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Akkuş M, Gelirgün ÖG, Karataş KS, Telatar TG, Gökçen O, Dönmez F. The Role of Anxiety and Depression in the Relationship Among Emotional Eating, Sleep Quality, and Impulsivity. J Nerv Ment Dis 2024:00005053-990000000-00164. [PMID: 38704649 DOI: 10.1097/nmd.0000000000001783] [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: 05/06/2024]
Abstract
ABSTRACT The aim of this study was to investigate the relationship among sleep quality, impulsivity, anxiety, and depression in individuals with emotional eating behavior. The study was designed as a cross-sectional study. The study included 92 individuals (age 31.29 ± 9.17; female, 67.4% [n = 62]; male, 32.6% [n = 30]) with symptoms of emotional eating but no previous psychiatric diagnosis or treatment. Participants were administered a Structured Clinical Interview for DSM-5 Disorders interview form, a sociodemographic data form, the Emotional Eating Scale, the Beck Depression Scale, the Barratt Impulsivity Scale, the Beck Anxiety Scale, and the Pittsburgh Sleep Quality Index Scale. Emotional eating is positively correlated with anxiety (r = 0.377, p = 0.001), depression (r = 0.375, p = 0.001), impulsivity (r = 0.250, p = 0.016), and poor sleep quality (r = 0.478, p = 0.001). Obese individuals (defined as having a body mass index of 30 or higher) showed higher emotional eating (z = -2.552, p = 0.016) and poorer sleep quality (z = -2.089, p = 0.044) than nonobese individuals, and women showed higher emotional eating (t = 2116, p = 0.037) and poorer sleep quality (z = -2537, p = 0.010) than men. Poor sleep quality was associated with emotional eating. In this relationship, poor sleep quality influenced emotional eating through all mediators, including anxiety and depression (B = 3.491; standardized effect, 0.485; p = 0.001). Poor sleep quality directly influenced emotional eating (B = 2.806; standardized effect, 0.390; p = 0.001). The findings of the study suggest that emotional eating is associated with higher levels of anxiety, depression, impulsivity, and sleep problems, especially in women. It suggests that the interrelationships of psychological factors associated with emotional eating should be investigated.
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Affiliation(s)
- Merve Akkuş
- Department of Psychiatry, Kütahya Health Sciences University, Faculty of Medicine, Evliya Çelebi Education and Research Hospital, Kütahya, Turkey
| | | | - Kader Semra Karataş
- Department of Psychiatry, Kütahya Health Sciences University, Faculty of Medicine, Evliya Çelebi Education and Research Hospital, Kütahya, Turkey
| | - Tahsin Gökhan Telatar
- Department of Public Health, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Onur Gökçen
- Department of Psychiatry, Kütahya Health Sciences University, Faculty of Medicine, Evliya Çelebi Education and Research Hospital, Kütahya, Turkey
| | - Feyza Dönmez
- Department of Psychiatry, Kütahya Health Sciences University, Faculty of Medicine, Evliya Çelebi Education and Research Hospital, Kütahya, Turkey
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Preuss-van Viersen H, Kirschbaum-Lesch I, Eskic J, Lukes S, Pydd J, Derks L, Hammerle F, Legenbauer T. Modified cue exposure for adolescents with binge eating behaviour: study protocol of a randomised pilot trial called EXI (ea)T. BMJ Open 2023; 13:e067626. [PMID: 36963795 PMCID: PMC10039999 DOI: 10.1136/bmjopen-2022-067626] [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] [Indexed: 03/26/2023] Open
Abstract
INTRODUCTION Binge eating (BE) behaviour is highly prevalent in adolescents, and can result in serious metabolic derangements and overweight in the long term. Weakened functioning of the behavioural inhibition system is one potential pathway leading to BE. Food cue exposure focusing on expectancy violation (CEEV) is a short intervention for BE that has proven effective in adults but has never been tested in adolescents. Thus, the current randomised pilot trial evaluates the feasibility of CEEV for adolescents and its efficacy in reducing eating in the absence of hunger (EAH) of binge food items. METHODS AND ANALYSIS The trial will include N=76 female adolescents aged between 13 and 20 years with a diagnosis of bulimia nervosa, binge eating disorder (BED) or their subthreshold forms based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Participants will be randomly assigned to two sessions of CEEV or behavioural analysis (BA), a classical cognitive-behavioural therapy-based intervention. The primary endpoint is the change in EAH measured according to ad libitum consumption of personally preferred binge food in a bogus taste test at post-test based on the intention-to-treat population. Key secondary endpoints are changes in EAH of standardised binge food at post-test, in EAH at 3-month follow-up (FU) and in food craving after induction of food cue reactivity at post-test and FU. To identify further valid outcome parameters, we will assess effects of CEEV compared with BA on global ED psychopathology, BE frequency within the last 28 days, body weight, response inhibition and emotion regulation abilities. Treatment groups will be compared using analysis of covariance with intervention as fixed factor and body mass index at baseline as covariate. ETHICS AND DISSEMINATION This clinical trial has been approved by the Ethics Review Committee of the Medical Association of Rhineland-Palatinate and the Medical Faculty of the Ruhr-University Bochum. The collected data will be disseminated locally and internationally through publications in relevant peer-reviewed journals and will be presented at scientific and clinical conferences. Participants data will only be published in an anonymised form. TRIAL REGISTRATION NUMBER DRKS00024009.
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Affiliation(s)
- Hanna Preuss-van Viersen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Inken Kirschbaum-Lesch
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
| | - Jasmina Eskic
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sophie Lukes
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jana Pydd
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
| | - Laura Derks
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Ruhr University Bochum, Hamm, Germany
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Rennhak SK, Martus P, Zipfel S, Giel KE, Schag K. Process Analyses of Impulsive Behavior in Binge-Eating Disorder During the Randomized Controlled IMPULS Trial. Behav Ther 2023; 54:260-273. [PMID: 36858758 DOI: 10.1016/j.beth.2022.08.007] [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: 06/04/2021] [Revised: 08/05/2022] [Accepted: 08/26/2022] [Indexed: 11/19/2022]
Abstract
Impulsivity represents a risk factor for patients with binge-eating disorder, and we therefore investigated the treatment process of impulsive behaviors including binge-eating episodes in the randomized controlled IMPULS trial. Using 8 weekly online questionnaires throughout the assessment period, we compared 41 patients participating in the IMPULS program, which emphasized impulsive eating behavior (IG), with 39 control patients who received no intervention (CG). We assessed the frequency of binge eating, other impulsive behaviors, situations in which such behaviors could be inhibited, and the execution of alternative behaviors. Results indicate a stronger binge-eating reduction in the IG compared to the CG at the fifth, seventh, and eighth treatment weeks. Overall, both groups reduced other impulsive behaviors. They did not differ in the amount of inhibited impulsive behaviors and showed similar alternative behaviors, "distraction" most frequently used. IG patients evaluated the IMPULS program as very helpful. The stronger reduction of binge eating in the IG and positive evaluation of the treatment indicate a specific treatment effect regarding impulsive eating behavior. The reduction of other impulsive behaviors across both groups, and the initial reduction of binge eating within the CG, could be explained by an increased degree of self-observation.
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Affiliation(s)
- Sina K Rennhak
- Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy
| | - Peter Martus
- Medical University Hospital Tübingen, Institute for Clinical Epidemiology and Applied Biometry
| | - Stephan Zipfel
- Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy
| | - Katrin E Giel
- Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy
| | - Kathrin Schag
- Medical University Hospital Tübingen, Department of Psychosomatic Medicine and Psychotherapy.
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4
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Villa FM, Crippa A, Rosi E, Nobile M, Brambilla P, Delvecchio G. ADHD and eating disorders in childhood and adolescence: An updated minireview. J Affect Disord 2023; 321:265-271. [PMID: 36356347 DOI: 10.1016/j.jad.2022.10.016] [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: 11/09/2021] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with overactivity, inattention, and impulsivity as core characteristics. Recent studies suggest that 20 % of children with ADHD also develop eating disorders (EDs), including anorexia nervosa, bulimia nervosa and binge eating disorder. However, little is still known about the association between ADHD and EDs through childhood and adolescence. Therefore, in the present work, we aimed at summarizing the studies investigating ADHD and EDs in childhood and adolescence over the last 10 years. METHODS A bibliographic search on PubMed was performed and only studies that considered participants with a clinical diagnosis of ADHD, patients with an additional diagnosis of EDs and patients under 18 years old were included. A total of 7 studies were retrieved and included in the review. RESULTS The majority of the reviewed studies (N = 5) found an association between ADHD and EDs, while the remaining, which focused on EDs symptomatology, reported either lower ED symptoms in ADHD sample or no association between ADHD and EDs. LIMITATIONS the majority of studies were cross-sectional and therefore did not allow to explore the longitudinal casual relation between ADHD and EDs in the developmental age range considered. CONCLUSIONS This review suggests that children and adolescents with ADHD should be monitored for EDs. However, more work is still needed to better understand the clinical implications of the comorbidity between ADHD and EDs and its prospective impact on the life of children and adolescents with ADHD.
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Affiliation(s)
- F M Villa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - A Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - E Rosi
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - M Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - G Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Himmerich H, Saedisomeolia A, Krügel U. Editorial: Community series in extreme eating behaviors-Volume II. Front Psychiatry 2023; 14:1200098. [PMID: 37187858 PMCID: PMC10176084 DOI: 10.3389/fpsyt.2023.1200098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London, United Kingdom
- *Correspondence: Hubertus Himmerich
| | - Ahmad Saedisomeolia
- School of Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, QC, Canada
| | - Ute Krügel
- Rudolf Boehm Institute of Pharmacology and Toxicology, Medical Faculty, University of Leipzig, Leipzig, Germany
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6
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Sampedro-Piquero P, Zancada-Menéndez C, Bernabéu-Brotons E, Moreno-Fernández RD. The Relationship between Binge Drinking and Binge Eating in Adolescence and Youth: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:232. [PMID: 36612554 PMCID: PMC9819376 DOI: 10.3390/ijerph20010232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Adolescence and youth are critical periods in which alcohol consumption is usually initiated, especially in the form of binge drinking. In recent years, it is increasingly common to find adolescents and young people who also present binge behaviors towards unhealthy food with the aim of alleviating their anxiety (emotional eating) and/or because of impulsive personality. Despite the social and health relevance of this issue, it remains scarcely studied and more preventive research needs to be developed. Our meta-analysis study aimed to evaluate the relationship and co-occurrence of both binge behaviors during adolescence and young adulthood to clarify the link between binge drinking and eating. Selective literature search on different online databases was performed. We identified discrete but significant results regarding the direct association between binge drinking and binge eating in correlation coefficients and odds ratio. Future research should focus on the common psychological background and motives behind these problematic behaviors owing to their clinical implications for effective prevention and treatment.
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Affiliation(s)
- Patricia Sampedro-Piquero
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Clara Zancada-Menéndez
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja (UNIR), 26006 Logroño, Spain
| | - Elena Bernabéu-Brotons
- Facultad de Educación y Psicología, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Román D. Moreno-Fernández
- Facultad de Educación y Psicología, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
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Filippone L, Shankland R, Hallez Q. The relationships between social media exposure, food craving, cognitive impulsivity and cognitive restraint. J Eat Disord 2022; 10:184. [PMID: 36434703 PMCID: PMC9701005 DOI: 10.1186/s40337-022-00698-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Young adults are increasingly exposed to social media and their image/video-based activities. They use these platforms to share images, videos and advice in different fields like food and nutrition with: recipe ideas, nutritional opinions or specific diets. Along with the rise of digital technologies, the prevalence of eating disorders in young adults continues to grow. The present study analyzes the psychological and eating processes through which exposure to social media may lead to the development of food craving and problematic eating behaviors. METHODS A total of 103 young adult men (n = 15) and women (n = 88) answered questionnaires measuring their impulsivity (Barratt Impulsiveness Scale), eating habits (Three-Factor Eating Questionnaire), food craving (Food Cravings Questionnaire-Trait-reduced), and time exposure to social media. RESULTS The results showed two significant serial mediations. We found a correlational link between time exposure to social media and food craving scores. This positive relation is indirectly mediated by cognitive impulsivity. We also found a positive correlation between cognitive impulsivity and food craving scores that was mediated by cognitive restraint. CONCLUSION A better understanding of the existing links between social media, food craving and eating behaviors such as cognitive restraint could help researchers and clinicians to better guide young adults in their use and appropriation of social media food contents.
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Affiliation(s)
- Lisa Filippone
- Laboratoire Développement, Individu, Processus, Handicap, Éducation (DIPHE), Institut de Psychologie, Université Lumière Lyon 2, 5 avenue Pierre Mendès-France, Bron, France.
| | - Rebecca Shankland
- Laboratoire Développement, Individu, Processus, Handicap, Éducation (DIPHE), Institut de Psychologie, Université Lumière Lyon 2, 5 avenue Pierre Mendès-France, Bron, France.,Institut Universitaire de France, Paris, France
| | - Quentin Hallez
- Laboratoire Développement, Individu, Processus, Handicap, Éducation (DIPHE), Institut de Psychologie, Université Lumière Lyon 2, 5 avenue Pierre Mendès-France, Bron, France
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Zyoud SH, Shakhshir M, Abushanab AS, Koni A, Shahwan M, Jairoun AA, Al-Jabi SW. Mapping the landscape and structure of global research on binge eating disorder: Visualization and bibliometric analysis. World J Psychiatry 2022; 12:982-994. [PMID: 36051594 PMCID: PMC9331445 DOI: 10.5498/wjp.v12.i7.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/22/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Binge-eating disorder (BED) is a clinical syndrome and is considered the most common type of eating disorder. However, our understanding of the global performance and progress of BED research is limited.
AIM To describe and perform a bibliometric analysis of the state of BED research.
METHODS The term ‘Binge eating’ was searched in the title throughout the previous year’s up to December 31, 2020. We searched the Scopus and Reference Citation Analysis for publications on Binge eating. The VOSviewer software version 1.6.17 was used to produce the network visualization map of the most frequent author, collaborative relationships between countries/regions, and to determine the hotspots related to binge eating research. In addition, conventional bibliometric indicators were generated.
RESULTS The search strategy found 2713 total articles and an average of 62 articles per year. Among them, ‘Article’ represented 82.49% of the publications (n = 2238 articles) and was the most frequent type, followed by reviews (n = 243; 8.96%). The number of publications increased steadily during the last decade of the study period. One hundred and thirty-two countries contributed to binge eating research, with 1495 (55.11%) articles published in the United States, followed by Italy with 256 (9.44%), the United Kingdom with 183 (6.75%), and Germany with 182 (6.71%). Currently, the main hot topics related to BED are ‘type of treatment and management and treatment provided to BED”; “processes and pathways to binge eating”; and ‘diagnosis, signs and symptoms, comorbidities and prevalence and associated factors with BED’.
CONCLUSION The number of publications has increased noticeably during the previous decade. There are indeed relatively few publications on BED from low-and middle-income nations, so much is to be learned from the experience of all countries. Studies on this topic are critical in all countries to discover risk factors and effective intervention measures. Although our findings are preliminary, they imply that the future prospects for interventions aimed at BED management are bright, focusing on complex models of care and long-term maintenance of therapeutic gains.
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Affiliation(s)
- Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Poison Control and Drug Information Center, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Muna Shakhshir
- Department of Nutrition, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Amani S Abushanab
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
| | - Amer Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
- Division of Clinical Pharmacy, Hematology and Oncology Pharmacy Department, An-Najah National University Hospital, Nablus 44839, Palestine
| | - Moyad Shahwan
- Department of Pharmacy, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | | | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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Tang WSW, Ng TJY, Wong JZA, Ho CSH. The Role of Serious Video Games in the Treatment of Disordered Eating: A Systematic Review (Preprint). J Med Internet Res 2022; 24:e39527. [PMID: 36036967 PMCID: PMC9468918 DOI: 10.2196/39527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wymann S W Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tricia J Y Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Joseph Z A Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Giel KE, Bulik CM, Fernandez-Aranda F, Hay P, Keski-Rahkonen A, Schag K, Schmidt U, Zipfel S. Binge eating disorder. Nat Rev Dis Primers 2022; 8:16. [PMID: 35301358 PMCID: PMC9793802 DOI: 10.1038/s41572-022-00344-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/30/2022]
Abstract
Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018-2020 is estimated to be 0.6-1.8% in adult women and 0.3-0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging treatment approaches. Psychotherapy is the first-line treatment for BED. Recognition and research on BED has increased since its inclusion into DSM-5; however, continuing efforts are needed to understand underlying mechanisms of BED and to improve prevention and treatment outcomes for this disorder. These efforts should also include screening, identification and implementation of evidence-based interventions in routine clinical practice settings such as primary care and mental health outpatient clinics.
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany.
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | | | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
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11
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Novel Approaches to Tackling Emotional Loss of Control of Eating Across the Weight Spectrum. Proc Nutr Soc 2022; 81:255-263. [PMID: 35260206 DOI: 10.1017/s0029665122000994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Emotional overeating is a process that is particularly relevant to people within the binge spectrum of eating disorders. Approximately a third of people with overweight share this phenotype. In addition, this behaviour may occur in neurodevelopmental disorders (attention-deficit hyperactivity disorder (ADHD)) and other psychiatric disorders. The biopsychosocial underpinnings of emotional eating include a genetic vulnerability to a higher weight and various cognitive and emotional traits. The environment also plays a key role. For example, the commodification of food and beauty and exposure to weight stigma, unpleasant eating experiences and general adversity can set the scene. The majority of people with binge-eating disorder do not seek treatment (perhaps related to internalised stigma and shame). Hence opportunities for early intervention and secondary prevention are lost. Most guidelines for binge-eating disorder (based on the limited available research) recommend forms of cognitive psychotherapies and antidepressants. However, novel treatments that target underlying mechanisms are in development. These include interventions to improve emotional regulation and inhibitory control using neuromodulation and/or brain training. New technologies have been applied to talking therapies, including apps which can offer ‘just-in-time interventions’ or virtual reality or avatar work which can deliver more personalised interventions using complex scenarios. Drugs used for the treatment of ADHD, psychiatric and metabolic disorders may have the potential to be repurposed for binge-eating disorder. Thus, this is an area of rapid change with novel solutions being applied to this problem.
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Kulbida M, Kemps E, Tiggemann M. The role of rash impulsivity and sensitivity to reward in soft drink consumption. Appetite 2022; 173:105977. [PMID: 35240265 DOI: 10.1016/j.appet.2022.105977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022]
Abstract
Soft drink consumption has become a major public health issue. The present study aimed to examine the role of rash impulsivity and reward sensitivity in soft drink consumption using the two-factor model of impulsivity. Participants were a community sample of 229 adults (19-77 years). They completed self-report measures of impulsivity (SUPPS-P), reward sensitivity (RST-PQ) and beverage consumption (BEVQ-15). A principal component analysis was used to produce purer measures of rash impulsivity and reward sensitivity. Both rash impulsivity and reward sensitivity were positively associated with soft drink consumption, and each independently predicted soft drink consumption. Importantly, there was a significant interaction between the two, whereby rash impulsivity moderated the effect of reward sensitivity on soft drink consumption. The results support the logic of the two-factor model of impulsivity in the prediction of soft drink consumption. Further research should extend these findings to other consumption domains in both clinical and non-clinical populations.
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Giel KE, Schag K, Martus P, Max SM, Plewnia C. Ameliorating cognitive control in patients with binge eating disorder by electrical brain stimulation: study protocol of the randomized controlled ACCElect pilot trial. J Eat Disord 2022; 10:26. [PMID: 35183261 PMCID: PMC8857741 DOI: 10.1186/s40337-022-00544-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/27/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The current first-line treatment for binge eating disorder (BED), which is psychotherapy, is moderately effective in terms of abstinence from binge-eating. Neurobiological evidence suggests that people affected by BED show difficulties along the spectrum of impulsivity, including inhibitory control impairments and highlights the potential of novel treatment approaches directly targeting inhibitory control, including cognitive training approaches and non-invasive brain stimulation. METHODS ACCElect is a prospective, randomized controlled pilot trial investigating a novel, food-related inhibitory control training combined with transcranial direct current stimulation (tDCS). 40 patients with BED will be randomly assigned to receive the training either combined with verum or with sham stimulation (control condition). The inhibitory control training is based on principles of the antisaccade paradigm and comprises six training sessions over two weeks. Core aims are the investigation of feasibility and clinically relevant effects of a tDCS-enhanced inhibitory control training in BED patients and the establishment of a data basis for a larger efficacy trial. The primary clinical endpoint is binge-eating (BE) frequency in terms of changes in BE episodes four weeks after treatment termination as compared to baseline. Key secondary outcomes comprise ED pathology and general psychopathology, inhibitory control capacities, quality of life as well as acceptability and satisfaction with the intervention. DISCUSSION The results of the present trial will contribute to the development of novel neurobiologically informed treatment approaches for patients suffering from BED. Trial registration The ACCElect trial was prospectively registered on October 1, 2020, under the registration number NCT04572087 at ClinicalTrials.gov ( https://clinicaltrials.gov/ct2/show/NCT04572087 ).
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Eberhard Karls University Tübingen, Osianderstr. 5, 72076, Tübingen, Germany. .,Center of Excellence for Eating Disorders, Tübingen, Germany.
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Eberhard Karls University Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.,Center of Excellence for Eating Disorders, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biostatistics, Medical Faculty, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Sebastian M Max
- University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
| | - Christian Plewnia
- University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
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14
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Treasure J, Hübel C, Himmerich H. The evolving epidemiology and differential etiopathogenesis of eating disorders: implications for prevention and treatment. World Psychiatry 2022; 21:147-148. [PMID: 35015360 PMCID: PMC8751578 DOI: 10.1002/wps.20935] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,South London and Maudsley NHS Foundation TrustBethlem Royal HospitalBeckenham, KentUK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK,National Centre for Register‐based ResearchAarhus Business and Social Sciences, Aarhus UniversityAarhusDenmark
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK,South London and Maudsley NHS Foundation TrustBethlem Royal HospitalBeckenham, KentUK
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15
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Garavito DMN, Bjork JM. Impulsivity and Reflective Thinking in Veterans Seeking Care for Substance Use Disorder. Subst Use Misuse 2022; 57:1563-1571. [PMID: 35819091 DOI: 10.1080/10826084.2022.2096237] [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] [Indexed: 10/17/2022]
Abstract
Objective: Substance use disorder (SUD) is a major public health crisis, with increased overdose deaths in the past decade. This has coincided with a tremendous amount of research on those who misuse substances. However, extensive research on SUD vulnerability characteristics such as impulsivity may be complemented by research on theoretically relevant aspects of cognition. The Cognitive Reflection Test (CRT) was designed to measure a person's ability to subdue quick, intuitive decisions to reflect or deliberate. To some decision making theorists, this measure may help explain why some people are better able to inhibit "gut reactions" than others. Methods: We recruited 140 veterans from a Veterans Affairs medical center; 91 of whom were receiving SUD treatment. Participants completed the CRT and a measure of trait impulsivity (the UPPS-P). We ran planned ANCOVAs assessing differences in the number of correct answers on the CRT and the proportion of errors that were intuitive. Results: Participants who were receiving treatment gave significantly fewer correct, reflective answers on the CRT compared to controls. However, there were no significant differences in the proportion of errors that were due to intuitive responses. These findings did not change when controlling for age and/or trait impulsivity. Conclusion: Those suffering from SUD may exhibit cognitive deficits that do not stem from intuitive thinking. These deficits may, in turn, exacerbate issues arising from elevated impulsivity. Additional research which better incorporates decision making theory may be invaluable in providing clinically-relevant results and positive public health outcomes.
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Affiliation(s)
- David M N Garavito
- Department of Veterans Affairs, Mental Health Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
| | - James M Bjork
- Department of Veterans Affairs, Mental Health Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
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16
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Bhat R. Emerging trends and sustainability challenges in the global agri-food sector. FUTURE FOODS 2022. [DOI: 10.1016/b978-0-323-91001-9.00041-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Han XD, Zhang HW, Xu T, Liu L, Cai HT, Liu ZQ, Li Q, Zheng H, Xu T, Yuan TF. How Impulsiveness Influences Obesity: The Mediating Effect of Resting-State Brain Activity in the dlPFC. Front Psychiatry 2022; 13:873953. [PMID: 35619620 PMCID: PMC9127259 DOI: 10.3389/fpsyt.2022.873953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
Impulsiveness is a stable personal characteristic that contributes to obesity and may interact with it. Specifically, obesity is caused by unrestrained impulse eating that is not consciously controlled and leads to a hormonal imbalance that also can impair impulse control. However, the mechanism of this relationship is unclear. In our study, 35 obese individuals (body mass index, BMI > 28) were recruited and matched with 31 healthy controls (BMI < 24) in age and education level. All the participants underwent a resting-state fMRI and completed the Barratt Impulsiveness Scale-11. The results showed that patients with obesity had a significantly lower fractional amplitude of low-frequency fluctuations (fALFF) in the bilateral dorsolateral prefrontal cortex (dlPFC) and higher fALFF in the left fusiform cortex. In addition, non-planning impulsiveness was positively correlated with BMI. Importantly, we found that the right dlPFC completely mediated the relationship between non-planning impulsiveness and BMI. Our findings suggest that impulsivity is statistically more likely to precede obesity than to precede impulsivity and contributes to obesity by downregulating spontaneous activity in the dlPFC. This suggests that the dlPFC, which is associated with executive control, may be able a potential target for treating obesity.
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Affiliation(s)
- Xiao-Dong Han
- Department of Metabolic and Bariatric Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hong-Wei Zhang
- Department of Metabolic and Bariatric Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ting Xu
- Department of Metabolic and Bariatric Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lin Liu
- Department of Metabolic and Bariatric Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hui-Ting Cai
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zi-Qi Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Li
- MR Collaborations, Siemens Healthcare Ltd., Shanghai, China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Xu
- Department of Anaesthesiology, Affiliated Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.,Department of Anaesthesiology, Tongzhou People's Hospital, Nantong, China
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
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18
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İnce B, Max SM, Plewnia C, Leehr EJ, Zipfel S, Giel KE, Schag K. A Pilot Event-Related Potentials Study on Mechanisms Underlying a tDCS-Enhanced Food-Specific Response Inhibition Task for Patients With Binge Eating Disorder. Front Psychol 2021; 12:721672. [PMID: 34712172 PMCID: PMC8546297 DOI: 10.3389/fpsyg.2021.721672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022] Open
Abstract
Behavioural studies demonstrate alterations in cognitive functioning, particularly impaired response inhibition and increased attentional bias towards food in binge eating disorder (BED). This pilot study aimed to investigate the neurophysiological processing of a food-specific inhibition training combined with anodal transcranial direct current stimulation (tDCS) of the right dorsolateral prefrontal cortex (DLPFC) in 16 patients with BED (mean age = 38.6, mean BMI = 33.7 kg/m2). Patients performed a food-specific antisaccade task at baseline (T0) and in a cross-over design with verum vs. sham stimulation at T1 and T2. We investigated (i) event-related potentials (ERPs; N2, ERN and P3 amplitudes) while executing the task at baseline, (ii) whether baseline ERPs would predict task performance at T1 and T2 and (iii) associations between ERPs, eating disorder pathology and impulsivity at baseline. The mean amplitude of N2 was less pronounced in erroneous saccades (ES) than correct saccades (CS), whereas ERN and P3 mean amplitudes were more pronounced in ES. Moreover, the P3 mean amplitude of ES predicted the percentage of ES at both follow up-measurements irrespective of the applied stimulation (sham vs. verum). N2 in trials with correct saccades were negatively correlated with nonplanning trait impulsivity, while P3 in erroneous antisaccade trials was negatively correlated with food-related impulsivity. Overall, the findings of reduced ERN, enhanced P3 and N2 amplitude might be interpreted as difficulties in response inhibition towards food in individuals with BED. In particular, P3 predicts task outcome at follow-up and might represent a potential marker for inhibitory control processes.
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Affiliation(s)
- Başak İnce
- Department of Psychology, Haliç University, Istanbul, Turkey
| | - Sebastian M Max
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Tübingen, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Tübingen, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine & Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Centre of Excellence for Eating Disorders (KOMET), University Hospital Tübingen, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine & Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Centre of Excellence for Eating Disorders (KOMET), University Hospital Tübingen, Tübingen, Germany
| | - Kathrin Schag
- Department of Psychosomatic Medicine & Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Centre of Excellence for Eating Disorders (KOMET), University Hospital Tübingen, Tübingen, Germany
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19
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Bjork JM, Reisweber J, Burchett JR, Plonski PE, Konova AB, Lopez-Guzman S, Dismuke-Greer CE. Impulsivity and Medical Care Utilization in Veterans Treated for Substance Use Disorder. Subst Use Misuse 2021; 56:1741-1751. [PMID: 34328052 DOI: 10.1080/10826084.2021.1949603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Impulsivity has been defined by acting rashly during positive mood states (positive urgency; PU) or negative mood states (negative urgency; NU) and by excessive de-valuation of deferred rewards. These behaviors reflect a "live in the now" mentality that is not only characteristic of many individuals with severe substance use disorder (SUD) but also impedes medical treatment compliance and could result in repeated hospitalizations or other poor health outcomes. Purpose/objectives: We sought preliminary evidence that impulsivity may relate to adverse health outcomes in the veteran population. Impulsivity measured in 90 veterans receiving inpatient or outpatient SUD care at a Veterans Affairs Medical Center was related to histories of inpatient/residential care costs, based on VA Health Economics Resource Center data. Results: We found that positive urgency, lack of persistence and lack of premeditation, but not sensation-seeking or preference for immediate or risky rewards, were significantly higher in veterans with a history of one or more admissions for VA-based inpatient or residential health care that either included (n = 30) or did not include (n = 29) an admission for SUD care. Among veterans with a history of inpatient/residential care for SUD, NU and PU, but not decision-making behavior, correlated with SUD care-related costs. Conclusions/Importance: In veterans receiving SUD care, questionnaire-assessed trait impulsivity (but not decision-making) related to greater care utilization within the VA system. This suggests that veterans with high impulsivity are at greater risk for adverse health outcomes, such that expansion of cognitive interventions to reduce impulsivity may improve their health.
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Affiliation(s)
- James M Bjork
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Jarrod Reisweber
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Jason R Burchett
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Paul E Plonski
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Anna B Konova
- Department of Psychiatry, University Behavioral Health Care, and the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, NJ, USA
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