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Elwyn R, Williams M, Smith E, Smith S. Two identical twin pairs discordant for longstanding anorexia nervosa and OSFED: lived experience accounts of eating disorder and recovery processes. J Eat Disord 2024; 12:127. [PMID: 39223672 PMCID: PMC11367789 DOI: 10.1186/s40337-024-01078-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: 02/01/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Research into the risk of anorexia nervosa (AN) has examined twin pairs to further the understanding of the contributions of genetics, trait inheritance, and environmental factors to eating disorder (ED) development. Investigations of twin experiences of EDs have been biologically-based and have not considered the qualitative, phenomenological aspects of twin experiences. A gap in the literature exists regarding understanding of discordant twins with EDs. This research was developed in response, with the aim to deepen understanding of AN in discordant twins and to create novel ideas for further research and testing. The case studies presented in this article provide lived experience insights of two identical discordant twin pairs: one twin pair discordant for longstanding AN and one twin pair discordant for 'atypical' AN (the twin with AN has recovered). The perspectives and experiences of each co-twin (one with AN and one without) explore a number of factors that may have contributed to twin discordance in these cases, and how each twin has responded to the impact of AN in their lives. Through use of first-person accounts in case study presentation, this article centres social justice values of lived experience leadership and involvement in research. This article aims to extend current knowledge and understanding of EDs in discordant twins, particularly regarding risk for ED development, ED duration, diagnosis and treatment, and recovery processes.
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Affiliation(s)
- Rosiel Elwyn
- Neuroscience and Psychiatry, Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.
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2
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Zimmer-Gembeck MJ, Hawes MT, Scott DRA, Campbell MT, Webb DHJ. Adolescents’ online appearance preoccupation: A 5-year longitudinal study of the influence of peers, parents, beliefs, and disordered eating. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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3
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Liu S, Fuller-Tyszkiewicz M, Eddy S, Liu X, Portingale J, Giles S, Krug I. The Effects of Appearance-Based Comments and Non-Appearance-Based Evaluations on Body Dissatisfaction and Disordered Eating Urges: An Ecological Momentary Assessment Study. Behav Ther 2022; 53:807-818. [PMID: 35987540 DOI: 10.1016/j.beth.2022.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 11/26/2022]
Abstract
The current study used ecological momentary assessment (EMA) to investigate whether appearance-based comments, social and performance-based evaluations affected levels of body dissatisfaction (BD) and urges to engage in disordered eating behaviors (DE) throughout daily life. A total of 620 participants completed a baseline questionnaire assessing sociodemographic variables. Participants then downloaded a mobile app which alerted them to complete short surveys assessing their levels of BD, DE urges, and experiences of receiving comments and evaluations six times per day for 7 days. Negative appearance-based comments predicted greater levels of state BD, while positive appearance comments predicted lower levels of state BD. Negative social and performance-based evaluations predicted an increase in state BD, while positive evaluations predicted a decrease in this outcome variable. No significant predictor was found for the DE urge outcomes. The present findings suggest that receiving negative and positive feedback in various domains of one's life may predict opposite outcomes for body image. However, these effects do not necessarily associate with urges to engage in DE in a nonclinical population.
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4
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Day S, Bussey K, Trompeter N, Mitchison D. The Impact of Teasing and Bullying Victimization on Disordered Eating and Body Image Disturbance Among Adolescents: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:985-1006. [PMID: 33461439 DOI: 10.1177/1524838020985534] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Adolescence is a developmental period in which disordered eating and negative body image are highly prevalent, yet their risk factors are insufficiently understood and targeted. Despite research implicating both teasing and bullying victimization in the development of eating disorders, these strands of research are yet to be integrated. This systematic review hence aimed to identify whether teasing and bullying victimization are associated with greater risk of eating disorders and body image disturbance for adolescents. Systematic searches of PsycINFO and PubMed databases identified 79 papers that included quantitative analyses of the relationship between weight-related or nonspecific teasing or bullying victimization and disordered eating or body image disturbance. Overall, studies indicated that adolescents who are teased or bullied are more likely to experience disordered eating and negative body image compared to nonvictimized adolescents. This was more consistently observed in cross-sectional studies than in longitudinal findings. We identify several methodological limitations of the literature, including the infrequent consideration of potential mediating and moderating variables. Finally, we outline future directions such as temporal sequencing of the complex interrelationships among teasing and bullying, disordered eating, and body image disturbance in adolescents.
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Affiliation(s)
- Sinead Day
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- School of Medicine, Blacktown Clinical School, Translational Health Research Institute, Western Sydney University, Penrith, Australia
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5
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Kolar DR, Kaurin A, Meule A, Schlegl S, Dittmer N, Voderholzer U. Interpersonal, affective and compulsive features of driven exercise in anorexia nervosa. J Affect Disord 2022; 307:53-61. [PMID: 35337926 DOI: 10.1016/j.jad.2022.03.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND This preregistered (https://osf.io/g9ajb) analysis sought to integrate the current literature on trait compulsivity into maintenance models of driven exercise in anorexia nervosa (AN). We tested whether compulsivity increases the likelihood of driven exercise via interpersonal and affect-regulatory pathways. METHODS We used multilevel structural equation modeling to test the hypothesis that trait compulsivity predicts a stronger within-person link between affect-regulatory difficulties or interpersonal sensitivity and driven exercise in female adolescents and adults with AN. We used data from five assessments across inpatient treatment and 6-months follow-up of 207 adult and adolescent patients with AN (1035 datapoints). RESULTS In line with our hypotheses, patients who generally experienced more affect-regulatory difficulties or stronger interpersonal sensitivity tended to engage in driven exercise more strongly. Moreover, high levels of trait compulsivity amplified the effect of interpersonal sensitivity on driven exercise across time. Contrary to our hypotheses, the link between affect regulation and driven exercise was not moderated by compulsivity. Similar effects on general eating disorder psychopathology were found, but no cross-level moderation effect of compulsivity. LIMITATIONS Due to sample size, potential AN subtype-dependent effects were not analyzed. CONCLUSION Our results suggest that driven exercise coincides with self-reported experiences of interpersonal sensitivity and that this link varies as a function of compulsivity such that the within-person coupling is stronger among those scoring high on compulsivity. To derive clinically useful functional models of driven exercise, future studies might use intensive longitudinal data to investigate its momentary associations with affect and interpersonal sensitivity in the context of compulsive traits.
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Affiliation(s)
- D R Kolar
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - A Kaurin
- Faculty of Health/School of Psychology and Psychiatry, Witten/Herdecke University, Witten, Germany
| | - A Meule
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - S Schlegl
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - N Dittmer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - U Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
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6
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Rowlands K, Grafton B, Cerea S, Simic M, Hirsch C, Cruwys T, Yellowlees R, Treasure J, Cardi V. A multifaceted study of interpersonal functioning and cognitive biases towards social stimuli in adolescents with eating disorders and healthy controls. J Affect Disord 2021; 295:397-404. [PMID: 34500369 DOI: 10.1016/j.jad.2021.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive biases towards social stimuli have been identified as one of the putative modifiable mechanisms to remediate interpersonal difficulties in adolescents with mental disorders. However, evidence for these biases in adolescents with eating disorders is scarce. METHODS This study assessed interpersonal sensitivity, cognitive biases towards social stimuli, and quantity and quality of social group memberships in adolescents with eating disorders (n = 80), compared to healthy controls (n = 78), and examined whether a negative interpretation bias would mediate the relationship between interpersonal sensitivity, eating disorder symptoms and positive group memberships. RESULTS Adolescents with eating disorders displayed greater interpersonal awareness, negative interpretation biases of ambiguous social information and poorer quality relationships with their social groups compared to healthy controls. In a simple mediation model, interpersonal awareness predicted eating disorder symptoms, and this effect was partially mediated by a negative interpretation bias. CONCLUSIONS Psychological interventions which aim to reduce a negative interpretation bias might help to reduce the severity of eating disorder symptoms in adolescents with eating disorders.
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Affiliation(s)
- Katie Rowlands
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| | - Ben Grafton
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Silvia Cerea
- Department of General Psychology, University of Padova, Italy
| | - Mima Simic
- Child and Adolescent Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Colette Hirsch
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Tegan Cruwys
- Research School of Psychology, The Australian National University, Canberra ACT 2601, Australia
| | - Robyn Yellowlees
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Valentina Cardi
- Department of General Psychology, University of Padova, Italy
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7
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Mikhail ME, Carroll SL, Clark DA, O'Connor S, Burt SA, Klump KL. Context matters: Neighborhood disadvantage is associated with increased disordered eating and earlier activation of genetic influences in girls. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:875-885. [PMID: 34843291 DOI: 10.1037/abn0000719] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Emerging evidence suggests socioeconomic disadvantage may increase risk for eating disorders (EDs). However, there are very few studies on the association between disadvantage and EDs, and all have focused on individual-level risk factors (e.g., family income). Neighborhood disadvantage (i.e., elevated poverty and reduced resources in one's neighborhood) is associated with increased risk for anxiety/depression and poor physical health. To date, no studies have examined phenotypic associations between neighborhood disadvantage and disordered eating, or how any form of disadvantage may interact with genetic individual differences in risk for EDs. We examined phenotypic and etiologic associations between neighborhood disadvantage and disordered eating in 2,922 girls ages 8-17 from same-sex twin pairs recruited through the Michigan State University Twin Registry. Parents rated the twins on nine items assessing core disordered eating symptoms (e.g., weight preoccupation, binge eating), and neighborhood disadvantage was calculated from 17 indicators of contextual disadvantage (e.g., median home value, neighborhood unemployment). Puberty was measured using the Pubertal Development Scale to examine whether associations were consistent across development. At a phenotypic level, greater neighborhood disadvantage was associated with significantly greater disordered eating symptoms in girls at all stages of puberty (β = .07). Moreover, Genotype × Environment models showed that girls living in more disadvantaged neighborhoods exhibited stronger and earlier (i.e., during pre/early puberty) activation of genetic influences on disordered eating. Results highlight the critical importance of considering contextual disadvantage in research on etiology and risk for disordered eating, and the need for increased screening and treatment for EDs in disadvantaged youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - D Angus Clark
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor
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8
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Allison S, Warin M, Bastiampillai T, Looi JCL, Strand M. Recovery from anorexia nervosa: the influence of women's sociocultural milieux. Australas Psychiatry 2021; 29:513-515. [PMID: 33939932 DOI: 10.1177/10398562211010796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Young women living in industrialised westernised societies have a higher prevalence of anorexia nervosa, partly due to a cultural emphasis on thinness as a beauty ideal. Sociocultural milieux might promote recovery from anorexia nervosa amongst young women. The current article is a commentary about the social influences on recovery from anorexia nervosa - based on social anthropology, narratives of people with lived experience, and clinical studies. CONCLUSION Anorexia nervosa increases social withdrawal, and recovery leads to re-engagement with meaningful relationships. Recovery also empowers women as 'cultural critics' who challenge assumptions about the thinness beauty ideal and gender roles. The gradual process of full or partial recovery often occurs during emerging adulthood (aged 20-29). In this life stage, adolescent friendship groups are dissolving as women move from education to work, reducing the danger of weight-based teasing by peers, which is an environmental risk factor for disordered eating. Women recovering from anorexia nervosa may connect with those aspirations of peers and mentors that eschew a focus on weight and shape, but relate to the life-stage tasks of starting careers, beginning new friendships, selecting life partners and family formation - that is, a broader role in larger relationship networks.
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Affiliation(s)
- Stephen Allison
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia
| | - Megan Warin
- School of Social Sciences, University of Adelaide, Adelaide, SA, Australia.,Fay Gale Centre for Research on Gender, University of Adelaide, SA, Australia
| | - Tarun Bastiampillai
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.,Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Jeffrey C L Looi
- Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT, Australia.,Academic Unit of Psychiatry and Addiction Medicine, the Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
| | - Mattias Strand
- Transcultural Centre, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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9
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MacIntyre RI, Heron KE, Crosby RD, Engel SG, Wonderlich SA, Mason TB. Measurement of the influences of social processes in appetite using ecological momentary assessment. Appetite 2021; 161:105126. [PMID: 33515621 DOI: 10.1016/j.appet.2021.105126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/23/2020] [Accepted: 01/11/2021] [Indexed: 11/16/2022]
Abstract
Obesity and eating disorders are serious health concerns that both involve dysregulated eating patterns, including binge eating and emotional eating. Though social processes and appetite dysregulation have been shown to predict dysregulated eating separately, limited research has examined the potential link between social processes and appetite in daily life. The purpose of the present study was to examine the association between naturally occurring social processes previously linked with dysregulated eating and appetite using ecological momentary assessment (EMA). Thirty women with binge-eating pathology completed five semi-random EMA surveys a day for 14 days. The EMA surveys included measures of social processes that occurred between surveys (i.e., interpersonal problems, body social comparisons, social media use, and external pressures for thinness) and assessments of appetite at time of survey. Multilevel analyses revealed that each social process approximately 2-h prior positively predicted appetite. Further, using lagged analyses, all of the social processes approximately 4-h prior, aside from social media use, predicted appetite. Our findings suggest that social processes are important in predicting appetite among women with binge-eating pathology. Future extensions of this research that include measures of dysregulated eating are needed.
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Affiliation(s)
- Rachel I MacIntyre
- The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA.
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA; Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Health, Fargo, ND, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Health, Fargo, ND, USA
| | | | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
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10
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Puhl RM, Lessard LM. Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice. Curr Obes Rep 2020; 9:402-411. [PMID: 33079337 DOI: 10.1007/s13679-020-00408-8] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma in clinical practice and pediatric care. RECENT FINDINGS Weight stigma is highly prevalent among youth with high body weight, who are targets of weight-based victimization from peers, parents, and teachers. These experiences place youth at risk for psychological distress (primarily depressive symptoms, low self-esteem, and suicidal ideation), worse social and academic outcomes, and adverse physical health consequences including maladaptive eating behaviors, lower physical activity, substance use, and weight gain. Healthcare professionals and clinicians have important roles to play in efforts to help reduce weight stigma and support youth with obesity. Fundamental to these efforts is the use of supportive, compassionate, and non-stigmatizing communication with youth and their families.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, USA.
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 0610, USA.
| | - Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 0610, USA
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11
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Risk factors and temporal patterns of disordered eating differ in adolescent boys and girls: Testing gender-specific appearance anxiety models. Dev Psychopathol 2020; 33:856-867. [DOI: 10.1017/s0954579420000188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAdolescent dieting and disordered eating (DE) are risks for clinical eating disorders. In this five-wave longitudinal study, we tested gender-specific models linking early risk factors to temporal patterns of DE, considering appearance anxiety as a mediator. Participants were 384 Australian students (age 10 to 13; 45% boys) who reported their purging and skipping meals, experience with appearance-related teasing, media pressure, and appearance anxiety. Parents reported pubertal maturation and height/weight was measured. Gender differences in temporal patterns of DE were found and predictive models were tested using latent-variable growth curve and path models. Boys’ DE was generally stable over time; girls showed stability in purging but an average increase in skipping meals. Peer teasing, media pressure, and pubertal maturation were associated with more elevated initial DE in girls, and pubertal maturation was associated with a steeper increase in DE. For boys, body mass index had a direct positive association with DE. Appearance anxiety was associated with more DE, but there was only one significant indirect effect via anxiety, which was for boys’ pubertal maturation. Findings support the dominant role of social interactions and messages, as well as pubertal maturation, for girls’ DE and the prominence of physical risk factors for explaining boys’ DE.
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12
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Albano G, Rowlands K, Baciadonna L, Coco GL, Cardi V. Interpersonal difficulties in obesity: A systematic review and meta-analysis to inform a rejection sensitivity-based model. Neurosci Biobehav Rev 2019; 107:846-861. [PMID: 31585134 DOI: 10.1016/j.neubiorev.2019.09.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/05/2019] [Accepted: 09/29/2019] [Indexed: 01/27/2023]
Abstract
Obesity is associated with difficulties due to stigma and loneliness. These impact negatively on individuals' quality of life and behaviour change efforts. Increased sensitivity to others' negative feedback might play a role in the maintenance of these difficulties and could be addressed in psychological interventions. We conducted a systematic review of interpersonal difficulties in individuals with obesity, across the lifespan. We investigated early interpersonal adversity (i.e. frequency of teasing/bullying), perceived interpersonal stress and quality of social life, based on a rejection sensitivity model. The databases PubMed, Web of Knowledge and AGRIS, Embase, Medline and PsychINFO were searched for published peer-reviewed journal articles (1980-June 2018). Thirty-two studies met inclusion criteria. Results from the meta-analyses (n = 16 studies) indicated that overweight/obese individuals reported more frequent experiences of teasing/bullying, greater interpersonal stress and poorer quality of social life than healthy weight individuals. Findings in the systematic review aligned to this evidence. Psychological interventions targeting increased sensitivity to negative interpersonal feedback could improve interpersonal functioning and, in turn, eating behaviours in individuals with obesity.
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Affiliation(s)
- Gaia Albano
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Luigi Baciadonna
- Queen Mary University of London, Biological and Experimental Psychology, School of Biological and Chemical Sciences, London, UK.
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Abstract
Most theories emphasize the role of sociocultural factors in the etiology of eating disorders (EDs). This article uses a broad search strategy to identify current etiologic studies. Women with an ED outnumber men in each diagnosis, but gender differences vary by diagnosis. Men were underrepresented in study samples, and information about variable risk factors in men is sparse. Findings suggest transdiagnostic risk factors and disorder-specific risk factors. Extracting data from population-based registers represents a major advance. Novel analytic approaches suggest complex pathways to ED. Although used in several studies, reliance on a transdiagnostic ED category (vs diagnosis-specific groupings) is premature.
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Affiliation(s)
- Ruth Striegel Weissman
- Department of Psychology, Wesleyan University, 207 High Street, Middletown, CT 06359, USA.
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14
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Abstract
Estimates of lifetime bulimia nervosa (BN) range from 4% to 6.7% across studies. There has been a decrease in the presentation of BN in primary care but an increase in disordered eating not meeting full diagnostic criteria. Regardless of diagnostic status, disordered eating is associated with long-term significant impairment to both physical and mental quality of life, and BN is associated with a significantly higher likelihood of self-harm, suicide, and death. Assessment should adopt a motivationally enhancing stance given the high level of ambivalence associated with BN. Cognitive behavior therapy specific to eating disorders outperforms other active psychological comparisons.
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Affiliation(s)
- Tracey D Wade
- School of Psychology, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia.
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15
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Abstract
PURPOSE OF REVIEW Internet prevention of eating disorders is a relatively new field that is expanding rapidly. We review randomized controlled trial designs examining the efficacy of Internet prevention in eating disorders that have emerged from 2016. RECENT FINDINGS Our literature search identified five studies that used randomized controlled trial designs to examine the efficacy of Internet prevention in eating disorders. All of the studies represented indicated prevention, that is, young women who have body image concerns. Three specific approaches were examined: media literacy, cognitive dissonance, and cognitive behavior therapy. All studies indicated significantly more impact of the intervention than a control condition, with between group effect sizes at follow-up ranging from 0.24 to 0.42. SUMMARY Although Internet interventions for eating disorders may be less effective than face-to-face interventions, and attrition increases when populations are used that reflect real-world usage, these interventions have an important role in a stepped-care approach. Future research should make direct comparisons of different Internet programs with a view to helping us understand who will gain most benefit out of which approach, including who requires moderated Internet approaches and who does not.
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16
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A case series to investigate food-related fear learning and extinction using in vivo food exposure in anorexia nervosa: A clinical application of the inhibitory learning framework. EUROPEAN EATING DISORDERS REVIEW 2018; 27:173-181. [DOI: 10.1002/erv.2639] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/10/2018] [Accepted: 08/06/2018] [Indexed: 12/11/2022]
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17
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Reactivity to interpersonal stress in patients with eating disorders: A systematic review and meta-analysis of studies using an experimental paradigm. Neurosci Biobehav Rev 2018; 87:133-150. [DOI: 10.1016/j.neubiorev.2018.02.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 02/05/2018] [Accepted: 02/05/2018] [Indexed: 12/20/2022]
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18
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Cardi V, Tchanturia K, Treasure J. Premorbid and Illness-related Social Difficulties in Eating Disorders: An Overview of the Literature and Treatment Developments. Curr Neuropharmacol 2018; 16:1122-1130. [PMID: 29345581 PMCID: PMC6187758 DOI: 10.2174/1570159x16666180118100028] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 12/06/2017] [Accepted: 01/11/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness. OBJECTIVE The aim of this paper is to briefly review the evidence of social problems in people with eating disorders and to consider the literature on treatments that target these features. METHOD A narrative review of the literature was conducted. RESULTS People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset. Further social difficulties occur as the illness develops, including impaired social cognition and increased threat sensitivity. All relationships with family, peers and therapists are compromised by these effects. Thus, social difficulties are both risk and maintaining factors of eating disorders and are suitable targets for interventions. Several forms of generic treatments (e.g. interpersonal psychotherapy, cognitive analytic therapy, focal psychodynamic therapy) have an interpersonal focus and show some efficacy. Guided self-management based on the cognitive interpersonal model of the illness directed to both individuals and support persons has been found to improve outcomes for all parties. Adjunctive treatments that focus on specific social difficulties, such as cognitive remediation and emotion skills training and cognitive bias modification have been shown to have a promising role. CONCLUSION More work is needed to establish whether these approaches can improve on the rather disappointing outcomes that are attained by currently used treatments for eating disorders.
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Affiliation(s)
- Valentina Cardi
- Section of Eating Disorders, King’s College London, Institute of Psychiatry, Psychological Medicine, 103 Denmark Hill, LondonSE5 8AF, UK
| | - Kate Tchanturia
- Section of Eating Disorders, King’s College London, Institute of Psychiatry, Psychological Medicine, 103 Denmark Hill, LondonSE5 8AF, UK
| | - Janet Treasure
- Section of Eating Disorders, King’s College London, Institute of Psychiatry, Psychological Medicine, 103 Denmark Hill, LondonSE5 8AF, UK
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Cardi V, Mallorqui-Bague N, Albano G, Monteleone AM, Fernandez-Aranda F, Treasure J. Social Difficulties As Risk and Maintaining Factors in Anorexia Nervosa: A Mixed-Method Investigation. Front Psychiatry 2018; 9:12. [PMID: 29535645 PMCID: PMC5834472 DOI: 10.3389/fpsyt.2018.00012] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Anorexia nervosa (AN) is a serious psychiatric disorder characterized by severe restriction of energy intake and dangerously low body weight. Other domains of functioning are affected, including social functioning. Although difficulties within this domain have started to be acknowledged by the literature, some important gaps remain to be filled. Do social difficulties predate the onset of the illness? What difficulties in particular are relevant for the development and maintenance of the illness? The aim of this study is to combine the use of quantitative and qualitative methods to answer these questions. Ninety participants with lifetime AN (88 women and 2 men) completed an online survey assessing memories of involuntary submissiveness within the family, fear of negative evaluation from others, perceived lack of social competence, feelings of social belonging, eating disorder symptoms, and work and social adjustment. Participants also answered three open questions regarding their experience of social relationships before and after the illness onset. The findings provided support for the hypothesized relationships between the study variables. Involuntary submissiveness and fear of negative evaluation predicted eating disorder symptoms and these associations were partially mediated by perceived lack of social competence. Two-thirds of the sample recalled early social difficulties before illness onset and recognized that these had played a role in the development of the illness. A larger proportion of participants stated that the eating disorder had affected their social relationships in a negative way. This study sheds some light on patients' perspective on the predisposing and maintaining role that social difficulties play in AN and identifies key psychological variables that could be targeted in treatment.
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Affiliation(s)
- Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Núria Mallorqui-Bague
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain
| | - Gaia Albano
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | | | - 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
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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