1
|
Lego SR, Raykos BC, Tonta KE, Erceg-Hurn DM, Waller G, McEvoy PM. Validation of the Interpersonal Relationships in Eating Disorders (IR-ED) Scale in an Eating Disorder Sample. Int J Eat Disord 2024. [PMID: 39016107 DOI: 10.1002/eat.24259] [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: 03/13/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE Interpersonal problems have been identified as a plausible mechanism underlying the onset and maintenance of eating disorders. The Interpersonal Relationships in Eating Disorders (IR-ED) scale is the first eating disorders-specific measure of interpersonal problems, which was developed in a nonclinical sample. The aims of the current study were to (a) confirm the factor structure of the IR-ED within a large clinical sample, (b) investigate measurement invariance of the IR-ED across nonclinical and clinical samples, (c) examine the convergent validity of the IR-ED using a generic measure of interpersonal problems, and (d) investigate the incremental clinical utility of the IR-ED in uniquely predicting eating disorder symptomatology. METHOD Treatment-seeking individuals (N = 437) completed the IR-ED at their initial assessment appointment at a specialist eating disorder outpatient service. RESULTS A multiple-group confirmatory factor analysis supported an invariant bifactor structure comprising a general interpersonal problems factor and two group factors-Avoidance of Body Evaluation and Food-Related Interpersonal Tension. Convergent validity was demonstrated by a large, statistically significant correlation with a generic measure of interpersonal problems (r = 0.62, p < 0.001). A series of structural equation models further revealed unique incremental predictive utility of the IR-ED for eating disorder symptomatology. DISCUSSION The IR-ED has strong psychometric properties and may prove beneficial in the assessment, formulation, and treatment of eating-specific interpersonal problems among patients with eating disorders.
Collapse
Affiliation(s)
- Sophia R Lego
- Discipline of Psychology, Perth, Western Australia, Australia
| | - Bronwyn C Raykos
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Kate E Tonta
- Discipline of Psychology, Perth, Western Australia, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
| | - David M Erceg-Hurn
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Glenn Waller
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Peter M McEvoy
- Discipline of Psychology, Perth, Western Australia, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
| |
Collapse
|
2
|
Baer NR, Grissmer NV, Schenk L, Wortmann HR, Warschburger P, Gisch UA. Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial. Nutrients 2024; 16:1949. [PMID: 38931304 PMCID: PMC11206497 DOI: 10.3390/nu16121949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.
Collapse
Affiliation(s)
- Nadja-R. Baer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Noemi Vanessa Grissmer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hanna R. Wortmann
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Petra Warschburger
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Ulrike A. Gisch
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
- Department of Nutritional Psychology, Institute of Nutritional Science, Justus Liebig University Giessen, Senckenbergstr. 3, 35390 Giessen, Germany
| |
Collapse
|
3
|
Muzi L, Carone N, Mirabella M, Franco A, Rugo MA, Mazzeschi C, Lingiardi V. Direct and indirect effects of psychological well-being and therapeutic alliance on therapy outcome in eating disorders. Front Psychol 2024; 15:1392887. [PMID: 38855305 PMCID: PMC11162114 DOI: 10.3389/fpsyg.2024.1392887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Outcome research in eating disorders (EDs) is commonly focused on psychopathological dysfunction. However, Ryff's model of psychological well-being (PWB) has shown promising-yet preliminary-results with ED patients. Additionally, despite substantial evidence highlighting the association between the therapeutic alliance and treatment outcome, findings in ED samples remain unclear. The present study aimed at exploring the direct effect of PWB dimensions and the early therapeutic alliance on ED patients' individual treatment responses, as well as the mediating role played by the early therapeutic alliance in the relationship between PWB dimensions and overall pre-post symptom change. Methods A sample of N = 165 ED patients assigned female at birth, who were receiving treatment in a residential program, completed the Psychological Well-Being Scale at treatment intake and the Working Alliance Inventory after the first four psychotherapy sessions. Patients also completed the Outcome Questionnaire-45.2 at the same time point and during the week prior to discharge. Results The PWB dimensions of autonomy, positive relations, and self-acceptance were associated with clinically significant change, while the dimensions of personal growth and self-acceptance were associated with reliable change. The early therapeutic alliance showed both direct and indirect effects on therapy outcome, predicting clinically significant and reliable symptom reduction. It also emerged as a significant mediator in the relationship between all PWB dimensions and overall symptomatic change. Conclusion The identification of individual, adaptive characteristics in ED patients that might influence their development of an early therapeutic alliance may help therapists to predict relationship ruptures and tailor their interventions to enhance treatment effectiveness.
Collapse
Affiliation(s)
- Laura Muzi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Nicola Carone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marta Mirabella
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Anna Franco
- Eating Disorder Clinic “Residenza Gruber”, Bologna, Italy
| | | | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
4
|
Sølvberg N, Torstveit MK, Solstad BE, Mountjoy M, Rosenvinge JH, Pettersen G, Sundgot-Borgen J. Risk factors for sexual harassment and abuse victimization among adolescent athletes and non-athletes: A one-year follow-up study. CHILD ABUSE & NEGLECT 2024; 147:106592. [PMID: 38113571 DOI: 10.1016/j.chiabu.2023.106592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/25/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The association between SHA and negative mental health increases the need to understand risk factors for SHA victimization, which is important for future development of prevention programs. OBJECTIVE To examine which combinations of demographic- and mental health factors were associated with subsequent SHA victimization, and the prevalence of elite athletes, recreational athletes, and reference students who experienced sexual revictimization. PARTICIPANTS AND SETTING Norwegian elite athletes and recreational athletes attending sport high schools, and reference students attending non-sport high schools (mean age: 17.1 years) were eligible for participation. METHODS The participants answered an online questionnaire at two measurement points one year apart, T1 and T2 (n = 1139, 51.1 % girls). After testing for measurement invariance, data were analyzed with Classification and Regression Tree analysis (CRT) using demographic- and mental health variables from T1 as independent variables, and SHA at T2 as outcome. RESULTS The combination of being a girl with high level of symptoms of eating disorders and other psychological symptoms was associated with subsequent reporting of SHA. Among the students with lifetime experience of SHA at T1 (n = 533, 58.3 %), 49.5 % reported revictimization at T2 (60.9 % girls, 32.2 % boys, p ≤ .001). The prevalence of SHA revictimization was lower among elite athletes (44.3 %) compared with recreational athletes (49.1 %) and reference students (59.4 %, p = .019). CONCLUSION The combination of female gender and mental health symptoms are risk factors for subsequent SHA victimization. These findings, and the high prevalence of SHA revictimization is important knowledge for developing preventive programs targeting elite athletes, recreational athletes, and reference students.
Collapse
Affiliation(s)
- Nina Sølvberg
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Postboks 4014 Ullevål stadion, 0806 Oslo, Norway.
| | - Monica Klungland Torstveit
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Postboks 422, 4604 Kristiansand, Norway.
| | - Bård Erlend Solstad
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Postboks 422, 4604 Kristiansand, Norway.
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada; International Olympic Committee Working Group on the Prevention of Harassment and Abuse in Sport, Lausanne, Switzerland; International Research Network on Violence and Integrity in Sport, Antwerp, Belgium.
| | - Jan H Rosenvinge
- Department of Psychology, UiT -The Arctic University of Norway, Postboks 6050 Langnes, 9037 Tromsø, Norway.
| | - Gunn Pettersen
- Department of Health and Care Sciences, UiT - The Arctic University of Norway, Postboks 6050 Langnes, 9037 Tromsø, Norway.
| | - Jorunn Sundgot-Borgen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Postboks 4014 Ullevål stadion, 0806 Oslo, Norway.
| |
Collapse
|
5
|
Springfield CR, Bonfils KA, Chernov NV, Moiseeva TV, Sozinova MV, Dmitryeva NG, Lysaker PH, Karpenko OA, Kostyuk GP. The paradoxical moderating effects of metacognition in the relationships between self-esteem, depressive symptoms, and quality of life in anorexia and bulimia. CONSORTIUM PSYCHIATRICUM 2023; 4:6-20. [PMID: 38250639 PMCID: PMC10795957 DOI: 10.17816/cp6139] [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: 04/06/2023] [Accepted: 07/03/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Self-esteem and depressive symptoms contribute to a lower quality of life in people suffering from eating disorders. However, limited research has examined whether other factors may affect how these variables influence one another over time. Metacognition is a previously unexplored determinant that may impact the relationships between self-esteem, depressive symptoms, and quality of life in instances of eating disorders. AIM This study sought to examine metacognitive self-reflectivity and mastery as moderators of the relationships between self-esteem, depressive symptoms, and quality of life and to determine if these relationships are different in people with anorexia compared with people with bulimia. METHODS Participants with anorexia (n=40) and bulimia (n=40) were recruited from outpatient clinics. The participants were assessed on their metacognitive ability and self-reported on measures to assess their depressive symptoms, self-esteem, and quality of life. RESULTS The results indicate that metacognitive self-reflectivity moderates the relationship between self-esteem, depressive symptoms, and quality of life in people with anorexia such that when self-reflectivity is high, lower self-esteem and higher depressive symptoms are associated with a lower quality of life. These relationships did not appear to be significant when self-reflectivity was low. In contrast, in the anorexia and bulimia groups, metacognitive mastery appeared to moderate the relationships between self-esteem, depressive symptoms, and quality of life such that when mastery was low, lower self-esteem and higher depressive symptoms were associated with a lower quality of life. These relationships did not appear significant when mastery was high. CONCLUSION Metacognitive self-reflectivity and mastery seem to play paradoxical moderating roles in the relationships between self-esteem, depressive symptoms, and quality of life in people with anorexia and bulimia. These findings pave the way toward further research and have important clinical implications.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Paul H. Lysaker
- Richard L Roudebush VA Medical Cent
- Indiana University School of Medicine
| | | | | |
Collapse
|
6
|
Lysaker PH, Chernov N, Moiseeva T, Sozinova M, Dmitryeva N, Makarova A, Kukla M, Myers E, Karpenko O, Kostyuk G. Contrasting Metacognitive, Emotion Recognition and Alexithymia Profiles in Bulimia, Anorexia, and Schizophrenia. J Nerv Ment Dis 2023; 211:348-354. [PMID: 37040137 DOI: 10.1097/nmd.0000000000001612] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
ABSTRACT Alexithymia, or deficits in emotion recognition, and metacognitive capacity have been noted both in psychosis and eating disorders and potentially linked to psychopathology. This study sought to compare levels of impairments in these phenomena and their associations with psychopathology in groups with eating disorders and psychosis. Participants with diagnoses of a schizophrenia spectrum disorder (SSD; n = 53), anorexia (n = 40), or bulimia (n = 40) were recruited from outpatient clinics. Alexithymia was measured with the Toronto Alexithymia Scale; emotion recognition, with the Ekman Faces Test; and metacognition, with the Metacognitive Assessment Scale-Abbreviated. Psychopathology was measured with the Eating Attitudes Test, Body Image Questionnaire, and Positive and Negative Syndrome Scale. Results indicated that the SSD group had significantly poorer metacognitive function than either eating disorder group. Metacognition was related to body image in the anorexia group and a range of different forms of general psychopathology in the bulimia group. Alexithymia was related to eating disorder behaviors in the bulimia group.
Collapse
Affiliation(s)
| | - Nikita Chernov
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| | - Tatyana Moiseeva
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| | - Marta Sozinova
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| | - Nadezhda Dmitryeva
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| | - Anastasiya Makarova
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| | | | | | - Olga Karpenko
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| | - Georgiy Kostyuk
- Department of Psychiatry, Mental-health clinic №1 named after N.A. Alexeev, Moscow, Russia
| |
Collapse
|
7
|
Hou X, Wang G, Wang H, Liu J, Liu W, Ji S, Wang E, Qu D, Hu J. Which came first? Bulimia and emotional symptoms: A cross-lagged panel analysis. Int J Clin Health Psychol 2022; 22:100320. [PMID: 35892043 PMCID: PMC9305338 DOI: 10.1016/j.ijchp.2022.100320] [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: 03/02/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Researchers have found growing evidence for the comorbidity link between bulimia and emotional symptoms among Chinese female youth. However, the prospective effect of one on the other is still unclear. Therefore, a cross-lagged model was used to examine the possible underlying mechanism between bulimia and two typical emotional problems (i.e., anxiety symptoms and depressive symptoms), respectively, in the present study. Methods A total of 471 female college students participated in the three waves of the present study. Self-reported questionnaires were delivered to assess their bulimia, anxiety symptoms, and depressive symptoms. Results After controlling for earlier levels of symptoms, our finding indicated that anxiety symptoms triggered more bulimia symptoms from Time 1 to Time 2. In turn, the reciprocal cycles occurred between anxiety symptoms and bulimia symptoms from Time 2 to Time 3. More interestingly, a similar pattern was found between depressive symptoms and bulimia. Conclusions The persistence and reciprocal cycle between bulimia and emotional symptoms are worthy of attention. Specifically, female youth with higher levels of emotional symptoms appear to be more profound at high risk for eating-related problems afterward. Further eating-related intervention programs may also need to take the level of female youth's emotional symptoms into consideration.
Collapse
Affiliation(s)
- Xiumei Hou
- Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, China
| | - Guoping Wang
- Third people's Hospital of Heze City, Heze, China
| | | | - Jindong Liu
- Third people's Hospital of Heze City, Heze, China
| | - Wei Liu
- Third people's Hospital of Heze City, Heze, China
| | - Shiyun Ji
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, P. R. China
| | - Enna Wang
- School of Education, Tianjin University, Tianjin, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jieyi Hu
- School of Humanities, Jinan University, Zhuhai, Guangdong, China
| |
Collapse
|