinical sample, this study showed a higher risk of FA in individuals reporting CSA and provided evidence that the relationship with the abuser, the type of sexual abuse, and the number of abuses are relevant factors. Additionally, in individuals with FA, the presence or absence of CSA did not influence depressive level, body esteem, dieting/weight preoccupations, or BMI. LEVEL OF EVIDENCE Level V, cross-sectional, descriptive study.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Stéphane Sabourin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
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Seligowski AV, Fonkoue IT, Noble NC, Dixon D, Gluck R, Kim YJ, Powers A, Pace TW, Jovanovic T, Umpierrez G, Ressler KJ, Quyyumi AA, Michopoulos V, Gillespie CF. Vagal control moderates the association between endothelial function and PTSD symptoms in women with T2DM. Brain Behav Immun Health 2022; 26:100527. [PMID: 36247837 PMCID: PMC9557816 DOI: 10.1016/j.bbih.2022.100527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Individuals with posttraumatic stress disorder (PTSD) are more likely to present with metabolic diseases such as type-2 diabetes mellitus (T2DM), and cardiovascular dysfunction has been implicated in this link. These diseases disproportionately affect women and individuals exposed to chronic environmental stressors (e.g., community violence, poverty). We examined associations among PTSD, cardiovascular indices, and metabolic function in highly trauma-exposed Black women with T2DM. Methods Participants (N = 80) were recruited for a follow-up study of stress and T2DM as part of the Grady Trauma Project. PTSD symptoms were assessed with the Clinician Administered PTSD Scale (CAPS-IV). Cardiovascular indices included heart rate (HR), blood pressure (BP), respiratory sinus arrhythmia (RSA), and endothelial function (assessed via flow-mediated dilation; FMD). An oral glucose tolerance test was used as an indicator of metabolic function. Results Of the cardiovascular indices, only FMD was significantly associated with PTSD symptoms (CAPS Avoidance symptoms; β = -0.37, p = .042), and glucose tolerance (β = -0.44, p = .019), controlling for age and body mass index. The association between FMD and PTSD Avoidance was moderated by RSA such that the effect of FMD was only significant at low levels of RSA (simple slopes β = -0.87, p = .004). Conclusions Our results indicate that endothelial function is significantly related to PTSD and glucose tolerance, over and above other cardiovascular measures (HR, BP, RSA). Further, our results suggest that low RSA may be a risk factor for the link between poor endothelial function and PTSD in women with T2DM.
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Affiliation(s)
- Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Ida T. Fonkoue
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Drew Dixon
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Rachel Gluck
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ye Ji Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Thaddeus W.W. Pace
- College of Nursing and College of Medicine (Psychiatry), University of Arizona, Tucson, AZ, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Guillermo Umpierrez
- Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Arshed A. Quyyumi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Charles F. Gillespie
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Examination of Individual Differences in Susceptibility to Food Addiction using Alcohol and Addiction Research Domain Criteria (AARDoC): Recent Findings and Directions for the Future. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00433-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Purpose of Review
Alcohol and Addiction Research Domain Criteria (AARDoC) is a transdiagnostic, circuits-based framework for studying addictive behaviors. We examined parallels in individual differences that might increase susceptibility to FA and other addictive disorders using the following units of analysis in AARDoC domains: craving, relative reinforcing value of food and attention bias in the incentive salience domain; decisional impulsivity (delay discounting) and inhibitory control (Go-No-Go, Conner’s Continuous Performance Test, and the flanker task) in the executive function domain; and emotion dysregulation and negative urgency in the negative emotionality domain.
Recent Findings
There are a number of parallels between FA and other addictions in the incentive salience and negative emotionality domains, but somewhat divergent findings in the executive function domain. Trauma appears to be an important environmental stressor in maintenance of FA.
Summary
AARDoC may be a useful organizing framework for studying addictions, including FA. Future studies should incorporate other units of analysis to better characterize FA.
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10
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Legendre M, Sabourin S, Bégin C. Maladaptive Eating Behaviors and Childhood Trauma: A Focus on Food Addiction. Cureus 2022; 14:e26966. [PMID: 35989855 PMCID: PMC9382990 DOI: 10.7759/cureus.26966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background Many studies have highlighted the clinical relevance of food addiction (FA) by showing its association with psychopathological severity and even more when co-occurring with binge eating disorder. It was suggested that the association between FA and greater psychopathological severity could be accounted for by a history of traumatic experiences. The present study examined the relationship between childhood trauma (including peer victimization, abuse, and neglect) and maladaptive eating behaviors (FA, binge eating, and grazing) and explored whether childhood trauma predicts FA when controlling for binge eating, grazing, and other confounding variables. Methods One hundred fourteen adult women seeking psychological help for problems related to eating or weight completed questionnaires measuring FA, binge eating, grazing, depressive symptoms, peer victimization, and childhood abuse and neglect. Results FA showed significantly small to moderate positive correlations with all measures of childhood trauma, except for physical neglect. A hierarchical regression, including binge eating, grazing, depressive symptoms, age, and childhood trauma explained 55% of FA variance, with 7% of variance explained uniquely by childhood trauma. Conclusions This study supports that FA is related to childhood trauma and provides a potential explanation for the association of FA with greater psychopathological severity. From a clinical perspective, FA provides an accurate and quick assessment of psychopathological severity and represents an essential complement to the evaluation of eating disorders related to overweight. Future studies should attempt to estimate the impact of childhood trauma on treatment outcomes.
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Hoover LV, Yu HP, Duval ER, Gearhardt AN. Childhood trauma and food addiction: The role of emotion regulation difficulties and gender differences. Appetite 2022; 177:106137. [PMID: 35738482 DOI: 10.1016/j.appet.2022.106137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Childhood trauma has been associated with substance use disorders (SUDs), but less research has investigated its association with food addiction (i.e., compulsive intake of highly processed foods containing refined carbohydrates and/or added fat). Existing research on childhood trauma and food addiction has focused primarily on women from restricted samples. Further, emotion dysregulation difficulties are implicated in both childhood trauma and food addiction, but research has not explored whether it may play a mediating role. METHOD Thus, the current study utilizes a sample of 310 participants recruited from Amazon Mechanical Turk (mean age = 41.3 years old, 47.4% men, 78.7% white) to investigate the mediating role of emotion dysregulation in the association between childhood trauma and food addiction. We also conducted exploratory analyses to investigate for gender differences in these associations. Gender-stratified correlational matrixes were conducted to investigate association between childhood trauma, food addiction, and emotional dysregulation. Moderated mediation models and multilevel regressions were also conducted to identify the role of gender in the association between childhood trauma, food addiction, and emotion dysregulation. RESULTS Emotion dysregulation was found to partially mediate the associations between food addiction and childhood trauma and gender was found to moderate associations between childhood trauma and emotion dysregulation, as well as childhood trauma and food addiction. Both moderating pathways were significantly stronger for men compared to women. DISCUSSION Results suggests that emotion dysregulation may be one important mediator in the association between childhood trauma and food addiction, particularly for men. The identification of other potential mechanisms contributing to the association between childhood trauma and food addiction and the use of longitudinal measurement strategies will be important in future research.
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Affiliation(s)
- Lindzey V Hoover
- Department of Psychology, University of Michigan, Ann Arbor, USA.
| | - Hayley P Yu
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Elizabeth R Duval
- Department of Psychology, University of Michigan, Ann Arbor, USA; Department of Psychiatry, University of Michigan, Ann Arbor, USA
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12
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Park EJ, Hwang SSH, Lee MS, Bhang SY. Food Addiction and Emotional Eating Behaviors Co-Occurring with Problematic Smartphone Use in Adolescents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4939. [PMID: 35564334 PMCID: PMC9103653 DOI: 10.3390/ijerph19094939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/06/2023]
Abstract
Addiction in adolescence is increasing and has a significant impact on physical and mental health. Notably, addictions can be comorbid and affect each other. Despite the recent growing interest in food addiction (FA) and problematic smartphone use (PSU), few studies have investigated their association in adolescents. We investigated the relationship between FA and PSU in adolescents and the effects of eating behaviors. A total of 209 adolescents (44.5% male; mean age = 12.86 ± 0.7 years) participated in the current school-based community study. We found a positive correlation between the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C2.0) and the Smartphone Overdependence Scale after adjusting for age, sex, body mass index, and socioeconomic status. The high-risk PSU group accounted for 17.2% of participants. Furthermore, this group showed 2.3 times higher dYFAS-C2.0 scores than the general group. Emotional overeating and satiety responsiveness were correlated with PSU. A comprehensive evaluation of addiction symptoms is needed for proper intervention, especially in adolescents with symptoms of abnormal eating behaviors.
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Affiliation(s)
- Eun-Jin Park
- Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang 10380, Korea;
- Center for School Mental Health, Eulji University, Seoul 01830, Korea;
| | | | - Mi-Sun Lee
- Center for School Mental Health, Eulji University, Seoul 01830, Korea;
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul 06591, Korea
| | - Soo-Young Bhang
- Center for School Mental Health, Eulji University, Seoul 01830, Korea;
- Department of Psychiatry, Eulji University Hospital, School of Medicine, Eulji University, Seoul 01830, Korea
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13
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The relations between C-reactive protein and trauma exposure, PTSD and depression symptoms, and PTSD psychotherapy treatment response in treatment seeking veterans and service members. Brain Behav Immun 2022; 101:84-92. [PMID: 34990746 DOI: 10.1016/j.bbi.2021.12.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/10/2021] [Accepted: 12/29/2021] [Indexed: 12/28/2022] Open
Abstract
While inflammatory markers have been implicated in the link between PTSD and poor health outcomes, there is a paucity of research investigating C-reactive protein (CRP) and psychotherapy treatment response for posttraumatic stress disorder (PTSD). The present study utilized a large, well-characterized sample of veterans and service members (N = 493) engaged in intensive psychotherapy to investigate the associations between CRP, trauma exposure, related variables, and PTSD and depression, as well as investigating if CRP was associated with PTSD psychotherapy treatment response. Bivariate correlation results indicate that CRP was significantly associated with BMI (r = 0.48) and severity of experiences of childhood physical and sexual abuse (r = 0.14 and 0.15, respectively) and was not significantly associated with baseline PTSD total symptom severity, PTSD symptom clusters, or depression symptom severity (rs ranging from -0.03 to 0.04). In multivariate regression models investigating if CRP and related variables were associated with PTSD baseline symptom severity, CRP was not a significant predictor (β = -0.03). Hierarchical linear modeling did not identify CRP as a significant predictor of PTSD psychotherapy outcome. Given that findings indicate that CRP was broadly elevated in this treatment seeking sample but not associated with PTSD and depression symptom severity, results suggest CRP may not be a specific biomarker for PTSD or depression but may be elevated in psychiatric disease more generally.
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14
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Subjective Social Status Is Associated with Dysregulated Eating Behaviors and Greater Body Mass Index in an Urban Predominantly Black and Low-Income Sample. Nutrients 2021; 13:nu13113893. [PMID: 34836146 PMCID: PMC8621735 DOI: 10.3390/nu13113893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Higher subjective social status (SSS) or a person’s perception of their social standing is related to better health outcomes, but few studies examined SSS in relation to obesity. Emotional eating and food addiction have been linked to obesity. Some studies indicated that manipulating SSS may lead to altered food intake, but the relationship between SSS and dysregulated eating, such as emotional eating and food addiction (FA), has not been examined. The goal of this study was to examine the associations between SSS in the community and the larger society, dysregulated eating (emotional eating and FA), and body mass index (BMI) in a majority racial minority sample. Methods: The participants (N = 89; 93% Black, 86% women, and 56% with obesity; 72% income lower than USD 2000), recruited from a publicly funded hospital in Atlanta, GA, completed the MacArthur Scale, Dutch Eating Behaviors Questionnaire, Yale Food Addiction Scale, Beck Depression Inventory, PTSD Symptom Checklist, and demographics questionnaire. Results: Twenty-two percent of the sample met the criteria for FA; those with FA had significantly higher BMI than those without (p = 0.018). In the hierarchical linear regression, the SSS community (but not in society) predicted higher severity of emotional eating (β = 0.26, p = 0.029) and FA (β = 0.30, p = 0.029), and higher BMI (β = 0.28, p = 0.046), independent from depression and PTSD symptoms. Conclusions: The findings indicate that, among Black individuals with predominantly low income in the U.S., perceived role in their community is associated with eating patterns and body mass. Given the small sample size, the results should be interpreted with caution.
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Jakubowski KP, Murray V, Stokes N, Thurston RC. Sexual violence and cardiovascular disease risk: A systematic review and meta-analysis. Maturitas 2021; 153:48-60. [PMID: 34654528 DOI: 10.1016/j.maturitas.2021.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk. METHODS PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test. RESULTS Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence. CONCLUSIONS Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts.
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Affiliation(s)
- Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Vanessa Murray
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Natalie Stokes
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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16
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Stojek MM, Lipka J, Maples-Keller JM, Rauch SAM, Black K, Michopoulos V, Rothbaum BO. Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD. Nutrients 2021; 13:nu13061840. [PMID: 34072212 PMCID: PMC8228620 DOI: 10.3390/nu13061840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Food addiction (FA) is a dysregulated eating pattern characterized by difficulties in controlling the intake of certain foods. There is an overlap in physical and mental health correlates of FA and post-traumatic stress disorder (PTSD). The purpose of this study was to examine sex differences in the rates of positive FA status in individuals with threshold/subthreshold PTSD, and to examine sex differences in the physical and mental health correlates of FA. METHODS Post-9/11 veterans/service members seeking PTSD treatment were recruited. Participants were diagnosed with PTSD via the administration of a clinical interview. FA status was determined using Modified Yale Food Addiction Scale-2, binary sex and body mass index were assessed with demographics questions. RESULTS Nearly half (43%) of the sample were women. There were no sex differences in the rates of FA, with an overall FA prevalence of 18%. There were no sex differences in FA symptom count in the whole sample (M = 1.63) or those with FA status (M = 6.21). Individuals with FA reported higher frequency of disordered eating, higher severity of PTSD, and depression symptoms. CONCLUSIONS FA should be assessed in tandem with PTSD symptoms, as its prevalence in that sample is higher than in the general population, and it appears to affect both sexes at similar rates.
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Affiliation(s)
- Monika M. Stojek
- Department of Social Sciences, University of Silesia, 40-007 Katowice, Poland;
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA; (J.M.M.-K.); (S.A.M.R.); (K.B.); (V.M.); (B.O.R.)
- Correspondence: or
| | - Justyna Lipka
- Department of Social Sciences, University of Silesia, 40-007 Katowice, Poland;
| | - Jessica M. Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA; (J.M.M.-K.); (S.A.M.R.); (K.B.); (V.M.); (B.O.R.)
- Emory Healthcare Veterans Program, Emory University School of Medicine, Atlanta, GA 30329, USA
- Grady Trauma Project, Grady Memorial Hospital, Atlanta, GA 30303, USA
| | - Sheila A. M. Rauch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA; (J.M.M.-K.); (S.A.M.R.); (K.B.); (V.M.); (B.O.R.)
- Emory Healthcare Veterans Program, Emory University School of Medicine, Atlanta, GA 30329, USA
- Atlanta VA Healthcare System, Decatur, GA 30033, USA
| | - Kathryn Black
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA; (J.M.M.-K.); (S.A.M.R.); (K.B.); (V.M.); (B.O.R.)
- Emory Healthcare Veterans Program, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA; (J.M.M.-K.); (S.A.M.R.); (K.B.); (V.M.); (B.O.R.)
- Grady Trauma Project, Grady Memorial Hospital, Atlanta, GA 30303, USA
- Yerkes National Primate Research Center, Emory University, Atlanta, GA 30322, USA
| | - Barbara O. Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA; (J.M.M.-K.); (S.A.M.R.); (K.B.); (V.M.); (B.O.R.)
- Emory Healthcare Veterans Program, Emory University School of Medicine, Atlanta, GA 30329, USA
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Cammack AL, Gazmararian JA, Suglia SF. History of child maltreatment and excessive dietary and screen time behaviors in young adults: Results from a nationally representative study. Prev Med 2020; 139:106176. [PMID: 32592792 PMCID: PMC7494614 DOI: 10.1016/j.ypmed.2020.106176] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/26/2020] [Accepted: 06/07/2020] [Indexed: 12/14/2022]
Abstract
Child maltreatment is common and has been associated with substance use addictions, yet few studies have examined associations with potentially addictive dietary and screen time behaviors. The goal of this study was to assess associations between retrospectively self-reported child maltreatment (sexual abuse, physical abuse, emotional abuse, and neglect) and excessive self-reported dietary (sugar sweetened beverage and fast food consumption) and screen time behaviors (television/video watching and leisure time computer use) in early adulthood, overall and by sex and race/ethnicity. Associations were examined using data from 10,813 participants 24-32 years old from the National Longitudinal Study of Adolescent to Adult Health. We used predicted marginal proportions accounting for the complex sample design to obtain prevalence ratios (PRs) and adjusted for demographic characteristics and physical activity. In females, exposure to poly-maltreatment (2+ types of child maltreatment) was associated with excessive sugar sweetened beverage consumption, television/video watching, and leisure time computer use; in males, exposure to poly-maltreatment was associated with excessive sugar sweetened beverage consumption, television/video watching, and fast food consumption. Some associations were particularly strong in racial/ethnic minorities, especially Latina females (poly-maltreatment-sugar sweetened beverage association: aPR = 6.14, 95% CI:2.12, 17.75; poly-maltreatment-computer use association: aPR = 3.08, 95% CI:1.44, 6.58). These findings show that child maltreatment is associated with excessive dietary and screen time behaviors into adulthood, and these associations are present in racial/ethnic groups at high risk of cardiometabolic disease. Extension of an addiction paradigm to include dietary and screen time behaviors may inform health risks and disease prevention efforts in child maltreatment survivors.
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Affiliation(s)
- Alison L Cammack
- Department of Epidemiology, Rollins School of Public Health, Emory University, United States of America.
| | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, United States of America
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, United States of America
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Bou Khalil R, Sleilaty G, Richa S, Seneque M, Iceta S, Rodgers R, Alacreu-Crespo A, Maimoun L, Lefebvre P, Renard E, Courtet P, Guillaume S. The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study. Nutrients 2020; 12:nu12102969. [PMID: 32998411 PMCID: PMC7601309 DOI: 10.3390/nu12102969] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 12/17/2022] Open
Abstract
Background: The current study aimed to test whether food addiction (FA) might mediate the relationship between the presence of a history of childhood maltreatment and eating disorder (ED) symptom severity. Methods: Participants were 231 patients with ED presenting between May 2017 and January 2020 to a daycare treatment facility for assessment and management with mainly the Eating Disorder Inventory-2 (EDI-2), the Child Trauma Questionnaire (CTQ), and the Yale Food Addiction Scale (YFAS 2.0). Results: Participants had a median age of 24 (interquartile range (IQR) 20–33) years and manifested anorexia nervosa (61.47%), bulimia nervosa (16.88%), binge-eating disorders (9.09%), and other types of ED (12.55%). They were grouped into those likely presenting FA (N = 154) and those without FA (N = 77). The group with FA reported higher scores on all five CTQ subscales, as well as the total score of the EDI-2 (p < 0.001). Using mediation analysis; significant indirect pathways between all CTQ subscales and the EDI-2 total score emerged via FA, with the largest indirect effect emerging for physical neglect (standardized effect = 0.208; 95% confidence interval (CI) 0.127–0.29) followed by emotional abuse (standardized effect = 0.183; 95% CI 0.109–0.262). Conclusion: These results are compatible with a model in which certain types of childhood maltreatment, especially physical neglect, may induce, maintain, and/or exacerbate ED symptoms via FA which may guide future treatments.
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Affiliation(s)
- Rami Bou Khalil
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut BP 166830, Lebanon;
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Correspondence: ; Tel.: +96-1142-1000
| | - Ghassan Sleilaty
- Clincal Research Center and Department of Cardiac and Thoracic Surgery, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut BP 166830, Lebanon;
| | - Sami Richa
- Department of Psychiatry, Saint Joseph University-Hôtel Dieu de France Hospital, Beirut BP 166830, Lebanon;
| | - Maude Seneque
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
| | - Sylvain Iceta
- Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada;
- School of Nutrition, Laval University, Québec, QC G1V 0A6, Canada
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Rachel Rodgers
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
| | - Adrian Alacreu-Crespo
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
| | - Laurent Maimoun
- PhyMedExp, University of Montpellier, INSERM, CNRS, 34295 Montpellier, France;
- Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295 Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, and Nutrition, CHRU, 34295 Montpellier, France; (P.L.); (E.R.)
| | - Eric Renard
- Department of Endocrinology, Diabetes, and Nutrition, CHRU, 34295 Montpellier, France; (P.L.); (E.R.)
- UMR CNRS 5203, INSERM U1191, Institute of Functional Genomics, University of Montpellier, 34295 Montpellier, France
| | - Philippe Courtet
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
| | - Sebastien Guillaume
- PSNREC, University of Montpellier, INSERM, CHU de Montpellier, 34295 Montpellier, France; (M.S.); (A.A.-C.); (P.C.); (S.G.)
- Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, 34295 Montpellier, France;
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