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Kowalewska E, Bzowska M, Engel J, Lew-Starowicz M. Comorbidity of binge eating disorder and other psychiatric disorders: a systematic review. BMC Psychiatry 2024; 24:556. [PMID: 39138440 PMCID: PMC11323383 DOI: 10.1186/s12888-024-05943-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE Binge eating disorder (BED), although relatively recently recognized as a distinct clinical syndrome, is the most common eating disorder. BED can occur as a separate phenomenon or in combination with other mental disorders, adding to the overall burden of the illness. Due to the relatively short history of recognizing BED as a distinct disorder, this review aimed to summarize the current knowledge on the co-occurrence of BED with other psychiatric disorders. METHOD This review adhered to the PRISMA guidelines. Multiple databases, such as MEDLINE, MEDLINE Complete, and Academic Search Ultimate, were used to identify relevant studies. Of the 3766 articles initially identified, 63 articles published within the last 13 years were included in this review. This systematic review has been registered through INPLASY (INPLASY202370075). RESULTS The most frequently observed comorbidities associated with BED were mood disorders, anxiety disorders and substance use disorders. They were also related to more severe BED presentations. Other psychiatric conditions frequently associated with BED include reaction to severe stress and adjustment disorders, impulse control disorder, ADHD, personality disorders, behavioral disorders, disorders of bodily distress or bodily experience, and psychotic disorders. Additionally, BED was linked to suicidality and sleep disorders. DISCUSSION The findings highlight the interconnected nature of BED with various psychiatric conditions and related factors, shedding light on the complexity and broader impact of BED on mental health and the need for appropriate screening and appropriately targeted clinical interventions.
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Affiliation(s)
- Ewelina Kowalewska
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland.
| | - Magdalena Bzowska
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jannis Engel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Michał Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
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van Riel L, van den Berg E, Polak M, Geerts M, Peen J, Ingenhoven T, Dekker J. Exploring effectiveness of CBT in obese patients with binge eating disorder: personality functioning is associated with clinically significant change. BMC Psychiatry 2023; 23:136. [PMID: 36879204 PMCID: PMC9990274 DOI: 10.1186/s12888-023-04626-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Binge eating disorder (BED), as the most prevalent eating disorder, is strongly related to obesity and other somatic and psychiatric morbidity. Despite evidence-based treatments a considerable number of BED patients fail to recover. There is preliminary evidence for the association between psychodynamic personality functioning and personality traits on treatment outcome. However, research is limited and results are still contradictory. Identifying variables associated with treatment outcome could improve treatment programs. The aim of the study was to explore whether personality functioning or personality traits are associated with Cognitive Behavioral Therapy (CBT) outcome in obese female patients with BED or subthreshold BED. METHODS Eating disorder symptoms and clinical variables were assessed in 168 obese female patients with DSM-5 BED or subthreshold BED, referred to a 6-month outpatient CBT program in a pre-post measurement design. Personality functioning was assessed by the Developmental Profile Inventory (DPI), personality traits by the Temperament and Character Inventory (TCI). Treatment outcome was assessed by the Eating Disorder Examination-Questionnaire (EDE-Q) global score and self-reported binge eating frequency. According to the criteria of clinical significance, 140 treatment completers were categorized in four outcome groups (recovered, improved, unchanged, deteriorated). RESULTS EDE-Q global scores, self-reported binge eating frequency and BMI significantly decreased during CBT, where 44.3% of patients showed clinically significant change in EDE-Q global score. Treatment outcome groups showed significant overall differences on the DPI Resistance and Dependence scales and the aggregated 'neurotic' scale. Significant overall differences were found between groups on TCI Harm avoidance, although post hoc t-tests were non-significant. Furthermore, multiple logistic regression analysis, controlling for mild to moderate depressive disorder and TCI harm avoidance showed that 'neurotic' personality functioning was a significant negative predictor of clinically significant change. CONCLUSION Maladaptive ('neurotic') personality functioning is significantly associated with a less favorable outcome after CBT in patients with binge eating. Moreover, 'neurotic' personality functioning is a predictor of clinically significant change. Assessment of personality functioning and personality traits could support indication for more specified or augmented care, tailored towards the patients' individual strengths and vulnerabilities. TRIAL REGISTRATION This study protocol was retrospectively evaluated and approved on 16-06-2022 by the Medical Ethical Review Committee (METC) of the Amsterdam Medical Centre (AMC). Reference number W22_219#22.271.
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Affiliation(s)
- Laura van Riel
- Centre for Eating Disorders and Obesity, Novarum, Arkin Institute of Mental Health, Amsterdam, The Netherlands. .,Centre for Personality Disorders, NPI, Arkin Institute of Mental Health, Amsterdam, The Netherlands.
| | - Elske van den Berg
- Centre for Eating Disorders and Obesity, Novarum, Arkin Institute of Mental Health, Amsterdam, The Netherlands
| | - Marike Polak
- Department of Psychology, Education & Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Marjolein Geerts
- Centre for Eating Disorders and Obesity, Novarum, Arkin Institute of Mental Health, Amsterdam, The Netherlands
| | - Jaap Peen
- Department of Research, Arkin Institute of Mental Health, Amsterdam, The Netherlands
| | - Theo Ingenhoven
- Centre for Personality Disorders, NPI, Arkin Institute of Mental Health, Amsterdam, The Netherlands
| | - Jack Dekker
- Department of Research, Arkin Institute of Mental Health, Amsterdam, The Netherlands
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Legg NK, Turner BJ. Personality correlates of eating pathology severity and subtypes in The National Comorbidity Survey Adolescent Supplement. J Clin Psychol 2021; 77:189-210. [PMID: 32627202 PMCID: PMC7725846 DOI: 10.1002/jclp.23021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 05/30/2020] [Accepted: 06/11/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We examined how personality traits are associated with eating pathology (EP) across a range of severities and symptom subtypes. METHOD The National Comorbidity Survey Adolescent Supplement (N = 10,148) was used to compare personality across severities (i.e., clinical Eating Disorders [EDs], subclinical disordered eating, preclinical weight concerns, or no weight/EP [no W/EP]), subclinical subtypes (i.e., Binge Eating Only, Binge-Purge, Binge-Restrict, Restrict-Purge, or no W/EP), and clinical subtypes (i.e., Anorexia Nervosa [AN]), Bulimia Nervosa [BN], Binge Eating Disorder [BED], internalizing disorders, or no ED or internalizing disorder) of EP. RESULTS More severe EP was associated with more extreme personality trait endorsements. Impulsivity-related traits did not consistently distinguish binge eating/purging from restricting subtypes, although behavioral disinhibition differentiated adolescents with BN or BED from AN. CONCLUSION Personality traits related to affectivity and impulsivity were more consistently associated with severity rather than subtype of EP.
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Affiliation(s)
- Nicole K Legg
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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Personality Functioning in Obesity and Binge Eating Disorder: Combining a Psychodynamic and Trait Perspective. J Psychiatr Pract 2020; 26:472-484. [PMID: 33275384 DOI: 10.1097/pra.0000000000000513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE There is preliminary evidence for an association between personality traits and binge eating disorder (BED) in obese patients. In addition, recent studies have shown impaired psychodynamic personality functioning in BED. However, these results are partly inconsistent. The goal of this study was to explore and evaluate personality traits and personality functioning in obese patients with BED or subthreshold BED. Moreover, we aimed to explore the additional value of combined assessment of personality traits and personality functioning. METHODS Treatment-seeking obese female patients with BED (n=129) or subthreshold BED (n=91) were compared with obese (n=107) and nonobese (n=90) female community controls in terms of personality traits (using the Temperament and Character Inventory) and personality functioning (using the Developmental Profile Inventory) in univariate and multivariate analyses. RESULTS Harm Avoidance was higher and Self-Directedness was lower in obese patients with BED or subthreshold BED compared with obese and nonobese community controls. In addition, obese patients with BED or subthreshold BED presented more maladaptive and less adaptive personality functioning than controls. Although univariate analyses did not find significant differences in personality traits or personality functioning between obese patients with BED and those with subthreshold BED, when both personality traits and personality functioning were combined in multivariate analysis (data from both the Temperament and Character Inventory and Developmental Profile Inventory), obese patients with BED showed greater vulnerabilities in personality traits and functioning than obese patients with subthreshold BED. CONCLUSIONS Obese patients with BED or subthreshold BED had specific impairments in personality traits and personality functioning. Combined assessment indicated that patients with BED had the most vulnerable personality profile of the 4 groups. The results support the added value of assessment of both personality traits and psychodynamic personality functioning, in line with the alternative Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) model for personality disorders.
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Levallius J, Clinton D, Högdahl L, Norring C. Personality as predictor of outcome in internet-based treatment of bulimic eating disorders. Eat Behav 2020; 36:101360. [PMID: 31887560 DOI: 10.1016/j.eatbeh.2019.101360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023]
Abstract
Internet-based cognitive behavioral therapy (ICBT) for bulimic eating disorders has demonstrated clinical utility and cost efficiency, but is associated with low patient preference, low credibility, sizeable dropout and only moderate symptom reduction. To improve outcome it is imperative to learn more about who might benefit from internet-based interventions. To do this, the current study investigated the Five Factor Model of personality as predictor of outcome in patients with full or sub-threshold bulimia nervosa (n = 109). Patients in a randomized controlled trial of ICBT were assessed prior to and at the end of treatment. Patients showed significant symptom reduction over time (Cohen's d = 1.0, p < .001). Remission as well as overall symptom reduction was positively predicted by Openness to Experience and Conscientiousness. Binge eating cessation specifically, was positively predicted by Extraversion. The study supports the use of personality assessment for patient selection and outcome optimization in internet-based treatment of bulimic eating disorders.
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Affiliation(s)
- Johanna Levallius
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Eating Disorders Innovation, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - David Clinton
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Center for Eating Disorders Innovation, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute for Eating Disorders, Kruses gate 8, Oslo, Norway
| | - Louise Högdahl
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Claes Norring
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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MacNeill LP, Best LA, Davis LL. The role of personality in body image dissatisfaction and disordered eating: discrepancies between men and women. J Eat Disord 2017; 5:44. [PMID: 29075494 PMCID: PMC5648431 DOI: 10.1186/s40337-017-0177-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Body image and disordered eating research has focused mostly on the female experience. The present study examined gender differences in the relationship between personality, disordered eating, and body image dissatisfaction. METHODS Participants were 238 female and 85 male undergraduates (Mage = 20.52 years, SD = 4.22) at a Canadian university. Materials included a battery of self-report questionnaires pertaining to personality, body image, and disordered eating. RESULTS As expected, females reported more body dissatisfaction and disordered eating than males. Personality factors were found to be significantly related to the experience of body dissatisfaction in both genders. Further, several personality traits significantly contributed to the prediction of male (high Neuroticism, low Conscientiousness) and female (high Neuroticism) body dissatisfaction beyond the influence of body mass index (BMI). Interestingly, and contrary to findings with female participants, personality traits were not significantly related to disordered eating scores in men. Among women, disordered eating scores were significantly predicted by high Neuroticism and Extraversion, and low Conscientiousness. CONCLUSIONS Although the relationship between disordered eating, body image dissatisfaction, and personality is well-documented in females, this relation may differ for males. The focus on male body image has been increasing in Western society; exploring how males view their bodies may be beneficial to researchers and clinicians alike.
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Affiliation(s)
- L P MacNeill
- Deparment of Psychology, University of New Brunswick, Saint John, 100 Tucker Park Road, P.O. Box 5050, Saint John, NB E2L 4L5 Canada
| | - L A Best
- Deparment of Psychology, University of New Brunswick, Saint John, 100 Tucker Park Road, P.O. Box 5050, Saint John, NB E2L 4L5 Canada
| | - L L Davis
- Deparment of Psychology, University of New Brunswick, Saint John, 100 Tucker Park Road, P.O. Box 5050, Saint John, NB E2L 4L5 Canada
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Levallius J, Roberts BW, Clinton D, Norring C. Take charge: Personality as predictor of recovery from eating disorder. Psychiatry Res 2016; 246:447-452. [PMID: 27792973 DOI: 10.1016/j.psychres.2016.08.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/14/2016] [Accepted: 08/13/2016] [Indexed: 02/05/2023]
Abstract
Many treatments for eating disorders (ED) have demonstrated success. However, not all patients respond the same to interventions nor achieve full recovery, and obvious candidates like ED diagnosis and symptoms have generally failed to explain this variability. The current study investigated the predictive utility of personality for outcome in ED treatment. One hundred and thirty adult patients with bulimia nervosa or eating disorder not otherwise specified enrolled in an intensive multimodal treatment for 16 weeks. Personality was assessed with the NEO Personality Inventory Revised (NEO PI-R). Outcome was defined as recovered versus still ill and also as symptom score at termination with the Eating Disorder Inventory-2 (EDI-2). Personality significantly predicted both recovery (70% of patients) and symptom improvement. Patients who recovered reported significantly higher levels of Extraversion at baseline than the still ill, and Assertiveness emerged as the personality trait best predicting variance in outcome. This study indicates that personality might hold promise as predictor of recovery after treatment for ED. Future research might investigate if adding interventions to address personality features improves outcome for ED patients.
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Affiliation(s)
- Johanna Levallius
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
| | - Brent W Roberts
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - David Clinton
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Claes Norring
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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8
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Vroling MS, Wiersma FE, Lammers MW, Noorthoorn EO. Predicting Dropout from Intensive Outpatient Cognitive Behavioural Therapy for Binge Eating Disorder Using Pre-treatment Characteristics: A Naturalistic Study. EUROPEAN EATING DISORDERS REVIEW 2016; 24:494-502. [PMID: 27594180 DOI: 10.1002/erv.2474] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 07/19/2016] [Accepted: 08/01/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Dropout rates in binge eating disorder (BED) treatment are high (17-30%), and predictors of dropout are unknown. METHOD Participants were 376 patients following an intensive outpatient cognitive behavioural therapy programme for BED, 82 of whom (21.8%) dropped out of treatment. An exploratory logistic regression was performed using eating disorder variables, general psychopathology, personality and demographics to identify predictors of dropout. RESULTS Binge eating pathology, preoccupations with eating, shape and weight, social adjustment, agreeableness, and social embedding appeared to be significant predictors of dropout. Also, education showed an association to dropout. DISCUSSION This is one of the first studies investigating pre-treatment predictors for dropout in BED treatment. The total explained variance of the prediction model was low, yet the model correctly classified 80.6% of cases, which is comparable to other dropout studies in eating disorders. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Maartje S Vroling
- GGNet Amarum, Expert Centre for Eating Disorders, Zutphen/Nijmegen, the Netherlands. .,NijCare, Radboud University Nijmegen, Nijmegen, the Netherlands. .,Department of Clinical Psychology, Radboud University Nijmegen, Behavioral Science Institute, Nijmegen, the Netherlands.
| | - Femke E Wiersma
- GGNet Amarum, Expert Centre for Eating Disorders, Zutphen/Nijmegen, the Netherlands.,Department of Personality Disorders, Pro Persona Mental Health Care, Arnhem, the Netherlands
| | - Mirjam W Lammers
- GGNet Amarum, Expert Centre for Eating Disorders, Zutphen/Nijmegen, the Netherlands.,Department of Clinical Psychology, Radboud University Nijmegen, Behavioral Science Institute, Nijmegen, the Netherlands
| | - Eric O Noorthoorn
- GGNet, Training Centre for Psychiatrists Warnsveld, Warnsveld, the Netherlands.,Dutch Information Centre for Coercive Measures, Stichting Benchmark GGZ, Bilthoven, the Netherlands
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9
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Farstad SM, McGeown LM, von Ranson KM. Eating disorders and personality, 2004–2016: A systematic review and meta-analysis. Clin Psychol Rev 2016. [DOI: 10.1016/j.cpr.2016.04.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Amianto F, Ottone L, Abbate Daga G, Fassino S. Binge-eating disorder diagnosis and treatment: a recap in front of DSM-5. BMC Psychiatry 2015; 15:70. [PMID: 25885566 PMCID: PMC4397811 DOI: 10.1186/s12888-015-0445-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 03/18/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Binge Eating Disorders is a clinical syndrome recently coded as an autonomous diagnosis in DSM-5. Individuals affected by Binge Eating Disorder (BED) show significantly lower quality of life and perceived health and higher psychological distress compared to the non-BED obese population. BED treatment is complex due to clinical and psychological reasons but also to high drop-out and poor stability of achieved goals. The purpose of this review is to explore the available data on this topic, outlining the state-of-the-art on both diagnostic issues and most effective treatment strategies. METHODS We identified studies published in the last 6 years searching the MeSH Term "binge eating disorder", with specific regard to classification, diagnosis and treatment, in major computerized literature databases including: Medline, PubMed, PsychINFO and Science Direct. RESULTS A total of 233 studies were found and, among them, 71 were selected and included in the review. REVIEW Although Binge Eating Disorder diagnostic criteria showed empirical consistency, core psychopathology traits should be taken into account to address treatment strategies. The available body of evidence shows psychological treatments as first line interventions, even if their efficacy on weight loss needs further exploration. Behavioral and self-help interventions evidenced some efficacy in patients with lower psychopathological features. Pharmacological treatment plays an important role, but data are still limited by small samples and short follow-up times. The role of bariatric surgery, a recommended treatment for obesity that is often required also by patients with Binge Eating Disorder, deserves more specific studies. Combining different interventions at the same time does not add significant advantages, planning sequential treatments, with more specific interventions for non-responders, seems to be a more promising strategy. CONCLUSIONS Despite its recent inclusion in DSM-5 as an autonomous disease, BED diagnosis and treatment strategies deserve further deepening. A multidisciplinary and stepped-care treatment appears as a promising management strategy. Longer and more structured follow-up studies are required, in order to enlighten long term outcomes and to overcome the high dropout rates affecting current studies.
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Affiliation(s)
- Federico Amianto
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Luisa Ottone
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Giovanni Abbate Daga
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
| | - Secondo Fassino
- Department of Neurosciences, University of Torino, Psychiatric Clinic, Via Cherasco 11, 10126, Turin, Italy.
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Manjrekar E, Berenbaum H, Bhayani N. Investigating the moderating role of emotional awareness in the association between urgency and binge eating. Eat Behav 2015; 17:99-102. [PMID: 25679369 DOI: 10.1016/j.eatbeh.2015.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/26/2014] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
Binge eating has been found to be associated with urgency (the tendency to act impulsively in response to negative affect) and emotional awareness (i.e., attention to emotions, clarity of emotions). The present study tested the hypothesis that the relation between binge eating and urgency would be moderated by emotional awareness, over and above negative affect. Participants were 249 female college students. Items from the Trait Meta Mood Scale (TMMS), the Urgency subscale of the UPPS Impulsive Behavior Scale, and the Bulimia (B) subscale of the Eating Disorders Inventory (EDI-3) were administered. As predicted, emotional awareness moderated the link between urgency and binge eating. Both Urgency×Attention to emotions and Urgency×Clarity of emotions significantly predicted binge eating scores, even after taking into account negative affect. Consistent with past research, higher levels of urgency were associated with higher levels of binge eating, even after taking negative affect into account. However, the associations were particularly strong among individuals with low levels of attention to emotions and low levels of clarity of emotions. The findings from this study have implications for future research examining binge eating.
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Affiliation(s)
- Eishita Manjrekar
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel St., Champaign, IL 61820, USA.
| | - Howard Berenbaum
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel St., Champaign, IL 61820, USA
| | - Natasha Bhayani
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel St., Champaign, IL 61820, USA
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Lammers MW, Vroling MS, Ouwens MA, Engels RCME, van Strien T. Predictors of outcome for cognitive behaviour therapy in binge eating disorder. EUROPEAN EATING DISORDERS REVIEW 2015; 23:219-28. [PMID: 25802175 DOI: 10.1002/erv.2356] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 02/04/2015] [Accepted: 02/22/2015] [Indexed: 12/12/2022]
Abstract
The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N = 304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6 months later (N = 190). We assessed eating disorder psychopathology, general psychopathology, personality characteristics and demographic variables using self-report questionnaires. Treatment outcome was measured using the bulimia subscale of the Eating Disorder Inventory 1. Predictors were determined using hierarchical linear regression analyses. Several variables significantly predicted outcome, four of which were found to be both baseline predictors of treatment outcome and end-of-treatment predictors of follow-up: Higher levels of drive for thinness, higher levels of interoceptive awareness, lower levels of binge eating pathology and, in women, lower levels of body dissatisfaction predicted better outcome in the short and longer term. Based on these results, several suggestions are made to improve treatment outcome for BED patients.
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Affiliation(s)
- Mirjam W Lammers
- Amarum, Expertise Centre for Eating Disorders, GGNet Network for Mental Health Care, The Netherlands
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13
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Gerlach G, Herpertz S, Loeber S. Personality traits and obesity: a systematic review. Obes Rev 2015; 16:32-63. [PMID: 25470329 DOI: 10.1111/obr.12235] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/22/2014] [Accepted: 10/01/2014] [Indexed: 12/19/2022]
Abstract
Based on a bio-social-ecological systems model of the development and maintenance of obesity, there has been in the last few years a growing research interest in the association of obesity and personality traits. The aim of the present review was a comprehensive and critical evaluation of the existing literature taking into account the methodological quality of studies to enhance our understanding of personality traits associated with body weight, the development of overweight and obesity as well as the effectiveness of weight loss interventions including bariatric surgery. Personality traits play an important role both as risk as well as protective factors in the development of overweight and obesity. While thus in particular 'neuroticism', 'impulsivity' and 'sensitivity to reward' appear as risk factors, 'conscientiousness' and 'self-control' have been shown to have a protective function in relation to weight gain. Conscientiousness is a measure of regulation of internal urges and self-discipline, and may thus provide a potential source of control over impulsive reward-oriented behaviour. The results of the present review suggest that, within the context of therapeutic weight reduction measures, it is meaningful to identify subgroups of patients for whom specific treatment options need to be developed, such as measures for strengthening self-control skills.
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Affiliation(s)
- G Gerlach
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University, Bochum, Germany
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