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Terhoeven V, Faschingbauer S, Huber J, Simon JJ, Herzog W, Friederich HC, Nikendei C. Autobiographical memory following weight gain in adult patients with Anorexia Nervosa: A longitudinal study. EUROPEAN EATING DISORDERS REVIEW 2024; 32:809-823. [PMID: 38558236 DOI: 10.1002/erv.3091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/10/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Patients with anorexia nervosa (AN) show overgeneralization of memory (OGM) when generating autobiographical episodes related to food and body shape. These memories are central for the construction of a coherent self-concept, interpersonal relationships, and problem-solving abilities. The current study aims to investigate changes in autobiographical memory following weight gain. METHODS OGM was assessed with an adapted version of the Autobiographical Memory Test including food-, body-, depression-related, and neutral cues. N = 41 female patients with AN (28 restricting-, 13 binge-eating/purging-subtype; mean disease duration: 4.5 years; mean BMI: 14.5 kg/m2) and N = 27 healthy controls (HC) were included at baseline. After inpatient treatment (mean duration: 11 weeks), 24 patients with AN and 24 age-matched HC were reassessed. Group differences were assessed using independent samples t-tests for cross-sectional comparisons and repeated measures ANOVAs for longitudinal data. RESULTS At baseline, patients with AN generated significantly fewer specific memories than HC, independent of word category (F(1.66) = 27.167, p < 0.001). During inpatient stay, the average weight gain of patients with AN was 3.1 body mass index points. At follow-up, patients with AN showed a significant improvement in the number of specific memories for both depression-related and neutral cues, but not for food- and body-related cues. CONCLUSIONS Generalised OGM (i.e., independent of word category) in patients with AN before weight restoration may be a general incapacity to recall autobiographical memory. After weight gain, the previously well-studied pattern of eating disorder-related OGM emerges. The clinical relevance of the continuing disorder-related OGM in patients with AN after weight gain is discussed.
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Affiliation(s)
- Valentin Terhoeven
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Sandra Faschingbauer
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Huber
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Joe J Simon
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Wolfgang Herzog
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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Coutinho BDMC, Pariz CG, Krahe TE, Mograbi DC. Are you how you eat? Aspects of self-awareness in eating disorders. PERSONALITY NEUROSCIENCE 2024; 7:e9. [PMID: 38826820 PMCID: PMC11140494 DOI: 10.1017/pen.2024.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/15/2024] [Accepted: 04/13/2024] [Indexed: 06/04/2024]
Abstract
Eating disorders (ED) are severe psychiatric disorders characterized by dysfunctional behaviors related to eating or weight control, with profound impacts on health, quality of life, and the financial burden of affected individuals and society at large. Given that these disorders involve disturbances in self-perception, it is crucial to comprehend the role of self-awareness in their prevalence and maintenance. This literature review presents different self-awareness processes, discussing their functioning across different levels of complexity. By deconstructing this concept, we can gain a better understanding of how each facet of self and personality relates to the symptoms of these disorders. Understanding the absence or impairment of self-awareness in ED holds significant implications for diagnosis, treatment, and overall management. By recognizing and comprehending the characteristics of self-awareness, clinicians can develop tailored interventions and evidence-based treatments for individuals with ED. Furthermore, this narrative review underscores the importance of considering temperament and personality factors in the context of ED, as temperament traits and personality characteristics may interact with self-awareness processes, influencing the development and maintenance of ED. Ultimately, the results highlight the pressing need for further research on the development of effective interventions and support strategies grounded in the aspects of self-awareness mechanisms for individuals affected by these disorders.
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Affiliation(s)
- Bruna de Moura Cortes Coutinho
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro. Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP 22451-900, Brazil
| | - Caio Gomes Pariz
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro. Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP 22451-900, Brazil
| | - Thomas E. Krahe
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro. Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP 22451-900, Brazil
| | - Daniel C. Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro. Rua Marquês de São Vicente 225 Gávea, Rio de Janeiro, RJ CEP 22451-900, Brazil
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Psychology & Neuroscience, KCL, PO Box 078, De Crespigny Park, SE5 8AF, London, UK
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3
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von Spreckelsen P, Wessel I, Glashouwer KA, de Jong PJ. Repeated exposure to body-related memories in women with high body-related self-disgust: Impact on disgust, avoidance, and acceptance. Behav Res Ther 2024; 175:104496. [PMID: 38401244 DOI: 10.1016/j.brat.2024.104496] [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: 02/24/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
Disgust-based body image concerns can bias autobiographical memory towards the recall and avoidant processing of disgust-related memories of the own body. Repeated exposure to such memories may help breaking avoidance and promote the habituation of disgust, thereby lowering body concerns. Using a pre-post within-participant experimental design, we tested if repeatedly exposing women with high self-disgust (N = 61) to disgust-focused body memories vs. neutral memories led to changes in disgust, body acceptance, and reactive avoidance. Contrary to expectations, state disgust towards the body itself only decreased following exposure to neutral memories. Yet, disgust elicited by body-related memories decreased following both repeated exposure to neutral and body memories. Although acceptance was not found to significantly change in either exposure session, pre-post decreases in state disgust were associated with increases in acceptance following the disgust-focused exposure. In contrast to expectations, reactive avoidance increased from pre to post in the disgust-focused exposure. Overall, the results indicate that repeated exposure to disgust-focused body memories may help reduce disgust elicited by these memories and promote body acceptance. Yet, the effect of this repeated exposure to body memories did not extend to changing state disgust towards the body, possibly due to reactive avoidance.
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Affiliation(s)
- Paula von Spreckelsen
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands.
| | - Ineke Wessel
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands.
| | - Klaske A Glashouwer
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands; Department of Eating Disorders, Accare Child and Adolescent Psychiatry, Groningen, the Netherlands.
| | - Peter J de Jong
- University of Groningen, Department of Psychology (Expertise Group: Clinical Psychology and Experimental Psychopathology), Groningen, the Netherlands.
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Forester G, Johnson JS, Reilly EE, Lloyd EC, Johnson E, Schaefer LM. Back to the future: Progressing memory research in eating disorders. Int J Eat Disord 2023; 56:2032-2048. [PMID: 37594119 PMCID: PMC10843822 DOI: 10.1002/eat.24045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Human behaviors, thoughts, and emotions are guided by memories of the past. Thus, there can be little doubt that memory plays a fundamental role in the behaviors (e.g., binging), thoughts (e.g., body-image concerns), and emotions (e.g., guilt) that characterize eating disorders (EDs). Although a growing body of research has begun to investigate the role of memory in EDs, this literature is limited in numerous ways and has yet to be integrated into an overarching framework. METHODS In the present article, we provide an operational framework for characterizing different domains of memory, briefly review existing ED memory research within this framework, and highlight crucial gaps in the literature. RESULTS We distinguish between three domains of memory-episodic, procedural, and working-which differ based on functional attributes and underlying neural systems. Most recent ED memory research has focused on procedural memory broadly defined (e.g., reinforcement learning), and findings within all three memory domains are highly mixed. Further, few studies have attempted to assess these different domains simultaneously, though most behavior is achieved through coordination and competition between memory systems. We, therefore, offer recommendations for how to move ED research forward within each domain of memory and how to study the interactions between memory systems, using illustrative examples from other areas of basic and clinical research. DISCUSSION A stronger and more integrated understanding of the mechanisms that connect memory of past experiences to present ED behavior may yield more comprehensive theoretical models of EDs that guide novel treatment approaches. PUBLIC SIGNIFICANCE Memories of previous eating-related experiences may contribute to the onset and maintenance of eating disorders (EDs). However, research on the role of memory in EDs is limited, and distinct domains of ED memory research are rarely connected. We, therefore, offer a framework for organizing, progressing, and integrating ED memory research, to provide a better foundation for improving ED treatment and intervention going forward.
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Affiliation(s)
- Glen Forester
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Jeffrey S. Johnson
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Erin E. Reilly
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - E. Caitlin Lloyd
- Columbia University Irving Medical Center, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Emily Johnson
- Department of Psychology, North Dakota State University, Fargo, North Dakota, USA
| | - Lauren M. Schaefer
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
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Wallis DJ, Moss J, Varnam B, Dritschel B, Ridout N. Autobiographical memory specificity and restrained eating: examining the influence of priming with images of healthy and unhealthy foods. Eat Weight Disord 2023; 28:53. [PMID: 37341829 DOI: 10.1007/s40519-023-01577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/24/2022] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Dietary restraint has been linked to deficits in the ability to recall detailed memories of personally experienced events (referred to as autobiographical memory specificity). As priming with healthy foods increases the salience of restraint it would be expected to lead to greater deficits in memory specificity. OBJECTIVE To determine if priming word cues with images of healthy or unhealthy foods would influence the specificity of memory retrieval, and if deficits in memory specificity would be more evident in those reporting higher levels of dietary restraint, or currently dieting. METHODS Sixty female undergraduates self-reported if they were currently dieting and completed measures of mood, restraint, and disinhibition, and a modified version of the autobiographical memory task. Participants were presented with positive and negative words (unrelated to eating concerns) and asked to retrieve a specific memory in response to each cue. A food image was shown prior to each word cue; half of the participants were primed with images of healthy foods and half with images of unhealthy foods. RESULTS As expected, participants primed with healthy foods retrieved fewer specific memories than did those primed with unhealthy foods. However, neither restraint nor current dieting behaviour was associated with memory specificity. CONCLUSIONS Differences in memory specificity between the priming conditions cannot be explained in terms of increased salience of restraint. However, it is plausible that unhealthy images led to an increase in positive affect, which in turn improved memory specificity. LEVEL OF EVIDENCE Level I: Evidence obtained from: at least one properly designed experimental study.
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Affiliation(s)
- Deborah J Wallis
- School of Applied Social Sciences, De Montfort University, Leicester, LE1 9BH, UK
- School of Social Sciences, Birmingham City University, Birmingham, B4 7BD, UK
| | - Jessica Moss
- School of Applied Social Sciences, De Montfort University, Leicester, LE1 9BH, UK
| | - Bethany Varnam
- School of Applied Social Sciences, De Montfort University, Leicester, LE1 9BH, UK
| | - Barbara Dritschel
- School of Psychology, University of St Andrews, St Andrews, KY16 9BU, UK
| | - Nathan Ridout
- School of Psychology, College of Health and Life Sciences, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
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Terhoeven V, Nikendei C, Faschingbauer S, Huber J, Young KD, Bendszus M, Herzog W, Friederich HC, Simon JJ. Neurophysiological correlates of disorder-related autobiographical memory in anorexia nervosa. Psychol Med 2023; 53:844-854. [PMID: 34140047 DOI: 10.1017/s003329172100221x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by an overgeneralization of food/body-related autobiographical memories (AM). This is regarded as an emotion regulation strategy with adverse long-term effects implicated in disorder maintenance and treatment resistance. Therefore, we aimed to examine neural correlates of food/body-related AM-recall in AN. METHODS Twenty-nine female patients with AN and 30 medication-free age-sex-matched normal-weight healthy controls (HC) underwent functional magnetic resonance imaging while recalling AMs in response to food/body-related and neutral cue words. To control for general knowledge retrieval, participants engaged in a semantic generation and riser detection task. RESULTS In comparison to HC, patients with AN generated fewer and less specific AMs in response to food/body-related words, but not for neutral cue words. Group comparisons revealed reduced activation in regions associated with self-referential processing and memory retrieval (precuneus and angular gyrus) during the retrieval of specific food/body-related AM in patients with AN. Brain connectivity in regions associated with memory functioning and executive control was reduced in patients with AN during the retrieval of specific food/body-related AM. Finally, resting-state functional connectivity analysis revealed no differences between groups, arguing against a general underlying disconnection of brain networks implicated in memory and emotional processing in AN. CONCLUSIONS These results indicate impaired neural processing of food/body-related AM in AN, with a reduced involvement of regions involved in self-referential processing. Our findings are discussed as possible neuronal correlates of emotional avoidance in AN and provide new insights of AN-pathophysiology underscoring the importance of targeting dysfunctional emotion regulation strategies during treatment.
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Affiliation(s)
- Valentin Terhoeven
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Sandra Faschingbauer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Huber
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Kymberly D Young
- The Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martin Bendszus
- Department of Neuroradiology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Joe J Simon
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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Keeler JL, Konyn CY, Treasure J, Cardi V, Himmerich H, Tchanturia K, Mycroft H. "Your mind doesn't have room for anything else": a qualitative study of perceptions of cognitive functioning during and after recovery from anorexia nervosa. J Eat Disord 2022; 10:201. [PMID: 36575533 PMCID: PMC9793561 DOI: 10.1186/s40337-022-00723-6] [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: 09/13/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Past research has indicated the presence of cognitive difficulties in individuals with anorexia nervosa (AN), although it is unclear how these are experienced in real life. Moreover, it is unclear how and whether the experience of cognitive difficulties changes in nature and intensity over the course of the illness and following recovery. METHODS Twenty-one female participants (AN = 11; recovered AN = 10) participated in online semi-structured interviews, utilising open-ended questions and exploring topics relating to their experiences of their cognitive function, changes over time and their perspectives on the future. Reflexive thematic analysis was conducted on the resulting transcripts. RESULTS Six themes were identified, centred around the effects of the illness on mental and physical function, cognition, adaptation to living with the illness, similarities between AN and other psychopathology, tentative optimism for the future and recovery as a representation of liberation. Whilst respondents with AN appeared to perform remarkably well in their professional and educational lives, the cognitive difficulties were described as significantly impacting their ability to engage in life, particularly in the context of leisure and socialising. Respondents recovered from AN noted the importance of developing a non-AN identity as well as better emotion-regulation skills as central to recovery. CONCLUSIONS Whilst people with AN may be able to adapt their lives to the demands of the illness, they report significant cognitive difficulties that interfere with their engagement in many aspects of daily life. This should be considered by professionals working in the clinical management of AN. Treatments focused on ameliorating cognitive difficulties, and promoting emotional regulation and identity in AN are warranted.
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Affiliation(s)
- Johanna Louise Keeler
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, Section of Eating Disorders, London, SE5 8AF, UK.
| | - Carol Yael Konyn
- Department of Social, Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, Section of Eating Disorders, London, SE5 8AF, UK.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Valentina Cardi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, Section of Eating Disorders, London, SE5 8AF, UK.,Department of General Psychology, University of Padova, Padua, Italy
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, Section of Eating Disorders, London, SE5 8AF, UK.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 103 Denmark Hill, Section of Eating Disorders, London, SE5 8AF, UK.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK.,Illia State University, Tbilisi, Georgia.,Psychological Set Research and Correction Center, Tbilisi State Medical University, Tbilisi, Georgia
| | - Hazel Mycroft
- School of Psychology, University of Exeter, Exeter, Devon, UK
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Mariani R, Marini I, Di Trani M, Catena C, Patino F, Riccioni R, Pasquini M. Emotional dysregulation and linguistic patterns as a defining feature of patients in the acute phase of anorexia nervosa. Eat Weight Disord 2022; 27:3267-3277. [PMID: 35939211 PMCID: PMC9358383 DOI: 10.1007/s40519-022-01456-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/20/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE This research aims to analyze the relationship between emotional regulation and the symbolic process in autobiographical narratives of a group of individuals diagnosed with restrictive anorexia nervosa (AN), compared to a non-clinical group. The study is framed within multiple code theory (MCT) (Bucci, 1997; 2021), which considers mind-body integration. The purposes of this study are to investigate whether participants of the AN group will show greater alexithymia and emotional dysregulation than the non-clinical group; and whether the specific linguistic and symbolic features, such as somato-sensory words, affect words, and difficulty in the symbolizing process will predict the AN group. METHODS Twenty-nine female participants hospitalized with AN during an acute phase (mean age 19.8 ± 4.1) and 36 non-clinical female participants (mean age 21 ± 2.4) were selected through snow-ball sampling. The participants completed the Toronto Alexithymia Scale (TAS-20), the Profile of Mood of State (POMS), the Emotion Regulation Questionnaire (ERQ), and the Relationship Anecdotes Paradigm Interview (RAP). The RAP interview was audio-recorded and transcribed to apply the Referential Process (RP) Linguistic Measures. A T test for paired samples and a logistic binary regression was performed. RESULTS AN presented a significantly higher emotional dysregulation through the ERQ, TAS20 and POMS measures. Specifically, AN showed higher ER expression/suppression strategies, fewer functional cognitive strategies, higher alexithymia, and higher mood dysregulation. Specific linguistic features such as sensory-somatic, word affect, and difficulty in RP symbolizing predict the AN group (R2 = 0.349; χ2 = 27,929; df = 3; p = .001). CONCLUSIONS Emotional dysregulation is connected to AN symptoms and autobiographical narratives. The results can help a clinical assessment phase showing specific linguistic features in AN patients. LEVEL OF EVIDENCE Level II, controlled trial without randomization.
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Affiliation(s)
- Rachele Mariani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy.
| | - Isabella Marini
- Azienda Ospedaliera-Universitaria, Policlinico Umberto I, Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carlotta Catena
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Francesca Patino
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | | | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University, Rome, Italy
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Keeler JL, Peters-Gill G, Treasure J, Himmerich H, Tchanturia K, Cardi V. Difficulties in retrieving specific details of autobiographical memories and imagining positive future events in individuals with acute but not remitted anorexia nervosa. J Eat Disord 2022; 10:172. [PMID: 36401319 PMCID: PMC9675114 DOI: 10.1186/s40337-022-00684-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The factors that contribute to the maintenance of anorexia nervosa (AN) are not fully understood, although it is generally accepted that depression is a core feature and contributes to poor prognosis. Individuals with depression tend to have difficulties in producing specific details of autobiographical memories and future episodes. Our aim was to investigate autobiographical memory and episodic future thinking (EFT) in individuals with AN (n = 46), people recovered from AN (recAN; n = 40), and non-affected controls (n = 35). METHOD Using a remotely administered computerised version of the autobiographical memory test and episodic future thinking task, we measured six aspects of memory retrieval and EFT generation: specificity, detailedness, difficulty in remembering/imagining, positivity, vividness and realism. Memory and EFT cue valence was manipulated; cues were either positive, neutral, or disorder-related/negative. As the production of EFTs is theoretically linked to the ability to retrieve autobiographical memories, the relationship between autobiographical memory specificity and EFT specificity was explored. To investigate whether autobiographical memory and EFT performance were independent of performance on other forms of cognition, working memory, verbal fluency and cognitive flexibility were measured. RESULTS People with AN had difficulties retrieving specific details of autobiographical memories and rated autobiographical memories as less positive overall, and less vivid when primed by positive cues. People with a lifetime diagnosis (currently ill or recovered) reported greater difficulty in retrieving memories. The AN group generated less positive EFTs, particularly to positive and neutral cues. Comorbid depressive symptoms had some contribution to the observed findings. Lastly, in all groups autobiographical memory specificity predicted EFT specificity. DISCUSSION Problems with retrieving specific details of autobiographical memories and simulating positive EFTs may be a state feature of AN. Treatments targeted at alleviating depressive symptoms, as well those targeted towards facilitating memory retrieval or reconsolidation, and the construction of positive EFTs, may contribute to hope for recovery and strengthen the sense of self beyond the disorder.
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Affiliation(s)
- Johanna Louise Keeler
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.
| | | | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Hubertus Himmerich
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Kate Tchanturia
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK.,Illia State University, Tbilisi, Georgia.,Psychological Set Research and Correction Center, Tbilisi State Medical University, Tbilisi, Georgia
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 103 Denmark Hill, London, SE5 8AF, UK.,Department of General Psychology, University of Padova, Padua, Italy
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10
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Azzi V, Bianchi D, Pompili S, Laghi F, Gerges S, Akel M, Malaeb D, Obeid S, Hallit S. Emotion regulation and drunkorexia behaviors among Lebanese adults: the indirect effects of positive and negative metacognition. BMC Psychiatry 2022; 22:391. [PMID: 35689196 PMCID: PMC9185707 DOI: 10.1186/s12888-022-04030-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although metacognition processes are a core feature of restrictive eating and alcohol cravings and entail an individual to control both of his/her emotions and thoughts, yet, to our knowledge, a scarcity of research has examined their potential role in drunkorexia as cognitive and emotional predictors. The following study investigates the different associations between two emotion regulation strategies (i.e. emotional suppression and cognitive reappraisal) and drunkorexia behaviors in a sample of Lebanese adults, exploring the possible indirect effects of positive and negative alcohol-related metacognitions. METHODS This was a cross-sectional study that enrolled 335 participants (March-July 2021). RESULTS Higher problematic alcohol use (beta = 5.56), higher physical activity index (beta = 0.08), higher expressive suppression (beta = 0.23), higher negative metacognitive beliefs about cognitive harm due to drinking (beta = 0.75) and higher cognitive reappraisal (beta = 0.20) were significantly associated with more drunkorexic behaviors. The positive metacognitive beliefs about cognitive self-regulation significantly mediated the association between cognitive reappraisal and drunkorexia behaviors. Both the positive metacognitive beliefs about cognitive self-regulation and the negative metacognitive beliefs about the uncontrollability of drinking significantly mediated the association between expressive suppression and drunkorexia behaviors. CONCLUSION This study demonstrated that emotional and metacognitive processes are associated with drunkorexia, addressing as well the mediating effect between deficient emotional regulation and risky behavioral patterns. Overall, our results would speculate that the lack of emotional and cognitive assets might enhance internal distress perceived out of control, leading individuals to indulge in maladaptive behavioral patterns for managing the underlying impairment.
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Affiliation(s)
- Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Dora Bianchi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- School of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
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11
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Gandolphe MC, Nandrino JL, Hendrickx M, Willem C, Cottencin O, Gérardin P, Guardia D, Buttitta M, Zanini V, Dodin V. Specificity and wealth of autobiographical memories in restrictive and mixed anorexic patients. PLoS One 2021; 16:e0256959. [PMID: 34506532 PMCID: PMC8432787 DOI: 10.1371/journal.pone.0256959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/19/2021] [Indexed: 11/19/2022] Open
Abstract
The reduced specificity of positive and negative autobiographical memories observed in anorexic (AN) patients may reflect a global disturbance in their emotional information processing. However, their emotional difficulties may differ according to the subtype of AN, implying possible differences in the manifestation of autobiographical memory impairments. The aims of the study were (1) to confirm the autobiographical memory deficits in AN patients in terms of specificity and wealth of memories, and (2) to compare autobiographical deficits according to the AN subtype: restrictive type (AR) or binge/purging type (AB). Ninety-five non-clinical (NC) individuals and 95 AN patients including 69 AR and 22 AB patients were administered the Williams' and Scott's Autobiographical Memory Test. The results confirmed a lack of specificity regardless of emotional valence in the overall AN patient group without any distinction of subtype, which was linked to the number of hospitalizations. When the AN subtype was considered, AR patients demonstrated reduced specificity for negative memories only, suggesting differences in emotional functioning or in the mechanisms underlying reduced specificity between AR and AB patients. Furthermore, the overall AN group demonstrated lower variability and complexity in their memory content than the NC group. However, this difference in the complexity of recalled memories was only found in response to negative cues. When AN subtypes were considered, AR patients showed fewer complex memories than NC individuals. Beyond a reduced specificity, AN patients also depict a poverty in the range of event recall and a difficulty in developing narrative content. The clinical implications of such autobiographical memory deficits need to be further investigated.
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Affiliation(s)
- Marie-Charlotte Gandolphe
- Univ. Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences Affectives, F-59000, Lille, France
- * E-mail:
| | - Jean-Louis Nandrino
- Univ. Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences Affectives, F-59000, Lille, France
| | - Marion Hendrickx
- GHICL Service de Psychiatrie, Hôpital Saint-Vincent de Paul, Lille, France
| | - Clémence Willem
- Univ. Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences Affectives, F-59000, Lille, France
- Lille Catholic Hospital, Delegation for Clinical Research and Innovation, Lille, France
| | - Olivier Cottencin
- Service d’Addictologie, Hôpital Fontan 2, CHRU de Lille, Lille, France
| | - Priscille Gérardin
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Rouen, Rouen, France
| | - Dewi Guardia
- Clinique Lautréamont, Service de Psychiatrie de l’Adolescent, Loos, France
| | - Marie Buttitta
- Lille Catholic Hospital, Delegation for Clinical Research and Innovation, Lille, France
- Univ. Lille, PSITEC Lab EA 4072, Lille, France
| | - Virginie Zanini
- Service de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Rouen, Rouen, France
| | - Vincent Dodin
- GHICL Service de Psychiatrie, Hôpital Saint-Vincent de Paul, Lille, France
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12
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Tenconi E, Collantoni E, Meregalli V, Bonello E, Zanetti T, Veronese A, Meneguzzo P, Favaro A. Clinical and Cognitive Functioning Changes After Partial Hospitalization in Patients With Anorexia Nervosa. Front Psychiatry 2021; 12:653506. [PMID: 33959056 PMCID: PMC8093567 DOI: 10.3389/fpsyt.2021.653506] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction: Anorexia nervosa is usually associated with emotional and cognitive difficulties. Little knowledge is available about the changes in cognitive functioning in patients undergoing treatments. The aim of the present study was to longitudinally assess the impact of partial hospitalization on clinical and cognitive functioning in anorexia nervosa. Materials and Methods: 56 women with anorexia nervosa according to DSM-5 criteria and 58 healthy women were enrolled in the study. At baseline, all participants underwent clinical, diagnostic and neuropsychological assessment (T0). Patients were also assessed at the end of the treatment program (T1; n = 56). Results: BMI improved significantly throughout treatment. At baseline, patients showed significantly poorer executive abilities and less specific autobiographical memory. After the day-hospital program, decision-making abilities improved significantly. Response to treatment was predicted by BMI at admission and duration of illness, but neuropsychological performance did not contribute to the prediction model. Discussion: Cognitive difficulties, mostly regarding executive functions, resulted differently affected by clinical improvement. In particular, while cognitive monitoring and cognitive inhibition appear to be mostly stable trait-like characteristics, decision-making is both more state-dependent and sensitive to clinical status. None of the cognitive variables added information about the response to day hospital treatment; patients with short duration of illness and a rapidly decreasing BMI would benefit more from intensive interventions than less "acute" patients. These observations, if confirmed by future studies, have important clinical implications in order to understand the impact of malnutrition on cognitive functioning and to provide individualized effective treatment for patients with anorexia nervosa.
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Affiliation(s)
- Elena Tenconi
- Department of Neuroscience, University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| | | | - Valentina Meregalli
- Department of Neuroscience, University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Elisa Bonello
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Tatiana Zanetti
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Angela Veronese
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padua, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
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13
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Azzi V, Hallit S, Malaeb D, Obeid S, Brytek-Matera A. Drunkorexia and Emotion Regulation and Emotion Regulation Difficulties: The Mediating Effect of Disordered Eating Attitudes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052690. [PMID: 33800011 PMCID: PMC7967414 DOI: 10.3390/ijerph18052690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023]
Abstract
Drunorexia refers to food calorie intake restriction to prevent weight gain and the desire to enhance the more extensive intoxicating effects of alcohol. The present study aimed to investigate the association of drunkorexia with emotion regulation as well as emotion regulation difficulties across the Lebanese population, and assess disordered eating attitudes as a potential mediator of these relationships. The cross-sectional study enrolled participants (n = 258) from all Lebanese districts. The study was performed through an online survey based on a self-designed and structured questionnaire. The Drunkorexia Motives and Behaviors Scales (DMBS), the College Life Alcohol Salience Scale (CLASS), the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire (ERQ) and the Eating Attitudes Test (EAT-26) were used in the present study. The results showed that higher EAT-26 total scores (more disordered eating attitudes) (B = 0.16) and higher DERS-16 total score (B = 0.30) were significantly associated with more drunkorexia motives. Also, higher EAT-26 total scores (B = 0.09) and higher DERS-16 total score (B = 0.17) were significantly associated with more drunkorexia behaviors. In addition, higher EAT-26 total scores (B = 0.10) and higher DERS-26 total score (B = 0.36) were significantly associated with more drunkorexia fails. Furthermore, higher EAT-26 total scores (B = 0.07), and higher DERS-16 total score (B = 0.37) were significantly associated with more drunkorexia during an alcohol consumption event. Higher EAT-26 total scores (B = 0.09), and higher DERS-16 total score (B = 0.22) were significantly associated with more post-drinking compensation. Higher EAT-26 total scores (B = 0.21), higher DERS-16 total scores (B = 0.65) and higher emotion regulation (B = 0.33) were significantly associated with higher CLASS scores. The results showed that EAT-26 total scores partially mediated the association between DERS-16 total score and drunkorexia motives (25.20%), between DERS-16 total score and drunkorexia behaviors (25.16%), between DERS-16 total score and drunkorexia fails (106.87%), between DERS-16 total score and drunkorexia during an alcohol consumption event (11.84%), between DERS-16 total score and post-drinking compensation (22.55%), between ERQ total score and college life alcohol salience (8.35%) and between DERS-16 total score and college life alcohol salience (20.14%). This study highlighted that only emotional regulation difficulties were associated with drunkorexia, whereas emotional regulation was not significantly associated with such behavior.
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Affiliation(s)
- Vanessa Azzi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon;
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Correspondence: (S.H.); (A.B.-M.)
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut 1083, Lebanon;
| | - Sahar Obeid
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut 6573-14, Lebanon;
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh 446, Lebanon
| | - Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Dawida 1, 50-527 Wroclaw, Poland
- Correspondence: (S.H.); (A.B.-M.)
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14
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Psychological characteristics and eating attitudes in adolescents with drunkorexia behavior: an exploratory study. Eat Weight Disord 2020; 25:709-718. [PMID: 30888609 DOI: 10.1007/s40519-019-00675-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Drunkorexia represents an emerging phenomenon that is still understudied especially among adolescents. The present study aimed to investigate the relation between drunkorexia and psychological characteristics relevant and commonly associated with existing forms of eating disorders. METHODS The sample was composed of 849 adolescents (513 boys, 334 girls, 2 unknown; range 14-22) who completed a survey composed of Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale and Psychological scales of the Eating Disorders Inventory-3. RESULTS Our findings highlighted that drunkorexia was associated with low self-esteem, personal alienation, interoceptive deficits, emotional dysregulation, and asceticism. Hierarchical multiple regression analysis indicated that difficulties with emotion regulation and ascetic tendencies were significant predictors of drunkorexia among adolescents. CONCLUSIONS Our findings suggest the importance for programs preventing drunkorexia to be focused on training adolescents in using more adaptive strategies to manage emotions and accepting both emotional and physical signals without feeling guilty or threatened. LEVEL OF EVIDENCE Level V, descriptive study.
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15
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Castellon P, Sudres JL, Voltzenlogel V. Self-defining memories in female patients with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2020; 28:513-524. [PMID: 32363663 DOI: 10.1002/erv.2739] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/07/2020] [Accepted: 04/08/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Overgeneral autobiographical memory (AM) was reported in patients with anorexia nervosa (AN) using AM cueing tasks that did not directly indexes memories that are personally important to the individual, that is, self-defining memories (SDMs). The aim of this study is to investigate characteristics of SDMs in females with AN. METHOD A total of 46 outpatients with chronic AN and 52 healthy controls (HC) were asked to recall three SDMs. RESULTS Compared to HC, patients with AN presented less specific SDMs, but have preserved ability to give meaning to their memories. Patients' SDMs were associated with more negative emotions, more tension (i.e. explicit expression of discomfort, disagreement or unease) and more contamination (i.e. transformation in the memory narrative from a positive to a negative affective state). Content of SDMs differed between patients with AN and HC. Finally, no difference was found in SDMs characteristics between the two subtypes of anorexia nervosa (restricting type and binge eating / purging type). DISCUSSION Patients with AN recalled overgeneral SDMs with negative content and emotions. In this context, a clinical intervention based on SDMs together with cognitive and emotional remedial therapies could help patients with AN to improve emotion processing and redefine their identity in a more positive way.
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Affiliation(s)
- Pascaline Castellon
- CERPPS, EA 7411, Department of Psychology, University of Toulouse, Toulouse, France
| | - Jean-Luc Sudres
- CERPPS, EA 7411, Department of Psychology, University of Toulouse, Toulouse, France.,Castelviel Psychiatric Clinic, CLINEA, Castelmaurou, France
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16
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Nandrino JL, Doba K, Pezard L, Dodin V. Role of emotion regulation processes in the organization of autobiographical memories in patients with anorexia. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2013.09.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A deficit of emotional regulation is now classically described in the development and maintenance of eating disorders [4]. These difficulties in regulating emotional states are characterized by more limited access to emotion regulation strategies but also a predominant use of unsuitable ones such as avoidance, suppression and lack of flexibility (perseveration of emotional states) [1]. We assume that the use of these emotional strategies could lead to specific recall of autobiographical memories and so a specific construction of their life story and their identity. We showed in a first study [3], that the autobiographical memory of anorexic patients is characterized by an overgeneralization mechanism for both positive and negative memories. The use of such a cognitive avoidance strategy modifies the access to autobiographical emotional memories by retrieving positive or negative memories less specifically. Moreover, this impairment is reinforced by illness duration. In a second study [2], we studied the dynamics of emotions in anorexic patients’ autobiographical speech. The temporal pattern of emotional expression was studied in transforming the autobiographical narratives into symbolic sequences of positive, negative, and neutral emotional expressions. The computed dynamic indices showed in patients’ speech a cycle of negative emotions and silence. These results showed specific dynamics of emotional expression in persons with anorexia characterized by the presence of negative emotional perseveration. These changes in the processes of autobiographical memories organization support the hypothesis of changes in the construction of their identity. We present two methods for a psychotherapeutic work on the construction of autobiographical memory. A first one consists in programs stimulating the specific autobiographical memories by using olfactory or visual media, the other is focused on remediation methods seeking to modify the cognitive and emotional flexibility of these patients [5].
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17
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Verbal emotional expressiveness in women with eating disorders: recalling autobiographical memories. Eat Weight Disord 2019; 24:915-922. [PMID: 30382541 DOI: 10.1007/s40519-018-0604-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 10/21/2018] [Indexed: 02/02/2023] Open
Abstract
PURPOSE This study aimed to study autobiographical memories in women with eating disorders regarding emotional verbal expression, according to age. Our hypotheses are threefold: due to the emotional avoidance that occurs in women with eating disorders, in the younger ages, it was hypothesized that younger participants with anorexia and bulimia nervosa will present a lower number of emotional expressions in the descriptions of their memories than women without eating disorders; that older participants with anorexia and bulimia nervosa will present a greater number of negative verbal expressions in the reports of their memories than women without eating disorders, given the development of negative bias that occurs with age in women with eating disorders; and that women with eating disorders will use more words in a description of their sad memories than women without eating disorders because of the existence of negative bias. METHODS With a sample of 90 women and combining age and the presence or absence of eating disorders, we formed four groups. The task that they had to perform was to recall a sad and a happy life event. RESULTS The younger women used more words than the older women to describe their memories, and women with eating disorders used more words in their descriptions of the sad memories. However, there were no differences in terms of the number of positive and negative expressions. CONCLUSIONS Women with eating disorders exhibit higher levels of cognitive reappraisal and thus use more positive expressions and fewer negative expressions. LEVEL OF EVIDENCE Level V, Descriptive study.
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18
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Oldershaw A, Startup H, Lavender T. Anorexia Nervosa and a Lost Emotional Self: A Psychological Formulation of the Development, Maintenance, and Treatment of Anorexia Nervosa. Front Psychol 2019; 10:219. [PMID: 30886593 PMCID: PMC6410927 DOI: 10.3389/fpsyg.2019.00219] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022] Open
Abstract
In this paper, we argue that Anorexia Nervosa (AN) can be explained as arising from a 'lost sense of emotional self.' We begin by briefly reviewing evidence accumulated to date supporting the consensus that a complex range of genetic, biological, psychological, and socio-environmental risk and maintenance factors contribute to the development and maintenance of AN. We consider how current interventions seek to tackle these factors in psychotherapy and potential limitations. We then propose our theory that many risk and maintenance factors may be unified by an underpinning explanation of emotional processing difficulties leading to a lost sense of 'emotional self.' Further, we discuss how, once established, AN becomes 'self-perpetuating' and the 'lost sense of emotional self' relentlessly deepens. We outline these arguments in detail, drawing on empirical and neuroscientific data, before discussing the implications of this model for understanding AN and informing clinical intervention. We argue that experiential models of therapy (e.g., emotion-focused therapy; schema therapy) be employed to achieve emergence and integration of an 'emotional self' which can be flexibly and adaptively used to direct an individual's needs and relationships. Furthermore, we assert that this should be a primary goal of therapy for adults with established AN.
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Affiliation(s)
- Anna Oldershaw
- Salmons Centre for Applied Psychology, Canterbury Christ Church University, Canterbury, United Kingdom
- Kent and Medway All Age Eating Disorder Service, North East London NHS Foundation Trust, London, United Kingdom
| | - Helen Startup
- Sussex Eating Disorders Service and Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Tony Lavender
- Salmons Centre for Applied Psychology, Canterbury Christ Church University, Canterbury, United Kingdom
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19
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Mang L, Ridout N, Dritschel B. The influence of mood and attitudes towards eating on cognitive and autobiographical memory flexibility in female university students. Psychiatry Res 2018; 269:444-449. [PMID: 30195233 DOI: 10.1016/j.psychres.2018.08.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 05/13/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Abstract
Cognitive flexibility, as measured through set-shifting ability, appears to be impaired in patients with eating disorders (EDs). Thus, it is important to determine if the switching deficit seen in clinical eating disorders generalizes to participants with a subclinical disordered eating. Another deficit manifested by clinical and subclinical disordered eating is the ability to retrieve specific autobiographical memories. It is possible that deficits in autobiographical memory retrieval extends to the ability to shift between retrieving specific versus general autobiographical memory information, a function important for problem -solving and emotion regulation. Therefore, the aims of the present study were to determine whether deficits in set-shifting are evident in a non-clinical sample of female university students with eating concerns, and whether inflexibility is also manifested in autobiographical memory retrieval. Sixty-nine female undergraduate students completed a measure of autobiographical memory flexibility, a set-shifting task (Brixton Spatial Anticipation Test) and measures of mood, ruminative thinking, and eating habits. After controlling for mood and rumination, bulimic traits predicted set-shifting ability and flexibility in autobiographical memory retrieval. Thus, flexibility deficits appear to manifest at the subclinical level, are evident in different domains, and appear to be related to bulimic traits, such as binge eating.
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Affiliation(s)
- Luisa Mang
- School of Psychology and Neuroscience, University of St. Andrews, UK.
| | - Nathan Ridout
- Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK.
| | - Barbara Dritschel
- School of Psychology and Neuroscience, University of St. Andrews, UK.
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20
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Green ET, Venta A. Lack of implementation of eating disorder education and prevention programs in high schools: Data from incoming college freshmen. Eat Disord 2018; 26:430-447. [PMID: 29565723 DOI: 10.1080/10640266.2018.1453629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to examine the implementation of eating disorder education and prevention programs in high schools retrospectively, as reported by incoming college freshmen, exploring whether characteristics of the school influenced implementation. The sample, 169 first-year students from a public university, participated in an online survey inquiring about exposure to programs and high school characteristics. Results demonstrated few students exposed to any eating disorder programming (29.0%), with no students reporting exposure to prevention programming. Furthermore, there were no significant differences in the implementation based on school characteristics, suggesting that this is a universal issue across high schools.
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Affiliation(s)
- Emalee T Green
- a Department of Psychology and Philosophy , Sam Houston State University , Huntville , TX , USA
| | - Amanda Venta
- a Department of Psychology and Philosophy , Sam Houston State University , Huntville , TX , USA
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21
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González-Arias M, Martínez-Molina A, Galdames S, Urzúa A. Psychometric Properties of the 20-Item Toronto Alexithymia Scale in the Chilean Population. Front Psychol 2018; 9:963. [PMID: 29946289 PMCID: PMC6005868 DOI: 10.3389/fpsyg.2018.00963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/24/2018] [Indexed: 01/06/2023] Open
Abstract
Alexithymia can be defined as inability to identify and describe emotions in the self. Has shown to be related to several psychological and pathological processes that can result in unsatisfactory interpersonal relationships and decreased social adjustment. Advances in research of alexithymia require the development and validation of assessment instruments, and its application to different population. With this aim, we studied the psychometric properties of the Twenty-Item Toronto Alexithymia Scale (TAS-20) in Chilean population using various modeling procedures (e.g., CFA, ESEM) in different structures (i.e., Correlated, Unidimensional, Hierarchical or Wording factors). Among the 10 models tested, the four-dimensional structure offered the best fit but with item-loading problems in the last factor (Pragmatic Thinking). We suggest that the studied version of the scale needs improvement (theoretical and empirical) to ensure optimal indices of validation for Chilean population.
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Affiliation(s)
| | - Agustín Martínez-Molina
- Metodología de las Ciencias del Comportamiento, Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Alfonso Urzúa
- Psicología, Universidad Católica del Norte, Antofagasta, Chile
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22
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Pompili S, Laghi F. Drunkorexia among adolescents: The role of motivations and emotion regulation. Eat Behav 2018; 29:1-7. [PMID: 29413818 DOI: 10.1016/j.eatbeh.2018.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The co-occurrence of disordered eating and alcohol use and misuse has frequently been highlighted in literature. METHOD The first aim of the present study was to examine the association of drunkorexia with various disordered eating behaviors and alcohol consumption in a sample of male and female adolescents. The second goal was to investigate the motivations underlying drunkorexia and the third goal was to examine the relationship between drunkorexia and different dimensions of emotion regulation. One thousand adolescents (608 females and 392 males; range 16-21) completed a survey of self-report measures. RESULTS Results from hierarchical multiple regression analyses revealed that fasting and engaging in binge drinking and getting drunk were significant predictors of drunkorexia in both males and females; furthermore, females were found to engage in drunkorexia mainly for enhancement motives. Conversely, drunkorexia in males was significantly predicted by difficulties regulating emotions. CONCLUSION This research suggests that disordered eating and alcohol use similarly contribute to drunkorexia in male and female adolescents, even though highlights important gender differences.
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Affiliation(s)
- Sara Pompili
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy.
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23
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Nandrino JL, Gandolphe MC, El Haj M. Autobiographical memory compromise in individuals with alcohol use disorders: Towards implications for psychotherapy research. Drug Alcohol Depend 2017; 179:61-70. [PMID: 28756101 DOI: 10.1016/j.drugalcdep.2017.06.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 11/20/2022]
Abstract
It has been found that Autobiographical memory (i.e., memory for personal experiences and facts about the self) are not properly maintained in people with alcohol-use disorders (AUD). The present paper offers a comprehensive overview of findings regarding the consequences of AUD on autobiographical memory. More specifically, we offer a theoretical model (the AMAUD Autobiographical Memory and Alcohol Use Disorders model) according to which chronic alcohol consumption compromises emotion regulation as well as executive control, which maintains the construction of autobiographical memory. Compromises in emotional regulation and executive functioning can be linked to a weak aspiration to construct detailed memories (i.e., autobiographical overgenerality), compromises of subjective reliving, anterograde amnesia, negative self-defining memories, and a difficulty to mentally project oneself forward in time to generate complex autobiographical representations and self-images. By gathering cognitive and clinical aspects of autobiographical decline in AUD, this model constitutes a theoretical foundation that may lead to a better understanding of this decline. Different clinical perspectives are proposed for developing personalized autobiographical memory rehabilitation programs for individuals with AUD.
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Affiliation(s)
- Jean-Louis Nandrino
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
| | - Marie-Charlotte Gandolphe
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Mohamad El Haj
- Univ. Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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24
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Westwood H, Kerr-Gaffney J, Stahl D, Tchanturia K. Alexithymia in eating disorders: Systematic review and meta-analyses of studies using the Toronto Alexithymia Scale. J Psychosom Res 2017; 99:66-81. [PMID: 28712432 PMCID: PMC5986724 DOI: 10.1016/j.jpsychores.2017.06.007] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this review was to synthesise the literature on the use of the Toronto Alexithymia Scale (TAS) in eating disorder populations and Healthy Controls (HCs) and to compare TAS scores in these groups. METHOD Electronic databases were searched systematically for studies using the TAS and meta-analyses were performed to statistically compare scores on the TAS between individuals with eating disorders and HCs. RESULTS Forty-eight studies using the TAS with both a clinical eating disorder group and HCs were identified. Of these, 44 were included in the meta-analyses, separated into: Anorexia Nervosa; Anorexia Nervosa, Restricting subtype; Anorexia Nervosa, Binge-Purge subtype, Bulimia Nervosa and Binge Eating Disorder. For all groups, there were significant differences with medium or large effect sizes between the clinical group and HCs, with the clinical group scoring significantly higher on the TAS, indicating greater difficulty with identifying and labelling emotions. CONCLUSION Across the spectrum of eating disorders, individuals report having difficulties recognising or describing their emotions. Given the self-report design of the TAS, research to develop and evaluate treatments and clinician-administered assessments of alexithymia is warranted.
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Affiliation(s)
- Heather Westwood
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK.
| | - Jess Kerr-Gaffney
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK.
| | - Daniel Stahl
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Biostatistics, London, UK.
| | - Kate Tchanturia
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Psychological Medicine, London, UK; South London and Maudsley NHS Trust, National Eating Disorders Service, Psychological Medicine Clinical Academic Group, UK; Ilia State University, Tbilisi, Georgia.
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25
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Nandrino JL, Gandolphe MC. Characterization of Self-Defining Memories in Individuals with Severe Alcohol Use Disorders After Mid-Term Abstinence: The Impact of the Emotional Valence of Memories. Alcohol Clin Exp Res 2017; 41:1484-1491. [DOI: 10.1111/acer.13424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 05/22/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Jean-Louis Nandrino
- CNRS UMR 9193; SCALab; Université de Lille; Villeneuve d'Ascq France
- Clinique Medico-Psychologique; Fondation Santé des Etudiants de France; Villeneuve d'Ascq France
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26
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Bentz M, Jepsen JRM, Kjaersdam Telléus G, Moslet U, Pedersen T, Bulik CM, Plessen KJ. Neurocognitive functions and social functioning in young females with recent-onset anorexia nervosa and recovered individuals. J Eat Disord 2017; 5:5. [PMID: 28261479 PMCID: PMC5327534 DOI: 10.1186/s40337-017-0137-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/26/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Young individuals with anorexia nervosa (AN) or recovered from AN display impairments of social function. To date, however, it is not clear whether they differ from controls with respect to neurocognitive performance and whether those functions contribute to the compromised social function observed in individuals with AN. METHODS We included 43 young females with first-episode AN, 28 individuals recovered from adolescent-onset AN, and 41 control individuals (14-22 yr), all without comorbid autism spectrum disorder. We compared the performance of participants across groups in seven neurocognitive functions relevant to social functioning: set-shifting, local processing, processing speed, working memory, sustained attention, verbal memory, and verbal abstraction. Further, we tested the association between neurocognitive function and social function, measured by Autism Diagnostic Observation Schedule (ADOS), with an ordinal logistic regression model. RESULTS First, participants did not differ on any neurocognitive function across groups. Second, only the neurocognitive function "verbal memory" was significantly associated with social function. Higher performance in verbal memory was associated with lower odds of impaired social function. Diagnostic group remained a significant factor, but the absence of an interaction between group and neurocognitive performance indicated that the association between verbal memory and social function was independent of group membership. CONCLUSION Young individuals with AN and those recovered from AN did not differ from controls with respect to neurocognitive performance. Verbal memory was associated with social function in all groups.
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Affiliation(s)
- Mette Bentz
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Moellegaard Jepsen
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Psychiatric Center Glostrup, Glostrup, Denmark
| | - Gry Kjaersdam Telléus
- Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Ulla Moslet
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark
| | - Tine Pedersen
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Bispebjerg Bakke 30, 2400 København NV, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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27
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More emotional facial expressions during episodic than during semantic autobiographical retrieval. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2016; 16:374-81. [PMID: 26667366 DOI: 10.3758/s13415-015-0397-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is a substantial body of research on the relationship between emotion and autobiographical memory. Using facial analysis software, our study addressed this relationship by investigating basic emotional facial expressions that may be detected during autobiographical recall. Participants were asked to retrieve 3 autobiographical memories, each of which was triggered by one of the following cue words: happy, sad, and city. The autobiographical recall was analyzed by a software for facial analysis that detects and classifies basic emotional expressions. Analyses showed that emotional cues triggered the corresponding basic facial expressions (i.e., happy facial expression for memories cued by happy). Furthermore, we dissociated episodic and semantic retrieval, observing more emotional facial expressions during episodic than during semantic retrieval, regardless of the emotional valence of cues. Our study provides insight into facial expressions that are associated with emotional autobiographical memory. It also highlights an ecological tool to reveal physiological changes that are associated with emotion and memory.
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28
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D'Agata F, Caroppo P, Amianto F, Spalatro A, Caglio MM, Bergui M, Lavagnino L, Righi D, Abbate-Daga G, Pinessi L, Mortara P, Fassino S. Brain correlates of alexithymia in eating disorders: A voxel-based morphometry study. Psychiatry Clin Neurosci 2015; 69:708-16. [PMID: 25967072 DOI: 10.1111/pcn.12318] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 04/24/2015] [Accepted: 05/11/2015] [Indexed: 01/14/2023]
Abstract
AIMS Alexithymia is a personality trait that consists of difficulty in identifying and acknowledging one's own and others' feelings. Recent studies reported that alexithymia is present in both anorexia (AN) and bulimia nervosa (BN). Brain morphological studies on healthy subjects showed that alexithymia correlates with several brain regions involved in emotions processing. The aim of this study was to investigate the anatomical correlates of alexithymia in AN and BN. METHODS We performed a voxel-based morphometry study on 21 patients with AN and 18 with BN. Seventeen healthy subjects were used as a control group. Alexithymia, depression and anxiety were assessed with self-administered questionnaires and correlated to gray matter (GM) density in each group. RESULTS In BN, alexithymia was correlated with the GM of the parietal lobe, in particular of the right angular gyrus. The correlation was predominantly linked with Difficulty Describing Feelings. In AN, we did not find correlations between GM and alexithymia. CONCLUSIONS In BN, our results support the hypothesis that this trait may represent a relevant pathogenic or maintenance factor that contributes to relational difficulties, present in this pathology. In AN, the lack of correlation between GM volume and alexithymia may be influenced by atrophy in several brain regions that in turn can be, as previously reported, a consequence of caloric restriction. Also, the nature of alexithymia may be different from that of BN and controls and this trait could be secondary to a psychopathologic process specific to AN.
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Affiliation(s)
| | - Paola Caroppo
- Department of Neuroscience, University of Turin, Turin, Italy.,Besta Neurological Institute, Milan, Italy
| | | | - Angela Spalatro
- Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Mauro Bergui
- Department of Neuroscience, University of Turin, Turin, Italy.,Radiology Section, AOU Città della Salute e della Scienza, Turin, Italy
| | - Luca Lavagnino
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center (UTHealth), Houston, USA
| | - Dorico Righi
- Radiology Section, AOU Città della Salute e della Scienza, Turin, Italy
| | | | - Lorenzo Pinessi
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Paolo Mortara
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Secondo Fassino
- Department of Neuroscience, University of Turin, Turin, Italy
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29
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Ridout N, Matharu M, Sanders E, Wallis DJ. The influence of eating psychopathology on autobiographical memory specificity and social problem-solving. Psychiatry Res 2015; 228:295-303. [PMID: 26144580 DOI: 10.1016/j.psychres.2015.06.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 05/27/2015] [Accepted: 06/07/2015] [Indexed: 11/15/2022]
Abstract
The primary aim was to examine the influence of subclinical disordered eating on autobiographical memory specificity (AMS) and social problem solving (SPS). A further aim was to establish if AMS mediated the relationship between eating psychopathology and SPS. A non-clinical sample of 52 females completed the autobiographical memory test (AMT), where they were asked to retrieve specific memories of events from their past in response to cue words, and the means-end problem-solving task (MEPS), where they were asked to generate means of solving a series of social problems. Participants also completed the Eating Disorders Inventory (EDI) and Hospital Anxiety and Depression Scale. After controlling for mood, high scores on the EDI subscales, particularly Drive-for-Thinness, were associated with the retrieval of fewer specific and a greater proportion of categorical memories on the AMT and with the generation of fewer and less effective means on the MEPS. Memory specificity fully mediated the relationship between eating psychopathology and SPS. These findings have implications for individuals exhibiting high levels of disordered eating, as poor AMS and SPS are likely to impact negatively on their psychological wellbeing and everyday social functioning and could represent a risk factor for the development of clinically significant eating disorders.
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Affiliation(s)
- Nathan Ridout
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK.
| | - Munveen Matharu
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Elizabeth Sanders
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, UK
| | - Deborah J Wallis
- Loughborough University Centre for Research into Eating Disorders, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
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30
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Huber J, Salatsch C, Ingenerf K, Schmid C, Maatouk I, Weisbrod M, Herzog W, Friederich HC, Nikendei C. Characteristics of Disorder-Related Autobiographical Memory in Acute Anorexia Nervosa Patients. EUROPEAN EATING DISORDERS REVIEW 2015; 23:379-89. [PMID: 26095135 DOI: 10.1002/erv.2379] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/28/2015] [Accepted: 05/24/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE First studies revealed overgeneral autobiographical memories in anorexia nervosa (AN) patients. The aim of the present study was to investigate frequency, generalization and valence of autobiographical memories in AN patients in response to eating disorder-related cue words. METHOD Autobiographical memory was examined in 21 AN patients and 21 healthy controls (HC) using a modified version of the Autobiographical Memory Test, incorporating body-related, food-related, perfectionism-related, depression-related and neutral cues. RESULTS Anorexia nervosa patients recalled fewer and more general autobiographical memories compared with HC. For eating disorder-related cues as against neutral ones, AN patients compared with HC showed fewer memories for food-related and body-related cues, an elevated overgeneralization for food-related cues, while the valence of the retrieved memories was more negative in response to body-related cues. DISCUSSION This study detects disorder-related autobiographical memory alterations in AN, which are intensified in response to symptom-related cues. The findings are discussed with regard to their maladaptive function in emotion regulation.
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Affiliation(s)
- Julia Huber
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Carmen Salatsch
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Katrin Ingenerf
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Carolin Schmid
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Matthias Weisbrod
- Department of General Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Germany
| | - Wolfgang Herzog
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, LVR-Clinic Essen, Clinics and Institute of the University Duisburg-Essen, Germany
| | - Christoph Nikendei
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Germany
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31
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Lavender JM, Wonderlich SA, Engel SG, Gordon KH, Kaye WH, Mitchell JE. Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clin Psychol Rev 2015; 40:111-22. [PMID: 26112760 DOI: 10.1016/j.cpr.2015.05.010] [Citation(s) in RCA: 307] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 04/10/2015] [Accepted: 05/31/2015] [Indexed: 12/14/2022]
Abstract
Several existing conceptual models and psychological interventions address or emphasize the role of emotion dysregulation in eating disorders. The current article uses Gratz and Roemer's (2004) multidimensional model of emotion regulation and dysregulation as a clinically relevant framework to review the extant literature on emotion dysregulation in anorexia nervosa (AN) and bulimia nervosa (BN). Specifically, the dimensions reviewed include: (1) the flexible use of adaptive and situationally appropriate strategies to modulate the duration and/or intensity of emotional responses, (2) the ability to successfully inhibit impulsive behavior and maintain goal-directed behavior in the context of emotional distress, (3) awareness, clarity, and acceptance of emotional states, and (4) the willingness to experience emotional distress in the pursuit of meaningful activities. The current review suggests that both AN and BN are characterized by broad emotion regulation deficits, with difficulties in emotion regulation across the four dimensions found to characterize both AN and BN, although a small number of more specific difficulties may distinguish the two disorders. The review concludes with a discussion of the clinical implications of the findings, as well as a summary of limitations of the existing empirical literature and suggestions for future research.
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Affiliation(s)
- Jason M Lavender
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA.
| | - Stephen A Wonderlich
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Scott G Engel
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Kathryn H Gordon
- North Dakota State University, Department of Psychology, Fargo, ND, USA
| | - Walter H Kaye
- University of California, San Diego School of Medicine, San Diego, CA, USA
| | - James E Mitchell
- Neuropsychiatric Research Institute, Fargo, ND, USA; University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
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32
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Mellemkjaer L, Papadopoulos FC, Pukkala E, Ekbom A, Gissler M, Christensen J, Olsen JH. Cancer Incidence among Patients with Anorexia Nervosa from Sweden, Denmark and Finland. PLoS One 2015; 10:e0128018. [PMID: 26000630 PMCID: PMC4441362 DOI: 10.1371/journal.pone.0128018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/21/2015] [Indexed: 11/30/2022] Open
Abstract
A diet with restricted energy content reduces the occurrence of cancer in animal experiments. It is not known if the underlying mechanism also exists in human beings. To determine whether cancer incidence is reduced among patients with anorexia nervosa who tend to have a low intake of energy, we carried out a retrospective cohort study of 22 654 women and 1678 men diagnosed with anorexia nervosa at ages 10-50 years during 1968-2010 according to National Hospital Registers in Sweden, Denmark and Finland. The comparison group consisted of randomly selected persons from population registers who were similar to the anorexia nervosa patients in respect to sex, year of birth and place of residence. Patients and population comparisons were followed for cancer by linkage to Cancer Registries. Incidence rate ratios (IRR) were estimated using Poisson models. In total, 366 cases of cancer (excluding non-melanoma skin cancer) were seen among women with anorexia nervosa, and the IRR for all cancer sites was 0.97 (95% CI = 0.87-1.08) adjusted for age, parity and age at first child. There were 76 breast cancers corresponding to an adjusted IRR of 0.61 (95% CI = 0.49-0.77). Significantly increased IRRs were observed for esophageal, lung, and liver cancer. Among men with anorexia nervosa, there were 23 cases of cancer (age-adjusted IRR = 1.08; 95% CI = 0.71-1.66). There seems to be no general reduction in cancer occurrence among patients with anorexia nervosa, giving little support to the energy restriction hypothesis.
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Affiliation(s)
- Lene Mellemkjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- * E-mail:
| | - Fotios C. Papadopoulos
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Anders Ekbom
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jane Christensen
- Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jørgen H. Olsen
- Research Management, Danish Cancer Society Research Center, Copenhagen, Denmark
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33
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Rhind C, Mandy W, Treasure J, Tchanturia K. An exploratory study of evoked facial affect in adolescent females with anorexia nervosa. Psychiatry Res 2014; 220:711-5. [PMID: 25130780 DOI: 10.1016/j.psychres.2014.07.057] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/04/2014] [Accepted: 07/24/2014] [Indexed: 11/25/2022]
Abstract
The aim of this exploratory study was to investigate facial affect in adolescent females with anorexia nervosa (AN). Evoked facial affect was recorded whilst AN and control participants (n=34) viewed emotional films. Significantly less facial affect was found in AN adolescents, despite reporting no differences in subjective emotion experience. These findings correspond with previous studies in adults with AN. Altered facial affect may impair interpersonal functioning and contribute to illness maintenance.
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Affiliation(s)
- Charlotte Rhind
- King׳s College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, UK.
| | - William Mandy
- University College London, Department of Health and Clinical Psychology, London, UK
| | - Janet Treasure
- King׳s College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, UK
| | - Kate Tchanturia
- King׳s College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, UK; South London and Maudsley NHS Trust, Eating Disorders National Service, London, UK; Tbilisi Illia University, Tbilisi, Georgia
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34
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Bomba M, Marfone M, Brivio E, Oggiano S, Broggi F, Neri F, Nacinovich R. Autobiographical memory in adolescent girls with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 22:479-86. [PMID: 25267565 DOI: 10.1002/erv.2321] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 08/26/2014] [Accepted: 09/02/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of the study is to investigate deficits in autobiographical memory in adolescents with anorexia nervosa (AN). METHODS Sixty female individuals with AN and 60 healthy volunteers with an age range of 11-18 years were enrolled. The Autobiographical Memory Test (AMT), the Eating Disorder Inventory-3, the Toronto Alexithymia Scale-20 for the evaluation of alexithymia and Children's Depression Inventory to evaluate depressive traits were administered. In addition to classical AMT words, we proposed seven experimental cues, chosen from words often used by individuals with eating disorders in daily life. RESULTS Girls with AN showed a massive overgeneral memory effect. This effect was not related to the presence of depression or alexithymia but increased with the duration of the disorder rather than with its severity. DISCUSSION The alteration of autobiographical memory manifests in adolescence. Girls with AN showed a dysregulation of both negative and positive emotional experiences that seemed to be influenced by the disease duration.
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Affiliation(s)
- Monica Bomba
- Department of Child and Adolescent Psychiatry, San Gerardo Hospital, Monza, Italy; Department of Surgery and Translational Medicine, University of Milano-Bicocca, Italy
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35
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Riva G. Out of my real body: cognitive neuroscience meets eating disorders. Front Hum Neurosci 2014; 8:236. [PMID: 24834042 PMCID: PMC4018545 DOI: 10.3389/fnhum.2014.00236] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 04/01/2014] [Indexed: 12/15/2022] Open
Abstract
Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models—the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory—identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies—body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric).
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Affiliation(s)
- Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano Milan, Italy ; Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
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36
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Caglar-Nazali HP, Corfield F, Cardi V, Ambwani S, Leppanen J, Olabintan O, Deriziotis S, Hadjimichalis A, Scognamiglio P, Eshkevari E, Micali N, Treasure J. A systematic review and meta-analysis of ‘Systems for Social Processes’ in eating disorders. Neurosci Biobehav Rev 2014; 42:55-92. [PMID: 24333650 DOI: 10.1016/j.neubiorev.2013.12.002] [Citation(s) in RCA: 190] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 11/08/2013] [Accepted: 12/02/2013] [Indexed: 11/28/2022]
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37
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Brockmeyer T, Grosse Holtforth M, Bents H, Herzog W, Friederich HC. Lower body weight is associated with less negative emotions in sad autobiographical memories of patients with anorexia nervosa. Psychiatry Res 2013; 210:548-52. [PMID: 23850436 DOI: 10.1016/j.psychres.2013.06.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/11/2013] [Accepted: 06/12/2013] [Indexed: 11/25/2022]
Abstract
Food restriction and weight-loss have been proposed to represent pathogenic mechanisms of emotion regulation in anorexia nervosa (AN). However, there is a lack of studies empirically examining this hypothesis. Therefore, the present study compared 25 women with AN and 25 healthy control women (HC) regarding spontaneous emotional processing of autobiographic memories. Participants' idiographic memories of sad autobiographic events were analyzed using computerized, quantitative text analysis as an unobtrusive approach of nonreactive assessment. Compared to HC, AN patients retrieved more negative but a comparable number of positive emotions. Moreover, the lesser the body weight in AN patients, the lesser negative emotions they retrieved, irrespective of current levels of depressive symptoms and duration of illness. No such association was found in HC. These preliminary findings are in line with models of AN proposing that food restriction and weight-loss may be negatively reinforced by the alleviation of aversive emotional responses.
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Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; University of Heidelberg, Centre for Psychological Psychotherapy, Hauptstrasse 47-51, 69117 Heidelberg, Germany.
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Le récit de vie des patients souffrant de schizophrénie. Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Des troubles de l’identité personnelle sont décrits depuis longtemps dans la schizophrénie, or les mécanismes cognitifs de ces perturbations restent encore mal compris. Afin de mieux comprendre ces mécanismes, nous avons exploré la façon dont les patients souffrant de schizophrénie organisent le récit autobiographique de leur vie. Nous avons ainsi analysé la cohérence causale des récits de vie de patients en les comparant aux récits de sujets contrôles. Nos résultats montrent que les récits des patients contiennent moins de liens entre les événements qu’ils ont vécus et leur identité que les récits des sujets contrôles. De plus, ces liens correspondent davantage à des relations de causalité élémentaires et moins à des réflexions plus complexes reliant les événements vécus à l’identité, et les intégrant dans le contexte plus général de l’ensemble de la vie de l’individu. Ces éléments indiquent que la cohérence causale des récits des patients est diminuée. Nous avons enfin trouvé que la diminution de la cohérence des récits est corrélée positivement aux troubles exécutifs des patients. Ces résultats suggèrent que les troubles cognitifs présents dans la schizophrénie pourraient altérer la capacité des patients à établir des liens entre les événements marquants de leur vie et leur identité. Ces altérations pourraient rendre compte d’une construction défaillante de l’identité chez les patients et constituer une cible d’intervention thérapeutique spécifique.
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Gandolphe MC, Nandrino JL, Hancart S, Vosgien V. Autobiographical memory and differentiation of schematic models in substance-dependent patients. J Behav Ther Exp Psychiatry 2013; 44:114-21. [PMID: 22960708 DOI: 10.1016/j.jbtep.2012.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 07/11/2012] [Accepted: 07/30/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES This study aims at investigating reduced autobiographical memory specificity in substance-dependent patients. We examined whether this phenomenon is related to undifferentiated schematic models of self and to depression and anxiety levels. We also investigated the maintenance of these impairments after early clinical remission. METHODS Seventy-three dependent patients (including 30 active users, 23 methadone-maintained patients, 20 early abstinent patients) and 31 control participants were given Williams' and Scott's Autobiographical Memory Test (AMT) to evaluate the level of memory specificity. Depression and anxiety levels were assessed with the Hospital Anxiety and Depression Scale (HADS), and the ability of differentiation in affect-related schematic models of self with the Level of Emotional Awareness Scale (LEAS). RESULTS Dependent patients recall less specific memories than control individuals to the AMT. For all the participants, only the ability to differentiate emotional states predicts the level of specificity, whereas reduced specificity is not linked to depression and anxiety levels. The results also show that reduced specificity is still observable in methadone-maintained patients and in abstinent patients. LIMITATIONS Despite the absence of difference in the level of memory specificity in the three groups of dependent patients, we cannot state that reduced memory specificity is stable over time because non-active consumers may not remain in remission for a long period. CONCLUSIONS Only a lack of emotional differentiation seems to impede the access to specific memories in dependent patients and in general population. The reduced memory specificity observed in dependent patients seems to last after recent clinical improvement.
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Affiliation(s)
- Marie-Charlotte Gandolphe
- URECA, EA 1059, Staff FASE, Famille, Santé & Emotions, University of Lille North of France, Department of Psychology, B.P. 60149, F-59653 Villeneuve d'Ascq Cedex, France.
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Nowakowski ME, McFarlane T, Cassin S. Alexithymia and eating disorders: a critical review of the literature. J Eat Disord 2013; 1:21. [PMID: 24999402 PMCID: PMC4081716 DOI: 10.1186/2050-2974-1-21] [Citation(s) in RCA: 156] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 04/25/2013] [Indexed: 02/05/2023] Open
Abstract
Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.
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Affiliation(s)
- Matilda E Nowakowski
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
| | - Traci McFarlane
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada ; Eating Disorder Program, The Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Stephanie Cassin
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada
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Griffith JW, Sumner JA, Raes F, Barnhofer T, Debeer E, Hermans D. Current psychometric and methodological issues in the measurement of overgeneral autobiographical memory. J Behav Ther Exp Psychiatry 2012. [PMID: 23200427 DOI: 10.1016/j.jbtep.2011.05.008] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Autobiographical memory is a multifaceted construct that is related to psychopathology and other difficulties in functioning. Across many studies, a variety of methods have been used to study autobiographical memory. The relationship between overgeneral autobiographical memory (OGM) and psychopathology has been of particular interest, and many studies of this cognitive phenomenon rely on the Autobiographical Memory Test (AMT) to assess it. In this paper, we examine several methodological approaches to studying autobiographical memory, and focus primarily on methodological and psychometric considerations in OGM research. We pay particular attention to what is known about the reliability, validity, and methodological variations of the AMT. The AMT has adequate psychometric properties, but there is great variability in methodology across studies that use it. Methodological recommendations and suggestions for future studies are presented.
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Affiliation(s)
- James W Griffith
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N Michigan Ave, 27th Floor, Suite 2700, Chicago, IL 60610, USA.
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42
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Neuropsychology and anorexia nervosa. Cognitive and radiological findings. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2011.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Neuropsicología y anorexia nerviosa. Hallazgos cognitivos y radiológicos. Neurologia 2012; 27:504-10. [DOI: 10.1016/j.nrl.2011.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 07/15/2011] [Accepted: 08/26/2011] [Indexed: 12/28/2022] Open
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Zhu Y, Hu X, Wang J, Chen J, Guo Q, Li C, Enck P. Processing of Food, Body and Emotional Stimuli in Anorexia Nervosa: A Systematic Review and Meta-analysis of Functional Magnetic Resonance Imaging Studies. EUROPEAN EATING DISORDERS REVIEW 2012; 20:439-50. [PMID: 22945872 DOI: 10.1002/erv.2197] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Yikang Zhu
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy; University of Bonn; Bonn; Germany
| | - Jijun Wang
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Jue Chen
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Qian Guo
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Chunbo Li
- Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai; China
| | - Paul Enck
- Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy; University Hospital Tuebingen; Tuebingen; Germany
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Brockmeyer T, Holtforth MG, Bents H, Kämmerer A, Herzog W, Friederich HC. Starvation and emotion regulation in anorexia nervosa. Compr Psychiatry 2012; 53:496-501. [PMID: 22036318 DOI: 10.1016/j.comppsych.2011.09.003] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 09/12/2011] [Accepted: 09/14/2011] [Indexed: 10/15/2022] Open
Abstract
Self-starvation, with concomitant weight loss, may serve as a dysfunctional behavior to attenuate negative affective states in anorexia nervosa (AN). A total of 91 participants composed of patients with acute AN, women recovered from AN, clinical controls with either depression or anxiety disorder, and healthy controls were tested on a measure of emotion regulation. Patients with acute AN as well as recovered patients with AN and clinical controls showed increased emotion regulation difficulties as compared with healthy controls. In patients with acute AN, a specific association between body weight and emotion regulation was found: the lower the body mass index in patients with acute AN, the lesser were their difficulties in emotion regulation. This association could only be found in the subsample of patients with acute AN but not in the control groups. Moreover, there were no confounding effects of depression or duration of illness. The findings are consistent with the hypothesis that self-starvation with accompanying low body weight serves as a dysfunctional behavior to regulate aversive emotions in AN.
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Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
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Nandrino JL, Berna G, Hot P, Dodin V, Latrée J, Decharles S, Sequeira H. Cognitive and physiological dissociations in response to emotional pictures in patients with anorexia. J Psychosom Res 2012; 72:58-64. [PMID: 22200524 DOI: 10.1016/j.jpsychores.2011.11.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 10/27/2011] [Accepted: 11/02/2011] [Indexed: 01/21/2023]
Abstract
Recent studies suggest that patients with anorexia may express dissociated cognitive and physiological reactivities to emotional stimuli. The present research aimed to compare subjective and autonomic responses to pleasant, unpleasant and neutral scenes during a categorization task and an activation rating task in anorexic (AN), alexithymic (AL), depressed (DEP) and control participants (CONT). The participants first categorized pictures according to their emotional valence, followed by a rating of their activation level, concomitant with the recording of skin conductance responses (SCRs). Main findings showed that the AN patients presented major difficulty in categorizing pictures, particularly neutral ones. Contrary to the AL participants, this difficulty did not induce significant increases of SCR amplitude in the AN patients. In the second task, the AN patients rated the intensity of activation of unpleasant pictures higher than the AL participants and that of pleasant ones higher than the AL and CONT participants. In addition, no significant linear correlation was observed between the intensity of activation ratings and SCR amplitude in the AN, AL or DEP participants contrarily to what was observed for control participants. This lack of relation suggests a non-specific disconnection between physiological and cognitive self-reported responses to emotional stimuli. Our results highlight a specific form of emotional processing in the AN patients distinct from that observed in alexithymia or depression and characterized by a dissociation between cognitive and physiological responses. This kind of disconnection could be associated with emotional regulation processes and may benefit the AN patients by lowering the psychological stress response.
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Affiliation(s)
- Jean-Louis Nandrino
- URECA EA1059 Université Lille Nord de France, 59653 Villeneuve d'Ascq, France.
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Davies H, Swan N, Schmidt U, Tchanturia K. An Experimental Investigation of Verbal Expression of Emotion in Anorexia and Bulimia Nervosa. EUROPEAN EATING DISORDERS REVIEW 2011; 20:476-83. [DOI: 10.1002/erv.1157] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Helen Davies
- King's College; Division of Psychological Medicine and Psychiatry; Section of Eating Disorders; Institute of Psychiatry; London; UK
| | - Nicola Swan
- King's College; Division of Psychological Medicine and Psychiatry; Section of Eating Disorders; Institute of Psychiatry; London; UK
| | - Ulrike Schmidt
- King's College; Division of Psychological Medicine and Psychiatry; Section of Eating Disorders; Institute of Psychiatry; London; UK
| | - Kate Tchanturia
- King's College; Division of Psychological Medicine and Psychiatry; Section of Eating Disorders; Institute of Psychiatry; London; UK
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Haynos AF, Fruzzetti AE. Anorexia nervosa as a disorder of emotion dysregulation: Evidence and treatment implications. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1468-2850.2011.01250.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gandolphe MC, Nandrino JL. Stratégies de surgénéralisation des souvenirs autobiographiques chez les consommateurs de cannabis et les polyconsommateurs de substances psychoactives. Encephale 2011; 37:144-52. [DOI: 10.1016/j.encep.2010.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Accepted: 04/08/2010] [Indexed: 11/27/2022]
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