Sophie Fletcher, Tabitha Jackson, Talar R Moukhtarian, Carla Toro, Glenn Waller, Caroline Meyer
Objective: Limited literature exists on the extent of eating concerns among adolescents. This study examines the extent of eating disorder pathology and psychosocial correlates among 11- to 18-year-olds.
Method: School pupils (N = 382; 52% female; 72.8% Caucasian) provided demographic information and completed measures of eating disorder pathology (using a cut-off of > 3.64 on the seven-item Eating Disorders Examination-Questionnaire), psychosocial impairment, body shape dissatisfaction and mood. Levels of comorbid problems were compared across adolescents with low- and high-risk for eating disorders, using Mann-Whitney tests and Chi-squared tests and an alpha of 0.001 (to account for exploratory analyses).
Results: A fifth (20.7%) of pupils exhibited clinical levels of eating disorder pathology, and they scored significantly worse on the other measures of psychopathology than those without such eating concerns. The majority (89.9%) of pupils with eating disorder pathology scores were above the clinical threshold in one or more comorbid areas. Eating disorder pathology and measures of comorbidity were all significantly intercorrelated.
Discussion: A fifth of pupils were at-risk of eating disorder pathology, and almost all demonstrated substantial comorbidity. Contrary to the 'white female' eating disorder stereotype, many of those with eating concerns were non-white and over a third did not identify as female. These findings require further work on the screening technology, but highlight the pressing need for access to eating disorder prevention and treatment for a diverse population of such adolescents.
{"title":"The Extent of Eating Disorders and Comorbid Psychopathology Among Adolescent School Pupils.","authors":"Sophie Fletcher, Tabitha Jackson, Talar R Moukhtarian, Carla Toro, Glenn Waller, Caroline Meyer","doi":"10.1002/erv.70044","DOIUrl":"https://doi.org/10.1002/erv.70044","url":null,"abstract":"<p><strong>Objective: </strong>Limited literature exists on the extent of eating concerns among adolescents. This study examines the extent of eating disorder pathology and psychosocial correlates among 11- to 18-year-olds.</p><p><strong>Method: </strong>School pupils (N = 382; 52% female; 72.8% Caucasian) provided demographic information and completed measures of eating disorder pathology (using a cut-off of > 3.64 on the seven-item Eating Disorders Examination-Questionnaire), psychosocial impairment, body shape dissatisfaction and mood. Levels of comorbid problems were compared across adolescents with low- and high-risk for eating disorders, using Mann-Whitney tests and Chi-squared tests and an alpha of 0.001 (to account for exploratory analyses).</p><p><strong>Results: </strong>A fifth (20.7%) of pupils exhibited clinical levels of eating disorder pathology, and they scored significantly worse on the other measures of psychopathology than those without such eating concerns. The majority (89.9%) of pupils with eating disorder pathology scores were above the clinical threshold in one or more comorbid areas. Eating disorder pathology and measures of comorbidity were all significantly intercorrelated.</p><p><strong>Discussion: </strong>A fifth of pupils were at-risk of eating disorder pathology, and almost all demonstrated substantial comorbidity. Contrary to the 'white female' eating disorder stereotype, many of those with eating concerns were non-white and over a third did not identify as female. These findings require further work on the screening technology, but highlight the pressing need for access to eating disorder prevention and treatment for a diverse population of such adolescents.</p>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439670","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}
Self-face perception, including recognising one's face as one's own and evaluating its appearance, is important to physical self-concept. Yet how body dysmorphic disorder (BDD) and muscle dysmorphia (MD) symptoms relate to these processes remains underexplored, particularly in men. This study examined how self-face recognition accuracy and self-face appearance evaluations are influenced by the severity of BDD and MD symptoms in men.
Methods
Sixty-eight male participants (Mage = 22.6 years, SD = 3.5; White and East/Southeast Asian) from the community performed a self-face recognition task during which their faces were digitally morphed with an unfamiliar male face, providing an index of objective self-face recognition sensitivity. Participants also completed measures of BDD and MD symptomatology, subjective self-face recognition difficulty, and self-face evaluations (attractiveness, adiposity, and dissatisfaction).
Results
Higher levels of BDD symptoms and MD-related appearance intolerance symptoms were associated with greater subjective self-face recognition difficulty and more negative self-face evaluations (lower attractiveness, greater dissatisfaction). Neither symptom dimension predicted objective self-face recognition sensitivity or perceived facial adiposity.
Conclusion
These findings reveal a theoretically informative dissociation: men with higher levels of BDD and MD symptoms experience greater subjective self-recognition difficulties and negatively biased facial appearance evaluations despite intact objective self-recognition performance. This pattern suggests that self-face disturbances in BDD and MD may reflect cognitive-affective biases rather than perceptual abnormalities, at least at non-clinical severity levels. Future research in clinical samples is needed to determine whether perceptual deficits emerge at higher symptom severity and establish causality.
{"title":"Self-Face Perception in Men With Elevated Body Dysmorphic and Muscle Dysmorphia Symptoms: Subjective Recognition Difficulty and Negative Appearance Evaluation","authors":"Jade Portingale, Isabel Krug, David Butler","doi":"10.1002/erv.70039","DOIUrl":"10.1002/erv.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Self-face perception, including recognising one's face as one's own and evaluating its appearance, is important to physical self-concept. Yet how body dysmorphic disorder (BDD) and muscle dysmorphia (MD) symptoms relate to these processes remains underexplored, particularly in men. This study examined how self-face recognition accuracy and self-face appearance evaluations are influenced by the severity of BDD and MD symptoms in men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-eight male participants (<i>M</i><sub>age</sub> = 22.6 years, SD = 3.5; White and East/Southeast Asian) from the community performed a self-face recognition task during which their faces were digitally morphed with an unfamiliar male face, providing an index of objective self-face recognition sensitivity. Participants also completed measures of BDD and MD symptomatology, subjective self-face recognition difficulty, and self-face evaluations (attractiveness, adiposity, and dissatisfaction).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher levels of BDD symptoms and MD-related appearance intolerance symptoms were associated with greater subjective self-face recognition difficulty and more negative self-face evaluations (lower attractiveness, greater dissatisfaction). Neither symptom dimension predicted objective self-face recognition sensitivity or perceived facial adiposity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings reveal a theoretically informative dissociation: men with higher levels of BDD and MD symptoms experience greater subjective self-recognition difficulties and negatively biased facial appearance evaluations despite intact objective self-recognition performance. This pattern suggests that self-face disturbances in BDD and MD may reflect cognitive-affective biases rather than perceptual abnormalities, at least at non-clinical severity levels. Future research in clinical samples is needed to determine whether perceptual deficits emerge at higher symptom severity and establish causality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"486-499"},"PeriodicalIF":3.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423495","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}
Repetitive transcranial magnetic stimulation (rTMS) has potential as a therapeutic tool for eating disorders. In this scoping review, we examine the efficacy and safety of rTMS therapy for eating disorders besides stimulation parameters and the clinical statuses of participants.
Method
Following PRISMA-ScR framework, we searched four databases (PubMed, Scopus, Web of Science and PsycInfo) to review clinical interventional studies using rTMS for patients with eating disorders.
Results
Thirty-two studies were included. Benefits of rTMS on mood or eating disorder symptoms were reported for patients with anorexia nervosa. Meanwhile, there was improvement in binge eating and impulsivity in patients with bulimia nervosa, but without statistical significance in randomised controlled studies. There were no serious adverse events in relation to rTMS therapy. Stimulation of the left dorsolateral prefrontal cortex at high frequency with 20,000 stimulations was shown to be widely adopted in research on rTMS therapy for eating disorders.
Conclusion
The number of pulses to the left dorsolateral prefrontal cortex may have been insufficient. The dorsomedial prefrontal cortex is suggested to be an effective stimulation site for patients with binge-purge symptoms. Future research should focus on optimising stimulation parameters including the frequency, the intensity, the session number, and the stimulation site.
目的：重复经颅磁刺激（rTMS）有可能作为一种治疗进食障碍的工具。在这篇综述中，我们考察了rTMS治疗进食障碍的有效性和安全性，以及刺激参数和参与者的临床状态。方法：在PRISMA-ScR框架下，检索PubMed、Scopus、Web of Science和PsycInfo四个数据库，回顾rTMS治疗饮食失调患者的临床干预研究。结果：纳入32项研究。据报道，rTMS对神经性厌食症患者的情绪或饮食失调症状有好处。与此同时，神经性贪食症患者的暴食和冲动有所改善，但在随机对照研究中没有统计学意义。无与rTMS治疗相关的严重不良事件。在进食障碍的rTMS治疗研究中，对左背外侧前额叶皮层进行高频2万次刺激已被广泛采用。结论：左背外侧前额皮质的脉冲数量可能不足。背内侧前额叶皮层被认为是一个有效的刺激部位，患者的暴饮清除症状。未来的研究重点应放在优化刺激参数上，包括频率、强度、会话次数和刺激部位。
{"title":"rTMS Therapy for Eating Disorders: Scoping Review on Efficacy, Safety, Stimulation Parameters and Study Subjects","authors":"Shun Takahashi, Shunichiro Ikeda, Masaya Ueda, Tomoko Harada, Ryouhei Ishii","doi":"10.1002/erv.70046","DOIUrl":"10.1002/erv.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Repetitive transcranial magnetic stimulation (rTMS) has potential as a therapeutic tool for eating disorders. In this scoping review, we examine the efficacy and safety of rTMS therapy for eating disorders besides stimulation parameters and the clinical statuses of participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Following PRISMA-ScR framework, we searched four databases (PubMed, Scopus, Web of Science and PsycInfo) to review clinical interventional studies using rTMS for patients with eating disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two studies were included. Benefits of rTMS on mood or eating disorder symptoms were reported for patients with anorexia nervosa. Meanwhile, there was improvement in binge eating and impulsivity in patients with bulimia nervosa, but without statistical significance in randomised controlled studies. There were no serious adverse events in relation to rTMS therapy. Stimulation of the left dorsolateral prefrontal cortex at high frequency with 20,000 stimulations was shown to be widely adopted in research on rTMS therapy for eating disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The number of pulses to the left dorsolateral prefrontal cortex may have been insufficient. The dorsomedial prefrontal cortex is suggested to be an effective stimulation site for patients with binge-purge symptoms. Future research should focus on optimising stimulation parameters including the frequency, the intensity, the session number, and the stimulation site.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"464-475"},"PeriodicalIF":3.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402451","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}
Renee D. Rienecke, Catherine R. Drury, Alan Duffy, Philip S. Mehler, Erin E. Reilly
Objective
Low symptom endorsement among adolescents with eating disorders (EDs) may pose challenges for the accurate assessment of symptoms. To better understand low symptom endorsement, the current study examined demographic and clinical characteristics associated with lower symptom endorsement among adolescents with EDs, and compared patterns of endorsement between adolescents and their caregivers.
Method
Treatment-seeking adolescents (N = 629) completed measures of ED psychopathology (Eating Disorder Examination-Questionnaire; EDE-Q), depression, and anxiety at admission, and caregivers completed the Parent EDE-Q. Patients were categorised as ‘higher endorsers’ or ‘lower endorsers’ based on their EDE-Q Global score.
Results
Patients with anorexia nervosa–restricting subtype (AN-R) were more likely to be low symptom endorsers than those with AN–binge/purge subtype (AN-BP). Lower endorsers had a shorter length of stay, lower anxiety and depression symptoms at admission, and lower percent of expected body weight at admission and discharge than higher endorsers. Adolescents with AN-R exhibited more discrepancy between their report of ED symptoms and their caregivers' report than adolescents with AN-BP.
Conclusion
The current study supports the importance of including multiple informants when assessing adolescents with EDs.
{"title":"Higher and Lower Endorsement of Eating Disorder Symptoms Among Adolescents and Their Caregivers","authors":"Renee D. Rienecke, Catherine R. Drury, Alan Duffy, Philip S. Mehler, Erin E. Reilly","doi":"10.1002/erv.70047","DOIUrl":"10.1002/erv.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Low symptom endorsement among adolescents with eating disorders (EDs) may pose challenges for the accurate assessment of symptoms. To better understand low symptom endorsement, the current study examined demographic and clinical characteristics associated with lower symptom endorsement among adolescents with EDs, and compared patterns of endorsement between adolescents and their caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Treatment-seeking adolescents (<i>N</i> = 629) completed measures of ED psychopathology (Eating Disorder Examination-Questionnaire; EDE-Q), depression, and anxiety at admission, and caregivers completed the Parent EDE-Q. Patients were categorised as ‘higher endorsers’ or ‘lower endorsers’ based on their EDE-Q Global score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with anorexia nervosa–restricting subtype (AN-R) were more likely to be low symptom endorsers than those with AN–binge/purge subtype (AN-BP). Lower endorsers had a shorter length of stay, lower anxiety and depression symptoms at admission, and lower percent of expected body weight at admission and discharge than higher endorsers. Adolescents with AN-R exhibited more discrepancy between their report of ED symptoms and their caregivers' report than adolescents with AN-BP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study supports the importance of including multiple informants when assessing adolescents with EDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"476-485"},"PeriodicalIF":3.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402518","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}
Marie-Christine Opitz, Sarah Cooney, Nora Trompeter, Sylvane Desrivières, Nadia Micali, Ulrike Schmidt, Helen Sharpe
Objective
Despite common bio-behavioural mechanisms underlying maladaptive sleep and eating, little is known about their temporal associations. The present study aimed to assess the longitudinal relationship between weight loss behaviours (age 13) and sleep (age 17/18) in adolescents (N = 5705) from the ’98 Growing Up in Ireland cohort.
Method
Using structural equation modelling, regression models were specified and excessive online behaviours (age 17/18) were tested as a moderator, while depressive symptoms (age 13) were tested as a mediator for the prospective association.
Results
Weight loss behaviours significantly predicted falling asleep at inappropriate times (β = 0.16, SE = 0.04, p < 0.001) and shorter sleep duration (β = 0.06, SE = 0.02, p < 0.001), but no other sleep behaviours. Associations with falling asleep at inappropriate times were partially mediated through depressive symptoms. Associations with shorter sleep duration were fully mediated by depressive symptoms. Excessive online behaviours did not moderate the relationship between sleep and weight loss behaviours.
Conclusions
In line with clinical research, this study provides preliminary evidence for the longitudinal relationship between weight loss behaviours and shorter sleep. Further research into the causal and potentially bi-directional relationship between sleep and disordered eating is needed to aid in preventing the exacerbation of both symptom presentations and to inform general health promotion strategies.
目的：尽管睡眠和饮食不良的常见生物行为机制，但对它们的时间关联知之甚少。本研究旨在评估1998年爱尔兰成长队列中青少年（N = 5705）减肥行为（13岁）与睡眠（17/18岁）之间的纵向关系。方法：使用结构方程模型，指定回归模型，并测试过度上网行为（17/18岁）作为调节因素，而抑郁症状（13岁）作为前瞻性关联的中介因素。结果：减肥行为显著预测不适当睡眠时间（β = 0.16, SE = 0.04, p）。结论：本研究与临床研究一致，为减肥行为与睡眠时间缩短之间的纵向关系提供了初步证据。需要进一步研究睡眠和饮食失调之间的因果关系和潜在的双向关系，以帮助预防这两种症状的恶化，并为一般的健康促进策略提供信息。
{"title":"Investigating the Prospective Relationship Between Weight Loss Behaviours and Sleep in Adolescents From the Growing Up in Ireland Cohort","authors":"Marie-Christine Opitz, Sarah Cooney, Nora Trompeter, Sylvane Desrivières, Nadia Micali, Ulrike Schmidt, Helen Sharpe","doi":"10.1002/erv.70045","DOIUrl":"10.1002/erv.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite common bio-behavioural mechanisms underlying maladaptive sleep and eating, little is known about their temporal associations. The present study aimed to assess the longitudinal relationship between weight loss behaviours (age 13) and sleep (age 17/18) in adolescents (<i>N</i> = 5705) from the ’98 Growing Up in Ireland cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Using structural equation modelling, regression models were specified and excessive online behaviours (age 17/18) were tested as a moderator, while depressive symptoms (age 13) were tested as a mediator for the prospective association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Weight loss behaviours significantly predicted falling asleep at inappropriate times (<i>β</i> = 0.16, SE = 0.04, <i>p</i> < 0.001) and shorter sleep duration (<i>β</i> = 0.06, SE = 0.02, <i>p</i> < 0.001), but no other sleep behaviours. Associations with falling asleep at inappropriate times were partially mediated through depressive symptoms. Associations with shorter sleep duration were fully mediated by depressive symptoms. Excessive online behaviours did not moderate the relationship between sleep and weight loss behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In line with clinical research, this study provides preliminary evidence for the longitudinal relationship between weight loss behaviours and shorter sleep. Further research into the causal and potentially bi-directional relationship between sleep and disordered eating is needed to aid in preventing the exacerbation of both symptom presentations and to inform general health promotion strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"455-463"},"PeriodicalIF":3.4,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370519","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}
Jiana Schnabel, Marita Cooper, Kristin Stedal, Mark Rose, Betteke Maria van Noort, Deborah A. G. Drabick, Lauren B. Alloy, C. Alix Timko
Objective
Research suggests executive functioning (EF) inefficiencies contribute to anorexia nervosa (AN) onset and maintenance. Identifying EF subtypes in adolescents and adults with AN compared to healthy controls (HC) may provide insights into differences in illness severity, risk for prolonged illness, and highlight who could respond best to different treatments.
Method
We conducted secondary analysis of 751 participants: adolescents (n = 559) and adults with AN (n = 74), and adolescent HC (n = 118). Latent profiles of six Delis Kaplan Executive Function System scores measuring EF constructs implicated in AN were derived. Differences across profiles on demographics, eating disorder cognitions (EDE/EDE-Q score), BMI/BMI z-score, length of illness, weight suppression, and full-scale IQ were examined.
Results
A three-profile solution best fit the data: Profile 1 (n = 324)—‘high verbal’, Profile 2 (n = 349)—‘average’, and Profile 3 (n = 78)—‘low flexibility and inhibition’. The low flexibility and inhibition profile comprised 10.6% of adolescents with AN, 30.0% of adults with AN, and 1.7% of adolescent HCs. Compared to other profiles, this profile was older, had a longer illness duration, higher EDE global scores, lower BMI z-scores, and lower full-scale IQ scores. No profile differences emerged in BMI or EDE-Q global scores.
Discussion
Only a small subset of our sample showed marked difficulties in flexibility and inhibition, challenging the notion that EF difficulties are a core feature of AN. Adolescents with AN in this profile showed greater illness severity, suggesting vulnerability to a more prolonged course of illness. These findings are a first step towards developing tailored treatment strategies based on EF profiles.
{"title":"Identifying Distinct Latent Profiles of Executive Functioning Among Adolescents and Adults With Anorexia Nervosa and Adolescent Healthy Controls","authors":"Jiana Schnabel, Marita Cooper, Kristin Stedal, Mark Rose, Betteke Maria van Noort, Deborah A. G. Drabick, Lauren B. Alloy, C. Alix Timko","doi":"10.1002/erv.70043","DOIUrl":"10.1002/erv.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Research suggests executive functioning (EF) inefficiencies contribute to anorexia nervosa (AN) onset and maintenance. Identifying EF subtypes in adolescents and adults with AN compared to healthy controls (HC) may provide insights into differences in illness severity, risk for prolonged illness, and highlight who could respond best to different treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted secondary analysis of 751 participants: adolescents (<i>n</i> = 559) and adults with AN (<i>n</i> = 74), and adolescent HC (<i>n</i> = 118). Latent profiles of six Delis Kaplan Executive Function System scores measuring EF constructs implicated in AN were derived. Differences across profiles on demographics, eating disorder cognitions (EDE/EDE-Q score), BMI/BMI <i>z</i>-score, length of illness, weight suppression, and full-scale IQ were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A three-profile solution best fit the data: Profile 1 (<i>n</i> = 324)—‘high verbal’, Profile 2 (<i>n</i> = 349)—‘average’, and Profile 3 (<i>n</i> = 78)—‘low flexibility and inhibition’. The low flexibility and inhibition profile comprised 10.6% of adolescents with AN, 30.0% of adults with AN, and 1.7% of adolescent HCs. Compared to other profiles, this profile was older, had a longer illness duration, higher EDE global scores, lower BMI <i>z</i>-scores, and lower full-scale IQ scores. No profile differences emerged in BMI or EDE-Q global scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Only a small subset of our sample showed marked difficulties in flexibility and inhibition, challenging the notion that EF difficulties are a core feature of AN. Adolescents with AN in this profile showed greater illness severity, suggesting vulnerability to a more prolonged course of illness. These findings are a first step towards developing tailored treatment strategies based on EF profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"442-454"},"PeriodicalIF":3.4,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349238","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}
Hospitalised patients with eating disorders (EDs) often present with severe malnutrition, electrolyte imbalances, and metabolic complications that require specialised nutritional approaches. This consensus aimed to develop evidence-informed, expert-driven recommendations for the nutritional management of hospitalised patients with EDs, addressing risk stratification, caloric progression, refeeding protocols, formulation selection, supplementation and long-term monitoring.
Methods
An eight-expert panel conducted a modified Delphi process in two online rating rounds. One hundred six statements were formulated across 12 thematic sections and evaluated on a 5-point Likert scale (≥ 85% accepted, 80%–84.9% revised, < 80% rejected). Revised statements were re-evaluated in Round 2 and, if necessary, finalised at an online meeting.
Results
Of the 106 original statements, 89 (84.0%) reached immediate consensus, 14 (13.2%) required revision, and three (2.8%) were eliminated. Ten revised statements exceeded the ≥ 85% threshold in Round 2, one was rejected, and three ‘pending’ statements were approved in a conclusive online meeting. The final statements span key domains of inpatient care of EDs, including comprehensive nutritional assessment, stepwise refeeding regimens, careful electrolyte and biochemical monitoring, personalised approaches for those at high risk of refeeding syndrome and tailored considerations for paediatric and perinatal populations.
Discussion
The final consensus statements provide a structured framework for the nutritional rehabilitation of hospitalised patients with EDs, emphasising balanced yet flexible refeeding protocols, vigilant metabolic monitoring, ethical considerations in limited-capacity cases, and continuity of care through discharge and relapse prevention. By aligning clinical practice with specialist insight and existing guidelines, these recommendations aim to standardise and enhance inpatient ED management.
{"title":"Medical Nutrition Therapy and Nutritional Rehabilitation in Hospitalised Patients Affected by Eating Disorders","authors":"Lezo Antonella, Mascheroni Annalisa, Troiano Ersilia, Gandullia Paolo, Milano Walter, Turchetto Monica, Demontis Stefania, Cereda Emanuele, Borodani Sara, Corradi Ettore","doi":"10.1002/erv.70042","DOIUrl":"10.1002/erv.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Hospitalised patients with eating disorders (EDs) often present with severe malnutrition, electrolyte imbalances, and metabolic complications that require specialised nutritional approaches. This consensus aimed to develop evidence-informed, expert-driven recommendations for the nutritional management of hospitalised patients with EDs, addressing risk stratification, caloric progression, refeeding protocols, formulation selection, supplementation and long-term monitoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An eight-expert panel conducted a modified Delphi process in two online rating rounds. One hundred six statements were formulated across 12 thematic sections and evaluated on a 5-point Likert scale (≥ 85% accepted, 80%–84.9% revised, < 80% rejected). Revised statements were re-evaluated in Round 2 and, if necessary, finalised at an online meeting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 106 original statements, 89 (84.0%) reached immediate consensus, 14 (13.2%) required revision, and three (2.8%) were eliminated. Ten revised statements exceeded the ≥ 85% threshold in Round 2, one was rejected, and three ‘pending’ statements were approved in a conclusive online meeting. The final statements span key domains of inpatient care of EDs, including comprehensive nutritional assessment, stepwise refeeding regimens, careful electrolyte and biochemical monitoring, personalised approaches for those at high risk of refeeding syndrome and tailored considerations for paediatric and perinatal populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The final consensus statements provide a structured framework for the nutritional rehabilitation of hospitalised patients with EDs, emphasising balanced yet flexible refeeding protocols, vigilant metabolic monitoring, ethical considerations in limited-capacity cases, and continuity of care through discharge and relapse prevention. By aligning clinical practice with specialist insight and existing guidelines, these recommendations aim to standardise and enhance inpatient ED management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"422-441"},"PeriodicalIF":3.4,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313839","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}
Elizabeth N. Dougherty, Glen Forester, Matthew F. Murray, Brianne N. Richson, Angeline R. Bottera, Samantha E. Weiss, Jennifer E. Wildes
Introduction
Childhood maltreatment is associated with more severe eating disorder (ED) symptoms and compulsivity, and compulsivity is implicated in anorexia nervosa (AN). However, the role of childhood maltreatment and compulsivity in shaping the clinical course of AN remains unclear.
Objective
We investigated whether childhood maltreatment was associated with compulsivity, and whether childhood maltreatment and compulsivity moderated changes in ED symptoms over time following discharge from treatment in AN.
Method
Individuals (N = 194; Age = 16–62) with AN restricting type (AN-R) and AN binge-eating/purging type (AN-BP) completed a diagnostic interview and self-report measures of compulsivity and childhood maltreatment upon admission to treatment. They completed follow-up assessments of ED symptoms at discharge and three, six, and 12 months post-discharge.
Results
Higher exposure to childhood maltreatment was associated with greater compulsivity at admission in individuals with AN-BP. Childhood maltreatment moderated changes in ED symptoms from discharge to 12 months post-discharge in individuals with AN-R, such that those with lower levels of maltreatment showed symptom improvement, whereas those with higher levels of maltreatment showed no change in symptoms. Compulsivity did not moderate changes in symptoms.
Conclusions
Findings highlight childhood maltreatment as a potentially important factor to account for in improved interventions for AN.
{"title":"Naturalistic Associations Between Childhood Maltreatment, Compulsivity, and Eating Disorder Symptoms Over a 12-Months Period Among Individuals With Anorexia Nervosa","authors":"Elizabeth N. Dougherty, Glen Forester, Matthew F. Murray, Brianne N. Richson, Angeline R. Bottera, Samantha E. Weiss, Jennifer E. Wildes","doi":"10.1002/erv.70041","DOIUrl":"10.1002/erv.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childhood maltreatment is associated with more severe eating disorder (ED) symptoms and compulsivity, and compulsivity is implicated in anorexia nervosa (AN). However, the role of childhood maltreatment and compulsivity in shaping the clinical course of AN remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated whether childhood maltreatment was associated with compulsivity, and whether childhood maltreatment and compulsivity moderated changes in ED symptoms over time following discharge from treatment in AN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Individuals (<i>N</i> = 194; Age = 16–62) with AN restricting type (AN-R) and AN binge-eating/purging type (AN-BP) completed a diagnostic interview and self-report measures of compulsivity and childhood maltreatment upon admission to treatment. They completed follow-up assessments of ED symptoms at discharge and three, six, and 12 months post-discharge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher exposure to childhood maltreatment was associated with greater compulsivity at admission in individuals with AN-BP. Childhood maltreatment moderated changes in ED symptoms from discharge to 12 months post-discharge in individuals with AN-R, such that those with lower levels of maltreatment showed symptom improvement, whereas those with higher levels of maltreatment showed no change in symptoms. Compulsivity did not moderate changes in symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings highlight childhood maltreatment as a potentially important factor to account for in improved interventions for AN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"411-421"},"PeriodicalIF":3.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287326","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}
Bede Carr, An Binh Dang, Litza Kiropoulos, Isabel Krug
Objectives
This study investigated the influence of illness perceptions (IPs) on clinical severity across Major Depressive Disorder (MDD), Anorexia Nervosa (AN), Generalised Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), and Panic Disorder (PD), and compared the IPs across these conditions.
Method
We administered the Brief Illness Perception Questionnaire alongside disorder-specific severity scales to 774 participants (85.1% female).
Results
Significant associations between IPs and symptom severity emerged for AN and GAD only. Higher perceived Personal Control was associated with reduced severity in GAD but with greater severity in AN, whereas higher perceived Treatment Control was linked to lower severity in AN. In contrast, stronger perceptions of Concern were associated with increased severity in GAD. Although several IP dimensions demonstrated transdiagnostic overlap, differential associations also emerged, particularly for AN with respect to Timeline, Identity, and Emotional Representations.
Discussion
Our findings underscore the critical role of IPs in mental health severity and support the need for tailored recovery-oriented interventions targeting specific maladaptive IPs to improve clinical outcomes. However, given the high prevalence of comorbidity across the assessed disorders, the findings should be interpreted with caution, as overlapping conditions may have shaped both IPs and their associations with severity.
{"title":"Illness Perceptions in Psychiatric Disorders: Assessing Differences and Associations With Symptom Severity","authors":"Bede Carr, An Binh Dang, Litza Kiropoulos, Isabel Krug","doi":"10.1002/erv.70036","DOIUrl":"10.1002/erv.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigated the influence of illness perceptions (IPs) on clinical severity across Major Depressive Disorder (MDD), Anorexia Nervosa (AN), Generalised Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), and Panic Disorder (PD), and compared the IPs across these conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We administered the Brief Illness Perception Questionnaire alongside disorder-specific severity scales to 774 participants (85.1% female).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant associations between IPs and symptom severity emerged for AN and GAD only. Higher perceived Personal Control was associated with reduced severity in GAD but with greater severity in AN, whereas higher perceived Treatment Control was linked to lower severity in AN. In contrast, stronger perceptions of Concern were associated with increased severity in GAD. Although several IP dimensions demonstrated transdiagnostic overlap, differential associations also emerged, particularly for AN with respect to Timeline, Identity, and Emotional Representations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings underscore the critical role of IPs in mental health severity and support the need for tailored recovery-oriented interventions targeting specific maladaptive IPs to improve clinical outcomes. However, given the high prevalence of comorbidity across the assessed disorders, the findings should be interpreted with caution, as overlapping conditions may have shaped both IPs and their associations with severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"398-410"},"PeriodicalIF":3.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253123","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}
Lucía Camacho-Barcia, Lia T. Sánchez-Salido, Jessica Jiménez del Toro, Roser Granero, Isabel Sánchez, Kim Supit, Nadia Micali, Katrin Elisabeth Giel, Susana Jiménez-Murcia, Stephan Zipfel, Fernando Fernández-Aranda
Objective
This study investigates clinical heterogeneity in patients with binge eating disorder (BED) and its association with treatment outcomes.
Methods
A two-step cluster analysis was conducted on a clinical sample of 196 BED patients, using an agglomerative hierarchical procedure based on both categorical and quantitative measures—psychopathological symptoms, personality traits, emotional dysregulation, body composition, and food addiction. A subsequent comparison between clusters assessed therapy outcomes.
Results
Two distinct clusters emerged: C1 (n = 77) and C2 (n = 119). C2 patients exhibited a more dysfunctional profile, marked by more frequent binge episodes, higher eating psychopathology, greater emotion regulation difficulties, higher impulsivity levels, worse psychopathological state, higher food addiction levels, and personality traits reflecting greater harm avoidance and lower self-directedness and cooperativeness. While clusters did not differ by age, C2 had earlier age of onset and longer duration of the disorder. In contrast, C1 showed a more functional profile, later age of onset, lower total body fat mass, and better treatment outcomes.
Conclusion
These findings highlight heterogeneity in BED, particularly regarding age of onset and associated clinical features, which may influence treatment response. The results suggest the need for distinct treatment strategies and more personalised therapeutic approaches tailored to patient subtypes.
{"title":"Addressing Heterogeneity in Binge Eating Disorder: A Cluster Analysis Approach Based on Age of Onset, Clinical and Psychopathological Features","authors":"Lucía Camacho-Barcia, Lia T. Sánchez-Salido, Jessica Jiménez del Toro, Roser Granero, Isabel Sánchez, Kim Supit, Nadia Micali, Katrin Elisabeth Giel, Susana Jiménez-Murcia, Stephan Zipfel, Fernando Fernández-Aranda","doi":"10.1002/erv.70034","DOIUrl":"10.1002/erv.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigates clinical heterogeneity in patients with binge eating disorder (BED) and its association with treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A two-step cluster analysis was conducted on a clinical sample of 196 BED patients, using an agglomerative hierarchical procedure based on both categorical and quantitative measures—psychopathological symptoms, personality traits, emotional dysregulation, body composition, and food addiction. A subsequent comparison between clusters assessed therapy outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two distinct clusters emerged: C1 (<i>n</i> = 77) and C2 (<i>n</i> = 119). C2 patients exhibited a more dysfunctional profile, marked by more frequent binge episodes, higher eating psychopathology, greater emotion regulation difficulties, higher impulsivity levels, worse psychopathological state, higher food addiction levels, and personality traits reflecting greater harm avoidance and lower self-directedness and cooperativeness. While clusters did not differ by age, C2 had earlier age of onset and longer duration of the disorder. In contrast, C1 showed a more functional profile, later age of onset, lower total body fat mass, and better treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight heterogeneity in BED, particularly regarding age of onset and associated clinical features, which may influence treatment response. The results suggest the need for distinct treatment strategies and more personalised therapeutic approaches tailored to patient subtypes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48117,"journal":{"name":"European Eating Disorders Review","volume":"34 2","pages":"375-387"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226257","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}
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