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Glisenti K, Strodl E, King R. The Role of Beliefs About Emotions in Emotion-Focused Therapy for Binge-Eating Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09555-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractIndividuals with binge-eating disorder (BED) often experience emotion regulation deficits, including negative beliefs about emotions and low emotional expressivity. The current exploratory study examined whether emotion-focused therapy (EFT) for BED could change negative beliefs about emotions and emotional expressivity. Twenty participants were randomly allocated to either immediate treatment of 12 weekly one-hour sessions of EFT for BED, or a waitlist control group. Beliefs about emotions and emotional expressivity were assessed before and after 12 sessions of EFT or 12 weeks on the waitlist. A repeated measures ANOVA was used to examine beliefs about emotions and emotional expressivity changes. EFT for BED resulted in significant changes in particular beliefs about emotions (Overwhelming and uncontrollable, shameful and irrational, invalid and meaningless, and total score on the beliefs about emotions questionnaire) but not emotional expressivity treatment outcomes. This pilot study provides preliminary evidence that EFT may be effective in improving maladaptive beliefs about emotions in adults with BED.Trial registration ACTRN12620000563965, 14 May 2020, retrospectively registered.
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Petersson S, Wåhlin I. A piece of a puzzle—Patient and psychologist experiences of the Affect School as additional treatment in a Swedish eating disorder unit. PLoS One 2022; 17:e0271902. [PMID: 35901040 PMCID: PMC9333312 DOI: 10.1371/journal.pone.0271902] [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: 05/21/2021] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Emotion dysregulation has been shown to be a transdiagnostic characteristic of eating disorders. The Affect School aims to enhance emotional awareness and the ability to perceive and express emotions. This study was conducted as part of an RCT where patients with various eating disorders were randomised to participation in the Affect School as a supplement to treatment.
Aim
To explore Affect School participants’ and leaders’ experiences of the Affect school at an Eating Disorder outpatient unit in Sweden.
Method
Nine patients with eating disorder diagnoses and three Affect School leaders at an eating disorder outpatient clinic in Sweden were interviewed for their experiences of the intervention. The interviews were analysed with Thematic Analysis.
Result
Eight themes were revealed at the analysis, five from the participants: “Worries about group participation”, “Not alone anymore and gaining new insights about oneself”, “Shared stories can also be painful”, “Relationships outside the Affect School as a foundation for affective work”, and “A change is coming”, and three from the leaders:”Affect awareness is important in eating disorders”, “Group meetings create opportunities and challenges”, and “The Affect School setup needs more customisation”.
Conclusion
The results suggested that the Affect School provided an acceptance for experiencing all sorts of affects. Both leaders and participants considered working with affects necessary, although participants reported no changes in their life situation or condition after the intervention but considered the intervention as part of a process with gradual results. Being part of a group and sharing experiences was experienced as positive by participants and leaders, but the model could be further developed to better adapt to patients with an eating disorder.
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Affiliation(s)
- Suzanne Petersson
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
- Division of Rehabilitation, Region Kalmar County, Kalmar, Sweden
- * E-mail:
| | - Ingrid Wåhlin
- Department of Health and Caring Science, Linnaeus University, Kalmar, Sweden
- The Research Section, Region Kalmar County, Kalmar, Sweden
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Osoro A, Villalobos D, Tamayo JA. Efficacy of emotion-focused therapy in the treatment of eating disorders: A systematic review. Clin Psychol Psychother 2021; 29:815-836. [PMID: 34779059 DOI: 10.1002/cpp.2690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/08/2021] [Accepted: 11/01/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND The high incidence of eating disorders (EDs) means that its treatment is approached from various perspectives, among which we find emotion-focused therapy (EFT). Therefore, the main objective of this systematic review was to know the effectiveness of EFT for eating disorders. METHOD A systematic review of PubMed, the Cochrane Library and the Psychology and Behavioural Sciences Collection was carried out without a time limit and in a population with an eating disorder diagnosis. RESULTS Eight studies fulfilled the eligibility criteria: (1) six studies treated the population with binge eating disorder (BED) five were group treatments, and four included the combined modality; (2) one with BED, bulimia nervosa (BN) and Eating Disorder No Otherwise Specified (EDNOS); and (3) one for a single case of anorexia nervosa (AN). The duration of treatments ranged from 12 weeks to 18 months, and all studies used the original EFT protocol. Specific variables of each type of eating disorder were studied, as well as comorbid symptoms. CONCLUSIONS It seems that the results coincide in the existence of post-treatment improvements both in eating psychopathology and in affective symptoms, although with variable data during follow-up. More research is needed to affirm the efficacy of EFT as an empirically validated treatment for EDs.
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Affiliation(s)
- Andrea Osoro
- Department of Psychology, San Juan de Dios Foundation, Calle Herreros de Tejada, 3, Madrid, Spain, 28016, Spain.,Department of Psychology, San Rafael-Nebrija Health Sciences Center, Paseo de la Habana, 70 bis, Madrid, Spain, 28036, Spain
| | - Dolores Villalobos
- Department of Psychology, San Juan de Dios Foundation, Calle Herreros de Tejada, 3, Madrid, Spain, 28016, Spain.,Department of Psychology, San Rafael-Nebrija Health Sciences Center, Paseo de la Habana, 70 bis, Madrid, Spain, 28036, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid and Complutense University of Madrid, Madrid, Spain
| | - José Antonio Tamayo
- Department of Psychology, San Juan de Dios Foundation, Calle Herreros de Tejada, 3, Madrid, Spain, 28016, Spain.,Department of Psychology, San Rafael-Nebrija Health Sciences Center, Paseo de la Habana, 70 bis, Madrid, Spain, 28036, Spain
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Glisenti K, Strodl E, King R, Greenberg L. The feasibility of emotion-focused therapy for binge-eating disorder: a pilot randomised wait-list control trial. J Eat Disord 2021; 9:2. [PMID: 33407948 PMCID: PMC7789500 DOI: 10.1186/s40337-020-00358-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 12/06/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Research into psychotherapy for binge-eating disorder (BED) has focused mainly on cognitive behavioural therapies, but efficacy, failure to abstain, and dropout rates continue to be problematic. The experience of negative emotions is among the most accurate predictors for the occurrence of binge eating episodes in BED, suggesting benefits to exploring psychological treatments with a more specific focus on the role of emotion. The present study aimed to explore the feasibility of individual emotion-focused therapy (EFT) as a treatment for BED by examining the outcomes of a pilot randomised wait-list controlled trial. METHODS Twenty-one participants were assessed using a variety of feasibility measures relating to recruitment, credibility and expectancy, therapy retention, objective binge episodes and days, and binge eating psychopathology outcomes. The treatment consisted of 12 weekly one-hour sessions of EFT for maladaptive emotions over 3 months. A mixed model approach was utilised with one between effect (group) using a one-way analysis of variance (ANOVA) to test the hypothesis that participants immediately receiving the EFT treatment would demonstrate a greater degree of improvement on outcomes relating to objective binge episodes and days, and binge eating psychopathology, compared to participants on the EFT wait-list; and one within effect (time) using a repeated-measures ANOVA to test the hypothesis that participation in the EFT intervention would result in significant improvements in outcome measures from pre to post-therapy and then maintained at follow-up. RESULTS Recruitment, credibility and expectancy, therapy retention outcomes indicated EFT is a feasible treatment for BED. Further, participants receiving EFT demonstrated a greater degree of improvement in objective binge episodes and days, and binge eating psychopathology compared to EFT wait-list control group participants. When participants in the EFT wait-list control group then received treatment and outcomes data were combined with participants who initially received the treatment, EFT demonstrated significant improvement in objective binge episodes and days, and binge eating psychopathology for the entire sample. CONCLUSIONS These findings provide further preliminary evidence for the feasibility of individual EFT for BED and support more extensive randomised control trials to assess efficacy. TRIAL REGISTRATION The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12620000563965 ) on 14 May 2020.
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Affiliation(s)
- Kevin Glisenti
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia.
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia
| | - Robert King
- School of Psychology and Counselling, Queensland University of Technology, Faculty of Health, Brisbane, Queensland, Australia
| | - Leslie Greenberg
- Department of Psychology, York University, Faculty of Health, Toronto, Canada
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Momentary changes in heart rate variability can detect risk for emotional eating episodes. Appetite 2020; 152:104698. [DOI: 10.1016/j.appet.2020.104698] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 12/22/2022]
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Robinson A. Enhancing Empathy in Emotion-Focused Group Therapy for Adolescents with Autism Spectrum Disorder: A Case Conceptualization Model for Interpersonal Rupture and Repair. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2019. [DOI: 10.1007/s10879-019-09443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Adolescents with autism spectrum disorder (ASD) are vulnerable to trauma-related experiences due to difficulties in emotion recognition, including recognising their own and others’ emotions, leading to interpersonal conflict and problems in making and maintaining friendships. There are limited intervention methodologies of how to work with interpersonal conflict and relational repair. This paper presents, for the first time, a case conceptualization model of relational rupture and repair as a clinical strategy to guide therapists working therapeutically with clients with ASD. The model is constructed from a task analysis applied to dyads of therapy and Interpersonal Process Recall sessions of Emotion-Focused Group Therapy with autistic adolescents (EFGT-AS). This model shows that when therapists use Interpersonal Process Recall of shared trauma-related experiences and misempathy encounters as a process-guiding method, it leads to a deepening of emotional processing in both cognitive and affective empathy. Autistic adolescents are able to use EFGT-AS to explore self-agency within interpersonal ruptures and enhance self and other cognitive-affective empathy within a relational repair process. This rational-empirical model for working with relational rupture and repair stands as a hypothesis for future testing.
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Thompson S, Girz L. Overcoming shame and aloneness: Emotion-focused group therapy for self-criticism. PERSON-CENTERED & EXPERIENTIAL PSYCHOTHERAPIES 2019. [DOI: 10.1080/14779757.2019.1618370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sarah Thompson
- Centre for Student Development and Counselling, Ryerson University, Toronto, Ontario, Canada
| | - Laura Girz
- Centre for Student Development and Counselling, Ryerson University, Toronto, Ontario, Canada
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Beasley CC, Ager R. Emotionally Focused Couples Therapy: A Systematic Review of Its Effectiveness over the past 19 Years. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2019; 16:144-159. [PMID: 30605013 DOI: 10.1080/23761407.2018.1563013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Purpose: A meta-analysis is the review of several qualifying studies where the findings of each study is analyzed and is then pooled as to determine if an intervention is effective or not. The aim of this meta-analysis was to evaluate if the intervention of Emotionally Focused Couples Therapy (EFCT), also referred to as Emotionally Focused Therapy (EFT), continues to be an effective intervention, since its last meta-analysis in 1999, and to determine whether the improvements noted in EFCT continue to be effective, over a period of time, following the initial intervention.Method: For the meta-analysis, nine studies which identify as randomized control trials (RCTs), were extracted and utilized from the original systematic search. These nine studies were used to evaluate EFCT's initial pre to post-treatment effectiveness. The portion of the meta-analysis, which evaluates whether EFCT sustained improvement at follow-up, consisted of four studies that identify as RCTs.Results: The results strongly suggest that the intervention of EFCT not only improved marital satisfaction (Hedge's g coefficient = 2.09) but also, the improvement in marital satisfaction was sustained at follow up. This sustained improvement was evident through the results of both the Friedman's repeated-measures and the post hoc Wilcox (χ2 = 6.500, p = 0.039).Conclusion: The findings provide preliminary support that, as it relates to marital satisfaction, EFCT is an effective treatment, both in facilitating change during treatment, and in maintaining those improvements following treatment.
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Affiliation(s)
| | - Richard Ager
- Tulane University, School of Social Work, New Orleans, LA, USA
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Gayner B. Emotion-focused mindfulness therapy. PERSON-CENTERED & EXPERIENTIAL PSYCHOTHERAPIES 2019. [DOI: 10.1080/14779757.2019.1572026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Bill Gayner
- Department of Psychiatry, Mount Sinai Hospital, Toronto, ON, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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10
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Glisenti K, Strodl E, King R. Emotion-focused therapy for binge-eating disorder: A review of six cases. Clin Psychol Psychother 2018; 25:842-855. [PMID: 30118179 DOI: 10.1002/cpp.2319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 06/06/2018] [Accepted: 07/14/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to provide preliminary evidence of the usefulness of emotion-focused therapy (EFT) for binge-eating disorder (BED). METHODS We used a single-subject design in which 12 weeks of individual EFT were applied nonconcurrently to six female adult participants with BED, following three weekly baseline sessions. Participants were assessed for binge-eating psychopathology and emotion regulation difficulties on a weekly basis during baseline and treatment. They were assessed on a 2-, 4-, and 8-week basis during posttreatment, and they were assessed for binge-eating episodes, eating disorder attitudes, alexithymia, and psychiatric comorbidity at pretreatment and posttreatment. RESULTS All cases experienced reliable recovery from binge-eating psychopathology and a significant decrease in binge-eating frequency. For all cases, there was reliable improvement or recovery on eating and shape concerns, and there was improvement on weight concern for the majority of cases. For all cases, reliable recovery or improvement occurred in overall emotion regulation. Most cases that were in the clinical range pretreatment recovered for anxiety, and reliable improvement in or recovery from depression occurred for all cases. There was reliable recovery or improvement in alexithymia for half of the cases; however, the other half experienced no change or deteriorated. There were no treatment dropouts. CONCLUSION Individual EFT demonstrates potential as a psychological treatment for BED. The current study provides preliminary evidence to guide the development of a more extensive trial to test the efficacy of individual EFT for BED as well as to identify possible mechanisms of change.
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Affiliation(s)
- Kevin Glisenti
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Robert King
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
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Peterson CB, Berg KC, Crosby RD, Lavender JM, Accurso EC, Ciao AC, Smith TL, Klein M, Mitchell JE, Crow SJ, Wonderlich SA. The effects of psychotherapy treatment on outcome in bulimia nervosa: Examining indirect effects through emotion regulation, self-directed behavior, and self-discrepancy within the mediation model. Int J Eat Disord 2017; 50:636-647. [PMID: 28117906 PMCID: PMC5459657 DOI: 10.1002/eat.22669] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/14/2016] [Accepted: 12/18/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The purpose of this investigation was to examine the indirect effects of Integrative Cognitive-Affective Therapy (ICAT-BN) and Cognitive-Behavioral Therapy-Enhanced (CBT-E) on bulimia nervosa (BN) treatment outcome through three hypothesized maintenance variables: emotion regulation, self-directed behavior, and self-discrepancy. METHOD Eighty adults with BN were randomized to 21 sessions of ICAT-BN or CBT-E. A regression-based bootstrapping approach was used to test the indirect effects of treatment on outcome at end of treatment through emotion regulation and self-directed behavior measured at mid-treatment, as well as the indirect effects of treatment at follow-up through emotion regulation, self-directed behavior, and self-discrepancy measured at end of treatment. RESULTS No significant differences in outcome between treatment conditions were observed, and no significant direct or indirect effects were found. Examination of the individual paths within the indirect effects models revealed comparable treatment effects. Across treatments, improvements in emotion regulation and self-directed behavior between baseline and mid-treatment predicted improvements in global eating disorder scores but not binge eating and purging frequency at end of treatment. Baseline to end of treatment improvements in emotion regulation and self-directed behavior also predicted improvements in global eating disorder scores at follow-up. Baseline to end of treatment improvements in emotion regulation predicted improvements in binge eating and baseline to end of treatment increases in positive self-directed behavior predicted improvements in purging at follow-up. DISCUSSION These findings suggest that emotion regulation and self-directed behavior are important treatment targets and that ICAT-BN and CBT-E are comparable in modifying these psychological processes among individuals with BN.
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Affiliation(s)
- Carol B. Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota,The Emily Program, St. Paul, Minnesota
| | - Kelly C. Berg
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, and Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Jason M. Lavender
- Department of Clinical Research, Neuropsychiatric Research Institute, and Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Erin C. Accurso
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California
| | - Anna C. Ciao
- Department of Psychology, Western Washington University, Bellingham, Washington
| | - Tracey L. Smith
- VA South Central Mental Illness Research, Education & Clinical Center at the Center for Innovations in Quality, Effectiveness & Safety (IQuEST; CIN 13-413), Michael E. DeBakey VA Medical Center, Houston Texas. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Marjorie Klein
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - James E. Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, and Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott J. Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota,The Emily Program, St. Paul, Minnesota
| | - Stephen A. Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, and Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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Fernandez-Aranda F, Jimenez-Murcia S, Santamaría JJ, Giner-Bartolomé C, Mestre-Bach G, Granero R, Sánchez I, Agüera Z, Moussa MH, Magnenat-Thalmann N, Konstantas D, Lam T, Lucas M, Nielsen J, Lems P, Tarrega S, Menchón JM. The Use of Videogames as Complementary Therapeutic Tool for Cognitive Behavioral Therapy in Bulimia Nervosa Patients. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2015; 18:744-51. [DOI: 10.1089/cyber.2015.0265] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Susana Jimenez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Juan J. Santamaría
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Cristina Giner-Bartolomé
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Barcelona, Spain
| | - Maher H. Moussa
- Faculty of Social Sciences and Economics, University of Geneva, Geneva, Switzerland
| | | | - Dimitri Konstantas
- Faculty of Social Sciences and Economics, University of Geneva, Geneva, Switzerland
| | | | - Mikkel Lucas
- Serious Game Interactive (SGI), Copenhagen, Denmark
| | | | | | - Salomé Tarrega
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Manuel Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSam), Instituto Salud Carlos III, Barcelona, Spain
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