Journal of Eating Disorders最新文献

The combination of in-person and telehealth treatment for individuals with eating disorders is becoming an important clinical and research avenue. Despite this, a framework for describing such care, which is coming to be known as hybrid treatment, is lacking. We propose a definition for "the hybrid space" and a conceptual model that delineates the characteristics of hybrid interventions, using a person-centered approach. These characteristics include sociodemographic characteristics and social determinants of health; factors determining use; clinical characteristics; treatment context, participants, and services provided; treatment modality; and the proportion of in-person to telehealth care. Such a model may be helpful in steering development in this nascent field as it provides a framework that clinicians can flexibly adapt to their specific contexts and that researchers can investigate more rigorously. This model may contribute to the improvement of eating disorder treatment as hybrid interventions have the potential to exploit the best of both in-person and telehealth care while offering the possibility for personalizing and tailoring treatment to individuals. Ultimately, we hope that this framework will be a useful clinical tool which can lead to the development of guidelines for clinical practice.

Background: Binge-eating disorder (BED) is the most common eating disorder with university students being particularly vulnerable. The study aimed to investigate the association between binge eating and Internet addiction (IA), body shape (BS) concerns, and body mass index (BMI) among university students.

Methods: In this cross-sectional study, 448 university students (221 males and 227 females) aged between 18 and 25 years were recruited. A multicomponent questionnaire included socio-demographic information, and validated scales such as the International Physical Activity Questionnaire (IPAQ), Binge-Eating Disorder Screener-7 (BEDS-7), Internet Addiction Test (IAT), and Body Shape Questionnaire (BSQ). Anthropometric measurements [weight, height, and waist circumference (WC)] were recorded, and BMI was calculated.

Results: The findings reported that approximately 31% of the participants were at risk of BED, 24.3% had moderate/severe IA, 27.8% were moderate/marked concerned about their BS, and 41.1% were overweight/obese. The risk of BED was significantly associated with IA (OR = 1.06, 95%CI: 0.34-0.93; p < 0.005), BS concerns (OR = 1.39, 95%CI:0.90-2.16; p < 0.001), BMI (OR = 1.74, 95%CI:1.16-2.60; p < 0.005), and WC (OR = 1.78, 95%CI: 1.16-2.75; p < 0.006). Regression analysis showed that the risk of BED had a highly significant positive association with WC, BSQ, and IA with the WC identified as the strongest predictor for risk of BED (β = 0.23, p < 0.001).

Conclusions: This study underscores the need for targeted national initiatives and awareness programs that promote balanced food consumption, healthy internet use, and increased physical activity among young adults of both sexes. By fostering these healthy habits, such interventions can reduce the risk of binge eating disorder and support overall mental and physical well-being in this population.

Background: The desire to control personal weight status is ever-increasing among adolescents to achieve societal desirability for thinness across developed and developing countries. The purpose of this study was to estimate the magnitude of unhealthy weight control behaviors and determinants among female adolescents.

Method: School based cross sectional study was conducted among 526 randomly selected female adolescent students using self-administered questionnaire. Unhealthy weight control behaviors, Body Mass Index-for-age, perceived weight status, depression symptoms and body part satisfaction were assessed. Binary logistic regression was used to analyze data and adjusted odds ratio with 95% confidence interval was used to measure strength of association.

Result: The overall prevalence of unhealthy weight control behaviors among female high school adolescent is 38% (95% CI: 34.0%, 42.0%). Perceived weight status (AOR = 1.82, 95% CI = 1.16-2.84), BMI for age (AOR = 3.38; 95% CI = 1.85-6.17), level of depression; mild depression (AOR = 1.81, 95% CI = 1.18-2.77) and moderate (AOR = 2.68; 95% CI = 1.11-6.47), weight related teasing (AOR = 1.69, 95% CI = 1.11-2.57)., and use social media (AOR = 3.04; 95% CI = 1.60-5.77) were remained associated factors of UWCBs among female adolescent students.

Conclusion: The current study has shown that more than one in three female adolescents was engaged in UWCBs. Therefore, school-based awareness creation by establishing clubs which promote healthy lifestyle should be given due emphasis. Such intervention should consider factors like; weight perception, depressive mood, weight related teasing, and social media use.

Background: There is a substantial and growing evidence base that has identified three distinct personality types (Overcontrol, Undercontrol and Resilient) among samples of individuals with eating disorders, as well as non-clinical samples. Even in studies where up to six personality types have been identified, the three core types representing Overcontrol, Undercontrol and Resilient consistently emerge. The aim of the research was to explore whether latent Overcontrol and Undercontrol personality types could be identified using pathological personality types as part of the Alternative Model for Personality Disorders published in DSM-5. We further aimed to understand how these personality types were associated with eating pathology, depressed mood and anxiety.

Methods: A total of 391 women, 167 men and 10 gender-diverse individuals aged 16 to 31 years completed measures of the alternative model of personality disorder traits, disordered eating behaviours, eating pathology, depression, anxiety and stress. A systematic four-step process using hierarchical, k-means, and random forest cluster analyses were used to identify the best fitting cluster solution in the data.

Results: The results revealed a four-cluster solution that represented overcontrol, undercontrol, resilient and an antisocial/psychoticism cluster. The overcontrol, undercontrol, and antisocial/psychoticism types were all associated with increased disordered eating, eating pathology, depression, anxiety and stress compared to the resilient types, with the undercontrol cluster scoring significantly higher than the other three clusters on all measures of clinical pathology.

Conclusions: Pathological personality traits, as conceptualised within the DSM-5 alternative model of personality disorders may have merit for identifying overcontrol and undercontrol personality types. Our findings provide additional evidence that both overcontrol and undercontrol personality types are associated with increased eating pathology, depression, anxiety and stress.

Background: Individuals diagnosed with schizophrenia have a two to five-fold higher risk of developing obesity and up to threefold higher risk of developing disordered eating behaviors relative to the general population. Over the past decades, the Eating Attitude Test (EAT) has been well-recognized and widely used in clinical practice. However, only little psychometric information is available on the EAT for researchers and clinicians who deal with patients with schizophrenia, and it is still unclear whether the scale could fulfill measurement needs and help clinical and research decision-making in the context of psychotic disorders. This study aimed to investigate the psychometric properties of the shortest version of the EAT (EAT-7) among newly-diagnosed patients with schizophrenia who had minimal exposure to antipsychotics at the start of the study.

Methods: This is an observational, cross-sectional survey that was carried out in the department of psychiatry at Razi Hospital, Manouba, Tunisia. The study took place between January and June 2024, and involved clinically-stabilized outpatients with schizophrenia who have had < 3 months of treatment with antipsychotics (N = 112; mean age of 24.44 ± 5.41 years).

Results: In terms of factor analysis, the EAT-7 presented a one-dimensional structure. All seven items strongly loaded on a single factor, with all indices of the CFA suggesting a good fit to the data. In addition, the EAT-7 yielded excellent reliability coefficients, with both a McDonald's ω and a Cronbach's α of 0.88. Measurement invariance of the EAT-7 across sex groups was tested using multi-group CFA, and established at the configural, scalar, and metric levels. No significant differences in EAT-7 scores between males and females were found. Finally, EAT-7 scores positively correlated with scores of depression and anxiety, supporting concurrent validity of the scale.

Conclusion: The shortness, items' clarity and conciseness of the EAT-7 make it an efficient tool appropriate as a first-step screening tool to detect disordered eating in patients with schizophrenia at low cost and burden. We hope that this study will facilitate the widespread application of the EAT-7 in routine assessment and monitoring of disordered eating in patients with schizophrenia, in both clinical and research practices.

Background: Despite the potential clinical and treatment relevance of food addiction (FA) among individuals with schizophrenia, the scientific literature on its characteristics and correlates within this population is sparse. Limited knowledge on FA in patients with schizophrenia may impede progress in developing effective treatments for pathological eating patterns and the common obesity and metabolic syndrome problems in this population. Considering these research gaps, the present study aimed to compare the nature and prevalence of FA symptoms among patients with first-episode schizophrenia, their siblings, and healthy controls. As a secondary objective, this study sought to examine the psychopathological correlates of FA in the patients' group.

Methods: A cross-sectional study was conducted in Razi Hospital, Tunis, Tunisia, from January to June 2024. A total of 112 newly diagnosed, clinically stabilized patients with first-episode schizophrenia, 77 of their unaffected siblings and 78 healthy controls were included. FA was assessed using the modified version of the Yale Food Addiction Scale (mYFAS 2.0). The Metacognitions Questionnaire (MCQ-30) and the Emotion Regulation Questionnaire were administered to the patients' group.

Results: Findings showed a higher prevalence of FA in the patient group (32.1%) compared to both siblings (13.0%) and controls (9.0%). Siblings had higher FA scores compared to controls (16.12 ± 4.95 versus 15.00 ± 6.09; p < 0.001). After Bonferroni correction for multiple testing, higher FA scores were significantly associated with less cognitive self-consciousness (Beta = - 0.54), older age (Beta = 0.45), and higher psychological distress (Beta = 0.63).

Conclusion: Our findings suggest that people with first-episode schizophrenia are likely to present with co-occurring FA, and experience associated distress. Findings also provide initial support for a possible connection between dysfunctional metacognitive beliefs and FA in patients with schizophrenia, suggesting that cognitive self-consciousness may be a fundamental cognitive process in FA in this population. This may lend some theoretical and clinical implications for alleviating FA symptoms in schizophrenia.

Purpose: Severe eating and feeding disorders including Anorexia Nervosa of both restricting (AN-R) and binge-purge (AN-BP) subtypes and Avoidant Restrictive Food Intake Disorder (ARFID) lead to multiple macronutrient and micronutrient deficiencies, including zinc, in the setting of inadequate dietary intake. We investigated whether zinc levels correlated with severe malnutrition, with particular subtypes of eating disorders (EDs), and the effect of the refeeding process.

Methods: This prospective study included 92 adult patients with severe AN or ARFID hospitalized in a medical stabilization unit. Denver Health staff were recruited as controls. Blood samples were drawn within four days of admission and 72 h of discharge. All inferential analyses were performed using general linear models.

Results: Admission zinc levels were statistically significantly lower in cases compared to controls. Admission zinc levels were significantly higher for patients with AN-R than patients with AN-BP. Zinc levels decreased significantly during treatment in cases, compared to controls. ED diagnoses and percent ideal body weight (%IBW) did not appear to predict changes in zinc levels during admission.

Conclusions: Given zinc's pervasive roles in metabolism throughout the body as well as common symptoms of deficiency including impaired taste and smell, decreased appetite, and depression, zinc levels could be relevant to the high relapse rate in severe ED. The observed decrease in zinc, which was larger in cases than controls, during refeeding suggests the possibility of a "refeeding hypozincemia" which may present a new therapeutic target. These characteristics make zinc an intriguing focus of future study that could impact the recidivism rate in severe ED.

Level of evidence iii: Evidence obtained from well-designed cohort or case-control analytic studies.

Background: This study seeks to investigate the impact of anorexia awareness videos on the perception of anorexic figures and pro-anorexia attitude among young females, considering the employed fear appeals and the presence of pro-anorexia content in danmu, an online commenting system prevalent in China.

Methods: An experiment was conducted employing a 3 (Fear level of video: low, medium, high) × 4 (Danmu type: no danmu, pro-anorexia, anti-anorexia, mixed pro- and anti-anorexia) between-participants design. A total of 633 female participants were randomly assigned to view one of the twelve videos and subsequently evaluated on fear arousal, pro-anorexia attitude and perception of the anorexic figure scales.

Results: A moderated moderated mediation model demonstrates that heightened fear levels of anorexia awareness videos were linked to a more adverse perception of individuals with anorexia, subsequently reducing pro-anorexia attitude. Furthermore, the fear level of an anorexia awareness video, aroused fear, and the type of danmu interacted in a three-way manner regarding the perception of anorexic individuals. The presence of pro-anorexia content in danmu counteracted the observed positive impact.

Conclusions: These results imply that anorexia awareness videos should strive to evoke appropriate levels of fear while also addressing the potential adverse effects of pro-anorexia danmu, which may glorify anorexic bodies and undermine the intended protective outcomes.

Background: Currently, we know little regarding how stigma attributed to eating disorders compares to that of other psychological disorders and additionally within different types of eating disorders. In the current study, we aimed to explore the stigmatisation of eating disorders by comparing the stigma attributed to anorexia nervosa, bulimia nervosa, and binge-eating disorder, utilising depression as a comparative control.

Methods: A total of 235 participants from the general population were randomly assigned to an anorexia nervosa, bulimia nervosa, binge-eating disorder, or depression condition. Participants responded to a questionnaire consisting of several adapted versions of pre-existing subscales that measured levels of stigma associated with psychological disorders generally, as well as stigma associated with eating disorders specifically. We used several one-way analyses of variance to investigate the differences in stigma attributed towards the aforementioned psychological disorders.

Results: Results suggested that all three eating disorders were significantly more stigmatised than was depression. Between the eating disorders, the three were generally equivalent except that binge-eating disorder was significantly more stigmatised than both anorexia nervosa and bulimia nervosa on a subscale measuring trivialness.

Conclusions: These findings indicate that individuals with eating disorders, including binge-eating disorder, may be at a higher risk of experiencing the negative implications of stigma when compared to other psychological disorders, such as depression. To our knowledge, this study is one of few that directly quantify and compare stigma attributed towards anorexia nervosa, bulimia nervosa, and binge-eating disorder. Through further research, a better understanding around the expression of stigma towards specific eating disorders could inform the development of targeted interventions to help reduce the stigma associated with these disorders. This knowledge could also advance the understanding of the lived experience of individuals living with eating disorders, subsequently informing treatment practices.

Objective: The aim of this study was to identify naturally occurring groups of individuals experiencing binge eating (BE) symptoms based on their endorsement of varied functions of BE.

Method: Adults (N = 646) with self-reported BE symptoms were examined using latent profile analysis to identify differentiated profiles based on eight established functions of BE. Profiles were also compared on measures of BE symptoms, eating disorder psychopathology, internal shame, body shame, psychological distress, adverse childhood experiences, and demographic variables.

Results: A four-profile solution was selected balancing goodness-of-fit and interpretability. Profiles identified were Emotion Avoidance, Classic, Emotion Reactivity, and Complex, with profiles differing primarily on emotion- and trauma-related functions of BE, and varying on all associated characteristics examined, with the Complex profile showing the most adverse associations.

Discussion: The identification of these distinct profiles suggests that individuals present with differentiated, inter-related patterns or reasons for BE. These clinically relevant profiles may inform binge-eating intervention choice and the targeting of specific maintenance factors within profiles. Further research is needed to examine the clinical utility of these profiles in informing the most suitable psychological treatment for an individual.