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Clemente-Suárez VJ, Ramírez-Goerke MI, Redondo-Flórez L, Beltrán-Velasco AI, Martín-Rodríguez A, Ramos-Campo DJ, Navarro-Jiménez E, Yáñez-Sepúlveda R, Tornero-Aguilera JF. The Impact of Anorexia Nervosa and the Basis for Non-Pharmacological Interventions. Nutrients 2023; 15:2594. [PMID: 37299557 PMCID: PMC10255390 DOI: 10.3390/nu15112594] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Anorexia nervosa is a psychiatric disorder with an unknown etiology that is characterized by an individual's preoccupation with their weight and body structure while denying the severity of their low body weight. Due to the fact that anorexia nervosa is multifaceted and may indicate the coexistence of genetic, social, hormonal, and psychiatric disorders, a description of non-pharmacological interventions can be used to ameliorate or reduce the symptoms of this condition. Consequently, the purpose of the present narrative review is to describe the profile's context in the anorexic person as well as the support they would require from their family and environment. In addition, it is aimed at examining preventative and non-pharmacological interventions, such as nutritional interventions, physical activity interventions, psychological interventions, psychosocial interventions, and physical therapy interventions. To reach the narrative review aims, a critical review was conducted utilizing both primary sources, such as scientific publications, and secondary sources, such as bibliographic indexes, web pages, and databases. Nutritional interventions include nutritional education and an individualized treatment for each patient, physical activity interventions include allowing patients to perform controlled physical activity, psychological interventions include family therapy and evaluation of the existence of other psychological disorders, psychosocial interventions include management of the relationship between the patient and social media and physical therapy interventions include relaxation massages and exercises to relieve pain. All these non-pharmacological interventions need to be individualized based on each patient's needs.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Maria Isabel Ramírez-Goerke
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain;
| | - Ana Isabel Beltrán-Velasco
- Psychology Department, Facultad de Ciencias de la Vida y la Naturaleza, Universidad Antonio de Nebrija, 28240 Madrid, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Rodrigo Yáñez-Sepúlveda
- Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile;
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (M.I.R.-G.); (J.F.T.-A.)
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Martínez-García C, Parra-Martínez C, Parra ÁT, Martínez-García TE, Alameda-Bailén JR. Iowa Gambling Task and Distortion in Perception of Body Image Among Adolescent Women With Eating Disorders. Front Psychol 2020; 11:2223. [PMID: 32982892 PMCID: PMC7488598 DOI: 10.3389/fpsyg.2020.02223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/10/2020] [Indexed: 11/13/2022] Open
Abstract
The Iowa gambling task (IGT) is an instrument for the neuropsychological evaluation of cognitive and emotional decision making (DM) processes that was created to test the somatic marker hypothesis (SMH) described by Damasio in 1994. It was initially applied to patients with frontal lobe lesions due to its association with executive functions but was subsequently used on patients with a variety of disorders. Although the DM process is inherently perceptual, few studies have applied the IGT to examine DM processes in patients with eating disorders (EDs), and even fewer have associated the IGT to the perceptual distortion of body image (PDBI) in this population. People diagnosed with ED exhibit heightened control over their somatic responses-for example, they can delay digestion for hours-and DM may be affected in this condition. This study compares the performance of two samples of adolescent women-hospitalized patients with ED, and healthy controls with similar demographic characteristics-on the IGT using body image as a possible factor in the SMH. Seventy-four women with a mean age of 14.97 years (SD = 2.347) participated. To analyze their body self-image, we used the figure-rating scale and compared the results with their body mass index (BMI). Correlations between indices of the IGT and distortion in body image were then explored. The results revealed significant differences between the groups in terms of evolving performance on the partial IGT. Patients with ED performed worse than their healthy counterparts in the last 40 trials and exhibited greater distortions in their body image, especially in terms of overestimation. Indices of these distortions were negatively correlated with the total IGT. These results are compatible with the SMH because they suggest that patients with ED evinced blindness with regard to the future, as described by their authors. In addition, a negative correlation was found between the IGT and PDBI, showing that a more distorted body image was associated with lower IGT, that is, more disadvantageous or riskier decisions were made by the subjects with more distortion.
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Affiliation(s)
- Concha Martínez-García
- Department of Developmental and Educational Psychology, University of Huelva, Huelva, Spain
| | - Cecilio Parra-Martínez
- Department of Chemistry, Faculty of Experimental Sciences, Research Center for Natural Resources, Health and the Environment (RENSMA), University of Huelva, Huelva, Spain
| | - Ángel T. Parra
- Department of Medicine, University of Seville, Seville, Spain
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Quiles Y, Quiles MJ, León E, Manchón J. Illness Perception in Adolescent Patients With Anorexia: Does It Play a Role in socio-Emotional and Academic Adjustment? Front Psychol 2020; 11:1730. [PMID: 32793063 PMCID: PMC7385588 DOI: 10.3389/fpsyg.2020.01730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/23/2020] [Indexed: 12/12/2022] Open
Abstract
People’s beliefs about their illness have been shown to affect their adjustment. The aim of this study was to describe illness perception in adolescent patients with anorexia nervosa (AN) and assess its relationship with socio-emotional and academic adjustment following Leventhal’s Self-Regulation Model. Thirty-four female AN patients, with a mean age of 15.76 (SD = 2.00), completed the Revised Illness Perception Questionnaire (IPQ-R), the Psychosocial Adjustment to Illness Scale (PAIS) and the Hospital Anxiety and Depression Scale (HAD). Adolescent anorexia patients perceived that they had control over their illness and treatment would improve their condition. However, they also believed that it was highly distressing, going to last a long time and would have serious consequences. As for the causes of the disorder, they were attributed primarily to a specific eating disorder and psychological factors. The results showed that anorexia patients’ illness perceptions were related to socio-emotional and academic adjustment. In this sense, identity with the illness was associated with a worse academic adjustment, while emotional representation was associated with a worse emotional and social adjustment. These findings highlight how important it is for patients’ beliefs about their disease to be considered in the treatment of anorexia. In this respect, clinicians treating these patients should consider how certain beliefs affect their academic and socio-emotional adjustment. It would be interesting for patients to become aware of how these beliefs influence the strategies they use to cope with their disease as well as their adjustment to it.
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Affiliation(s)
- Yolanda Quiles
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
| | - Maria José Quiles
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
| | - Eva León
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
| | - Javier Manchón
- Department of Behavioral Sciences and Health, Miguel Hernández University, Elche, Spain
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Zegarra-Valdivia JA, Chino-Vilca BN. Social Cognition and Executive Function Impairment in Young Women with Anorexia Nervosa. CLÍNICA Y SALUD 2018. [DOI: 10.5093/clysa2018a16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Paulukat L, Frintrop L, Liesbrock J, Heussen N, Johann S, Exner C, Kas MJ, Tolba R, Neulen J, Konrad K, Herpertz-Dahlmann B, Beyer C, Seitz J. Memory impairment is associated with the loss of regular oestrous cycle and plasma oestradiol levels in an activity-based anorexia animal model. World J Biol Psychiatry 2016; 17:274-84. [PMID: 27160428 DOI: 10.3109/15622975.2016.1173725] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Patients with anorexia nervosa (AN) suffer from neuropsychological deficits including memory impairments. Memory partially depends on 17β-oestradiol (E2), which is reduced in patients with AN. We assessed whether memory functions correlate with E2 plasma levels in the activity-based anorexia (ABA) rat model. METHODS Nine 4-week-old female Wistar rats were sacrificed directly after weight loss of 20-25% (acute starvation), whereas 17 animals had additional 2-week weight-holding (chronic starvation). E2 serum levels and novel object recognition tasks were tested before and after starvation and compared with 21 normally fed controls. RESULTS Starvation disrupted menstrual cycle and impaired memory function, which became statistically significant in the chronic state (oestrous cycle (P < 0.001), E2 levels (P = 0.011) and object recognition memory (P = 0.042) compared to controls). E2 reduction also correlated with the loss of memory in the chronic condition (r = 0.633, P = 0.020). CONCLUSIONS Our results demonstrate that starvation reduces the E2 levels which are associated with memory deficits in ABA rats. These effects might explain reduced memory capacity in patients with AN as a consequence of E2 deficiency and the potentially limited effectiveness of psychotherapeutic interventions in the starved state. Future studies should examine whether E2 substitution could prevent cognitive deficits and aid in earlier readiness for therapy.
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Affiliation(s)
- Lisa Paulukat
- a Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy , University Hospital Aachen, RWTH Aachen University , Aachen , Germany ;,b Institute of Neuroanatomy , RWTH Aachen University , Aachen , Germany
| | - Linda Frintrop
- b Institute of Neuroanatomy , RWTH Aachen University , Aachen , Germany
| | - Johanna Liesbrock
- a Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy , University Hospital Aachen, RWTH Aachen University , Aachen , Germany ;,b Institute of Neuroanatomy , RWTH Aachen University , Aachen , Germany
| | - Nicole Heussen
- c Department of Medical Statistics , University Hospital Aachen, RWTH Aachen University , Aachen , Germany
| | - Sonja Johann
- b Institute of Neuroanatomy , RWTH Aachen University , Aachen , Germany
| | - Cornelia Exner
- d Department of Animal Physiology , Philipps-University Marburg , Marburg , Germany
| | - Martien J Kas
- e Department of Translational Neuroscience, Brain Center Rudolf Magnus , University Medical Center Utrecht , Utrecht , the Netherlands
| | - Rene Tolba
- f Institute for Laboratory Animal Science and Experimental Surgery , University Hospital Aachen, RWTH Aachen University , Aachen , Germany
| | - Joseph Neulen
- g Department of Gynecological Endocrinology and Reproductive Medicine , University Hospital, RWTH Aachen University , Aachen , Germany
| | - Kerstin Konrad
- a Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy , University Hospital Aachen, RWTH Aachen University , Aachen , Germany
| | - Beate Herpertz-Dahlmann
- a Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy , University Hospital Aachen, RWTH Aachen University , Aachen , Germany
| | - Cordian Beyer
- b Institute of Neuroanatomy , RWTH Aachen University , Aachen , Germany
| | - Jochen Seitz
- a Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy , University Hospital Aachen, RWTH Aachen University , Aachen , Germany
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Oltra-Cucarella J, Espert R, Rojo L, Jacas C, Guillén V, Moreno S. Neuropsychological Impairments in Anorexia Nervosa: A Spanish Sample Pilot Study. APPLIED NEUROPSYCHOLOGY-ADULT 2013; 21:161-75. [DOI: 10.1080/09084282.2013.782030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Raul Espert
- a Unit of Neuropsychology , Hospital Clínico Universitario , Valencia , Spain
| | - Luís Rojo
- b Unit of Infant/Juvenile Psychiatry and Eating Disorders , Hospital Universitari y Politècnic La Fe , Valencia , Spain
| | - Carlos Jacas
- c Unit of Neuropsychology, Department of Psychiatry , Hospital Universitario Vall d'Hebrón , Barcelona , Spain
| | - Verónica Guillén
- d Faculty of Psychology , University of Valencia, and Unit of Eating Disorders, PREVI Center of Psychology , Valencia , Spain
| | - Sergio Moreno
- a Unit of Neuropsychology , Hospital Clínico Universitario , Valencia , Spain
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