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Delaquis CP, Godart N, Barry C, Ringuenet D, Maria AS, Nicolas I, Berthoz S. Perfectionism, self-esteem, and affective symptoms in anorexia nervosa subtypes: A network analysis of French inpatients. J Clin Psychol 2024; 80:1852-1875. [PMID: 38646977 DOI: 10.1002/jclp.23698] [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: 11/16/2023] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE Previous studies have highlighted the relevance of perfectionism, self-esteem, and anxio-depressive symptoms in anorexia nervosa (AN). However, the relationships between these factors and cardinal eating disorders (ED) symptoms remain unclear, particularly in AN subtypes. This study aimed to examine their interconnections using network analysis. METHOD The sample included n = 338 inpatients with AN who completed the Eating Disorder Examination Questionnaire, Frost Multidimensional Perfectionism Scale, Rosenberg Self-Esteem Scale, and Hospital Anxiety and Depression Scale. Using network analysis, we estimated three networks: full sample, AN-restrictive (AN-R) and AN-binge/purging (AN-BP) subtypes. We estimated central and bridge symptoms using expected influence and conducted an exploratory network comparison test to compare AN subtypes. RESULTS Overvaluation of Weight and Shape, Concern over Mistakes, and Personal Standards were consistently central in all networks. The most central bridge symptoms across all networks were Concern over Mistakes and Self-Esteem. Concern over Mistakes bridged perfectionism and ED symptoms, while Self-Esteem was highly connected to all symptom clusters. Anxiety was significantly more central in the AN-R network compared to the AN-BP network. CONCLUSIONS The present study contributes to a growing body of network studies suggesting that nodes related to perfectionism are just as central as cardinal ED symptoms, indicating the relevance of perfectionism in ED pathology. The high bridge centrality of self-esteem suggests that it may be an important link between perfectionism, mood, and ED symptoms. Future research should investigate the efficacy of targeting multiple psychological factors in the treatment of AN, as well as their potential transdiagnostic relevance.
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Affiliation(s)
| | - Nathalie Godart
- Fondation Santé des Etudiants de France, Paris, France
- CESP, Inserm, Université Paris Saclay, Villejuif, France
- UFR Simone Veil-Santé, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Caroline Barry
- CESP, Inserm, Université Paris Saclay, Villejuif, France
| | - Damien Ringuenet
- CESP, Inserm, Université Paris Saclay, Villejuif, France
- Unité de Traitement des Troubles des Conduites Alimentaires, Département de Psychiatrie et d'Addictologie, Hôpital Paul Brousse, Villejuif, France
| | | | - Isabelle Nicolas
- Department of Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Sylvie Berthoz
- INCIA CNRS UMR 5287, Univ. Bordeaux, Bordeaux, France
- Department of Psychiatry, Institut Mutualiste Montsouris, Paris, France
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Greville-Harris M, Vuillier L, Goodall S, Talbot CV, Walker C, Appleton KM. Striving for the perfect diet? The mediating role of perfectionism in the relationship between obsessive compulsive symptoms and traits of Orthorexia Nervosa. J Eat Disord 2024; 12:91. [PMID: 38951924 PMCID: PMC11218215 DOI: 10.1186/s40337-024-01032-w] [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: 01/12/2024] [Accepted: 05/27/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON) is a disordered eating style involving an unhealthy obsession with 'healthy' or 'clean' eating. Its aetiology is still poorly understood and is not yet recognised in diagnostic manuals. While ON has been associated with Obsessive Compulsive (OC) symptoms and perfectionism, no study to date has looked at the relationship between OC symptoms and ON tendencies via perfectionism, or the influence of two facets of perfectionism in this relationship, namely evaluative concern and achievement striving. Examining the potential role of perfectionism helps to understand the aetiology of ON as well as inform potential treatments tailored specifically for ON and comorbid OC symptoms. METHODS In this cross sectional study, we tested 507 participants (n = 70 males, n = 69 at risk of ON) on questionnaires measuring OC symptoms, perfectionism and ON symptoms. We ran two mediation analyses to look at the overall relationship between perfectionism and OC and ON symptoms (Model 1) as well as the specific contribution of evaluative concern and achievement striving in the relationship between OC and ON symptoms (Model 2). RESULTS We found that perfectionism partially mediated the relationship between OC and ON symptoms. Specifically, we found that while achievement striving and evaluative concern were associated with OC symptoms, only achievement striving was significantly associated with ON symptoms, mediating the relationship between OC and ON symptoms. CONCLUSIONS This study highlighted the role of one key facet of perfectionism (achievement striving) in the aetiology of ON. The role of achievement striving was indicated as a transdiagnostic construct explaining the link between ON and OC symptoms. These findings are discussed in terms of their implications for treatment models, specifically in terms of the potential role of targeting perfectionism in ON treatment.
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Affiliation(s)
- Maddy Greville-Harris
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK.
| | - Laura Vuillier
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Summer Goodall
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Catherine V Talbot
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Cliona Walker
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
| | - Katherine M Appleton
- Department of Psychology, Faculty of Science and Technology Poole House, Talbot Campus, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
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Ralph-Nearman C, Williams BM, Ortiz AML, Levinson CA. Investigating the Theory of Clinical Perfectionism in a Transdiagnostic Eating Disorder Sample Using Network Analysis. Behav Ther 2024; 55:14-25. [PMID: 38216228 DOI: 10.1016/j.beth.2023.05.001] [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: 08/25/2022] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 01/14/2024]
Abstract
Eating disorders are deadly psychiatric illnesses, with treatments working for less than half of individuals who seek treatment. The transdiagnostic theory of eating disorders proposes that eating disorders share similar maintaining symptoms, such as what this theory calls clinical perfectionism (i.e., high levels of concern over mistakes and personal standards). However, it has been difficult to examine the interrelationship of specific aspects of perfectionism, beyond assessing moderation effects, which have generally not found support for the theory of clinical perfectionism in eating disorders. Thus, we used network analysis to test the theory of perfectionism by testing the interrelationships between maladaptive perfectionism facets (concern over mistakes, personal standards, parental criticism, parental expectations, and personal standards) and eating disorder symptoms in 397 individuals diagnosed with an eating disorder. Concern over mistakes was a central symptom and demonstrated the strongest interrelationships with eating disorder symptoms compared to the other aspects of perfectionism, connecting to eating concerns and cognitive restraint. Objective binge eating had a strong negative connection to personal standards. We identified specific central symptoms and illness pathways of perfectionism, which partially supports the theory of clinical perfectionism. Results, if replicated, may suggest that concern over mistakes might be best reconceptualized as part of eating disorder pathology and be targeted to improve treatment outcomes for eating disorders.
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Scarth M, Westlye LT, Havnes IA, Bjørnebekk A. Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis among male weightlifters. BMC Psychiatry 2023; 23:342. [PMID: 37193971 DOI: 10.1186/s12888-023-04781-1] [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: 01/25/2023] [Accepted: 04/13/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Anabolic-androgenic steroid (AAS) dependence has numerous adverse health consequences, and may be driven in part by body image concerns, primarily muscle dysmorphia. This study aims to further understand and identify potential clinical targets using network analyses of AAS dependence and muscle dysmorphia symptoms in males who used AAS and weightlifting controls. METHODS A sample of 153 men who currently or previously used AAS and 88 weight-lifting controls were recruited through social media and relevant online forums, and via posters and flyers distributed in select gyms in Oslo, Norway. Symptoms of AAS dependence and muscle dysmorphia were assessed using clinical interviews and standardized questionnaires. Severity of muscle dysmorphia symptoms were compared between the groups using independent samples t-tests. The following symptom networks were computed using Gaussian graphical modeling or mixed graphical modeling: (1) AAS dependence symptoms among men with AAS use (2) muscle dysmorphia symptoms among men with AAS use and weight-lifting controls in two separate networks, which were compared using a network comparison test, and (3) AAS dependence and muscle dysmorphia symptoms among men with AAS use. RESULTS In a network of AAS dependence symptoms, continuing use despite physical and mental side effects, using longer than planned, tolerance, and work/life interference were the most central symptoms. When comparing symptom structures of muscle dysmorphia between those who used AAS and controls, the most central symptoms in each group were exercise dependence and size/symmetry concerns, respectively. Men with AAS use demonstrated elevated muscle dysmorphia symptoms compared to controls, indicating that both the severity and structure of symptoms differ between these groups. In a network including both AAS dependence and muscle dysmorphia symptoms, no significant connections between symptom groups were identified. CONCLUSIONS AAS dependence is complex, with correlated somatic and psychological challenges driving the symptom network, indicating that alleviating physical and mental health concerns during both AAS use and cessation is an important clinical target. Muscle dysmorphia symptoms related to taking action (diet, exercise, and supplement use) appear to cluster together more for those who use AAS than those who do not.
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Affiliation(s)
- Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Oslo, 0424, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT, Oslo University Hospital, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ingrid A Havnes
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Oslo, 0424, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Oslo, 0424, Norway
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Delaquis CP, Godart NT, Fatséas M, Berthoz S. Cognitive and Interpersonal Factors in Adolescent Inpatients with Anorexia Nervosa: A Network Analysis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040730. [PMID: 37189979 DOI: 10.3390/children10040730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
The cognitive-interpersonal model of anorexia nervosa (AN) posits that cognitive and interpersonal traits contribute to the development and maintenance of AN. We investigated cognitive and interpersonal factors put forward by the model in a sample of 145 adolescent inpatients with AN using network analysis. Our main outcomes included core eating disorder symptoms, cognitive style, socio-affective factors, and mood symptoms. We estimated a cross-sectional network using graphical LASSO. Core and bridge symptoms were identified using strength centrality. Goldbricker was used to reduce topological overlap. The node with the highest strength centrality was Concern over Mistakes, followed by Eating Preoccupation, Social Fear, and Overvaluation of Weight and Shape. The nodes with the highest bridge strength were Concern over Mistakes, Doubt about Actions, Overvaluation of Weight and Shape, and Depression. Notably, both performance on a cognitive flexibility task and BMI were not connected to any other nodes and were subsequently removed from the final network. We provide partial support for the cognitive-interpersonal model while also supporting certain premises put forward by the transdiagnostic cognitive-behavioral model. The high centrality of Concern over Mistakes and Social Fear supports the theory that both cognitive and interpersonal difficulties contribute to AN, particularly in adolescence.
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Affiliation(s)
| | - Nathalie T Godart
- Fondation Santé des Etudiants de France, 75014 Paris, France
- CESP, University Paris-Sud, UVSQ, INSERM U 1178, Université Paris-Saclay, 94805 Villejuif, France
- UFR Simone Veil-Santé, Université Versailles Saint-Quentin-en-Yvelines, 78047 Montigny-le-Bretonneux, France
| | - Melina Fatséas
- INCIA CNRS UMR 5287, Université de Bordeaux, 33000 Bordeaux, France
- Department of Addictology, CHU Bordeaux, 33000 Bordeaux, France
| | - Sylvie Berthoz
- INCIA CNRS UMR 5287, Université de Bordeaux, 33000 Bordeaux, France
- Department of Psychiatry, Institut Mutualiste Montsouris, 75014 Paris, France
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Wu C, Wang W, Cheng S, Zhang H, Li L, Tian C, Zhang L, Chen N, Du J, Ren L, Lang H. The relationship between components of hypoglycemia worries and avoiding hypoglycemia behavior in type 2 diabetes mellitus with hypoglycemia: a network analysis. BMC Psychiatry 2023; 23:204. [PMID: 36978022 PMCID: PMC10053460 DOI: 10.1186/s12888-023-04698-9] [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: 12/10/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The fear of hypoglycemia in type 2 diabetes mellitus (T2DM) patients with hypoglycemia has seriously affected their quality of life. They are always afraid of hypoglycemia and often take excessive action to avoid it. Yet, researchers have investigated the relationship between hypoglycemia worries and excessive avoiding hypoglycemia behavior using total scores on self-report measures. However, network analysis studies of hypoglycemia worries and excessive avoiding hypoglycemia behavior in T2DM patients with hypoglycemia are lacking. PURPOSE The present study investigated the network structure of hypoglycemia worries and avoiding hypoglycemia behavior in T2DM patients with hypoglycemia and aimed to identify bridge items to help them correctly treat hypoglycemia and properly deal with hypoglycemia fear. METHODS A total of 283 T2DM patients with hypoglycemia were enrolled in our study. Hypoglycemia worries and avoiding hypoglycemia behavior were evaluated with the Hypoglycemia Fear Scale. Network analyses were used for the statistical analysis. RESULTS B9 "Had to stay at home for fear of hypoglycemia" and W12 "I am worried that hypoglycemia will affect my judgment" have the highest expected influences in the present network. In the community of hypoglycemia worries, W17 "I worry about hypoglycemia during sleep" has the highest bridge expected influence. And in the community of avoiding hypoglycemia behavior, B9 "Had to stay at home for fear of hypoglycemia" has the highest bridge expected influence. CONCLUSION Complex patterns of associations existed in the relationship between hypoglycemia worries and avoiding hypoglycemia behavior in T2DM patients with hypoglycemia. From the perspective of network analysis, B9 "Had to stay at home for fear of hypoglycemia" and W12 "I am worried that hypoglycemia will affect my judgment" have the highest expected influence, indicating their highest importance in the network. W17 "I worry about hypoglycemia during sleep" aspect of hypoglycemia worries and B9 "Had to stay at home for fear of hypoglycemia" aspect of avoiding hypoglycemia behavior have the highest bridge expected influence, indicating they have the strongest connections with each community. These results have important implications for clinical practice, which provided potential targets for interventions to reduce hypoglycemia fear and improve the quality of life in T2DM patients with hypoglycemia.
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Affiliation(s)
- Chao Wu
- Nursing Department, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Wenwen Wang
- Department of Medical Statistics, School of Preventive Medicine, Air Force Medical University, Xi'an, China
| | - Sizhe Cheng
- Department of Military Medical Psychology, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Hongli Zhang
- Nursing Department, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Lu Li
- Department of Anesthesia Intensive Care Unit, Tangdu Hospital of Air Force Military Medical University, Xi'an, Shaanxi, China
| | - Ci Tian
- Cardio-Thoracic Surgery, The 305th Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Linyuan Zhang
- Nursing Department, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China
| | - Nana Chen
- Department of Otolaryngology, Army Hospital of the Seventy-seventh Group, Jiajiang, Sichuan, China
| | - Juan Du
- Nursing Department, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China.
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China.
| | - Hongjuan Lang
- Nursing Department, Air Force Medical University, No.169 Changle West Road, Xi'an, Shaanxi, 710032, China.
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Celeghin A, Palermo S, Giampaolo R, Di Fini G, Gandino G, Civilotti C. Brain Correlates of Eating Disorders in Response to Food Visual Stimuli: A Systematic Narrative Review of FMRI Studies. Brain Sci 2023; 13:brainsci13030465. [PMID: 36979275 PMCID: PMC10046850 DOI: 10.3390/brainsci13030465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
This article summarizes the results of studies in which functional magnetic resonance imaging (fMRI) was performed to investigate the neurofunctional activations involved in processing visual stimuli from food in individuals with anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). A systematic review approach based on the PRISMA guidelines was used. Three databases—Scopus, PubMed and Web of Science (WoS)—were searched for brain correlates of each eating disorder. From an original pool of 688 articles, 30 articles were included and discussed. The selected studies did not always overlap in terms of research design and observed outcomes, but it was possible to identify some regularities that characterized each eating disorder. As if there were two complementary regulatory strategies, AN seems to be associated with general hyperactivity in brain regions involved in top-down control and emotional areas, such as the amygdala, insula and hypothalamus. The insula and striatum are hyperactive in BN patients and likely involved in abnormalities of impulsivity and emotion regulation. Finally, the temporal cortex and striatum appear to be involved in the neural correlates of BED, linking this condition to use of dissociative strategies and addictive aspects. Although further studies are needed, this review shows that there are specific activation pathways. Therefore, it is necessary to pay special attention to triggers, targets and maintenance processes in order to plan effective therapeutic interventions. Clinical implications are discussed.
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Affiliation(s)
- Alessia Celeghin
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Sara Palermo
- Department of Psychology, University of Turin, 10124 Turin, Italy
- Neuroradiology Unit, Department of Diagnostic and Technology, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Giulia Di Fini
- Department of Psychology, University of Turin, 10124 Turin, Italy
| | | | - Cristina Civilotti
- Department of Psychology, University of Turin, 10124 Turin, Italy
- Faculty of Educational Science, Salesian University Institute (IUSTO), 10155 Turin, Italy
- Correspondence:
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Nicholas JK, Cusack CE, Levinson CA. Eating Disorder Symptom and Fear Change Trajectories During Imaginal Exposure Therapy: A Slope Network Analysis. Behav Ther 2023; 54:346-360. [PMID: 36858764 DOI: 10.1016/j.beth.2022.09.006] [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: 04/25/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 11/25/2022]
Abstract
Eating disorders (EDs) are characterized by fears related to food, body image, and social evaluation. Exposure-based interventions hold promise for targeting a range of ED fears and reducing ED psychopathology. We investigated change mechanisms and optimal fear targets in imaginal exposure therapy for EDs using a novel approach to network analysis. Individuals with an ED (N = 143) completed up to four online imaginal exposure sessions. Participants reported ED symptoms and fears at pretreatment, posttreatment, and 6-month follow-up. We constructed networks of symptoms (Model 1), fears (Model 2), and combined symptoms and fears (Model 3). Change trajectory networks from the slopes of symptoms/fears across timepoints were estimated to identify how change in specific ED symptoms/fears related to change in other ED symptoms/fears. The most central changing symptoms and fears were feeling fat, fear of weight gain, guilt about one's weight/shape, and feared concerns about consequences of eating. In Model 3, change in ED fears bridged to change in desire to lose weight, desiring a flat stomach, following food rules, concern about eating with others, and guilt. As slope networks present averages of symptom/fear change slopes over the course of imaginal exposure therapy, further studies are needed to examine causal relationships between symptom changes and heterogeneity of change trajectories. Fears of weight gain and consequences of eating may be optimal targets for ED exposure therapy, as changes in these fears were associated with maximal change in ED pathology. Slope networks may elucidate change mechanisms for EDs and other psychiatric illnesses.
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Comorbidity of posttraumatic stress disorder and depression among adolescents following an earthquake: A longitudinal study based on network analysis. J Affect Disord 2023; 324:354-363. [PMID: 36586597 DOI: 10.1016/j.jad.2022.12.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/15/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND High comorbidity between posttraumatic stress disorder (PTSD) and depression among adolescents often follows severe traumatic events. Models on the pathway to comorbidity dispute greatly and how PTSD and depression get comorbidity, remain unclear. METHODS A follow-up investigation was conducted of 424 adolescent survivors of the Jiuzhaigou earthquake at 12 months (T1) and 27 months (T2). RESULTS Contemporaneous network analysis and cross-lagged panel network analysis showed that PTSD and depression are two separate disorders with strong associations via links between dysphoric symptoms of PTSD and somatic or non-somatic symptoms of depression. However, the association weakened from T1 to T2, and internal connections between symptoms within each disorder became stronger. LIMITATION We only measured the comorbidity of PTSD and depression at two time points following the earthquake, which may limit the long-term applicability of our findings following trauma. CONCLUSIONS The findings also showed that the centrality in contemporaneous networks may indicate node connectivity rather than the influence or potential causality among nodes. These results help to elucidate the relationship between PTSD and depression and could contribute to the development of appropriate therapies.
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Cui J, Zhu K, Wen J, Nie W, Wang D. The relationship between moral judgment ability, parenting style, and perfectionism in obsessive-compulsive disorder patients: A mediating analysis. Front Psychol 2023; 14:1133880. [PMID: 36923138 PMCID: PMC10009154 DOI: 10.3389/fpsyg.2023.1133880] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
Introduction Guilt is an important part of obsessive-compulsive disorder. The abnormal moral cognition of obsessive-compulsive disorder patients may be closely related to their high level of guilt. The purpose of this study was to explore the development level of moral judgment in patients with obsessive-compulsive disorder and the role of parenting style and perfectionism in moral judgment development. Method A cross-sectional study was conducted in the clinical psychology department of a Class III hospital in Beijing. The patients with obsessive-compulsive disorder were recruited, and the healthy control subjects were recruited at the same time. Questionnaires were used to collect data, including the Yale-Brown Compulsion Scale, the Moral Judgment Test, the Parenting Style Evaluation Scale, and the Frost Multidimensional Perfectionism Scale. Result A total of 231 patients with obsessive-compulsive disorder and 246 healthy controls were included. The results showed that, first, the obsessive-compulsive group scored significantly lower on moral judgment than the healthy control group. Second, the tendency of non-adaptive perfectionism was significantly higher in the obsessive-compulsive group than in the healthy control group. Third, parents' excessive control, denial, punishment, and other parenting styles and non-adaptive perfectionism are higher than those of healthy people. Fourthly, the mother of obsessive-compulsive disorder patients is overly interference and protective. Rejection, denial, punishment, harshness, and father's rejection and denial play a partial mediating role in moral judgment ability through the degree of non-adaptive perfectionism. Conclusion The development level of moral judgment ability of patients with obsessive-compulsive disorder was significantly lower than that of the normal group, and the level of non-adaptive perfectionism was significantly higher than that of the normal group. Parents of obsessive-compulsive patients use more high-pressure control education. Parenting style partially affects the moral judgment of obsessive-compulsive patients through the degree of non-adaptive perfectionism.
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Affiliation(s)
- Jiacheng Cui
- Department of Applied Psychology, Binzhou Medical University, Yantai, China
| | - Kongmei Zhu
- Third Hospital of Beijing Chaoyang, Beijing, China
| | - Jianglin Wen
- Department of Applied Psychology, Binzhou Medical University, Yantai, China
| | - Wanjie Nie
- Department of Applied Psychology, Binzhou Medical University, Yantai, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chaoyang Hospital, Beijing, China
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Jiao K, Chow AY. The connections of physical and psychosocial symptoms among patients with terminal illnesses: A network analysis. Palliat Med 2023; 37:120-130. [PMID: 36474334 DOI: 10.1177/02692163221128452] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with terminal illnesses have different symptoms. The goal of palliative care is to alleviate the suffering induced by these symptoms. Available research on symptoms has focused on their prevalence or identification of clusters. Little is known about the central symptoms contributing to the maintenance of the whole system of symptoms or the mechanism of influence between symptoms, particularly between physical and psychosocial symptoms. AIM The study used network analysis to explore symptom clusters among patients with terminal illnesses and identify the central symptoms, the bridge symptoms, and pathways between physical and psychosocial symptoms. DESIGN AND SETTING/PARTICIPANTS This is a retrospective cohort study using baseline symptom assessment of 677 adults with terminal illnesses receiving care from the Integrated Community End-of-Life Care Support Teams. RESULTS Three symptom clusters were identified: physical, psychological, and practical clusters. "Weakness or lack of energy" was identified as the crucial symptom affecting the changes of other symptoms, followed by depression and anxiety. Three connections between the psychological and physical symptoms were identified: anxiety-pain, depression-constipation, and perceived family anxiety-poor appetite pathways. Pathways of practical concern-peace and practical concern-depression were indicated between practical and psychological symptoms. CONCLUSIONS This study is the first of its kind to investigate the connections and mechanism of influence between symptoms among patients with terminal illnesses. It offers clear pathways for intervention with the most influential symptoms of weakness, anxiety, and depression.
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Affiliation(s)
- Keyuan Jiao
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Amy Ym Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Jockey Club End-of-Life Community Care Project, The University of Hong Kong, Hong Kong SAR, China
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Laufer S, Herman E, Serfaty D, Latzer Y, Ashkenazi R, Attias O, Oren S, Shimomi M, Uziel M, Enoch-Levy A, Witztum E, Stein D. Case report: Anorexia nervosa and unspecified restricting-type eating disorder in Jewish ultra-orthodox religious males, leading to severe physical and psychological morbidity. Front Psychiatry 2023; 14:966935. [PMID: 37181911 PMCID: PMC10172673 DOI: 10.3389/fpsyt.2023.966935] [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: 06/11/2022] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Background Young Jewish Ultra-Orthodox women usually show less disturbances in body image and eating in comparison to less religious communities. By contrast, problems with eating are highly unknown and unrecognized in Jewish Ultra-Orthodox males. Aim To investigate whether in Ultra-Orthodox males, restricting-type AN (AN-R) with highly obsessional physical activity and unspecified restricting eating disorder (ED) in the context of obsessive-compulsive disorder (OCD) would lead to severe physical and emotional morbidity. Results The study included two groups: the first, 3 adolescents with AN-R developing severely increased ritualized obsessional physical activity in addition to restricting eating, requiring inpatient treatment because of severe bradycardia. These youngsters ignored the severity of their obsessional physical activity, continuing with it in hospital despite their grave medical condition. One student began extensive training for triathlon, whereas another student, upon remitting from AN, developed severe muscle dysmorphia. These findings suggest that young Ultra-Orthodox males with AN may develop obsessional physical activity to increase their muscle mass rather than to lose weight Another four Jewish Ultra-Orthodox males developed malnutrition in the context of severe OCD, with no evidence of dieting or body-image disturbances. These individuals developed highly obsessional adherence to different Jewish religious rules, including prolonged praying, asceticism, and overvalued strict adherence to Jewish Kashrut rules of eating, leading in all cases to severe food restriction. They were highly unaware of their severe weight loss and required hospitalization because of severe physical disturbances associated with malnutrition. Moreover, most did not cooperate with their treatment, and their ED-related obsessionality was mostly resistant to psychopharmacotherapy. Conclusion Owing to their highly ritualistic rigid way of life, combined with the need for excellency in studying, Jewish Ultra-Orthodox adolescent males with AN might be at a specific risk of developing severe physical disturbances if their illness is associated with highly perfectionistic obsessional physical activity. Second, Jewish Ultra-Orthodox religious males with OCD might be at a specific risk for severe undernutrition, as their rigid relentless observance of Jewish everyday laws might highly interfere with their eating.
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Affiliation(s)
- Sofia Laufer
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Estee Herman
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - David Serfaty
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Yael Latzer
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel
- Psychiatry Division, Rambam Health Care Campus, Eating Disorders Institution, Haifa, Israel
| | - Rachel Ashkenazi
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Orna Attias
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Sinai Oren
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Meirav Shimomi
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Moria Uziel
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
| | - Adi Enoch-Levy
- Eating Disorders Service for Children and Adolescents, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Eliezer Witztum
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Daniel Stein
- Department of Eating Disorders, Maayanei Hayeshuah Medical Center, Bnei Brak, Israel
- Eating Disorders Service for Children and Adolescents, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv, Israel
- *Correspondence: Daniel Stein,
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13
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The relationship between perfectionism and eating pathology: the mediating roles of body dissatisfaction and alexithymia. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04068-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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14
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Kinkel-Ram SS, Williams BM, Ortiz SN, Forrest L, Magee JC, Smith AR, Levinson CA. Testing intrusive thoughts as illness pathways between eating disorders and obsessive-compulsive disorder symptoms: a network analysis. Eat Disord 2022; 30:647-669. [PMID: 34711137 DOI: 10.1080/10640266.2021.1993705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Obsessive-compulsive disorder (OCD) and eating disorders (EDs) frequently co-occur. Intrusive thoughts are a mechanism that may maintain this comorbidity. This study used network analysis to identify central ED-related intrusive thoughts and tested which intrusive thoughts connected ED and OCD symptoms. Two cross-sectional graphical LASSO networks were computed using a sample of 353 non-clinical participants (mean age = 35.38, SD = 9.9, 40% female, 81.6% Caucasian) with elevated disordered eating symptoms. Model 1 included just ED-related intrusive thoughts, and Model 2 included ED-related intrusive thoughts, ED, and OCD symptoms. In Model 1, we found that thoughts about one's bodily appearance (i.e., looking horrible, getting fat, gaining weight) were most central. In Model 2, we found that desire to lose weight, eating in secret, and shape dissatisfaction were most central. We identified one illness pathway (i.e., difficulty concentrating due to thoughts of food/calories) connecting intrusive thoughts, ED symptoms, and OCD symptoms. However, intrusive thoughts did not bridge ED and OCD symptoms. Hence, we found some evidence that ED-related intrusive thoughts may contribute to ED and OCD symptoms based on thought content and frequency. However, other aspects of intrusive thoughts should be considered to ascertain whether they do in fact significantly contribute to ED and OCD comorbidity. Prevention efforts targeting ED-related intrusive thoughts may attenuate ED and OCD symptoms among subclinical individuals.
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Affiliation(s)
| | - Brenna M Williams
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - Lauren Forrest
- Department of Psychology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joshua C Magee
- Department of Psychology, Miami University, Oxford, Ohio, USA
| | - April R Smith
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| | - Cheri A Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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15
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Punzi C, Petti M, Tieri P. Network-based methods for psychometric data of eating disorders: A systematic review. PLoS One 2022; 17:e0276341. [PMID: 36315522 PMCID: PMC9621460 DOI: 10.1371/journal.pone.0276341] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Network science represents a powerful and increasingly promising method for studying complex real-world problems. In the last decade, it has been applied to psychometric data in the attempt to explain psychopathologies as complex systems of causally interconnected symptoms. One category of mental disorders, relevant for their severity, incidence and multifaceted structure, is that of eating disorders (EDs), serious disturbances that negatively affect a person's eating behavior. AIMS We aimed to review the corpus of psychometric network analysis methods by scrutinizing a large sample of network-based studies that exploit psychometric data related to EDs. A particular focus is given to the description of the methodologies for network estimation, network description and network stability analysis providing also a review of the statistical software packages currently used to carry out each phase of the network estimation and analysis workflow. Moreover, we try to highlight aspects with potential clinical impact such as core symptoms, influences of external factors, comorbidities, and related changes in network structure and connectivity across both time and subpopulations. METHODS A systematic search was conducted (February 2022) on three different literature databases to identify 57 relevant research articles. The exclusion criteria comprehended studies not based on psychometric data, studies not using network analysis, studies with different aims or not focused on ED, and review articles. RESULTS Almost all the selected 57 papers employed the same analytical procedures implemented in a collection of R packages specifically designed for psychometric network analysis and are mostly based on cross-sectional data retrieved from structured psychometric questionnaires, with just few exemptions of panel data. Most of them used the same techniques for all phases of their analysis. In particular, a pervasive use of the Gaussian Graphical Model with LASSO regularization was registered for in network estimation step. Among the clinically relevant results, we can include the fact that all papers found strong symptom interconnections between specific and nonspecific ED symptoms, suggesting that both types should therefore be addressed by clinical treatment. CONCLUSIONS We here presented the largest and most comprehensive review to date about psychometric network analysis methods. Although these methods still need solid validation in the clinical setting, they have already been able to show many strengths and important results, as well as great potentials and perspectives, which have been analyzed here to provide suggestions on their use and their possible improvement.
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Affiliation(s)
- Clara Punzi
- Data Science MSc Program, Sapienza University of Rome, Rome, Italy
| | - Manuela Petti
- DIAG Department of Computer, Control and Management Engineering, Sapienza University of Rome, Rome, Italy
- * E-mail:
| | - Paolo Tieri
- Data Science MSc Program, Sapienza University of Rome, Rome, Italy
- CNR National Research Council, IAC Institute for Applied Computing, Rome, Italy
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16
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Hambleton A, Pepin G, Le A, Maloney D, Touyz S, Maguire S. Psychiatric and medical comorbidities of eating disorders: findings from a rapid review of the literature. J Eat Disord 2022; 10:132. [PMID: 36064606 PMCID: PMC9442924 DOI: 10.1186/s40337-022-00654-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are potentially severe, complex, and life-threatening illnesses. The mortality rate of EDs is significantly elevated compared to other psychiatric conditions, primarily due to medical complications and suicide. The current rapid review aimed to summarise the literature and identify gaps in knowledge relating to any psychiatric and medical comorbidities of eating disorders. METHODS This paper forms part of a rapid review) series scoping the evidence base for the field of EDs, conducted to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded and released by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for English-language studies focused on the psychiatric and medical comorbidities of EDs, published between 2009 and 2021. High-level evidence such as meta-analyses, large population studies and Randomised Control Trials were prioritised. RESULTS A total of 202 studies were included in this review, with 58% pertaining to psychiatric comorbidities and 42% to medical comorbidities. For EDs in general, the most prevalent psychiatric comorbidities were anxiety (up to 62%), mood (up to 54%) and substance use and post-traumatic stress disorders (similar comorbidity rates up to 27%). The review also noted associations between specific EDs and non-suicidal self-injury, personality disorders, and neurodevelopmental disorders. EDs were complicated by medical comorbidities across the neuroendocrine, skeletal, nutritional, gastrointestinal, dental, and reproductive systems. Medical comorbidities can precede, occur alongside or emerge as a complication of the ED. CONCLUSIONS This review provides a thorough overview of the comorbid psychiatric and medical conditions co-occurring with EDs. High psychiatric and medical comorbidity rates were observed in people with EDs, with comorbidities contributing to increased ED symptom severity, maintenance of some ED behaviours, and poorer functioning as well as treatment outcomes. Early identification and management of psychiatric and medical comorbidities in people with an ED may improve response to treatment and overall outcomes.
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Affiliation(s)
- Ashlea Hambleton
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Genevieve Pepin
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, VIC, Australia
| | - Danielle Maloney
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Local Health District, Camperdown, NSW, Australia
| | | | - Stephen Touyz
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Local Health District, Camperdown, NSW, Australia
| | - Sarah Maguire
- InsideOut Institute, Central Clinical School, Faculty of Medicine and Health, Charles Perkins Centre (D17), University of Sydney, Camperdown, NSW, 2006, Australia.,Sydney Local Health District, Camperdown, NSW, Australia
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17
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Cui Y, Yang T, Gao H, Ren L, Liu N, Liu X, Zhang Y. The relationship between ego depletion and work alienation in Chinese nurses: A network analysis. Front Psychol 2022; 13:915959. [PMID: 35936327 PMCID: PMC9355549 DOI: 10.3389/fpsyg.2022.915959] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To investigate the network structure of ego depletion and work alienation in Chinese nurses and identify bridge items to provide suggestions to reduce ego depletion and work alienation. Methods A total of 353 nurses from three hospitals were enrolled in our cross-sectional study by convenience sampling from June to October 2021 in China. They completed an online survey, which included the Sociodemographic Questionnaire, Nurses’ Work Alienation Questionnaire, and Self-Regulating Fatigue Scale (SRF-S). The R packages qgraph, networktools, and bootnet were used to estimate the network model and calculate the indices. Results The correlation between ego depletion and work alienation was mainly positive. The correlation between “Sometimes I do not know what to do with the work instructions from my superiors” and “I have difficulties remembering things” was the strongest among the cross-community correlations (r = 0.14). The bridge strength centrality indices of “Sometimes I do not know what to do with the work instructions from my superiors,” “I always feel like a loser” and “I have difficulties remembering things” were the highest (z score = 3.15, 2.83, 1.43). The correlation stability coefficient of the centrality index was larger than 0.25. Conclusion Nurses’ ego depletion and work alienation are correlated. “Sometimes I do not know what to do with the work instructions from my superiors,” “I always feel like a loser” and “I have difficulties remembering things” act as bridges between ego depletion and work alienation communities, and should be the focus of nurses’ psychological tests. Our study provides potential targets for interventions to reduce work alienation from the perspective of ego depletion.
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Affiliation(s)
- Yi Cui
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Hui Gao
- Xi’an International Medical Center Hospital, Xi’an, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Na Liu
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
- *Correspondence: Xufeng Liu,
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi’an, China
- Yinling Zhang,
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18
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A network approach can improve eating disorder conceptualization and treatment. NATURE REVIEWS PSYCHOLOGY 2022; 1:419-430. [PMID: 36330080 PMCID: PMC9624475 DOI: 10.1038/s44159-022-00062-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Eating disorders are severe mental illnesses with the second highest mortality rate of all psychiatric illnesses. Eating disorders are exceedingly deadly because of their complexity. Specifically, eating disorders are highly comorbid with other psychiatric illnesses (up to 95% of individuals with an eating disorder have at least one additional psychiatric illness), have extremely heterogeneous presentations, and individuals often migrate from one specific eating disorder diagnosis to another. In this Perspective, we propose that understanding eating disorder comorbidity and heterogeneity via a network theory approach offers substantial benefits for both conceptualization and treatment. Such a conceptualization, strongly based on theory, can identify specific pathways that maintain psychiatric comorbidity, how diagnoses vary across individuals, and how specific symptoms and comorbidities maintain illness for one individual, thereby paving the way for personalized treatment.
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19
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Giles S, Hughes EK, Fuller‐Tyszkiewicz M, Treasure J, Fernandez‐Aranda F, Karwautz AFK, Wagner G, Anderluh M, Collier DA, Krug I. Bridging of childhood obsessive‐compulsive personality disorder traits and adult eating disorder symptoms: A network analysis approach. EUROPEAN EATING DISORDERS REVIEW 2022; 30:110-123. [DOI: 10.1002/erv.2885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/28/2021] [Accepted: 12/30/2021] [Indexed: 01/16/2023]
Affiliation(s)
- Sarah Giles
- Melbourne School of Psychological Sciences The University of Melbourne Melbourne Victoria Australia
| | - Elizabeth K. Hughes
- Melbourne School of Psychological Sciences The University of Melbourne Melbourne Victoria Australia
- Department of Paediatrics The University of Melbourne Melbourne Victoria Australia
- Centre for Adolescent Health Murdoch Children's Research Institute Melbourne Victoria Australia
| | - Matthew Fuller‐Tyszkiewicz
- School of Psychology Centre for Social and Early Emotional Development Deakin University Melbourne Victoria Australia
- School of Psychology Deakin University Geelong Victoria Australia
| | - Janet Treasure
- Department of Psychological Medicine King's College London Institute of Psychiatry and Neuroscience Section of Eating Disorders London UK
| | - Fernando Fernandez‐Aranda
- Instituto Salud Carlos III Ciber Fisiopatología Obesidad y Nutrición (CIBERobn) Barcelona Spain
- Department of Psychiatry University Hospital of Bellvitge Barcelona Spain
- Psychiatry and Mental Health Group Neuroscience Program Institut d’Investigació Biomèdica de Bellvitge ‐ IDIBELL L’Hospitalet de Llobregat Spain
- Department of Clinical Sciences School of Medicine and Health Sciences University of Barcelona Barcelona Spain
| | - Andreas F. K. Karwautz
- Department of Child and Adolescent Psychiatry Eating Disorders Unit Medical University of Vienna Vienna Austria
| | - Gudrun Wagner
- Department of Child and Adolescent Psychiatry Eating Disorders Unit Medical University of Vienna Vienna Austria
| | - Marija Anderluh
- Department of Child Psychiatry University Children's Hospital University Medical Centre Ljubljana Ljubljana Slovenia
| | - David A. Collier
- Department of Psychological Medicine King's College London Institute of Psychiatry and Neuroscience Section of Eating Disorders London UK
| | - Isabel Krug
- Melbourne School of Psychological Sciences The University of Melbourne Melbourne Victoria Australia
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20
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Reivan Ortiz GG, Rivera Tapia CJ, Elizalde Martínez BA, Icaza D. Mediating Mechanisms of Perfectionism: Clinical Comorbidity of OCD and ED. Front Psychiatry 2022; 13:908926. [PMID: 35911249 PMCID: PMC9329670 DOI: 10.3389/fpsyt.2022.908926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) and eating disorders (ED) share common causal factors and often represent similar entities. Studies on obsessive-compulsive disorders and eating disorders reveal a significant correlation between maladaptive perfectionism. The objective of this study is to evaluate the predictive variables of perfectionism in patients diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and OCD using a structural equation model (SEM). The sample consisted of 187 participants (60.9% women, 39.1% men) with a mean age of 26.68 (SD = 10.97). The findings reveal that the model is the same in all the disorders evaluated, achieving an adequate fit: χ2 = 7.95 (p = 0.000), RMSEA = 0.087 (95% confidence interval: 0.00 to 0.02), CFI = 0.991, TLI = 0.951 and with an overall predictive capacity of around 30% (CD = 0.318). It is recommended that future studies address the subtypes of disorders evaluated using longitudinal designs.
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Affiliation(s)
- Geovanny Genaro Reivan Ortiz
- Laboratory of Basic Psychology, Behavioral Analysis and Programmatic Development (PAD-LAB), Universidad Católica de Cuenca, Cuenca, Ecuador
| | | | | | - Daniel Icaza
- Laboratory of Basic Psychology, Behavioral Analysis and Programmatic Development (PAD-LAB), Universidad Católica de Cuenca, Cuenca, Ecuador
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21
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Unravelling the web of addictions: A network analysis approach. Addict Behav Rep 2022; 15:100406. [PMID: 35434247 PMCID: PMC9006673 DOI: 10.1016/j.abrep.2022.100406] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 12/31/2022] Open
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22
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Martini M, Marzola E, Brustolin A, Abbate-Daga G. Feeling imperfect and imperfectly feeling: A network analysis on perfectionism, interoceptive sensibility, and eating symptomatology in anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2021; 29:893-909. [PMID: 34510651 DOI: 10.1002/erv.2863] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE In recent years, the network analysis (NA) methodology has been applied to identify the central features of the psychopathology of anorexia nervosa (AN) and specific connections to previously recognized vulnerabilities. However, an NA investigating both multidimensional perfectionism and interoceptive sensibility in connection to eating symptomatology is currently missing. METHOD A total of 260 individuals (139 patients with AN, 121 healthy control individuals) completed the Frost Multidimensional Perfectionism Scale, the Multidimensional Assessment of Interoceptive Awareness and the Eating Disorders Inventory-2. Using state-of-the-art techniques, we estimated a main network with data from all participants and then compared the two separated networks. We checked the variables for empirical overlap through goldbricker, combined as suggested and implemented the empirical measure of the bridge nodes. RESULTS Ineffectiveness and need for control over self and body (resulting from combining Asceticism and Drive for Thinness) were the most central nodes, whereas perfectionistic evaluative concerns (resulting from combining Doubts about Actions and Concern over Mistakes) and mistrust in body sensations were the bridge nodes. No significant differences between the patient and control networks emerged. CONCLUSIONS Perfectionistic evaluative concerns and mistrust in body sensations could be key components in the relationships among perfectionism, interoceptive sensibility and eating symptomatology.
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Affiliation(s)
- Matteo Martini
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Enrica Marzola
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Annalisa Brustolin
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
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23
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Drakes DH, Fawcett EJ, Rose JP, Carter-Major JC, Fawcett JM. Comorbid obsessive-compulsive disorder in individuals with eating disorders: An epidemiological meta-analysis. J Psychiatr Res 2021; 141:176-191. [PMID: 34216946 DOI: 10.1016/j.jpsychires.2021.06.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/05/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
The present study aimed to provide a precise, meta-analytic estimate of the prevalence of obsessive-compulsive disorder (OCD) amongst those with a current primary eating disorder (ED) diagnosis, and to isolate its predictors. An online search of PubMed and PsycINFO was conducted with a Boolean search phrase incorporating keywords related to OCD, EDs, comorbidity, prevalence, and epidemiology, complemented by references coded from related review articles and contact with experts in the field. Articles were included if they (a) reported an observational study examining current ED diagnoses, (b) used a semi-structured or structured diagnostic interview for OCD and ED diagnosis, (c) applied DSM or ICD criteria, (d) included adolescent or adult samples (age > 12), (e) included patient or community samples, and (f) reported lifetime or current OCD comorbidity. From the 846 articles identified, 35 lifetime and 42 current estimates were calculated. OCD prevalence was extracted from each study for each ED diagnostic category, along with eleven additional potential moderators. Analyses revealed an aggregate lifetime OCD prevalence of 13.9% CI95% [10.4 to 18.1] and current OCD prevalence of 8.7% CI95% [5.8 to 11.8] across EDs. Moderator analyses revealed the prevalence of and risk for OCD in EDs to be greatest in anorexia nervosa binge-eating purging type (ANBP). Further, OCD is most prevalent amongst patient samples than samples recruited from the community.
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Affiliation(s)
- Dalainey H Drakes
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada.
| | - Emily J Fawcett
- Student Wellness and Counselling Centre, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Julia P Rose
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | - Jonathan M Fawcett
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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