Comparisons between atypical anorexia nervosa and anorexia nervosa: Psychological and comorbidity patterns

OBJECTIVE

Literature comparing "atypical" anorexia nervosa (atypical AN) and anorexia nervosa (AN) suggests these diagnoses share significant similarities in eating disorder (ED) pathology and psychiatric comorbidities. This study evaluated potential differences in ED pathology, psychiatric comorbidity, associated mechanisms (i.e., ED fears and perfectionism), and demographic factors (i.e., ethnicity and age) between individuals with atypical AN and AN.

METHOD

Data from seven protocols were combined for a total 464 individuals diagnosed with atypical AN (n = 215) or AN (n = 249). Between-group differences in ED severity and behaviors, psychiatric comorbidities, ED fears, perfectionism, and demographic factors were assessed using t-tests, Wilcoxon rank-sum tests, and Fisher's exact test.

RESULTS

Participants with atypical AN reported higher levels of overvaluation of weight and shape than those with AN. Participants with AN scored higher on food-related fears (anxiety about eating, food avoidance behaviors, and feared concerns) and fears of social eating, as well as obsessive-compulsive symptoms. Participants with AN were more likely to identify as Asian or Pacific Islander. No other statistically significant differences were found between groups for overall ED severity, ED behaviors, psychiatric comorbidities, general ED fears, perfectionism, or demographic factors.

DISCUSSION

Overall, results support previous literature indicating limited differences between individuals with atypical AN and AN, though individuals with atypical AN reported more overvaluation of weight and shape and those with AN reported higher food and social eating fears and obsessive-compulsive symptoms. Relatively few overall differences between atypical AN and AN highlight the importance of exploring dimensional conceptualizations of AN as an alternative to the current categorical conceptualization.

PUBLIC SIGNIFICANCE

This study assessed differences among individuals with atypical anorexia nervosa and anorexia nervosa in eating disorder severity and behaviors, comorbid psychiatric diagnoses, associated mechanisms, and demographic factors. Few differences emerged, though participants with atypical anorexia nervosa reported more overvaluation of weight and shape, while those with anorexia nervosa reported more food and social eating fears and higher obsessive-compulsive symptoms. Results support exploration of these diagnoses as a spectrum disorder.

Momentary physiological indices related to eating disorders: A systematic and methodological review

Eating disorders (ED) are serious psychiatric illnesses, with no everyday support to intervene on the high rates of relapse. Understanding physiological indices that can be measured by wearable sensor technologies may provide new momentary interventions for individuals with ED. This systematic review, searching large databases, synthesises studies investigating peripheral physiological (PP) indices commonly included in wearable wristbands (heart rate [HR], heart rate variability [HRV], electrodermal activity [EDA], peripheral skin temperature [PST], and acceleration) in ED. Inclusion criteria included: (a) full peer-reviewed empirical articles in English; (b) human participants with active ED; and (c) containing one of five wearable physiological measures. Kmet risk of bias was assessed. Ninety-four studies were included (Anorexia nervosa [AN; N = 4418], bulimia nervosa [BN; N = 916], binge eating disorder [BED; N = 1604], other specified feeding and eating disorders [OSFED; N = 424], and transdiagnostic [N = 47]). Participants with AN displayed lower HR and EDA and higher HRV compared to healthy individuals. Those with BN showed higher HRV, and lower EDA and PST compared to healthy individuals. Other ED and Transdiagnostic samples showed mixed results. PP differences are indicated through various assessments in ED, which may suggest diagnostic associations, although more studies are needed to validate observed patterns. Results suggest important therapeutic potential for PP in ED, and larger studies including diverse participants and diagnostic groups are needed to fully uncover their role in ED.

Exploring Sociocultural Influences Affecting Body Image in Survivors of Childhood Sexual Assault

This phenomenological study explored the lived experiences of survivors of childhood sexual assault, their meaning making process of the assault, and how messages from their sociocultural environment affected their relationship with, and perception of, their bodies. Utilizing a social constructivist framework, the research team interviewed eleven (n = 11) participants from a variety of backgrounds who were gender assigned female at birth and had survived childhood sexual assault (CSA). Four major themes emerged from the narratives collected. These include sociocultural impacts which included four subthemes: family relationships, peer relationships, societal and environmental influences, and cultural and ethnic influences; meaning making of the critical event, i.e., childhood sexual assault; self-perception of their bodies; internal processes that have shaped their perceptions and meaning making, i.e., thoughts, feelings, and behaviors. Findings indicate major influence of sociocultural factors in shaping participant's internal processes as survivors of CSA, meaning making, and subsequently self-perceptions of, and relationship with, their bodies. We discuss CSA and body image keeping the intersectionality of the individual, their experiences, and the impact of sociocultural contexts on that intersectionality.

Competing for perfection: A scoping review evaluating relationships between competitiveness and eating disorders or disordered eating behaviours

OBJECTIVE

Eating disorders (EDs) impact multiple domains in a person's life including interpersonal interactions. Although a considerable amount of literature has evaluated social comparison and ED pathology, less has focussed on the influence of competitiveness on eating behaviours within ED and community samples. To address this, a systematic scoping review was conducted to evaluate current knowledge on this topic.

METHOD

PRISMA guidelines for scoping reviews were utilised to identify relevant articles in three databases without limits to date or publication type.

RESULTS

A total of 2952 articles were identified. After removing duplicates and books, 1782 articles were evaluated against inclusion criteria, and 91 articles were included. Results were synthesised under six differing conceptualisations of competitiveness: competition in pro-eating disorder communities (n = 28), general personality competitiveness (n = 20), sexual competition hypothesis (n = 18), interpersonal competitiveness with peers (n = 17), familial competitiveness (n = 8) and competitiveness to avoid inferiority (n = 5).

CONCLUSION

Varying conceptualisations of competitiveness were identified within the ED literature, and preliminary evidence suggests competitiveness may be associated with ED pathology in ED and community samples, although results were not uniform. Future research is needed to clarify these relationships and to identify possible clinical implications.

Risks of Regional Anaesthesia for Caesarean Section: Women's Recall and Information Sources

Recall and information sources regarding the risks of regional anaesthesia in women having lower segment caesarean section have not been adequately assessed previously. We aimed to survey women's recall of their pre-anaesthesia risk discussion and determine where women, presenting for lower segment caesarean section under regional anaesthesia, obtain risk information. Following a small pilot survey, women's responses were recorded for “spontaneous” or “prompted” recalled risks, the information source and its reliability. One-hundred and fifty women were surveyed following caesarean section. Seventy women (46.7%) had an elective procedure and 80 (53.3%) had an emergency procedure. Overall, 142 women (94.6%) recalled at least four risks (44.6% spontaneously; 66% prompted). Of those women giving at least four spontaneous responses, 41 (58.6%) had elective and 26 (32.5%) had emergency lower segment caesarean section (P=0.001). The majority of women stated that anaesthetists were the main, and most reliable, source of their information regarding risks of regional anaesthesia for caesarean section. This report identifies the risks associated with regional anaesthesia for caesarean section that women most frequently recall, namely headache, paralysis, nerve damage and inadequate block.

Projected Dipole Moments of Individual Two-Level Defects Extracted Using Circuit Quantum Electrodynamics

Material-based two-level systems (TLSs), appearing as defects in low-temperature devices including superconducting qubits and photon detectors, are difficult to characterize. In this study we apply a uniform dc electric field across a film to tune the energies of TLSs within. The film is embedded in a superconducting resonator such that it forms a circuit quantum electrodynamical system. The energy of individual TLSs is observed as a function of the known tuning field. By studying TLSs for which we can determine the tunneling energy, the actual p_{z}, dipole moments projected along the uniform field direction, are individually obtained. A distribution is created with 60 p_{z}. We describe the distribution using a model with two dipole moment magnitudes, and a fit yields the corresponding values p=p_{1}=2.8±0.2  D and p=p_{2}=8.3±0.4  D. For a strong-coupled TLS the vacuum-Rabi splitting can be obtained with p_{z} and tunneling energy. This allows a measurement of the circuit's zero-point electric-field fluctuations, in a method that does not need the electric-field volume.

Decoupling a Cooper-pair box to enhance the lifetime to 0.2 ms

We present results on a circuit QED experiment in which a separate transmission line is used to address a quasilumped element superconducting microwave resonator which is in turn coupled to an Al/AlO(x)/Al Cooper-pair box charge qubit. With our device, we find a strong correlation between the lifetime of the qubit and the inverse of the coupling between the qubit and the transmission line. At the smallest coupling we measured, the lifetime of the Cooper-pair box was T₁=200 μs, which represents more than a twentyfold improvement in the lifetime of the Cooper-pair box compared with previous results. These results imply that the loss tangent in the AlO(x) junction barrier must be less than about 4×10⁻⁸ at 4.5 GHz, about 4 orders of magnitude less than reported in larger area Al/AlO(x)/Al tunnel junctions.

Torsade de pointes in a patient with acute prolonged QT syndrome and poorly controlled diabetes during sevoflurane anaesthesia

We report a case of torsade de pointes secondary to acute QT interval prolongation in a patient with poorly controlled diabetes mellitus towards the end of a laparoscopic nephrectomy under sevoflurane anaesthesia. The patient was successfully resuscitated and made a complete recovery. Our case suggests that acute QT interval prolongation should be considered in any patient with poor glycaemic control during prolonged procedures.

Rural anaesthesia practice: attitudes and recruitment following a period of anaesthetic training in rural and regional hospitals. A survey of new consultants

The provision of specialist anaesthetic services to rural and remote locations in Australia poses an ongoing challenge. Initiatives to improve delivery of specialist anaesthetic services include the provision of anaesthesia training opportunities at rural hospitals. Previous surveys of trainees demonstrated the positive effect of rural training on attitudes toward subsequent practice in rural areas. We aimed first to survey attitudes of specialist anaesthetists towards anaesthetic training at rural and regional hospitals. We then compared the current workplace of those who had experienced a period of training at rural/regional hospitals versus those who did not. A web-based survey was distributed to fellows of the Australian and New Zealand College of Anaesthetists who had commenced consultant practice in the preceeding five years. Six hundred and fifteen surveys were distributed with a response rate of 53%. Respondents held their rural training experience in high regard. Anaesthetic specialists with a period of training in rural/regional areas were more likely to subsequently practise in rural areas compared to those who did not.

Decoherence in Josephson qubits from dielectric loss

Dielectric loss from two-level states is shown to be a dominant decoherence source in superconducting quantum bits. Depending on the qubit design, dielectric loss from insulating materials or the tunnel junction can lead to short coherence times. We show that a variety of microwave and qubit measurements are well modeled by loss from resonant absorption of two-level defects. Our results demonstrate that this loss can be significantly reduced by using better dielectrics and fabricating junctions of small area . With a redesigned phase qubit employing low-loss dielectrics, the energy relaxation rate has been improved by a factor of 20, opening up the possibility of multiqubit gates and algorithms.

Simultaneous State Measurement of Coupled Josephson Phase Qubits

One of the many challenges of building a scalable quantum computer is single-shot measurement of all the quantum bits (qubits). We have used simultaneous single-shot measurement of coupled Josephson phase qubits to directly probe interaction of the qubits in the time domain. The concept of measurement crosstalk is introduced, and we show that its effects are minimized by careful adjustment of the timing of the measurements. We observe the antiphase oscillation of the two-qubit 01 and 10 states, consistent with quantum mechanical entanglement of these states, thereby opening the possibility for full characterization of multiqubit gates and elementary quantum algorithms.

Growth factor stimulation of adult articular cartilage

We have examined the effect of peptide growth factors on DNA and proteoglycan synthesis by adult bovine articular cartilage in organ culture. The actions of somatomedin-C/insulin-like growth factor I (Sm-C/IGF-I), insulin, epidermal growth factor (EGF), and fibroblast growth factor (FGF) from bovine pituitary were investigated individually and in combination. FGF stimulated a 10-fold increase in tritiated thymidine incorporation while other factors used individually did not influence mitotic activity. Used in concert, insulin with EGF and insulin with FGF acted synergistically in stimulating DNA synthesis 20-fold and 40-fold, respectively. All of these growth factors, acting individually, significantly enhanced radiosulfate incorporation. This stimulation was additive for Sm-C/IGF-I in combination with EGF or FGF, but not with insulin. These data indicate that adult bovine articular chondrocytes possess the capacity to augment both mitotic and differentiated cell functions in response to growth factors. The data further suggest that, with the exception of insulin and Sm-C/IGF-I, which appear to share a common mechanism of action, these factors produce their cellular effects via different receptor or postreceptor pathways.