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Izquierdo AM, Nelson JD, Daza A, Gasbarro A, Hardin R, Marino J, Fischer S. Predictors of current suicidal ideation in a multi-diagnostic sample of individuals with eating disorders. J Eat Disord 2023; 11:94. [PMID: 37291663 DOI: 10.1186/s40337-023-00789-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 04/20/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Individuals with eating disorders (EDs) have high rates of suicidal ideation (SI) and attempts (SA). Fasting, body dissatisfaction, binge eating and purging have been associated with SI in non-clinical samples, individuals with anorexia nervosa or low-weight EDs, and a multi-diagnostic sample. However, few studies have examined how ED symptoms contribute to risk for SI in conjunction with other well-established risk factors, such as nonsuicidal self-injury (NSSI) and past SA. The aim of this study was to examine which ED symptoms contribute unique risk for current SI in a multi-diagnostic, clinical sample when statistically adjusting for gender, NSSI, past SA, and past SI. METHODS We conducted a chart review of 166 individuals who presented for ED treatment at an outpatient facility and signed informed consent. Initial intake interviews were coded for the presence versus absence of fasting, fear of weight gain, binge eating, purging, excessive exercise, restriction, body checking, self-weighing, and body dissatisfaction, as well as NSSI, past SA, past SI, and current SI. RESULTS A total of 26.5% of the sample endorsed current SI. In a logistic regression analysis, identifying as male (n = 17) or having a non-binary gender identity (n = 1), the presence of fasting, and past SI were all significantly associated with increased odds of current SI, whereas excessive exercise significantly decreased odds of current SI. Fasting was equally common across all diagnostic groups. CONCLUSIONS Future research should establish the temporal relationship between fasting and SI to better inform intervention.
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Affiliation(s)
- Alyssa M Izquierdo
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA.
| | - Jillian D Nelson
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | - Alyssa Daza
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
| | | | | | | | - Sarah Fischer
- Department of Psychology, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA
- Potomac Behavioral Solutions, Arlington, VA, USA
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2
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Ciwoniuk N, Wayda-Zalewska M, Kucharska K. Distorted Body Image and Mental Pain in Anorexia Nervosa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010718. [PMID: 36613039 PMCID: PMC9819498 DOI: 10.3390/ijerph20010718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 06/12/2023]
Abstract
(1) Background: Body image is being defined as the picture of our own body in our mind with its size and shape, and with a perceptive and attitudinal evaluation of this body. It appears to be a complex clinical construct predisposing an individual to developing and maintaining anorexia nervosa (AN), as well as having considerable impact on prolonging the duration of this illness and its relapse risk. The aim of the research work was to assess whether the symptomatology of eating disorders, level of depression, and mental pain are associated with body image, and examine the influence of a distorted body image as well as eating disorders and depression symptoms on mental pain in AN; (2) Methods: A total of 36 women diagnosed with AN and 69 healthy controls (HC) participated in this study. All participants completed a battery of the following scales: EAT-26, BSQ-34, BIDQ, BDD-YBOCS, CESDR, and the Mental Pain Scale; (3) Results: Results show statistically significantly greater body image disturbances and higher level of depression and mental pain intensity in the AN compared to the HC group. Regression analysis indicates a greater impact of distorted body image, eating disorders, and depression symptoms on mental pain in AN; (4) Conclusions: As assumed, distorted body image and mental pain are central components of AN that should be especially emphasized in the therapeutical process of treating AN. Future research should focus on the etiopathogenesis of distorted body image in relation to the chronicity of mental pain and depression in AN, and address these outcomes in clinical practice to minimize suicide risk in this high-risk group of patients.
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3
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Expressive suppression a mediating variable between stress and procrastination in eating behavior disorder. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns3.6325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Eating disorders (EDs) are psychiatric illnesses in which emotions play an important role in their development and maintenance. These disorders are associated with expressive suppression, stress, and procrastination. The purpose of this work was to explain eating disorders from stress and procrastination, with expressive suppression as a mediating variable. It was attended by 918 students from three universities in Ecuador. The information was collected through four instruments: inventory of eating disorders, perceived stress scale, Tuckman procrastination scale and emotional regulation questionnaire. The data was analyzed through a mediational analysis in the Jasp program, version 15. The independent variables were: procrastination and stress, the dependent variable was risk of experiencing bulimia (REB) and the mediating variable was expressive suppression. Procrastination and stress, mediated by expressive suppression, were found to have no statistically significant effect on EBR. Procrastination has a direct effect on REB, although stress does not, and the model between expressive suppression and REB explains a good percentage of the variance.
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A Panorama of the Medicolegal Aspects of Suicide Assessments: Integrating Multiple Vantage Points in Improving Quality, Safety, and Risk Management. CNS Spectr 2022; 28:282-287. [PMID: 35383552 DOI: 10.1017/s1092852922000724] [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: 11/07/2022]
Abstract
Abstract
Epidemiological trends in global suicides have been of serious concern in the last decade. The burden of higher expectations in the assessment of suicidal behaviors on mental health professionals is mounting. However, the suicidal risk assessment has many evolving and moving parts, and is one of the most heavily researched fields in psychiatry. Although it is clear from current empirical research that suicide cannot accurately be predicted, the standard of care from regulatory bodies and professional organizations dictates the use of established measures and following consensus guidelines. However, the legal system has different parameters to assess for the deviation from these standards and views it from a different vantage point. Therefore, it is imperative to know these critical multifaceted panoramas of suicide assessment. Considering the gaps within suicide risk assessment tools, we propose that appropriate documentation and thorough treatment planning are key to navigating the complex medicolegal risks. These approaches are useful for risk management and improve clinical outcomes, quality of care, and overall patient safety.
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Wu J, Lin Z, Liu Z, He H, Bai L, Lyu J. Secular trends in the incidence of eating disorders in China from 1990 to 2017: a joinpoint and age-period-cohort analysis. Psychol Med 2022; 52:946-956. [PMID: 32744194 DOI: 10.1017/s0033291720002706] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Eating disorders (ED) have increasingly become a global topic of concern for public health. A better understanding of ED incidence is a basic requirement for improving its management. However, the temporal trend of ED incidence in China is still unknown. METHODS The incidence rates of ED from 1990 to 2017 were collected from the Global Burden of Disease Study 2017 database according to the following: subtype, i.e. anorexia nervosa (AN) and bulimia nervosa (BN); sex; and age group. The average annual percent changes and relative risks were calculated using joinpoint regression and the age-period-cohort model, respectively. RESULTS From 1990 to 2017, age-standardized incidence rates of ED continued to increase in males and females, and this variation trend was observed in AN and BN. Joinpoint regression analysis showed that the incidence rates increased in all age groups. Adolescents had the highest risk of developing ED, followed by young adults. Age effects were the most influential risk factor for ED incidence. Period effects showed that the risk of developing ED continuously increased with increasing time periods in BN, but not in ED and AN. Concerning the cohort effects, people born after the 1990s presented a higher risk of ED, though they presented a lower risk of BN as compared to the whole cohort. CONCLUSIONS ED incidence rates continue to increase in China, particularly among adolescents and young adults. Further etiological studies are needed to explain these increases and to facilitate the early identification of high-risk individuals.
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Affiliation(s)
- Jiayuan Wu
- School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Department of Clinical Research, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Zhixiong Lin
- Department of Psychiatry, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Zhou Liu
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Ling Bai
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Jun Lyu
- School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
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de la Barrera U, Montoya-Castilla I, Pérez-Albéniz A, Lucas-Molina B, Fonseca-Pedrero E. Mental Health Difficulties Related to Suicidal Behavior in Adolescents: The Moderating Role of Self-Esteem. Arch Suicide Res 2022; 26:716-730. [PMID: 33027593 DOI: 10.1080/13811118.2020.1823918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The objective was to analyze the moderating effect of self-esteem on the relationship between mental health difficulties and suicidal behavior in adolescence. METHOD The sample was composed of 1,790 Spanish adolescents (M = 15.70 years; SD = 1.26; 53.7% girls) through a stratified random sampling by cluster at classroom level. The participants completed questionnaires about emotional symptoms, behavioral problems, peer relationship difficulties, hyperactivity, suicidal behavior, and self-esteem. RESULTS The results evidenced gender differences, showing that girls tend to have more emotional symptoms (t = -15.27; p ≤ .001; d = -0.71), more difficulties in peer relationship (t=-2.49; p = .013; d = -0.12) and less self-esteem (t = 12.15; p ≤ .001; d = 0.57), as well as more suicidal behaviors (t = -5.36; p ≤ .001; d = -0.25) than boys. It is also noted that emotional and behavioral difficulties influence suicidal behavior (R2 = 0.35; ΔF = 197.42; p ≤ .001). In addition, self-esteem appeared to act as a protective factor, buffering the relationship between emotional and behavioral problems and suicidal behavior (R2 = 0.39; F = 376.92; p ≤ .001). CONCLUSIONS Adolescents who present mental health difficulties might commit suicidal behavior if they have an unfavorable attitude toward themselves. However, the risk of committing suicidal behavior decreases if their attitude toward themselves is favorable. Thus, the development of self-esteem may be included in intervention programs for the prevention of suicidal behavior.HIGHLIGHTSGirls present more suicidal behaviors and less self-esteem than boys.Mental health difficulties influence the appearance of suicidal behavior.Self-esteem moderates the relationship between emotional problems and suicidal behavior.
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Sahlan RN, Saunders JF, Perez M, Blomquist KK, Fitzsimmons-Craft EE, Bodell LP. The validation of a Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescent boys and girls. Eat Weight Disord 2022; 27:665-674. [PMID: 33970468 DOI: 10.1007/s40519-021-01204-6] [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: 03/11/2021] [Accepted: 04/26/2021] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Although some studies have been conducted to examine general psychosocial impairment in Iran, there is no research to date on clinical impairment secondary to disordered eating in Iranian adolescents. The purpose of this study was to evaluate the Farsi version of the Clinical Impairment Assessment (F-CIA) among Iranian adolescents. METHODS A total of 1112 adolescents (ageM [SD] = 15.55 [1.59], body mass index [zBMI] M [SD] = - 0.00 [1.0]; 54.6% girls) were recruited from four cities (Tehran [Capital], Tabriz [North-Western], Kurdistan [West], and Rasht [North]) in Iran. After translation and back-translation procedures, the F-CIA, Eating Disorder Examination Questionnaire (EDE-Q), and Beck Depression Inventory-Second Edition (BDI-II) were administered to adolescents. We used confirmatory factor analysis (CFA), measurement invariance, independent samples t tests, Pearson correlation, chi-square tests, and internal consistency to test validity and reliability. RESULTS CFA indicated that F-CIA demonstrated good fit to the data and supported a three-factor model. The scale was invariant across gender and zBMI. The F-CIA had good internal consistency (αs = 0.76-0.93) and positive associations (rs = 0.13-0.62; p < 0.001) with zBMI, disordered eating symptoms, and binge/purge symptoms. We found no gender differences across mean scores on the F-CIA, but adolescents with higher zBMI reported higher scores on the F-CIA relative to those with lower zBMIs. Finally, adolescents scoring above CIA cutoffs reported higher zBMI, disordered eating outcomes, and depression. CONCLUSION Findings suggested that the F-CIA is a reliable and valid measure of clinical eating disorder-related impairment in Iranian adolescents. LEVEL OF EVIDENCE III; Evidence obtained from well-designed observational study, including case-control design for relevant aspects of the study.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jessica F Saunders
- Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA
| | - Marisol Perez
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | | | | | - Lindsay P Bodell
- Department of Psychology, University of Western Ontario, 361 Windermere Road, London, ON, N6A 3K7, Canada.
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Gómez Del Barrio A, Pardo de Santayana G, Ruiz Guerrero F, Benito Gonzalez P, Calcedo Giraldo G, González Gómez J, García-Unzueta MT. Suicidal ideation in a sample with a first-episode of restrictive eating disorders: The role of biomarkers. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2021.100305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Perkins NM, Ortiz SN, Smith AR, Brausch AM. Suicidal Ideation and Eating Disorder Symptoms in Adolescents: The Role of Interoceptive Deficits. Behav Ther 2021; 52:1093-1104. [PMID: 34452664 PMCID: PMC8403232 DOI: 10.1016/j.beth.2021.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/19/2021] [Accepted: 03/07/2021] [Indexed: 01/11/2023]
Abstract
Eating disorder symptoms and suicidal ideation are relatively common, and often begin to emerge in adolescence. Interoceptive deficits, or the inability to perceive and accurately identify the physiological condition of the body, is an established risk factor for both eating disorders and suicidal thoughts and behaviors. Despite this, longitudinal research examining the temporal dynamics between these variables is scarce, especially within adolescent samples. Using a three-wave longitudinal design, the present study tested bidirectional relationships between interoceptive deficits, eating disorder symptoms, and suicidal ideation to examine whether interoceptive deficits predicted eating disorder symptoms and suicidal ideation over the course of a year among a sample of adolescents. Participants were 436 community adolescents recruited from local middle- and high-schools. Data were collected at baseline, 6-month follow-up, and 12-month follow-up. Study measures assessed current suicidal ideation, eating disorder symptom severity, and interoceptive deficits. Autoregressive cross-lagged modeling was conducted in MPlus. We found baseline eating disorder symptoms significantly predicted suicidal ideation at 6-month follow-up when controlling for baseline suicidal ideation. Baseline interoceptive deficits significantly predicted eating disorder symptoms 6-months later, while 6-month follow-up interoceptive deficits significantly predicted 12-month follow-up suicidal ideation. Our findings highlight the need for early and regular assessment of suicidal ideation and eating disorder symptoms in adolescents. Given that interoceptive deficits was a shared risk factor for both conditions within this sample, these results underscore the need for targeted interventions aimed at improving interoception.
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Affiliation(s)
- Natalie M. Perkins
- Department of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH, 45056,Correspondence concerning this article should addressed to Natalie M. Perkins,
| | - Shelby N. Ortiz
- Department of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH, 45056
| | - April R. Smith
- Department of Psychology, Miami University, 90 N. Patterson Avenue, Oxford, OH, 45056
| | - Amy M. Brausch
- Department of Psychological Science, Western Kentucky University, 1906 College Heights Boulevard, Bowling Green, KY
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Bodell LP, Smith AR, Witte TK. Dynamic associations between interpersonal needs and suicidal ideation in a sample of individuals with eating disorders. Psychol Med 2021; 51:1516-1523. [PMID: 32138797 DOI: 10.1017/s0033291720000276] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Over half of individuals with eating disorders experience suicidal ideation at some point in their lives, yet few longitudinal studies have examined predictors of ideation in this at-risk group. Moreover, prospective research has focused on relatively distal or trait-level factors that are informative for distinguishing who is most at risk but not when. Little is known about more proximal or state-level risk factors that fluctuate within an individual, which is critical for determining when a person is most likely to engage in suicidal behaviors. METHODS Women (N = 97) receiving treatment for their eating disorder completed questionnaires weekly to assess suicidal ideation and interpersonal constructs (i.e. perceived burdensomeness, thwarted belongingness) theorized to be proximal predictors of suicidal desire. Longitudinal multilevel models were conducted to examine both within- and between-person predictors of suicidal ideation across 12 weeks of treatment. RESULTS Statistically significant within-person effects for burdensomeness (β = 0.06; p < 0.001) indicate that when individuals have greater feelings of burdensomeness compared to their own average, they also experience higher suicidal ideation. We did not find any significant influence of thwarted belongingness or the interaction between burdensomeness and belongingness on suicidal ideation. CONCLUSIONS This study was the first to examine dynamic associations between interpersonal constructs and suicidal ideation in individuals with eating disorders. Results are only partially consistent with the Interpersonal Theory of Suicide and suggest that short-term changes in burdensomeness may impact suicidal behavior in individuals with eating disorders.
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Affiliation(s)
- Lindsay P Bodell
- Department of Psychology, Western University, London, Ontario, Canada
| | - April R Smith
- Department of Psychology, Miami University of Ohio, Oxford, Ohio, USA
| | - Tracy K Witte
- Department of Psychology, Auburn University, Auburn, Alabama, USA
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11
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Rasouli A, Mohiti S, Javadi M, Panjeshahin A, Kazemi M, Shiri-Shahsavar MR. The effect of daily fast food consumption, family size, weight-caused stress, and sleep quality on eating disorder risk in teenagers. Sleep Breath 2021; 25:1527-1533. [PMID: 33411190 DOI: 10.1007/s11325-020-02189-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/29/2020] [Accepted: 09/12/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Eating disorder (ED) is a common complication with disturbance of eating or eating-related behaviors that lead to physical and psychosocial disorders. The purpose of this study was to evaluate the association between eating disorders and daily fast food consumption, family size, weight-caused stress, and sleep quality in teenagers in Zanjan, Iran. METHODS Adolescent girl students aged 12-15 years (n = 370), selected in a cross-sectional study, completed the Eating Attitude Test-26 and Pittsburgh Sleep Quality Index questionnaires. The cluster random sampling method was used. Statistical analysis was performed using R software version 3.6.3. Logistic regression modeling was used for investigating the relationship between factors and odds of EDs. A p value of less than 0.05 was considered significant. RESULTS A significant relationship was found between family size (OR = 0.77, p = 0.049), fast food-daily consumption (OR = 5.42, p = 0.043), weight-caused stress (OR = 12.47, p < 0.001), and poor sleep quality (OR = 1.70, p = 0.024) and odds of eating disorder among teenage girls. CONCLUSION A significant positive association was found between a low number of family members, daily fast food consumption, stress status, poor sleep quality and odds of EDs. However more longitudinal studies are required to confirm the results.
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Affiliation(s)
- Ahmadreza Rasouli
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sara Mohiti
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Javadi
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.,Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Asieh Panjeshahin
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Morteza Kazemi
- Department of Biostatistics and Epidemiology, School of Health Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Reza Shiri-Shahsavar
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran. .,Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
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Mohammadi MR, Mostafavi SA, Hooshyari Z, Khaleghi A, Ahmadi N, Molavi P, Armani Kian A, Safavi P, Delpisheh A, Talepasand S, Hojjat SK, Pourdehghan P, Ostovar R, Hosseini SH, Mohammadzadeh S, Salmanian M, Alavi SS, Ahmadi A, Zarafshan H. Prevalence, correlates and comorbidities of feeding and eating disorders in a nationally representative sample of Iranian children and adolescents. Int J Eat Disord 2020; 53:349-361. [PMID: 31742760 DOI: 10.1002/eat.23197] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study investigated the prevalence of feeding and eating disorders, and identified their correlates and comorbidities among children and adolescents. METHOD We used the nationally representative sample of the Iranian Children and Adolescents' Psychiatric disorders (IRCAP) survey, with 30,532 participants randomly selected by a multistage cluster sampling method. We employed the kiddie schedule for affective disorders and schizophrenia-present and lifetime version (K-SADS-PL) semi-structured face-to-face interview to screen for any psychiatric disorders, including feeding and eating disorders, and associated factors. We used multivariate binary logistic regression to analyze the data. RESULTS Valid data from 27,111 participants were analyzed. The total prevalence of feeding and eating disorders among children and adolescents was 0.89 (0.81-1.10). In all types of feeding and eating disorders, the adjusted odds ratio was higher among girls (except binge-eating disorder) and older adolescents but was lower among rural residents. The most common psychiatric comorbidities observed in children and adolescents with feeding and eating disorders were obsessive-compulsive disorder (20.2%), agoraphobia (20.2%), depressive disorder (16.4%), social phobia (10.1%), oppositional defiant disorder (10.1%), generalized anxiety disorder (9.4%), attention deficit hyperactivity disorder (7.5%), and conduct disorder (5.7%), which were significantly more common compared to their peers without feeding and eating disorders. DISCUSSION Older age, female gender and living in an urban area are predisposing factors in feeding and eating disorders (in binge-eating disorder, the male gender is a positive correlate). We suggest that future works pay attention to the role of gender, comorbidities and predisposing factors.
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Affiliation(s)
- Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hooshyari
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Parviz Molavi
- Department of Psychiatry, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Armani Kian
- Department of Psychiatry, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parvin Safavi
- Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ali Delpisheh
- Department of Clinical Epidemiology Faculty of Medicine, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | | | - Seyed Kaveh Hojjat
- Addiction and Behavioral Sciences Research center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Parandis Pourdehghan
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Ostovar
- Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Seyed Hamzeh Hosseini
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Soleiman Mohammadzadeh
- Department of Psychiatry, Neuroscience Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Maryam Salmanian
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Salman Alavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Ahmadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Zarafshan
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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Ortiz SN, Smith A. A longitudinal examination of the relationship between eating disorder symptoms and suicidal ideation. Int J Eat Disord 2020; 53:69-78. [PMID: 31479165 DOI: 10.1002/eat.23162] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/15/2019] [Accepted: 08/18/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Cross-sectional research demonstrates significant correlations between eating disorders (EDs) and suicidal thoughts and behaviors. Although suicide ideation (SI) is a risk factor for suicidal behavior, longitudinal research investigating SI among EDs is limited. Thus, the aim of this study was to offer insight into the dynamic relationship between EDs and SI by investigating if these variables predicted one another at weekly time points. METHOD Autoregressive cross-lagged modeling was used to test bidirectional relationships between ED symptoms and suicidal ideation among an ED patient sample (n = 92). Participants completed a measure of suicidal ideation and the Eating Disorder Examination-Questionnaire (EDE-Q) weekly for 5 weeks. RESULTS SI and ED symptoms were correlated with each other at each time point. Unexpectedly, the majority of cross-lagged pathways were nonsignificant. However, SI at Week 4 predicted ED symptoms at Week 5, while controlling for Week 4 ED symptoms. This pattern of results was found when the shape concerns, weight concerns, and eating concerns subscales of the EDE-Q were entered into the model. Moreover, Week 2 shape concerns predicted Week 3 SI and Week 3 eating concerns predicted Week 4 SI. No significant cross-lagged pathways were found with the dietary restraint subscale. DISCUSSION Nonsignificant cross-lagged pathways may indicate that third variables better explain the relations between certain ED symptoms and SI over time. However, there were instances where ED symptoms and SI predicted one another. Given this, targeting suicidal thoughts in therapy may help to reduce eating pathology and vice versa.
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Affiliation(s)
- Shelby N Ortiz
- Department of Psychology, Miami University, Oxford, Ohio
| | - April Smith
- Department of Psychology, Miami University, Oxford, Ohio
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Ortiz S, Knauft K, Smith A, Kalia V. Expressive suppression mediates the relation between disordered eating and suicidal ideation. J Clin Psychol 2019; 75:1943-1958. [PMID: 31332800 DOI: 10.1002/jclp.22830] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Although disordered eating is robustly associated with suicidal thoughts, it is not well understood why these conditions relate to each other. Emotion dysregulation is a shared risk factor for disordered eating and suicidal thoughts. Individuals with dysregulated emotions struggle to select appropriate strategies to modulate emotions and the strategies they use might explain some of the shared variances. Thus, we examined whether emotion regulation strategies mediated the relationship between disordered eating and suicidal ideation. METHOD Adult participants (N = 230) completed questionnaires on current disordered eating symptoms, emotion regulation strategies, and current suicidal ideation. RESULTS Disordered eating symptoms positively associated with suicidal ideation. In addition, expressive suppression mediated the relation between disordered eating symptoms and current suicidal ideation. No relation was found for cognitive reappraisal. CONCLUSIONS The use of expressive suppression as an emotion regulation strategy may be related to increased suicidal ideation in individuals who express concerns about eating.
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Affiliation(s)
- Shelby Ortiz
- Department of Psychology, Miami University, Oxford, Ohio
| | | | - April Smith
- Department of Psychology, Miami University, Oxford, Ohio
| | - Vrinda Kalia
- Department of Psychology, Miami University, Oxford, Ohio
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