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Mitchison D, Wang SB, Wade T, Haynos AF, Bussey K, Trompeter N, Lonergan A, MNeuroPsych JT, Hay P. Development of transdiagnostic clinical risk prediction models for 12-month onset and course of eating disorders among adolescents in the community. Int J Eat Disord 2023; 56:1406-1416. [PMID: 37052452 PMCID: PMC10404110 DOI: 10.1002/eat.23951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/26/2023] [Accepted: 03/26/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE To develop and internally validate risk prediction models for adolescent onset and persistence of eating disorders. METHODS N = 963 Australian adolescents (11-19 years) in the EveryBODY Study cohort completed online surveys in 2018 and 2019. Models were built to predict 12-month risk of (1) onset, and (2) persistence of a DSM-5 eating disorder. RESULTS Onset Model. Of the n = 687 adolescents without an eating disorder at baseline, 16.9% were identified with an eating disorder after 12 months. The prediction model was based on evidence-based risk factors for eating disorder onset available within the dataset (sex, body mass index percentile, strict weight loss dieting, history of bullying, psychological distress, weight/shape concerns). This model showed fair discriminative performance (mean AUC = .75). The most important factors were psychological distress, weight and shape concerns, and female sex. Diagnostic Persistence Model. Of the n = 276 adolescents with an eating disorder at baseline, 74.6% were identified as continuing to meet criteria for an eating disorder after 12 months. The prediction model for diagnostic persistence was based on available evidence-based risk factors for eating disorder persistence (purging, distress, social impairment). This model showed poor discriminative performance (mean AUC = .65). The most important factors were psychological distress and self-induced vomiting for weight control. DISCUSSION We found preliminary evidence for the utility of a parsimonious model for 12-month onset of an eating disorder among adolescents in the community. Future research should include additional evidence-based risk factors and validate models beyond the original sample. PUBLIC SIGNIFICANCE This study demonstrated the feasibility of developing parsimonious and accurate models for the prediction of future onset of an eating disorder among adolescents. The most important predictors in this model included psychological distress and weight and shape concerns. This study has laid the ground work for future research to build and test more accurate prediction models in diverse samples, prior to translation into a clinical tool for use in real world settings to aid decisions about referral to early intervention.
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Affiliation(s)
- Deborah Mitchison
- Eating Disorder and Body Image Network, Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Shirley B. Wang
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Tracey Wade
- Flinders Institute for Mental Health and Wellbeing, Flinders University, Adelaide, South Australia, Australia
| | - Ann F. Haynos
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kay Bussey
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Nora Trompeter
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Jack Tame MNeuroPsych
- Eating Disorder and Body Image Network, Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Phillipa Hay
- Eating Disorder and Body Image Network, Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
- Mental Health Services, South West Sydney Local Health District, Campbelltown, Australia
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Foroughi N, Hay P, Mannan H. Community Women’s Lifestyle and Eating Disorders in the Era of COVID-19 Pandemic: A 15-Year Follow-Up Study. Nutrients 2023; 15:nu15071676. [PMID: 37049516 PMCID: PMC10097118 DOI: 10.3390/nu15071676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023] Open
Abstract
Most studies suggest that COVID-19 has adversely affected the quality of life and mental health, including eating disorders. However, studies have yet to examine longitudinally the impact of COVID-19 on eating disorder symptomatic individuals. This study aims to examine longitudinally the impact of the COVID-19 pandemic on the lifestyle and eating disorder symptoms of a symptomatic group of community-dwelling women. These women (n = 171) were enrolled in a longitudinal study, completed a COVID-19 modular self-report (post or Qualtrics, 2020/21), and participated in the current study. This study examined a 15th year follow-up. In 2020, 40% were tested for COVID-19. Of these, 87% had negative results; 5.3% self-isolated at home; 20.5% stopped working/studying in person; 28% continued online work/study; and 28% stopped work/studying in person. The pandemic affected sporting activities, music, and club activities (32.7% discontinued); 38% socialized in person; 16% socialized online; and 10% completely stopped socializing. Preliminary findings showed that the respondents showed no significant changes in levels of psychological distress (K10: 21.4 ± 9.8 vs. 19.0 ± 7.1, p < 0.171), and impaired quality of life (SF12: 50.9 ± 8.0 vs. 48.3 ± 9.5, p < 0.055) at 15-year follow-up. Eating disorder symptoms increased over time (EDE-Q global: 2.1 ± 1.4 vs. 2.9 ± 1.4, p < 0.013). Observed worsening of eating disorder-related symptoms during the COVID-19 pandemic may be due to interrupted eating patterns, exercise restrictions and the absence of social support. Provision and access to interventions to support those affected by eating disorders are a high priority, especially during these times. Further analyses with data imputation may find or further establish direct implications of COVID-19 in eating disorders.
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Affiliation(s)
- Nasim Foroughi
- Correspondence: ; Tel.: +61-(02)-4634-4580; Fax: +61-(02)-4620-3891
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Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia-a rapid review. J Eat Disord 2023; 11:23. [PMID: 36793104 PMCID: PMC9933292 DOI: 10.1186/s40337-023-00738-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Understanding of the epidemiology and health burden of eating disorders has progressed significantly in the last 2 decades. It was considered one of seven key areas to inform the Australian Government commissioned National Eating Disorder Research and Translation Strategy 2021-2031, as emerging research had highlighted a rise in eating disorder prevalence and worsening burden-of-illness. The aim of this review was to better understand the global epidemiology and impact of eating disorders to inform policy decision-making. METHODS Using a systematic Rapid Review methodology, ScienceDirect, PubMed and Medline (Ovid) were searched for peer-reviewed studies published between 2009 and 2021. Clear inclusion criteria were developed in consultation with experts in the field. Purposive sampling of literature was conducted, which predominately focused on higher-level evidence (meta-analyses, systematic reviews, and large epidemiological studies), synthesised, and narratively analysed. RESULTS 135 studies were deemed eligible for inclusion in this review (N = 1324). Prevalence estimates varied. Global Lifetime prevalence of any eating disorder ranged from 0.74 to 2.2% in males, and 2.58-8.4% in females. Australian 3-month point-prevalence of broadly defined disorders was around 16% in females. Eating disorders appeared more prevalent in young people and adolescents, particularly females (in Australia: eating disorders ~ 22.2%; disordered eating ~ 25.7%). Limited evidence was found on sex, sexuality and gender diverse (LGBTQI +) individuals, particularly males, who had a six-fold increase in prevalence compared to the general male population, with increased illness impact. Similarly, limited evidence on First Australian's (Aboriginal and Torres Strait Islander) suggests prevalence rates similar to non-Indigenous Australians. No prevalence studies were identified specifically assessing culturally and linguistically diverse populations. Global disease burden of any eating disorder was 43.4 age-standardised disability-adjusted-life-years per 100,000; increasing by 9.4% between 2007 and 2017. Australian's total economic cost was estimated at $84 billion from years-of-life lost due to disability and death, and annual lost earnings ~ $1.646 billion." CONCLUSIONS There is no doubt that eating disorder prevalence and impact are on the rise, particularly in at-risk and understudied populations. Much of the evidence came from female-only samples, and Western, high-income countries which more readily have access to specialised services. Future research should examine more representative samples. There is an urgent need for more refined epidemiological methods to better understand these complex illnesses over time, to guide health policy and development-of-care.
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Pehlivan MJ, Miskovic-Wheatley J, Le A, Maloney D, Research Consortium NED, Touyz S, Maguire S. Models of care for eating disorders: findings from a rapid review. J Eat Disord 2022; 10:166. [PMID: 36380363 PMCID: PMC9667640 DOI: 10.1186/s40337-022-00671-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Delayed diagnosis, gaps in services and subsequent delays in specialist care and treatment lead to poorer health outcomes for individuals with eating disorders (EDs) and drive significant government healthcare expenditure. Given the significant disease burden associated with EDs, it is imperative that current implementation research is summarised to identify gaps in care and enable refinement for optimal patient outcomes. This review aimed to provide an updated synthesis on models of care for EDs in developed healthcare systems. METHODS This paper was conducted as part of a series of Rapid Reviews (RRs) to be published in a special series in the Journal of Eating Disorders. To provide a current and rigorous review, peer-reviewed articles published in the English language between 2009 and 2021 across three databases (ScienceDirect, PubMed and Ovid/Medline) were searched, with priority given to higher level evidence (e.g., meta-analyses, large population studies, Randomised Control Trials (RCTs)). The current review synthesises data from included studies investigating models of care for people with EDs. RESULTS Sixty-three studies (4.5% of the original RR) were identified, which included several diagnostic populations, the most common being Anorexia Nervosa (AN) (30.51%). Across EDs, specialist care was found to improve patient outcomes, with many patients effectively being treated in outpatient or day programs with multi-disciplinary teams, without the need for lengthy inpatient hospitalisation. Few studies investigated the interaction of different ED services (e.g., inpatient, community services, primary care), however stepped care models emerged as a promising approach to integrate ED services in a targeted and cost-effective way. Issues surrounding low treatment uptake, underdiagnosis, long waiting lists and limited hospital beds were also evident across services. CONCLUSION Findings suggested further research into alternatives to traditional inpatient care is needed, with partial and shorter 'hospitalisations' emerging as promising avenues. Additionally, to tackle ongoing resource issues and ensure timely detection and treatment of EDs, further research into novel alternatives, such as active waiting lists or a greater role for primary care clinicians is needed. This paper is part of a larger Rapid Review series carried out to guide Australia's National Eating Disorders Research and Translation Strategy 2021-2031. Rapid reviews aim to thoroughly summarise an area of research over a short time period, typically to help with policymaking in this area. This Rapid Review summarises the evidence relating to how we care for people with eating disorders in Western healthcare systems. Topics covered include inpatient/hospital care, residential care, day programs, outpatient/community care, and referral pathways. Findings suggested specialist eating disorder services may enhance detection, referral, and patient care. Stepped care models presented as a cost-effective approach which may help with linkage between different eating disorder services. There was a trend towards shorter hospital stays and approaches which allow for greater connection with the community, such as day programs. Evidence was also found of treatment delays, due to system issues (long waiting lists, lack of accurate assessment and diagnosis) and patient-related barriers (stigma, recognition). Upskilling and involving primary care clinicians in diagnosis and referral as part of a stepped care model may help to address some of these concerns. Further efforts to improve mental health literacy and de-stigmatise help-seeking for eating disorders are needed.
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Affiliation(s)
- Melissa J Pehlivan
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia.
| | - Jane Miskovic-Wheatley
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Anvi Le
- Healthcare Management Advisors, Melbourne, Australia
| | - Danielle Maloney
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | | | - Stephen Touyz
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Sydney, Australia
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Mental health and health behaviours among patients with eating disorders: a case-control study in France. J Eat Disord 2022; 10:160. [PMID: 36357945 PMCID: PMC9650850 DOI: 10.1186/s40337-022-00691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/13/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Eating disorders (ED) are a public health concern due to their increasing prevalence and severe associated comorbidities. The aim of this study was to identify mental health and health behaviours associated with each form of EDs. METHODS A case-control study was performed: cases were patients with EDs managed for the first time in a specialized nutrition department and controls without EDs were matched on age and gender with cases. Participants of this study filled self-administered paper questionnaire (EDs group) or online questionnaire (non-ED group). Collected data explored socio-demographics, mental health including anxiety and depression, body image, life satisfaction, substances and internet use and presence of IBS (Irritable Bowel Syndrome). RESULTS 248 ED patients (broad categories: 66 Restrictive, 22 Bulimic and 160 Compulsive) and 208 non-ED subjects were included in this study. Mean age was 36.0 (SD 13.0) and 34.8 (SD 11.6) in ED and non-ED groups, respectively. Among patients and non-ED subjects, 86.7% and 83.6% were female, respectively. Body Shape Questionnaire mean score was between 103.8 (SD 46.1) and 125.0 (SD 36.2) for EDs and non-ED group, respectively (p < 0.0001). ED patients had a higher risk of unsatisfactory friendly life, anxiety, depression and IBS than non-ED s (all p < 0.0001) Higher risk of anxiety, depression and IBS was found for the three categories of EDs. Higher risk of smoking was associated only with restrictive ED, while or assault history and alcohol abuse problems were associated only with bulimic ED. The risk of binge drinking was lower in all EDs categories than in non-ED. CONCLUSION This study highlights the common comorbidities shared by all EDs patients and also identifies some specific features related to ED categories. These results should contribute to the conception of future screening and prevention programs in at risk young population as well as holistic care pathways for ED patients. This case-control study evaluated mental health and health behaviours associated with the main categories of Eating Disorders (EDs). Cases were patients with EDs initiating care in a specialized nutrition department and controls without ED were matched on age and gender with cases. Self-administered paper questionnaires were filled by ED 248 patients (66 Restrictive, 22 Bulimic and 160 Compulsive) and online questionnaire by 241 non-ED controls. Body image satisfaction was significantly worse in ED patients than in controls. (p < 0.0001). Dissatisfactory life, anxiety, depression and irritable bowel syndrome were more found in patients with all EDs categories than in non-ED (p < 0.0001). Smoking risk was increased only in restrictive patients while and assault history and alcohol abuse was increased only in bulimic patients. These results highlight the global burden of ED and related comorbidities and provide useful information for future screening, prevention and care programs.
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Brockmeyer T, Febry H, Leiteritz-Rausch A, Wünsch-Leiteritz W, Leiteritz A, Friederich HC. Cognitive flexibility, central coherence, and quality of life in anorexia nervosa. J Eat Disord 2022; 10:22. [PMID: 35168670 PMCID: PMC8845392 DOI: 10.1186/s40337-022-00547-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/01/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) has consistently been found to be associated with poor cognitive flexibility and central coherence. These two cognitive functions have been considered important maintenance factors in AN and are addressed by specific treatment approaches such as cognitive remediation therapy. While there is clear empirical evidence that difficulties in such cognitive functions are related to impaired daily functioning in schizophrenia and bipolar disorder, this potential association has received only little attention in AN research so far. Therefore, the aim of this study was to examine potential relationships between weak cognitive flexibility, central coherence, and poor quality of life (QoL) in AN. METHODS Cognitive flexibility and central coherence were measured by both neuropsychological (i.e., performance based) and self-report measures alongside with self-reported QoL in a sample of 138 adult patients with AN. RESULTS Self-report but not performance based measures of cognitive flexibility and central coherence were associated with QoL. Weaker cognitive flexibility and central coherence were correlated with poorer QoL. These associations were independent of comorbid depression. The link between weak central coherence and poor QoL was particularly strong in patients with the restricting subtype of AN. The link between cognitive flexibility and QoL, however, was independent of AN subtype. CONCLUSIONS Weak cognitive flexibility and central coherence are associated with low QoL in AN, especially in patients with the restrictive subtype. However, this relationship is dependent on the method of measurement, where self-report measures seem to be more relevant than performance based measures.
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Affiliation(s)
- Timo Brockmeyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Gosslerstrasse 14, 37073, Goettingen, Germany. .,Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
| | - Hagen Febry
- Klinik Lueneburger Heide, Am Klaubusch 21, 29549, Bad Bevensen, Germany
| | | | | | - Andreas Leiteritz
- Klinik Lueneburger Heide, Am Klaubusch 21, 29549, Bad Bevensen, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
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Trompeter N, Bussey K, Forbes MK, Hay P, Goldstein M, Thornton C, Basten C, Heruc G, Roberts M, Byrne S, Griffiths S, Lonergan A, Mitchison D. Emotion Dysregulation and Eating Disorder Symptoms: Examining Distinct Associations and Interactions in Adolescents. Res Child Adolesc Psychopathol 2022; 50:683-694. [PMID: 35029782 PMCID: PMC9054869 DOI: 10.1007/s10802-022-00898-1] [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] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 11/30/2022]
Abstract
Emotion dysregulation has been posited as a key transdiagnostic factor of mental health difficulties, including eating disorders. However, how this transdiagnostic factor interacts with the disorder-specific factor of weight and shape concerns remains unclear. The current study examined whether emotion dysregulation is associated with eating disorder behaviors over and above the association between weight and shape concerns and whether these two factors interacted. The current study used data from two samples, a community sample of high school students (n = 2699), and a clinical sample of adolescents receiving outpatient treatment for an eating disorder (n = 149). Participants completed self-report measures on their eating behaviors, weight/shape concerns, and emotion dysregulation. Findings showed that emotion dysregulation had a unique association with engaging in binge eating and purging (community sample only). Weight and shape concerns were found to have a unique association with engaging in binge eating, fasting, purging, and driven exercise (community sample only). Additionally, weight and shape concerns moderated the association between emotion dysregulation and the probability of engaging in binge eating and driven exercise, whereby the strongest association between emotion dysregulation and these behaviors were observed among adolescents with the lowest levels of weight and shape concerns. Regarding the frequency of eating disorder behaviors, emotion dysregulation had a unique association with severity of binge eating and fasting. Weight and shape concerns were uniquely associated with severity of fasting and driven exercise (community sample only). Findings suggest that emotion dysregulation is a distinct factor of eating disorder behaviors among adolescents.
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Affiliation(s)
- Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Phillipa Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Camden and Campbelltown Hospital, SWSLHD, Sydney, Campbelltown, Australia
| | - Mandy Goldstein
- School of Medicine, Translational Health Research Institute, Western Sydney University, Camden and Campbelltown Hospital, SWSLHD, Sydney, Campbelltown, Australia
| | | | - Christopher Basten
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Gabriella Heruc
- School of Medicine, Translational Health Research Institute, Western Sydney University, Camden and Campbelltown Hospital, SWSLHD, Sydney, Campbelltown, Australia
| | - Marion Roberts
- School of Population Health, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Susan Byrne
- School of Psychological Sciences, University of Western Australia, Perth, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,School of Medicine, Translational Health Research Institute, Western Sydney University, Camden and Campbelltown Hospital, SWSLHD, Sydney, Campbelltown, Australia
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Trompeter N, Bussey K, Forbes MK, Mond J, Hay P, Basten C, Goldstein M, Thornton C, Heruc G, Byrne S, Griffiths S, Lonergan A, Touyz S, Mitchison D. Differences between Australian adolescents with eating disorder symptoms who are in treatment or not in treatment for an eating disorder. Early Interv Psychiatry 2021; 15:882-888. [PMID: 32881352 DOI: 10.1111/eip.13027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/23/2020] [Accepted: 08/02/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Mental health problems frequently occur during adolescence, however, few adolescents seek treatment for these problems, especially for eating disorders. The current study aimed to quantify how adolescents in a clinical sample (ie, those receiving treatment for an eating disorder), differ in terms of psychological factors (eating disorder symptoms and psychological distress), compared to adolescents with eating pathology in a community sample (ie, those not receiving treatment). METHOD Data were used from a community sample of adolescents with eating disorder pathology who have not sought treatment (n = 1011) and a clinical sample of adolescents presenting at eating disorder services for treatment (n = 153). Participants reported demographics and completed questionnaires assessing weight/shape concerns, disordered eating and psychological distress. RESULTS Adolescents with a lower BMI, more frequent purging and higher weight/shape concerns were more common in the clinical sample, while those engaging in more frequent driven exercise were less common in the clinical sample. The samples did not differ in severity of psychological distress. CONCLUSIONS The findings highlight the need for increasing mental health literacy about the role of BMI and driven exercise in eating disorder symptom presentation to increase early detection of these disorders among adolescents.
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Affiliation(s)
- Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.,Camden and Campbelltown Hospital, SWSLHD, Campbelltown, Australia
| | - Christopher Basten
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Mandy Goldstein
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,Mandy Goldstein Psychology, Private Practice, Sydney, Australia
| | - Christopher Thornton
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,The Redleaf Practice, Private Practice, Sydney, Australia
| | - Gabriella Heruc
- School of Medicine, Western Sydney University, Sydney, Australia.,Appetite for Change, Private Practice, Sydney, Australia
| | - Susan Byrne
- School of Psychological Sciences, University of Western Australia, Perth, Australia.,The Swan Centre, Private Practice, Perth, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Stephen Touyz
- School of Psychology and Inside Out Institute, University of Sydney, Sydney, Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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Aouad P, Hay P, Foroughi N, Cosh SM, Mannan H. Associations Between Defence-Style, Eating Disorder Symptoms, and Quality of Life in Community Sample of Women: A Longitudinal Exploratory Study. Front Psychol 2021; 12:671652. [PMID: 34276493 PMCID: PMC8281956 DOI: 10.3389/fpsyg.2021.671652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/31/2021] [Indexed: 12/27/2022] Open
Abstract
Background and Aim: Eating Disorders (EDs) impact an estimated 15% of the global population and are linked to maladaptive defence-styles (coping strategies) and poorer mental health outcomes. Defence-styles have been grouped into immature, neurotic, and mature behaviours. Studies have yet to examine all three defence-styles in ED symptomatic individuals over an extended period of time. The current study aimed to investigate using converse analysis the relationships between defence-style and ED outcomes over a 5-years period. Methods: Participants (n = 216, mean age 33 years) were recruited through the Women's Eating and Health Literacy study, with the current study examining a 5-years period of two waves (year-4 and year-9). The current study tested associations over time between eating pathology (EDE-Q), psychological distress (K10), mental and physical health related quality of life (M/PHRQoL, SF-12), and defence-style (DSQ-40). Results: Mature, immature and neurotic defence-styles did not significantly change over 5 years. Over the same period, only PHRQoL significantly predicted mature defence-styles having positive effect. Both MHRQoL and PHRQoL significantly predicted immature defence-styles having positive and negative effects, respectively. Psychological distress, PHRQoL and weight concern significantly predicted neurotic defence-styles having positive effects except for psychological distress. PHRQoL, MHRQoL, restraint and eating concern significantly predicted overall eating pathology having positive effects except for PHRQoL and MHRQoL. Conversely, among the defence-style variables, over 5 years, both immature and neurotic defence-styles significantly predicted psychological distress having positive effects, immature and mature defence-styles significantly predicted MHRQoL having negative and positive effects, respectively, while only immature defence-styles significantly predicted overall eating pathology having positive effect. Conclusions: The results of the current study suggest that immaturity and neuroticism but not maturity were the defence-style variables predicting psychological distress over a 5-years period while conversely psychological distress predicted only neurotic defence styles. The findings of the current study may suggest that without intervention, mature, immature and neurotic defence-styles may largely remain immutable to significant shifts over time. Limitations in the current study included limited demographic representation. The current study is anticipated to generate considerations into treatments that could strengthen defence-styles in individuals with increased eating pathology.
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Affiliation(s)
- Phillip Aouad
- InsideOut Institute, Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
- School of Psychology, University of New England, Armidale, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Nasim Foroughi
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Suzanne M. Cosh
- School of Psychology, University of New England, Armidale, NSW, Australia
| | - Haider Mannan
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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Emotion Dysregulation within the CBT-E Model of Eating Disorders: A Narrative Review. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10225-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Dann KM, Hay P, Touyz S. Are poor set-shifting and central coherence associated with everyday function in anorexia nervosa? A systematic review. J Eat Disord 2021; 9:40. [PMID: 33781337 PMCID: PMC8008586 DOI: 10.1186/s40337-021-00392-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 03/02/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is increasing interest in associations between cognitive impairments and clinical symptoms in Anorexia Nervosa (AN), however, the relationship with everyday function is unclear. The current review synthesizes existing data regarding associations between scores on tests of set-shifting and central coherence and functional outcome measures for individuals with AN. METHOD A systematic electronic database search yielded 13 studies which included participants with current or lifetime AN where scores on a neuropsychological test of set-shifting or central coherence were directly or indirectly compared to a functional outcome measure. RESULTS Associations between set-shifting and central coherence performance measures and functional outcomes were limited in number and noted only in adult or mixed-age cohorts. Associations were noted at subscale level, suggesting they are specific in nature. In younger cohorts, assessments of executive functioning in everyday life appear sensitive to cognitive-behavioral flexibility issues. CONCLUSIONS Associations between cognitive performance and functional outcome have not been as systematically assessed in AN as in other psychiatric disorders. Key factors to address in future research include: (a) the use of function measures which are sensitive to both the level of impairment, and specific rather than general impairments (b) the ecological validity of measures, (c) the task impurity problem, especially in regard to cognitive flexibility assessment, and (d) the need to measure both cognitive deficits and strengths, because tests of specific cognitive processes may underestimate the ability to function in daily life due to compensatory strategies.
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Affiliation(s)
- Kelly M Dann
- School of Psychology, University of Sydney, Sydney, Australia.
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Stephen Touyz
- InsideOut Institute and School of Psychology, University of Sydney, Sydney, Australia
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12
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Does Age Impact the Clinical Presentation of Adult Women Seeking Specialty Eating Disorder Treatment? J Nerv Ment Dis 2020; 208:742-745. [PMID: 32868689 DOI: 10.1097/nmd.0000000000001160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent evidence suggests that eating disorders (EDs) are becoming increasingly common in older women. Previous research examining differences between younger and older women with EDs has been mixed, making it unclear whether older women with EDs represent a distinct group. We sought to determine whether there are age differences in the clinical presentation of women seeking specialty treatment for an ED. We examined the linear relationship between age and clinical constructs among adult women (N = 436) diagnosed with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, ED. Across analyses, there was no impact of age on most measures of ED symptoms, comorbid psychopathology, self-esteem, quality of life, and motivation to change. However, older age was associated with fewer interoceptive awareness difficulties, maturity fears, anxiety symptoms, and body image concerns. These findings suggest that the clinical presentation of older ED cases is largely similar, although somewhat less severe than in younger women. The implications of this research for future research and treatment are discussed.
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13
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Holtzhausen N, Mannan H, Foroughi N, Hay P. Effects associated with the use of healthcare for eating disorders by women in the community: a longitudinal cohort study. BMJ Open 2020; 10:e033986. [PMID: 32859658 PMCID: PMC7454177 DOI: 10.1136/bmjopen-2019-033986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time. HYPOTHESIS We hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress. DESIGN, SETTING, PARTICIPANTS Data were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED-MHL, linear or logistic mixed-effects regression analyses were used. RESULTS 20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen's d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively. CONCLUSIONS Formal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED-MHL.
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Affiliation(s)
- Nicol Holtzhausen
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Haider Mannan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Nasim Foroughi
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith South, New South Wales, Australia
- Campbelltown Hospital Mental Health, South West Sydney Local Health District, Campbelltown, New South Wales, Australia
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14
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Galmiche M, Lucas N, Déchelotte P, Deroissart C, Le Solliec MA, Rondeaux J, Azhar S, Grigioni S, Colange G, Delay J, Achamrah N, Folope V, Belmonte L, Lamarre A, Rimbert A, Saillard T, Petit A, Quillard M, Coeffier M, Gillibert A, Lambert G, Legrand R, Tavolacci MP. Plasma Peptide Concentrations and Peptide-Reactive Immunoglobulins in Patients with Eating Disorders at Inclusion in the French EDILS Cohort (Eating Disorders Inventory and Longitudinal Survey). Nutrients 2020; 12:nu12020522. [PMID: 32085628 PMCID: PMC7071399 DOI: 10.3390/nu12020522] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022] Open
Abstract
Eating disorders (EDs) are increasingly frequent. Their pathophysiology involves disturbance of peptide signaling and the microbiota–gut–brain axis. This study analyzed peptides and corresponding immunoglobulin (Ig) concentrations in groups of ED. In 120 patients with restrictive (R), bulimic (B), and compulsive (C) ED, the plasma concentrations of leptin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and insulin were analyzed by Milliplex and those of acyl ghrelin (AG), des-acyl ghrelin (DAG), and α-melanocyte-stimulating hormone (α-MSH) by ELISA kits. Immunoglobulin G (in response to an antigen) concentrations were analyzed by ELISA, and their affinity for the respective peptide was measured by surface plasmon resonance. The concentrations of leptin, insulin, GLP-1, and PYY were higher in C patients than in R patients. On the contrary, α-MSH, DAG, and AG concentrations were higher in R than in C patients. After adjustment for body mass index (BMI), differences among peptide concentrations were no longer different. No difference in the concentrations of the IgG was found, but the IgG concentrations were correlated with each other. Although differences of peptide concentrations exist among ED subtypes, they may be due to differences in BMI. Changes in the concentration and/or affinity of several anti-peptide IgG may contribute to the physiopathology of ED or may be related to fat mass.
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Affiliation(s)
- Marie Galmiche
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
| | - Nicolas Lucas
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Pierre Déchelotte
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
- Correspondence: ; Tel.: +06-08-49-66-26
| | - Camille Deroissart
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Marie-Anne Le Solliec
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Julie Rondeaux
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Saida Azhar
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Sébastien Grigioni
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Guillaume Colange
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Julie Delay
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Najate Achamrah
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Vanessa Folope
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Liliana Belmonte
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Adèle Lamarre
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Agnès Rimbert
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Tiphaine Saillard
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - André Petit
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Muriel Quillard
- CIC-CRB 1404 INSERM, University Hospital of Rouen, 76000 Rouen, France;
| | - Moise Coeffier
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - André Gillibert
- Department of Biostatistics, Rouen University Hospital, F 76000 Rouen, France;
| | - Grégory Lambert
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Romain Legrand
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Marie-Pierre Tavolacci
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- CIC-CRB 1404 INSERM, University Hospital of Rouen, 76000 Rouen, France;
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15
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Kiekens G, Claes L. Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know. Curr Psychiatry Rep 2020; 22:68. [PMID: 33037934 PMCID: PMC7547297 DOI: 10.1007/s11920-020-01191-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. RECENT FINDINGS While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000, Leuven, Belgium. .,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
| | - Laurence Claes
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000 Leuven, Belgium ,grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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16
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Burt A, Mitchison D, Dale E, Bussey K, Trompeter N, Lonergan A, Hay P. Prevalence, features and health impacts of eating disorders amongst First-Australian Yiramarang (adolescents) and in comparison with other Australian adolescents. J Eat Disord 2020; 8:10. [PMID: 32190326 PMCID: PMC7066723 DOI: 10.1186/s40337-020-0286-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to support previous research conducted with First-Australians (FA) by establishing the prevalence of eating disorders, and their demographic distribution and burden in adolescent First-Australians compared to other-Australians (OA). METHODS Data were used from the baseline survey of the EveryBODY Study, a longitudinal investigation of eating disorders among Australian adolescents. Of the 5068 participants included, 402 (8%) identified as FA, 4586 (90.5%) identified as OA. Diagnosis of eating disorders was based on the Diagnostic and Statistical Manual version 5. Socioeconomic status and measures of impairment were assessed using validated instruments. Body mass index was calculated based on self-reported weight and height. Statistical analyses used data weighted to the distribution of gender in adolescents in New South Wales in the 2016 Australian Census. Chi-square tests were performed to determine prevalence of eating disorders amongst FA and to compare to OA. ANOVA and logistic regression analyses where conducted to examine the moderation effect of sociodemographic status, measures of impairment and FA status on the distribution of eating disorders. RESULTS The prevalence rates for eating disorder diagnoses where similar for FA and OA with the exception of Night eating Syndrome (OSFED-NES), which occurred in 7.14% (95%CI 4.81-10.49) of FA vs. 3.72% (95%CI 3.17-4.36) in OA. The greater prevalence of OSFED-NES in FA was largely explained by poorer psychosocial quality of life amongst FA. CONCLUSION Eating disorders are common amongst First-Australian adolescents and are associated with poor psychosocial quality of life. These findings are consistent with previous research conducted with First-Australian adults. There is a need to screen for eating disorders amongst First-Australian adolescent girls and boys.
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Affiliation(s)
- Adam Burt
- 1School of Medicine, Western Sydney University, Sydney, Campbelltown Australia
| | - Deborah Mitchison
- 2Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, Campbelltown Australia.,3Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales Australia
| | - Elizabeth Dale
- 4Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute and Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, Wollongong, New South Wales Australia
| | - Kay Bussey
- 5Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- 5Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Alexandra Lonergan
- 5Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Phillipa Hay
- 2Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, Campbelltown Australia.,6Campbelltown Hospital, SWSLHD, Sydney, Campbelltown Australia
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17
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Bardone-Cone AM, Alvarez A, Gorlick J, Koller KA, Thompson KA, Miller AJ. Longitudinal follow-up of a comprehensive operationalization of eating disorder recovery: Concurrent and predictive validity. Int J Eat Disord 2019; 52:1052-1057. [PMID: 31291036 DOI: 10.1002/eat.23128] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We aimed to replicate the concurrent validity of a comprehensive definition of eating disorder recovery (physical, behavioral, and cognitive indices) in a sample followed up 7-8 years from baseline, and to examine, for the first time with this comprehensive definition, predictive validity. METHOD Participants were 66 women with a history of an eating disorder and 31 age-matched controls who completed an online survey and phone interview. RESULTS In general, women who were fully recovered were statistically indistinguishable from controls and had significantly less eating disorder attitudes and behaviors than the partially recovered and eating disorder groups. Being fully recovered at baseline was a robust predictor of stability: of those fully recovered at baseline, 80% remained fully recovered at follow-up. One-third of those with an eating disorder and one-half of those in partial recovery at baseline attained full recovery at follow-up. DISCUSSION These findings support the current operationalization of eating disorder recovery, encompassing physical, behavioral, and cognitive indices, as valid and highlight that full recovery is not only possible but predicts full recovery years later. Future research should examine this operationalization in diverse samples and study trajectories of recovery to identify predictors.
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Affiliation(s)
- Anna M Bardone-Cone
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexandra Alvarez
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jenna Gorlick
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine A Koller
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine A Thompson
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexandra J Miller
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Nutley S, Varma D, Chen X, Striley CW. Willingness of individuals with eating disorders to participate in health research. Int J Eat Disord 2019; 52:914-923. [PMID: 31063267 PMCID: PMC8136836 DOI: 10.1002/eat.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND/AIMS This study examines the association between eating disorders (EDs) and willingness to participate in health research studies among community members. MATERIALS & METHOD Data were collected from Health Street, a University of Florida community engagement initiative which aims to reduce disparities in healthcare and health research by direct engagement of community members. RESULTS Among 8,226 community members, 3.9% (n = 324) reported a lifetime ED. For all six types of health research studies queried, individuals with a lifetime ED reported a higher willingness to participate in health research compared to individuals without a history. After adjusting for selected covariates, individuals with ED were significantly more likely than individuals without ED to say they would be willing to volunteer for research studies that: ask questions about health (OR: 7.601, 95% CI: [1.874, 30.839]); require an overnight stay in a hospital (OR: 2.041, 95% CI: [1.442, 2.889]); and provide no remuneration (OR: 1.415, 95% CI: [1.022, 1.958]). Furthermore, when compared to individuals with anxiety or depression, individuals with ED reported increased interest in research participation and increased willingness to participate in most types of research studies assessed. After stratifying by gender and race, we observed few differences in willingness to participate in research among individuals with ED. DISCUSSION These findings contribute to our current understanding of participant recruitment and enrollment in ED health research. Underrepresented populations who often do not seek treatment for EDs endorsed a high willingness to participate. CONCLUSION Future studies will likely benefit from including community members in ED research.
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Affiliation(s)
- Sara Nutley
- Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Deepthi Varma
- Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, Gainesville, Florida
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Mitchison D, Bussey K, Touyz S, Gonzalez-Chica D, Musker M, Stocks N, Licinio J, Hay P. Shared associations between histories of victimisation among people with eating disorder symptoms and higher weight. Aust N Z J Psychiatry 2019; 53:540-549. [PMID: 30501408 DOI: 10.1177/0004867418814961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The success of integrated prevention initiatives for eating disorders and obesity is hampered by a lack of shared risk factor research. Bullying and sexual abuse are potentially potent shared risk factors for the spectrum of eating and weight disorders. METHODS A representative sample of N = 3005 South Australian males and females ≥15 years was interviewed about their height, weight, eating disorder symptoms, lifetime experiences of bullying and sexual abuse and mental and physical health-related quality of life. RESULTS Participants who were currently obese (25.2%) or underweight (2.7%) or who reported current eating disorder symptoms (32.7%) were between 10% and 27% more likely to have experienced bullying, and obese and eating disordered participants were also 47% and 56% more likely to have experienced sexual abuse, respectively. In regard to specific symptoms, a lifetime history of bullying was associated with increased risk of obesity, extreme dieting, purging and overvaluation of body weight and/or shape, whereas a lifetime history of sexual abuse was associated with increased risk of obesity, binge eating and extreme dieting and decreased risk of underweight. Lifetime histories of bullying and sexual abuse were associated with health-related quality of life impairment; however, lifetime bullying was associated with a greater adverse impact among participants with current eating disorder symptoms. CONCLUSION Self-reported bullying and sexual abuse victimisation have shared associations with eating and weight spectrum problems. Differences in the symptoms associated with bullying versus sexual abuse are discussed, as well as the clinical and public health implications.
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Affiliation(s)
- Deborah Mitchison
- 1 Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW, Australia.,2 School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Kay Bussey
- 1 Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Stephen Touyz
- 3 School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - David Gonzalez-Chica
- 4 Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Michael Musker
- 5 Mind and Brain Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Nigel Stocks
- 4 Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Julio Licinio
- 6 Department of Psychiatry, College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Phillipa Hay
- 7 Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Trompeter N, Bussey K, Hay P, Griffiths S, Murray SB, Mond J, Lonergan A, Pike KM, Mitchison D. Fear of negative evaluation among eating disorders: Examining the association with weight/shape concerns in adolescence. Int J Eat Disord 2019; 52:261-269. [PMID: 30663786 DOI: 10.1002/eat.23018] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/17/2018] [Accepted: 12/21/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Fear of negative evaluation has been proposed as a transdiagnostic factor associated with the development of eating disorders and has been shown to relate to disorders of body image, especially those with weight/shape concerns such as eating disorders and muscle dysmorphia. The current study aimed to investigate whether fear of negative evaluation was a transdiagnostic factor of disorders diagnostically characterized by weight/shape concerns. The study examined whether fear of negative evaluation was associated with higher odds for meeting criteria for an eating disorder and/or muscle dysmorphia, especially those disorders diagnostically characterized by weight/shape concerns. METHOD Data were used from a subgroup of the first wave of the EveryBODY study, a longitudinal investigation of eating disorders and body image concerns among Australian adolescents (N = 4,030). Participants completed measures on demographics, weight/shape concerns, disordered eating, psychological distress, muscularity concerns, and fear of negative evaluation. RESULTS Findings revealed that fear of negative evaluation was associated with higher odds of meeting criteria for any eating disorder but significantly more so for those characterized by weight/shape concerns diagnostically, as well as binge-eating disorder. Similar results were found for muscle dysmorphia. DISCUSSION The findings suggest that fear of negative evaluation constitutes a transdiagnostic feature for developing and/or maintaining an eating disorder.
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Affiliation(s)
- Nora Trompeter
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Kay Bussey
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Stuart B Murray
- Department of Psychiatry, University of California San Francisco, San Francisco, California
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Alexandra Lonergan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | | | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia
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Purton T, Mond J, Cicero D, Wagner A, Stefano E, Rand-Giovannetti D, Latner J. Body dissatisfaction, internalized weight bias and quality of life in young men and women. Qual Life Res 2019; 28:1825-1833. [DOI: 10.1007/s11136-019-02140-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2019] [Indexed: 12/20/2022]
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Al-Thani MA, Khaled SM. "Toxic pleasures": A study of eating out behavior in Arab female university students and its associations with psychological distress and disordered eating. Eat Behav 2018; 31:125-130. [PMID: 30261365 DOI: 10.1016/j.eatbeh.2018.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 12/20/2022]
Abstract
University years are a critical period in which young people establish independence and adopt lasting health behaviors. The aim of this study was to estimate the associations between eating out, psychological distress, and disordered eating behaviors among young Arab females in Qatar a rapidly developing small nation. A cross-sectional probability-based survey of 1615 Qatar University's female students assessed the frequency of eating out (main independent variable) and other eating behaviors in relation to two main dependent variables, disordered eating and psychological distress, which were measured using the Eating Attitudes Test and the Kessler Psychological Distress Scale, respectively. Multivariable logistic-regression analyses were used to estimate these two main associations with and without adjustment for other potential confounding variables, including the main effects of psychological distress and disordered eating on each other. Of the students, 45% reported eating out 3 times or more a week. Furthermore, approximately 18% screened positive for disordered eating and 33% reported high levels of psychological distress in the past 30 days. After adjustment for other variables, eating out 5 times or more a week was not significantly associated with the odds of disordered eating (OR 1.21, p = 0.32). However, eating out 5 times or more per week was significantly associated with odds of having psychological distress (OR 1.46, p = 0.03). Both psychological distress and disordered eating were strongly associated with each other (OR 2.58, p < 0.001).
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Affiliation(s)
- Maryam A Al-Thani
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
| | - Salma M Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
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Mason TB, Wonderlich SA, Crosby RD, Engel SG, Mitchell JE, Crow SJ, Grange DL, Smith KE, Peterson CB. Associations among eating disorder behaviors and eating disorder quality of life in adult women with anorexia nervosa. Psychiatry Res 2018; 267:108-111. [PMID: 29886272 PMCID: PMC6760249 DOI: 10.1016/j.psychres.2018.05.077] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 05/22/2018] [Accepted: 05/27/2018] [Indexed: 11/16/2022]
Abstract
The study examined associations between eating disorder behaviors measured via ecological momentary assessment (EMA) and eating disorder quality of life (EDQOL) in anorexia nervosa (AN). Women with AN (N = 82) completed an EDQOL measure and two-weeks of EMA. Greater frequency of EMA-assessed restriction and bulimic behavior were independently related to lower EDQOL scores. Lower psychological EDQOL was associated with increased EMA dietary restriction; lower work-related EDQOL was associated with increased EMA binge eating; aspects of EDQOL were unrelated to EMA purging. Findings suggest that severity of restriction and bulimic behaviors may serve as severity indicators of EDQOL in AN.
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Affiliation(s)
- Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Stephen A. Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Ross D. Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott G. Engel
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - James E. Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Scott J. Crow
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN,The Emily Program, St. Paul, MN
| | - Daniel Le Grange
- Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA
| | - Kathryn E. Smith
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, North Dakota,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Carol B. Peterson
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN,The Emily Program, St. Paul, MN
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Zerbe KJ, Bradley KM. Bring Me Your Hungers: Omnipotence, Mourning, and the Inexorable Limits of Time and Self in the Psychodynamic Treatment of Eating Disorders. Psychoanal Rev 2018; 105:363-395. [PMID: 30063417 DOI: 10.1521/prev.2018.105.4.363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Drawing upon the classic use of physical hunger as both a concrete sign of and metaphor for deep emotional needs, this article elaborates upon the many layers of hunger the eating disorder patient experiences and narcissistic defenses commonly employed to deny them. The authors use two extended case examples that illustrate the arduous but worthwhile task of welcoming patients to "bring their hungers"-an invitation that calls clinicians to make contact with the patient's human desires, to repeatedly chip away at the omnipotence used to mask such cravings, and to provide a space for working through the inexorable limitations imposed by time and mortality. A third example of a clinician who struggled with embodied countertransference reactions further elucidates different manifestations of these defenses. This paper highlights the unique value that psychodynamic clinical work offers patients in tolerating their healthy physical and emotional appetites to ultimately facilitate a more satisfying life.
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Affiliation(s)
- Kathryn J Zerbe
- 621 SW Morrison St., Suite 1000, Portland, OR 97205. E-mail:
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25
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Landstedt E, Hammarström A, Fairweather-Schmidt AK, Wade T. Associations between adolescent risk for restrictive disordered eating and long-term outcomes related to somatic symptoms, body mass index, and poor well-being. Br J Health Psychol 2018; 23:496-518. [DOI: 10.1111/bjhp.12301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 01/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Anne Hammarström
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | | | - Tracey Wade
- School of Psychology; Flinders University; Adelaide South Australia Australia
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26
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Reas DL, Rø Ø. Less symptomatic, but equally impaired: Clinical impairment in restricting versus binge-eating/purging subtype of anorexia nervosa. Eat Behav 2018; 28:32-37. [PMID: 29310054 DOI: 10.1016/j.eatbeh.2017.12.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/18/2017] [Accepted: 12/28/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study investigated subtype differences in eating disorder-specific impairment in a treatment-seeking sample of individuals with anorexia nervosa (AN). METHOD The Clinical Impairment Assessment (CIA) and the Eating Disorder Examination-Questionnaire (EDE-Q) were administered to 142 patients. Of these, 54.9% were classified as restricting type (AN-R) and 45.1% were classified as binge-eating/purging type (AN-B/P) based on an average weekly occurrence of binge eating and/or purging episodes (≥4 episodes/28days). RESULTS Individuals with AN-B/P exhibited higher levels of core ED psychopathology (dietary restraint, eating concern, shape/weight concerns) in addition to the expected higher frequency of binge/purge episodes. No significant differences existed between AN subtypes in the severity of ED-related impairment. Weight/shape concerns and binge eating frequency significantly predicted level of impairment. Differential associations were observed between the type of ED pathology that significantly contributed to impairment according to AN subtype. DISCUSSION Although those with AN-B/P displayed higher levels of core attitudinal and behavioral ED pathology than AN-R, no significant differences in ED-specific impairment were found between AN subtypes. Eating disorder-related impairment in AN was not related to the severity of underweight or purging behaviors, but was uniquely and positively associated with weight/shape concerns and binge eating frequency.
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Affiliation(s)
- Deborah Lynn Reas
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway.
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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27
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Morin AJS, Arens AK, Tracey D, Parker PD, Ciarrochi J, Craven RG, Maïano C. Self-Esteem Trajectories and Their Social Determinants in Adolescents With Different Levels of Cognitive Ability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:539-560. [PMID: 29115873 DOI: 10.1352/1944-7558-122.6.539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examines the development of self-esteem in a sample of 138 Australian adolescents (90 males; 48 females) with cognitive abilities in the lowest 15% (L-CA) and a matched sample of 556 Australian adolescents (312 males; 244 females) with average to high levels of cognitive abilities (A/H-CA). These participants were measured annually (Grade 7 to 12). The findings showed that adolescents with L-CA and A/H-CA experience similar high and stable self-esteem trajectories that present similar relations with key predictors (sex, school usefulness and dislike, parenting, and peer integration). Both groups revealed substantial gender differences showing higher levels of self-esteem for adolescent males remaining relatively stable over time, compared to lower levels among adolescent females which decreased until midadolescence before increasing back.
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Affiliation(s)
- Alexandre J S Morin
- Alexandre J. S. Morin, Substantive-Methodological Synergy Research Laboratory Department of Psychology, Concordia University, Montreal, Canada
| | - A Katrin Arens
- A. Katrin Arens, German Institute for International Educational Research, Frankfurt, Germany
| | - Danielle Tracey
- Danielle Tracey, Western Sydney University, Sydney, Australia
| | - Philip D Parker
- Philip D. Parker, Joseph Ciarrochi, and Rhonda G. Craven, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia; and
| | - Joseph Ciarrochi
- Philip D. Parker, Joseph Ciarrochi, and Rhonda G. Craven, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia; and
| | - Rhonda G Craven
- Philip D. Parker, Joseph Ciarrochi, and Rhonda G. Craven, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia; and
| | - Christophe Maïano
- Christophe Maïano, Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada
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28
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Fogarty S, Ramjan LM. The tipping point of change in Anorexia Nervosa (AN): Qualitative findings from an online study. Women Health 2017; 58:1050-1061. [PMID: 28922078 DOI: 10.1080/03630242.2017.1372846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The aim of this study was to understand factors related to treatment and/or recovery from self-reported Anorexia Nervosa (AN), including 'the tipping point of change'. An online questionnaire was developed and administered from December 2014 to December 2015 to individuals ≥18 years of age with AN in the past or currently who were recruited through eating disorder organizations in Australia and the United Kingdom. Responses to a specific qualitative question on 'the tipping point of change' were analyzed using conventional content analysis (CCA). One hundred sixty-one participants completed some or all of the questionnaire; only 67 women (41.61%) answered Question six on 'the tipping point of change', and analyses were restricted to data from these women. The themes identified were: 1) realizing the loss of something valuable, 2) the risk of losing something valuable, and 3) something to live for/stay well for. These results are important for health-care providers as they work with patients to identify life experiences, including 'loss/potential loss' and 'the need for preservation', that have personal significance. Some patients may realize that 'enough is enough'; something needs to change. These intrinsic motivating factors may also be the impetus for eventual recovery for some individuals.
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Affiliation(s)
- Sarah Fogarty
- a School of Medicine , Western Sydney University, Campbelltown, New South Wales, Australia.,b National Institute of Complementary Medicine , Western Sydney University , Campbelltown , New South Wales , Australia
| | - Lucie M Ramjan
- c School of Nursing and Midwifery , Western Sydney University , Parramatta , New South Wales , Australia.,d Centre for Applied Nursing Research , Ingham Institute of Applied Medical Research , Penrith , New South Wales , Australia
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29
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Dahlgren CL, Stedal K, Rø Ø. Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA): clinical norms and functional impairment in male and female adults with eating disorders. Nord J Psychiatry 2017; 71:256-261. [PMID: 28084126 DOI: 10.1080/08039488.2016.1271452] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The aim of the current study was to collect clinical normative data for the Clinical Impairment Assessment questionnaire (CIA) and the Eating Disorder Examination Questionnaire (EDE-Q) from adult patients with eating disorders (EDs). This study also examined unique contributions of eating disorder (ED) symptoms on levels of ED-related impairment. METHODS A sample of 667 patients, 620 females and 47 males, was recruited from six specialist centres across Norway. The majority of the sample (40.3%) was diagnosed with eating disorder not otherwise specified (EDNOS), 34.5% had bulimia nervosa (BN), and 25.2% were diagnosed with anorexia nervosa (AN). RESULTS There were significant differences for global EDE-Q and CIA scores between females and males. In the female sample, significant differences were found on several EDE-Q sub-scales between the AN and BN group, and between the AN and EDNOS group. No significant differences were found between the diagnostic groups on the CIA. In the male sample, no significant differences were found between diagnostic groups on the EDE-Q or CIA. A multiple regression analysis revealed that 46.8% of the variance in impairment as measured by the CIA was accounted for by ED symptoms. CONCLUSIONS Body mass index, Eating Concern, Shape/Weight Concern, and binge eating served as significant, unique predictors of impairment. The results from the present study contribute to the interpretation of EDE-Q and CIA scores in ED samples.
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Affiliation(s)
- Camilla Lindvall Dahlgren
- a Regional Department for Eating Disorders, Division of Mental Health and Addiction , Oslo University Hospital, Ullevål HF , Oslo , Norway
| | - Kristin Stedal
- a Regional Department for Eating Disorders, Division of Mental Health and Addiction , Oslo University Hospital, Ullevål HF , Oslo , Norway
| | - Øyvind Rø
- a Regional Department for Eating Disorders, Division of Mental Health and Addiction , Oslo University Hospital, Ullevål HF , Oslo , Norway.,b Institute of Clinical Medicine, University of Oslo , Oslo , Norway
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30
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Mitchison D, Hay P, Griffiths S, Murray SB, Bentley C, Gratwick‐Sarll K, Harrison C, Mond J. Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents. Int J Eat Disord 2017; 50:118-126. [PMID: 27539911 PMCID: PMC6585604 DOI: 10.1002/eat.22592] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance. METHOD Male and female secondary students (N = 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating. RESULTS Overvaluation, dissatisfaction, and preoccupation were highly correlated (r = 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal. DISCUSSION Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118-126).
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Affiliation(s)
- Deborah Mitchison
- Department of PsychologyMacquarie UniversitySydneyNew South WalesAustralia,School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Phillipa Hay
- Centre for Health Research, Sydney, Western Sydney UniversityNew South WalesAustralia
| | - Scott Griffiths
- Department of PsychologyUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
| | - Stuart B. Murray
- Department of PsychiatryUniversity of CaliforniaSan FranciscoCalifornia
| | - Caroline Bentley
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Kassandra Gratwick‐Sarll
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Carmel Harrison
- Research School of PsychologyAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Jonathan Mond
- School of MedicineWestern Sydney UniversitySydneyNew South WalesAustralia
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Quality of life as a vulnerability and recovery factor in eating disorders: a community-based study. BMC Psychiatry 2016; 16:328. [PMID: 27724943 PMCID: PMC5057465 DOI: 10.1186/s12888-016-1033-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/07/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Emerging evidence suggests that changes in quality of life (QoL) predicts later changes in eating disorder (ED) symptoms. The objective of this study was to explore individual sufferers' perspectives on the influence of QoL on the onset, maintenance, and/or remission of ED symptoms. METHOD 19 women from the community with a history of eating disorders (n = 13 currently symptomatic; n = 6 recovered) were interviewed about their observations on the relationship between QoL and ED symptoms over time in their own lives. Interviews were audio-taped and transcribed, and then thematically analysed. RESULTS Thematic analysis uncovered two major themes: 1. QoL as a Vulnerability Factor, and 2. QoL as a Recovery Factor. In relation to the first theme, onset of ED symptoms was discussed by women in this study as having been triggered by impairment in QoL, including a general sense of lacking control in life, stress, abusive intimate relationships, poor role modelling from family, physical impairment related to obesity, peer pressure, and weight-related teasing. On the other hand, and in relation to the second theme, subsequent improvement in QoL was nominated as central to symptom improvement and recovery. QoL improvement was described by participants differently, but included increased general satisfaction in life, emotional maturation, prioritising and improving physical health, the development of a supportive intimate relationship and social relationships, and having children. CONCLUSIONS Impairment in QoL may act as a trigger for the onset and maintenance of ED symptoms, whereas improvement in QoL may be central to eating disorder improvement and eventual recovery. Treatment should involve consideration of a core focus on QoL improvement as a potential 'backdoor' approach to improving ED symptoms.
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Reciprocal Relationships between Teacher Ratings of
Internalizing and Externalizing Behaviors in Adolescents with Different Levels of Cognitive Abilities. J Youth Adolesc 2016; 46:801-825. [DOI: 10.1007/s10964-016-0574-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
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Sehm M, Warschburger P. Prospective Associations Between Binge Eating and Psychological Risk Factors in Adolescence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:770-784. [DOI: 10.1080/15374416.2016.1178124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Marie Sehm
- Department of Psychology, University of Potsdam
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34
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Wagner AF, Stefano EC, Cicero DC, Latner JD, Mond JM. Eating disorder features and quality of life: Does gender matter? Qual Life Res 2016; 25:2603-2610. [PMID: 27048498 DOI: 10.1007/s11136-016-1283-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. METHODS The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). RESULTS Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. CONCLUSION This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.
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Affiliation(s)
- Allison F Wagner
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA.
| | - Emily C Stefano
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | - David C Cicero
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
| | - Janet D Latner
- Department of Psychology, University of Hawai`i at Manoa, 2530 Campus Road, Honolulu, HI, 96822, USA
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35
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Fogarty S, Smith CA, Hay P. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review. Eat Behav 2016; 21:179-88. [PMID: 26970732 DOI: 10.1016/j.eatbeh.2016.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 02/23/2016] [Accepted: 03/01/2016] [Indexed: 11/19/2022]
Abstract
This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only.
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Affiliation(s)
- Sarah Fogarty
- National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia; School of Medicine, University of Western Sydney, Australia.
| | - Caroline A Smith
- National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia.
| | - Phillipa Hay
- School of Medicine, University of Western Sydney, Australia.
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36
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Palavras MA, Hay PJ, Lujic S, Claudino AM. Comparing symptomatic and functional outcomes over 5 years in two nonclinical cohorts characterized by binge eating with and without objectively large episodes. Int J Eat Disord 2015; 48:1158-65. [PMID: 26414868 DOI: 10.1002/eat.22466] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 08/27/2015] [Accepted: 08/30/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim was to compare symptomatic and functional outcomes over 5 years in women with regular subjective (SBEs), objective (OBEs), and no regular binge eating episodes. METHOD Data were derived from two cohorts of 330 women with high levels of eating disorders symptoms followed over 5 years. Three groups were formed: (a) regular SBEs but no regular OBEs (N = 68), (b) regular OBEs with or without regular SBEs (N = 154), and (c) with no regular binge eating episodes (N = 108). RESULTS At baseline, the groups did not differ significantly in restraint scores and quality of life. People in the OBE group scored higher than those in the SBE group in body mass index (BMI). Those who had no regular binge eating had lower global Eating Disorder Examination Questionnaire (EDE-Q) and weight and shape concern scores than those with regular SBEs, and lower eating concern scores than either binge eating groups. Across the follow-up, there were no significant effects of being in either binge eating or the nonbinge eating group on the rates of change in BMI, general psychological distress, quality of life, or EDE-Q scores with the exception that OBE group had a significantly different rate of change in eating concern and psychological distress compared to the group without regular binge eating. DISCUSSION Individuals that report regular SBEs without regular OBEs represent a group with similar mental hardship and outcomes to those with regular OBEs. The findings support inclusion of regular SBEs in criteria for eating disorder diagnostic categories characterized by recurrent binge eating.
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Affiliation(s)
- Marly A Palavras
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Ministry of Education (CAPES) Foundation, São Paulo, Brazil.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Phillipa J Hay
- School of Medicine, Western Sydney University, Sydney, Australia.,Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.,School of Medicine, James Cook University, Sydney, Australia
| | - Sanja Lujic
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.,Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Angélica M Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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Las Hayas C, Padilla P, del Barrio AG, Beato-Fernandez L, Muñoz P, Gámez-Guadix M. Individualised Versus Standardised Assessment of Quality of Life in Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2015; 24:147-56. [PMID: 26442984 DOI: 10.1002/erv.2411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/29/2015] [Accepted: 09/01/2015] [Indexed: 11/10/2022]
Abstract
Individualised measures of quality of life (QoL) refer to instruments that encourage the respondent to actively elicit which areas of their life are most relevant for his/her QoL. The aim of this study is to compare individualised versus standard measures of QoL in a sample of patients with eating disorder (ED). The Schedule for the Evaluation of the Individual Quality of Life (SEIQoL) and a generic measure of QoL [World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF)] were applied on two occasions (one-year follow-up) to a sample of 165 patients with ED, 57 recovered patients with ED, and 349 women from the general population. The areas of 'family', 'education/career or job', 'friends', 'leisure', 'romantic partner' and 'health' were identified as the most important for their QoL for all groups, both times. The WHOQOL-BREF was more sensitive than the SEIQoL in detecting changes that occurred over time. Clinical interventions for ED should consider social components as objectives of intervention.
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Affiliation(s)
- Carlota Las Hayas
- Faculty of Psychology and Education, University of Deusto, Bilbao, Spain.,REDISSEC-Health Services Research on Chronic Patients Network, University of Deusto, Bilbao, Spain
| | - Patricia Padilla
- Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Andrés Gómez del Barrio
- Center for Biomedical Research in Mental Health (CIBERSAM), Eating Disorders Unit, Department of Psychiatry, Hospital Universitario Marqués Valdecilla, Cantabria, Spain
| | | | - Pedro Muñoz
- Department of Psychiatry, Ortuella Mental Health Center, Ortuella, Spain
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