Associations Between Trauma, Early Maladaptive Schemas, Personality Traits, and Clinical Severity in Eating Disorder Patients: A Clinical Presentation and Mediation Analysis

Background: The literature has shown a significant association between traumatic experiences and eating psychopathology, showing a greater symptomatology in patients with trauma history. Less is known about the associations between trauma and cognitive schemas, and personality traits and the differences between childhood and adulthood trauma experiences. Thus, this paper aims to assess the clinical and psychological characteristics of eating disorder (ED) patients, looking for differences between patients without a history of trauma and patients with trauma experiences, as well as at possible differences between exposure in childhood, adulthood, or repeated events. Another aim of the paper is to evaluate the possible mediation role of cognitive schemas and personality traits in the relationship between early trauma and eating psychopathology.

Methods: From January to November 2020, 115 consecutive inpatients admitted for a specific multidisciplinary ED treatment in a dedicated Unit were evaluated for trauma, differentiating between trauma occurring in childhood and adulthood. The subjects were evaluated for early maladaptive schemas (EMS), personality traits, trauma symptomatology, quality of life, and specific psychopathologies linked to EDs. Mediation analyses between childhood and adulthood trauma and eating psychopathology were performed, with EMS and personality traits as mediators.

Results: Patients with a history of trauma showed higher physical and psychological symptomatology scores, with a more impaired clinical profile in patients with both childhood and adulthood trauma exposure. The mediation analysis showed a specific mediator role for the “disconnection and rejection (DR)” EMS factor in the relationship between childhood trauma (cT) and eating psychopathology.

Conclusion: Trauma experiences are associated with more severe clinical symptomatology in EDs and may need a specific assessment in patients with failed outpatient standard treatments. Specific cognitive schemas linked to DR domain should be evaluated in treatments for ED patients with history of trauma due to the mediation role between trauma and eating psychopathology. The need for outcome studies about treatment approaches for ED patients with history of trauma is discussed.

A very rare cause of retroperitoneal bleeding in young patients: do not forget the occurrence of a ruptured left gastroepiploic artery aneurysm!

Visceral artery aneurysms represent a very rare condition. The affected patients usually present as emergency secondary to the sudden rupture of the aneurysm or as an incidental finding on imaging. In this setting, gastric and gastroepiploic aneurysms account for only about 4% of all the splancnic aneurysms. Since ruptured visceral aneurysms present a high mortality, a prompt and adequate (surgical or radiological interventional) treatment is mandatory. Due to the difficulty in achieving an adequate transcatheter access in some cases the emergency laparotomy may represent the only chance for the recover of the affected patients. We report two cases of ruptured left gastroepiploic aneurysms occurred in two young male patients, treated respectively with emergency laparotomy and laparoscopy.

Measurement techniques for UMTS signals radiated by radio base stations

In the most European countries radio coverage for the third radio mobile generation. i.e, the UMTS (Universal Mobile Telecommunications System), will soon be started. In the past few years, national laws specifying limits on exposure to electromagnetic fields have drawn much attention on electromagnetic test bed and measurement procedures for radio mobile equipment/systems. An overview is given of the UMTS system, showing the main characteristics of the radio access network UTRAN (UMTS Terrestrial Radio Access Network). An analysis is also provided as to the measurement techniques and related instrumentation for the electric field intensity radiated by a UMTS radio station.

Encapsulating peritoneal sclerosis: do not be too late for the right diagnosis! Case report and short literature review

Encapsulating peritoneal sclerosis (EPS) is a rare clinical syndrome characterized by an acquired, inflammatory fibrocollagenous membrane encasing the small intestine, resulting in symptoms of bowel obstruction. It is still unclear whether early surgical intervention has an advantage over conservative management, but, in most reviewed case reports, it is preferred to preserve the surgical management in patients not responding to conservative measures, or when bowel ischaemia is occurring. We report a case of a 58-year old patients, affected by chronic renal failure, on treatment with peritoneal dialysis, in which a late diagnosis of encapsulating peritoneal sclerosis was made, and where surgical intervention was not sufficient to guarantee survival due to the late diagnosis.

The Interplay Between Personality and Clinical Syndromes in Eating Disorders: Implications for Personalized Treatment

INTRODUCTION

Eating disorders (EDs) are complex and multifactorial conditions with significant impacts on both physical and mental health. Despite advances in treatment, relapse rates remain high, highlighting the need for improved predictive models for treatment outcomes. This study aims to examine the role of personality traits and clinical syndromes, as assessed by the Millon Clinical Multiaxial Inventory-III (MCMI-III), in predicting treatment outcomes for individuals with EDs.

METHODS

A retrospective evaluation was conducted on 149 women diagnosed with EDs, receiving inpatient treatment at the Eating Disorder Unit of Casa di Cura Villa Margherita-KOS (Arcugnano-Vicenza) between 2020 and 2024. Participants completed the MCMI-III at treatment initiation, with the Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA) administered at baseline and discharge.

RESULTS

Regression analyses revealed that maladaptive personality traits (avoidant, dependent and histrionic) and clinical syndromes such as major depression were significant negative predictors of treatment response. In contrast, post-traumatic stress emerged as a positive predictor of improvement. Specific personality and clinical patterns were associated with changes in symptomatology, including reductions in eating concerns, shape concerns and clinical impairment. However, not all dimensions were predictive of treatment outcomes.

CONCLUSION

This study underscores the importance of personalized treatment approaches that account for both personality traits and clinical syndromes in individuals with EDs. Future research should explore how these factors interact over time and inform tailored therapeutic strategies, particularly for those with comorbid traits or disorders.

Body image flexibility and embodiment in eating disorders: a mixed-methods approach combining network analysis and pilot exposure protocol

OBJECTIVE

Body image (BI) disturbances are central to the psychopathology of eating disorders (EDs), where body dissatisfaction and disembodiment often co-occur, exacerbating negative body image experiences. We aimed to examine body image flexibility and embodiment in women with EDs and a general population (GP) sample.

METHOD

Data were collected from 172 participants, including 103 GP women and 69 women with EDs. Standardized questionnaires measuring body uneasiness, interoceptive awareness, and body image acceptance were administered. Additionally, a pilot group therapy intervention targeting body image concerns was evaluated with 24 ED participants.

RESULTS

Findings suggest that significant differences in embodiment-related features emerged (self-regulation and body trust), while both groups reported similar levels of interoceptive awareness. Network analysis revealed distinct patterns of partial correlations between variables within each group, with higher centrality for body image concerns and weight phobia in EDs. In contrast, the GP group exhibited stronger connections between embodiment features such as attention regulation and body image acceptance. The pilot intervention showed promise in improving body image flexibility and reducing body image concerns.

CONCLUSIONS

These results underscore the importance of fostering body image flexibility and embodiment in the clinical treatment of EDs, suggesting potential pathways for enhancing therapeutic interventions.

Distinct delay discounting patterns in anorexia nervosa: Comparing monetary and exercise rewards across clinical subgroups

AIMS

People with anorexia nervosa (AN) often engage in compulsive exercise to control weight and manage emotions, altering the reward associated with physical activity. Delay-discounting evaluates preference for immediate over delayed rewards, potentially indicating struggles with prioritizing long-term gains. However, the impact of AN on these factors remains unexplored. This study aims to assess the attitudes of individuals with AN using a modified exercise delay discount task, comparing them with the general population.

METHODS

A sample of 76 individuals (70 women, 92.1%) with a diagnosis of AN was compared with a sample of 124 people (115 women, 92.7%) without a lifetime diagnosis of any eating disorder. Two different delay discount tasks were used to evaluate different constructs: a standardized monetary delay discount task and a modified version focused on physical activity.

RESULTS

The standardized monetary delay discount task confirmed the existence of varied monetary rewards in different subtypes of AN. The exercise-related task demonstrated a specific emphasis on exercise within AN, showing a tendency to delay physical activity by looking for a greater amount of exercise. On the contrary, the general population opted for immediate exercise proposals.

CONCLUSIONS

Our findings suggest that the tendency to delay physical activity could be related to the compulsive nature of exercise in patients with AN, with a possible change in cognitive evaluation based on the magnitude of exercise. Finally, in addition to psychological problems related to eating disorders, additional cognitive factors likely contribute to exercise compulsiveness, necessitating further research exploration.