Samantha A. Everhart, Sohyun C. Han, Ramon Durazo-Arvizu
Objective
Family-Based Treatment (FBT) is the gold standard outpatient eating disorder treatment for children and adolescents with eating disorders. Especially within the past decade, higher levels of care (HLOC) programs including inpatient medical settings and partial hospitalisation programs have incorporated elements of FBT to improve the effectiveness of their treatments. The present study aimed to systematically review the state of the research on FBT adaptations in HLOC and describe the outcomes of those treatment programs.
Method
Articles were identified via a systematic search of three databases (PsycINFO, PubMed, Cochrane Database of Randomized Controlled Trials) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Results
Forty articles were identified including 35 studies and 5 programme descriptions, representing 17 inpatient and 23 partial hospitalisation and/or intensive outpatient programs. Thirty quantitative studies and five qualitative studies were included. Findings supported suitability and effectiveness of treatments in improving weight, eating disorder and mental health symptoms and family functioning.
Conclusions
Burgeoning research supports the effectiveness of FBT adapted to HLOC, with the most evidence for improving weight and eating disorder symptoms. The present review identifies further areas of research needed to expand on the current evidence, such as with controlled trials with sufficient follow-up data.
{"title":"Family-Based Treatment in Higher Levels of Care: A Systematic Review and Meta-Analysis","authors":"Samantha A. Everhart, Sohyun C. Han, Ramon Durazo-Arvizu","doi":"10.1002/erv.3208","DOIUrl":"10.1002/erv.3208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Family-Based Treatment (FBT) is the gold standard outpatient eating disorder treatment for children and adolescents with eating disorders. Especially within the past decade, higher levels of care (HLOC) programs including inpatient medical settings and partial hospitalisation programs have incorporated elements of FBT to improve the effectiveness of their treatments. The present study aimed to systematically review the state of the research on FBT adaptations in HLOC and describe the outcomes of those treatment programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Articles were identified via a systematic search of three databases (PsycINFO, PubMed, Cochrane Database of Randomized Controlled Trials) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty articles were identified including 35 studies and 5 programme descriptions, representing 17 inpatient and 23 partial hospitalisation and/or intensive outpatient programs. Thirty quantitative studies and five qualitative studies were included. Findings supported suitability and effectiveness of treatments in improving weight, eating disorder and mental health symptoms and family functioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Burgeoning research supports the effectiveness of FBT adapted to HLOC, with the most evidence for improving weight and eating disorder symptoms. The present review identifies further areas of research needed to expand on the current evidence, such as with controlled trials with sufficient follow-up data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"1074-1084"},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margaret Sala, Corey R. Roos, Hedy Kober, Jonathan B. Bricker, Casey M. Stern, Joshua Plutchik, Maya John, Angela M. Haeny, Jonathan M. Feldman, Mihaela Aslan, Jennifer L. Hay, Evan M. Forman
Objective
Delivering a single-session treatment digitally can offer increased accessibility. We developed and tested a single-session digital intervention for binge-eating disorder (BED) combining cognitive behavioural therapy (CBT) and mindfulness training.
Method
English-speaking adults who met criteria for BED were recruited nationally. Participants completed a 60-min digital single-session intervention for BED. Our primary outcome was to evaluate initial acceptability (usability, overall satisfaction, engagement, visual appeal of content, understandability of programme material, desire to continue the programme, and overall helpfulness) and feasibility (intervention completion). We also evaluated changes in binge eating episodes, assessed via the Eating Disorder Examination Questionnaire (EDE-Q) objective binge eating episodes question, and eating disorder symptoms, assessed via the EDE-Q and Binge Eating Scale (BES). Acceptability measures were administered immediately after the completion of the digital module, while the BES and EDE-Q were administered at pre-treatment and at 1-month follow-up.
Results
All participants (N = 21) completed the intervention. Ratings for acceptability were excellent, with averages above a four on a five-point Likert scale on ratings for all dimensions. Participants reported large and significant decreases in binge eating episodes (d = 0.86) and BES scores (d = 0.91) as well as medium and significant decreases in global eating disorder symptoms at 1-month follow-up (d = 0.55).
Discussion
Results from this pilot suggest promising acceptability and feasibility for a single session of Mindful Courage for BED. This single session also appears to be preliminarily efficacious in reducing binge eating.
{"title":"Combining Cognitive-Behaviour Therapy With Mindfulness Training in a Digital Intervention for Binge Eating Disorder: A Single-Session Pilot Trial","authors":"Margaret Sala, Corey R. Roos, Hedy Kober, Jonathan B. Bricker, Casey M. Stern, Joshua Plutchik, Maya John, Angela M. Haeny, Jonathan M. Feldman, Mihaela Aslan, Jennifer L. Hay, Evan M. Forman","doi":"10.1002/erv.3204","DOIUrl":"10.1002/erv.3204","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Delivering a single-session treatment digitally can offer increased accessibility. We developed and tested a single-session digital intervention for binge-eating disorder (BED) combining cognitive behavioural therapy (CBT) and mindfulness training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>English-speaking adults who met criteria for BED were recruited nationally. Participants completed a 60-min digital single-session intervention for BED. Our primary outcome was to evaluate initial acceptability (usability, overall satisfaction, engagement, visual appeal of content, understandability of programme material, desire to continue the programme, and overall helpfulness) and feasibility (intervention completion). We also evaluated changes in binge eating episodes, assessed via the Eating Disorder Examination Questionnaire (EDE-Q) objective binge eating episodes question, and eating disorder symptoms, assessed via the EDE-Q and Binge Eating Scale (BES). Acceptability measures were administered immediately after the completion of the digital module, while the BES and EDE-Q were administered at pre-treatment and at 1-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All participants (<i>N</i> = 21) completed the intervention. Ratings for acceptability were excellent, with averages above a four on a five-point Likert scale on ratings for all dimensions. Participants reported large and significant decreases in binge eating episodes (<i>d</i> = 0.86) and BES scores (<i>d</i> = 0.91) as well as medium and significant decreases in global eating disorder symptoms at 1-month follow-up (<i>d</i> = 0.55).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Results from this pilot suggest promising acceptability and feasibility for a single session of <i>Mindful Courage</i> for BED. This single session also appears to be preliminarily efficacious in reducing binge eating.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"1051-1060"},"PeriodicalIF":3.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiana Schnabel, Kristin Stedal, Mark Rose, Betteke Maria van Noort, Lauren B. Alloy, C. Alix Timko
Objective
Inefficiencies in cognitive flexibility (CF) are a potential vulnerability trait for anorexia nervosa (AN). Yet, much of the research on CF in AN has been conducted in adult samples, with mixed results from research on adolescents. Knowledge of the prevalence of low scores on assessments can help avoid erroneous interpretations of test scores. The current study examined the prevalence of low scores on the Delis Kaplan Executive Function System (D-KEFS) in adolescents and adults with AN and adolescent healthy controls.
Method
We conducted a secondary analysis of D-KEFS data from 739 participants (552 adolescents with AN [aged 15.39 ± 1.91, 92% female], 69 adults with AN [aged 26.5 ± 6.1, 98.6% female], and 118 adolescent healthy controls [HC] [aged 15.09 ± 2.14, 98.3% female]).
Results
Low scores on the D-KEFS were common across all groups. Adults with AN exhibited the highest proportion of individuals with abnormally low scores, followed by adolescents with AN and adolescent HC. Adolescents with a higher proportion of low scores had a lower BMI z-score and longer length of illness.
Conclusions
Results highlight differences between adults and adolescents and lend support to the hypothesis that inefficiencies in flexibility are either a marker of persistent course or a scar of AN illness.
{"title":"Base Rates of Low Delis Kaplan Executive Function System Scores in Individuals With Anorexia Nervosa","authors":"Jiana Schnabel, Kristin Stedal, Mark Rose, Betteke Maria van Noort, Lauren B. Alloy, C. Alix Timko","doi":"10.1002/erv.3202","DOIUrl":"10.1002/erv.3202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Inefficiencies in cognitive flexibility (CF) are a potential vulnerability trait for anorexia nervosa (AN). Yet, much of the research on CF in AN has been conducted in adult samples, with mixed results from research on adolescents. Knowledge of the prevalence of low scores on assessments can help avoid erroneous interpretations of test scores. The current study examined the prevalence of low scores on the Delis Kaplan Executive Function System (D-KEFS) in adolescents and adults with AN and adolescent healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a secondary analysis of D-KEFS data from 739 participants (552 adolescents with AN [aged 15.39 ± 1.91, 92% female], 69 adults with AN [aged 26.5 ± 6.1, 98.6% female], and 118 adolescent healthy controls [HC] [aged 15.09 ± 2.14, 98.3% female]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Low scores on the D-KEFS were common across all groups. Adults with AN exhibited the highest proportion of individuals with abnormally low scores, followed by adolescents with AN and adolescent HC. Adolescents with a higher proportion of low scores had a lower BMI <i>z</i>-score and longer length of illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results highlight differences between adults and adolescents and lend support to the hypothesis that inefficiencies in flexibility are either a marker of persistent course or a scar of AN illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"1044-1050"},"PeriodicalIF":3.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.3202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Pappaianni, B. Borsarini, C. Berchio, S. Aicoboaie, S. V. Konstantopoulou, D. Van de ville, N. Micali
Background
Eating disorders (EDs) are serious psychiatric disorders characterized by impairments in neurocognition and altered brain structure. To date the majority of studies have investigated these in acutely ill or recovered individuals. Studying children at familial high risk (FHR) for psychiatric disorders allows investigating vulnerability traits or trait markers that may be present before disorder onset. Our study is the first one to examine executive function and brain structure in girls at FHR for ED (Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder) compared to controls (girls not at familial high risk - HC).
Methods
Forty-six (46) FHR girls (median age: 10.5 years, range: 9) and 50 HC girls (median age: 12 years, range: 8) completed a battery of neuropsychological tests assessing cognitive flexibility, inhibitory control, and working memory. Structural magnetic resonance imaging assessed grey matter volume (GMV) and cortical thickness (CT).
Results
Girls at FHR for ED performed a higher number of errors in a cognitive flexibility task compared to HC (β = 0.15, p < 0.05). They also had increased GMV in posterior regions such as the right supramarginal gyrus, middle occipital gyrus, and lingual/fusiform gyrus compared to HC (p < 0.05 cluster-level FWE-corrected), as well as increased CT in the left transverse pole (p < 0.001) and right posterior cingulate cortex (p < 0.05).
Conclusions
Girls at FHR show characteristic neurocognitive performance similar to that seen in individuals with ED, as well as differences in brain structure compared to HC. Our findings, together with previous evidence, highlight impairment in cognitive flexibility as a possible trait marker of ED. Further longitudinal studies are needed to confirm differences in GMV and CT identified in this study.
{"title":"Neurobiology and Cognition in Girls at High-Risk of Eating Disorders: Exploring Imaging-Derived Trait Markers","authors":"E. Pappaianni, B. Borsarini, C. Berchio, S. Aicoboaie, S. V. Konstantopoulou, D. Van de ville, N. Micali","doi":"10.1002/erv.3203","DOIUrl":"10.1002/erv.3203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eating disorders (EDs) are serious psychiatric disorders characterized by impairments in neurocognition and altered brain structure. To date the majority of studies have investigated these in acutely ill or recovered individuals. Studying children at familial high risk (FHR) for psychiatric disorders allows investigating vulnerability traits or trait markers that may be present before disorder onset. Our study is the first one to examine executive function and brain structure in girls at FHR for ED (Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder) compared to controls (girls not at familial high risk - HC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-six (46) FHR girls (median age: 10.5 years, range: 9) and 50 HC girls (median age: 12 years, range: 8) completed a battery of neuropsychological tests assessing cognitive flexibility, inhibitory control, and working memory. Structural magnetic resonance imaging assessed grey matter volume (GMV) and cortical thickness (CT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Girls at FHR for ED performed a higher number of errors in a cognitive flexibility task compared to HC (<i>β</i> = 0.15, <i>p</i> < 0.05). They also had increased GMV in posterior regions such as the right supramarginal gyrus, middle occipital gyrus, and lingual/fusiform gyrus compared to HC (<i>p</i> < 0.05 cluster-level FWE-corrected), as well as increased CT in the left transverse pole (<i>p</i> < 0.001) and right posterior cingulate cortex (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Girls at FHR show characteristic neurocognitive performance similar to that seen in individuals with ED, as well as differences in brain structure compared to HC. Our findings, together with previous evidence, highlight impairment in cognitive flexibility as a possible trait marker of ED. Further longitudinal studies are needed to confirm differences in GMV and CT identified in this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"1032-1043"},"PeriodicalIF":3.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.3203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eating disorders (EDs) are significant comorbidities in individuals with schizophrenia spectrum disorders (SSDs), yet they are often under recognized. This systematic review and meta-analysis aimed to synthesise existing evidence on the prevalence of EDs in SSD populations and to explore potential moderators such as geographical location and diagnostic tools.
Methods
We conducted a systematic search of PubMed, Embase and Web of Science for studies reporting the prevalence of EDs in individuals with SSDs. Subgroup analyses examined the influence of geographical location and screening tools on prevalence estimates. Sensitivity analyses and a funnel plot were used to assess the robustness of the findings and potential publication bias.
Results
A total of 13 studies, comprising 1135 participants, were included in the review, with 12 studies contributing to the meta-analysis using R v4.4. The pooled prevalence of EDs in individuals with SSDs was 15.65% (95% CI: 8.04–28.26), with a prediction interval ranging from 1.62% to 67.66%. Subgroup analysis by geographical location revealed substantial variability, with prevalence estimates ranging from 5.88% in Southern Europe to 28.99% in the Middle East and North Africa. Studies using questionnaire-based tools reported a higher pooled prevalence (19.25%) compared to those employing DSM-based diagnostic criteria (11.90%). Significant heterogeneity was observed across studies (I2 = 87%).
Conclusions
This study highlights the considerable prevalence of EDs in SSD populations, emphasising the need for early identification and integrated care. The variability in prevalence estimates suggests that geographical, cultural and methodological factors play an important role in the findings. Future research should focus on longitudinal studies, the development of standardized diagnostic tools, and the inclusion of underrepresented regions to enhance understanding and improve care for this vulnerable population.
{"title":"Prevalence of Eating Disorders in Individuals With Schizophrenia Spectrum Disorder: A Systematic Review and Meta-Analysis","authors":"Swastik Subhankar Sahu, Mahalaqua Nazli Khatib, Rekha MM, Mandeep Kaur, Girish Chandra Sharma, Puneet Sudan, K. Satyam Naidu, Rajesh Singh, Brajgopal Kushwaha, Tripti Desai, Muhammed Shabil, Sanjay Singh Chauhan, Lokesh Verma, Amritpal Sidhu, Rachana Mehta, Prakasini Satapathy, Sanjit Sah, Abhay M. Gaidhane, Ganesh Bushi","doi":"10.1002/erv.3199","DOIUrl":"10.1002/erv.3199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Eating disorders (EDs) are significant comorbidities in individuals with schizophrenia spectrum disorders (SSDs), yet they are often under recognized. This systematic review and meta-analysis aimed to synthesise existing evidence on the prevalence of EDs in SSD populations and to explore potential moderators such as geographical location and diagnostic tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic search of PubMed, Embase and Web of Science for studies reporting the prevalence of EDs in individuals with SSDs. Subgroup analyses examined the influence of geographical location and screening tools on prevalence estimates. Sensitivity analyses and a funnel plot were used to assess the robustness of the findings and potential publication bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 studies, comprising 1135 participants, were included in the review, with 12 studies contributing to the meta-analysis using R v4.4. The pooled prevalence of EDs in individuals with SSDs was 15.65% (95% CI: 8.04–28.26), with a prediction interval ranging from 1.62% to 67.66%. Subgroup analysis by geographical location revealed substantial variability, with prevalence estimates ranging from 5.88% in Southern Europe to 28.99% in the Middle East and North Africa. Studies using questionnaire-based tools reported a higher pooled prevalence (19.25%) compared to those employing DSM-based diagnostic criteria (11.90%). Significant heterogeneity was observed across studies (<i>I</i><sup>2</sup> = 87%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the considerable prevalence of EDs in SSD populations, emphasising the need for early identification and integrated care. The variability in prevalence estimates suggests that geographical, cultural and methodological factors play an important role in the findings. Future research should focus on longitudinal studies, the development of standardized diagnostic tools, and the inclusion of underrepresented regions to enhance understanding and improve care for this vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"1017-1031"},"PeriodicalIF":3.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Connor Campbell, Xander Greig, Jessica Griffiths, Devon Hashman, Thomas Sottile, Masanori Isobe, Anees Bahji, Gina Dimitropoulos, Dan Devoe
Objective
Individuals with eating disorders (EDs) often present with maladaptive behaviours such as excessive exercise (EE). The consequences of EE include physical injuries, increased risk of anxiety and depression, and impaired social functioning. No systematic reviews have been conducted on the prevalence of EE in EDs. This study aimed to assess the prevalence of EE in EDs and by ED type.
Method
An electronic database search of the peer-reviewed literature was conducted from inception to October 2024. Review eligibility was restricted to research studies reporting prevalence data for EE in individuals diagnosed with EDs.
Results
Fifty-six studies met the inclusion criteria (n = 21,518; mean age: 22.34 years). The current prevalence of EE in all EDs was 48%. Current prevalence was highest in AN (48%), followed by BN (45%), OSFED (38%), and BED (11%). The lifetime prevalence of EE in all EDs was 63%. Lifetime prevalence was highest in AN (72%), followed by BN (57%) and OSFED (21%).
Conclusions
Nearly half of individuals with an ED engage in EE. High heterogeneity across the included studies likely influenced the prevalence found in this study. Data suggest clinical screening and longitudinal monitoring of EE in those with EDs. Future research into early intervention and treatment for EE in those with EDs is recommended.
Trial Registration
PROSPERO: CRD42023464148; Open Science Framework: https://doi.org/10.17605/OSF.IO/MYVXW
{"title":"The Prevalence of Excessive Exercise in Eating Disorders: A Systematic Review and Meta-Analysis","authors":"Connor Campbell, Xander Greig, Jessica Griffiths, Devon Hashman, Thomas Sottile, Masanori Isobe, Anees Bahji, Gina Dimitropoulos, Dan Devoe","doi":"10.1002/erv.3194","DOIUrl":"10.1002/erv.3194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Individuals with eating disorders (EDs) often present with maladaptive behaviours such as excessive exercise (EE). The consequences of EE include physical injuries, increased risk of anxiety and depression, and impaired social functioning. No systematic reviews have been conducted on the prevalence of EE in EDs. This study aimed to assess the prevalence of EE in EDs and by ED type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>An electronic database search of the peer-reviewed literature was conducted from inception to October 2024. Review eligibility was restricted to research studies reporting prevalence data for EE in individuals diagnosed with EDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-six studies met the inclusion criteria (<i>n</i> = 21,518; mean age: 22.34 years). The current prevalence of EE in all EDs was 48%. Current prevalence was highest in AN (48%), followed by BN (45%), OSFED (38%), and BED (11%). The lifetime prevalence of EE in all EDs was 63%. Lifetime prevalence was highest in AN (72%), followed by BN (57%) and OSFED (21%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nearly half of individuals with an ED engage in EE. High heterogeneity across the included studies likely influenced the prevalence found in this study. Data suggest clinical screening and longitudinal monitoring of EE in those with EDs. Future research into early intervention and treatment for EE in those with EDs is recommended.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO: CRD42023464148; Open Science Framework: https://doi.org/10.17605/OSF.IO/MYVXW</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"1005-1016"},"PeriodicalIF":3.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.3194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cognitive Behaviour Therapy Ten (CBT-T) is a relatively new manualised treatment for non-underweight patients with eating disorders. It has been found to be an effective treatment and to be rated highly by patients. However, it is also important to consider clinicians' perspectives in the implementation and development of new interventions, because clinician perspectives can impact treatment delivery, leading to issues such as therapist drift. Using a qualitative approach, this research aimed to examine clinician experiences of delivering CBT-T.
Method
The sample consisted of 13 clinicians currently delivering CBT-T, with at least six months experience of delivering this treatment. Semi-structured interviews were conducted via Microsoft Teams, using thematic analysis to identify themes from the interview transcripts.
Results
Three themes and 10 subthemes were identified. The main themes were: positive experiences of delivering CBT-T, changing experience over time, and challenges in delivery.
Discussion
Clinicians reported an overall largely positive experience of delivering CBT-T, with some challenges related to treatment delivery identified. Findings are discussed in relation to wider research literature, with recommendations given about how clinicians can be supported with their delivery of CBT-T, and for future research and CBT-T development.
{"title":"Clinicians' Experiences of Delivering Cognitive Behaviour Therapy Ten (CBT-T): A Qualitative Investigation","authors":"Chloe Hewitt, Siân Coker, Aaron Burgess, Glenn Waller","doi":"10.1002/erv.3200","DOIUrl":"10.1002/erv.3200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Cognitive Behaviour Therapy Ten (CBT-T) is a relatively new manualised treatment for non-underweight patients with eating disorders. It has been found to be an effective treatment and to be rated highly by patients. However, it is also important to consider clinicians' perspectives in the implementation and development of new interventions, because clinician perspectives can impact treatment delivery, leading to issues such as therapist drift. Using a qualitative approach, this research aimed to examine clinician experiences of delivering CBT-T.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The sample consisted of 13 clinicians currently delivering CBT-T, with at least six months experience of delivering this treatment. Semi-structured interviews were conducted via Microsoft Teams, using thematic analysis to identify themes from the interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three themes and 10 subthemes were identified. The main themes were: positive experiences of delivering CBT-T, changing experience over time, and challenges in delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Clinicians reported an overall largely positive experience of delivering CBT-T, with some challenges related to treatment delivery identified. Findings are discussed in relation to wider research literature, with recommendations given about how clinicians can be supported with their delivery of CBT-T, and for future research and CBT-T development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"995-1004"},"PeriodicalIF":3.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/erv.3200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jake Linardon, Claudia Liu, Zoe McClure, Hannah K. Jarman, Mariel Messer, Cleo Anderson, Matthew Fuller-Tyszkiewicz
Background
Self-guided interventions may broaden the dissemination of evidence-based prevention and treatment protocols for eating disorders. We conducted a meta-analysis comparing self-guided prevention and treatment approaches for eating disorders to (1) control groups and (2) professionally guided self-help programs.
Methods
Forty-six trials were included. Interventions ranged from web, to app, to CD-ROM to book-based programs. Random effects meta-analyses were conducted on numerous symptom and risk outcomes.
Results
Only four trials recruited an unselected sample, with self-guided programs reducing shape/weight concerns over control groups (g = 0.18). Among high risk/symptomatic samples (k = 25), self-guided interventions reduced several behavioural and cognitive symptoms (gs = 0.31–0.50) over control groups, with effects being robust when adjusting for higher risk of bias and small sample trials. Among clinical samples (k = 17), evidence for the effectiveness of self-guided interventions over control groups on symptom measures was only found for binge-eating disorder, as too few studies sampled other diagnostic subtypes. Among 10 trials that compared guided to unguided self-help, we observed a significant effect in symptom reduction in favour of guided self-help (g = −0.26). Dropout did not differ between guided and unguided self-help (OR = 0.97).
Conclusion
Self-guided interventions may be an effective, low intensity intervention format for high risk individuals or for binge-eating disorder presentations.
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Bruno Halioua, Leslie Sulimovic, Maurice Corcos, Patrick Bantman, Muriel Vaislic, Rachel Rimmer, Charles Taieb, Robert Ejnes, Stéphanie Dassa, Gerard Shadili
Introduction
Holocaust survivors experienced extreme trauma, including physical abuse and malnutrition, leading to various eating disorders. The aim of this study was to compare the eating behaviours of Children of Holocaust Survivors (CHS) with those of children of non-Jewish parents who had at least one parent in France during World War II (CW), and to explore the influence of parental relationships with food on these behaviours.
Methods
CHS and CW participants were recruited via social media for an online survey that collected demographic data, family war history, parental hunger experiences, and the prevalence of family silence about the war.
Results
Among 522 CHS and 100 CW, no significant difference was found in overall dietary behaviour. However, CHS were more likely to value holiday culinary traditions for themselves (77.6% vs. 40%), their parents (68.5% vs. 40.2%), and their children (61.1% vs. 32.1%). CHS whose parents experienced hunger were more likely to keep large food stores (69.5% vs. 51.2%), eat quickly (38.7% vs. 24.2%), eat all the food (61.1% vs. 47%), and overeat (55.5% vs. 45%).
Conclusion
This study, the first of its kind in a large cohort, highlights the lasting impact of the Holocaust on eating behaviour in CHS.
{"title":"Behaviour of Children of Holocaust Survivors in France Regarding Food","authors":"Bruno Halioua, Leslie Sulimovic, Maurice Corcos, Patrick Bantman, Muriel Vaislic, Rachel Rimmer, Charles Taieb, Robert Ejnes, Stéphanie Dassa, Gerard Shadili","doi":"10.1002/erv.3187","DOIUrl":"10.1002/erv.3187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Holocaust survivors experienced extreme trauma, including physical abuse and malnutrition, leading to various eating disorders. The aim of this study was to compare the eating behaviours of Children of Holocaust Survivors (CHS) with those of children of non-Jewish parents who had at least one parent in France during World War II (CW), and to explore the influence of parental relationships with food on these behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CHS and CW participants were recruited via social media for an online survey that collected demographic data, family war history, parental hunger experiences, and the prevalence of family silence about the war.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 522 CHS and 100 CW, no significant difference was found in overall dietary behaviour. However, CHS were more likely to value holiday culinary traditions for themselves (77.6% vs. 40%), their parents (68.5% vs. 40.2%), and their children (61.1% vs. 32.1%). CHS whose parents experienced hunger were more likely to keep large food stores (69.5% vs. 51.2%), eat quickly (38.7% vs. 24.2%), eat all the food (61.1% vs. 47%), and overeat (55.5% vs. 45%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study, the first of its kind in a large cohort, highlights the lasting impact of the Holocaust on eating behaviour in CHS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"33 5","pages":"974-983"},"PeriodicalIF":3.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel E. Liebman, Kristen M. Hernandez, Jennifer Ip, Jessica Burdo, Kathryn Trottier
Objective
The association between eating disorders (EDs) and both trauma exposure and posttraumatic stress disorder (PTSD) is well established. Existing evidence is inconclusive about the impact of trauma exposure and/or comorbid PTSD on ED treatment outcomes and if comorbid ED affects PTSD treatment outcomes. The objective of this systematic review is to consolidate the literature on treatment efficacy and effectiveness for individuals with EDs and trauma histories with and without PTSD, as well as to understand how ED and PTSD symptoms may impact improvement in each other, and how improvements in ED and PTSD symptoms might differ across treatment focus (ED-focused, PTSD-focused or both) and modality (e.g., cognitive behavioural, psychodynamic, transdiagnostic, integrative).
Methods
A systematic search of peer-reviewed publications was conducted across three databases (PsycINFO, PubMed, SCOPUS).
Results
Results indicate that comorbid PTSD symptoms, but not trauma history alone, may negatively affect ED treatment outcomes. Likewise comorbid ED symptoms may negatively affect PTSD treatment outcomes, but data is lacking. ED and/or PTSD symptom improvement was observed across treatment modalities.
Conclusions
Results suggest that individuals may respond to a variety of modalities. Integrated and concurrent treatments show promise as an effective strategy to achieve long-term recovery from this debilitating comorbid condition.
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