Journal of Eating Disorders最新文献

Background: Weight stigma is pervasive, and it has a significant impact on the social, physical, and psychological health of an individual. Weight stigma is observed from several different sources. Therefore, the present study developed and validated a new instrument, the Weight Stigma Exposure Inventory (WeSEI), to assess different sources of observed weight stigma across interpersonal and non-interpersonal sources.

Methods: The participants (n = 15,991) comprised Taiwanese young adults, Chinese adolescents, and Chinese young adults who completed paper-and-pencil and online surveys between September 2023 and December 2023. All participants provided demographic information, and completed the WeSEI, Weight Self-Stigma Questionnaire (WSSQ), and Perceived Weight Stigmatization Scale (PWSS). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the factor structure of the WeSEI.

Results: EFA and CFA results confirmed a seven-factor structure (television sources, traditional media sources, social media sources, parent sources, stranger sources, significant other sources, and friends sources) across 35 items of the WeSEI. Moreover, the WeSEI was supported by measurement invariance across subgroups (i.e., subsamples, gender, and weight status). Moreover, there were positive correlations between all seven factors of the WeSEI and the WSSQ and PWSS.

Conclusion: The WeSEI appears to assess observed weight stigma from different sources, and had good reliability, validity, and invariance across various subsamples. The WeSEI may be useful in clinical practice and research for assessing exposure to weight stigma from different sources.

Background: There is a need for improved understanding of why 20-30% of individuals with anorexia nervosa (AN) develop a severe and enduring form of illness (SE-AN). Previously, we reported differences in proactive inhibition (a pre-emptive slowing of responses) in individuals with AN compared to healthy controls (after controlling for intolerance of uncertainty). The present study is a preliminary exploration of proactive inhibition in which we compared women with SE-AN with healthy comparison (HC) women and explored its association with restrictive/avoidant eating behaviours.

Methods: Thirty-four women with SE-AN (defined by >3 years of illness and a previous unsuccessful course of eating disorder treatment) and 30 HCs completed (a) a cued reaction time task, to assess proactive inhibition, and (b) questionnaires assessing restrictive/avoidant eating behaviours and intolerance of uncertainty.

Results: Both SE-AN and HC participants showed slower reaction times under conditions of uncertainty, indicating proactive inhibition in both groups. There was a main effect of group, with SE-AN participants showing significantly slower reaction times compared to HC. There was no interaction between group and condition, suggesting that individuals with SE-AN did not differ in proactive inhibition compared to HCs. However, post-hoc analysis between-group tests for each trial type revealed that group differences were only present under conditions of uncertainty. Proactive inhibition was not significantly associated with self-reported restrictive/avoidant eating behaviours, including when taking intolerance of uncertainty into consideration.

Conclusions: It is unlikely that proactive inhibition contributes to avoidant and restrictive eating behaviours seen in SE-AN. Our findings suggest that the SE-AN group are relatively more cautious when responding under conditions of uncertainty. Longitudinal studies and between-group comparisons of individuals across different stages of illness will be required to elucidate the way in which proactive inhibition is specifically implicated in SE-AN, rather than in AN more generally.

Background: Biopsychosocial factors have been associated with body satisfaction/dissatisfaction and related body image concerns in adolescence; however, few studies have investigated these relationships in middle childhood, an important developmental phase for body satisfaction. This study investigated relationships between a range of biological (body mass index), psychological (child anxiety/depression, self-esteem, and self-oriented and socially prescribed perfectionism) and sociocultural (mother's body dissatisfaction and comments about child's appearance, father's body dissatisfaction and comments about child's appearance, peer teasing and child's media exposure) factors and body satisfaction cross-sectionally and longitudinally in a sample of 7- and 8-year-old children.

Methods: In this study, participants from the longitudinal Children's Body Image Development Study (in which children had been followed-up annually from 3 years old) were assessed by interview at 7 years old (Time 1; n = 293: girls = 167, boys = 126) and 8 years old (Time 2; n = 222; girls = 126, boys = 96) and their parents completed a questionnaire at each time point.

Results: Multiple regression analyses revealed that child self-esteem, socially prescribed perfectionism, and mother body dissatisfaction in the total sample at 7-years, as well as child self-esteem and mother body dissatisfaction in the total sample at 8-years were significant unique cross-sectional correlates of child body satisfaction. While self-esteem outcomes were replicated at both time points for boys and girls, some differences in patterns were found for other variables in the subsamples of boys versus girls across time points. Prospectively in partial correlations (controlling for Time 1 child body satisfaction), mother's body dissatisfaction predicted later child body satisfaction in boys and child self-esteem predicted later body satisfaction in girls. However, no longitudinal biopsychosocial predictors were identified as contributing unique variance in child body satisfaction from 7- to 8-years old after accounting for Time 1 (7-yearold) child body satisfaction.

Conclusions: These findings point to important psychosocial factors that are consistently related to body satisfaction in children and could be targets for intervention, but also suggest that a number of biopsychosocial variables develop concurrently with body satisfaction.

Background: Training gaps regarding the diagnosis and management of eating disorders in diverse populations, including racial, ethnic, sexual, and gender minoritized groups, have not been thoroughly examined.

Objective: This study aimed to examine resident physicians' knowledge and attitudes regarding eating disorders in diverse populations, with a focus on areas for improved training and intervention.

Methods: Ninety-two resident physicians in internal medicine, emergency medicine, obstetrics/gynecology, psychiatry, and surgery at an academic center completed an online survey from 12/1/2020-3/1/2021, which comprised multiple choice and vignette-style open-ended questions to assess knowledge and attitudes toward the management and clinical presentations of eating disorders. Overall, the survey response rate was 25.7%. Descriptive statistics were reported. Vignette-style questions were analyzed using inductive coding and the frequency of responses was reported.

Results: A minority of resident physicians self-reported confidence in their knowledge of the medical complications (n = 42, 45%), risk factors (n = 38, 41%), and clinical presentations (n = 32, 35%) associated with eating disorders. Responses to vignette-style questions correctly identified relevant management methods (such as electrolyte monitoring and referral to specialty care), but demonstrated limited knowledge of the clinical presentation of eating disorders. Furthermore, most respondents reported a lack of knowledge regarding eating disorders in sexual and gender minoritized patients (n = 68, 73.9%) as well as racial and ethnic minoritized patients (n = 64, 69.6%).

Conclusions: Our findings suggest concerning gaps in knowledge and confidence among resident physicians with regard to the diagnosis and treatment of eating disorders, particularly in racial, ethnic, sexual, and gender minoritized patients. Moreover, responses to vignette-like questions indicate significant homogeneity in respondents' perceptions of the clinical presentation of eating disorders, reflecting cultural biases which associate eating disorders with underweight, young, female patients. The majority did not feel competent in treating eating disorders in diverse populations and expressed desire for additional training in this area. More research is needed to better understand and address these gaps in eating disorder training, with the goal of increasing equity in patient outcomes.

Eating disorders (EDs) are a group of debilitating mental illnesses characterized by maladaptive eating behaviors and severe cognitive-emotional dysfunction, directly affecting 1-3% of the population. Standard treatments are not effective in approximately one third of ED cases, representing the need for scientific advancement. There is emerging evidence for the safety and efficacy of psilocybin-assisted psychotherapy (PAP) to improve treatment outcomes in individuals with EDs. However, the limited knowledge of the neurobiological mechanisms underlying the therapeutic effects of PAP restricts the ability to confirm its clinical utility. This narrative review presents an overview of methodologies used to elucidate the pathophysiological mechanisms of EDs or the effects of psilocybin that could be employed to probe the neurobiological correlates of PAP in EDs, including magnetic resonance imaging and molecular neuroimaging techniques, electrophysiological approaches, and neuroplasticity markers. Finally, the implications of these methodologies are described in relation to the unique features of the psychedelic study design, challenges, limitations, and future directions to advance the field. This paper represents a valuable resource for scientists during study conceptualization and design phases and stimulates advancement in the identification of effective therapeutic interventions for EDs.

Background: Improving care for SEED-AN patients is urgently needed. Current specialist eating disorder (SEDU) programs have minimal impact, resulting in poor quality of life. Flexible assertive community treatment (FACT) focuses on improving the quality of life of people with severe mental illness.

Aim: This study systematically examined professionals' and patients' experiences with existing care for SEED AN in two settings in two health districts in the Netherlands. Specifically, the specialised Eating Disorder Unit and FACT.

Methods: A qualitative approach was used: Twelve professionals participated in focus groups, and four professionals and six patients were interviewed individually. Reflective thematic analysis was used to analyse the data.

Results: Four themes were constructed: "We feel ignorant in the treatment of SEED-AN patients"; "There is a disability to act"; "We are more than executive practitioners alone"; and "The professionals at FACT have given me back my confidence in treatment". The findings reflect how support for SEED-AN patients is provided by both FACT and SEDU professionals and how SEED-AN patients experience the FACT approach.

Discussion: A resource group model promotes collaboration among professionals, patients and the patient's support system. The model is expected to increase knowledge about SEED-AN among stakeholders who support the quality of life of SEED-AN patients.

Background: Accruing evidence suggests that personality-based approaches to eating disorder classification may offer several advantages over current diagnostic models, with prior research consistently identifying three personality-based groups characterized by either (1) high levels of impulsivity and dysregulation (termed the "undercontrolled" group), (2) high levels of rigidity and avoidance (termed the "overcontrolled" group), or (3) relatively normative levels of personality functioning (termed the "low psychopathology" group). Cognitive inflexibility (i.e., difficulty adjusting thoughts or behaviors) has theorized relevance to eating disorders. However, prior research has frequently failed to observe differences in cognitive inflexibility across eating disorder diagnostic groups. The present study aimed to identify personality-based groups in an eating disorder sample, and then to examine the relations between these groups and behavioral measures of cognitive inflexibility.

Method: 83 men and women who met DSM-5 criteria for anorexia nervosa or bulimia nervosa completed self-report questionnaires to assess trait-level approach/avoidance behaviors and impulsivity, as well as behavioral tasks assessing attentional set-shifting and reversal learning, two facets of cognitive inflexibility.

Results: Latent profile analysis of measures assessing approach/avoidance behaviors and impulsivity supported a three-class model replicating the undercontrolled, overcontrolled, and low psychopathology groups. Notably, the low psychopathology group was characterized by elevated reward responding. One-way ANOVAs indicated that the low psychopathology group demonstrated heightened perseverative errors (an indicator of impaired reversal learning) relative to the other groups. No group differences were observed for attentional set-shifting errors or probabilistic switch errors.

Discussion: Findings from the present study provide additional support for personality-based classification approaches identifying undercontrolled, overcontrolled, and low psychopathology eating disorder groups. Results also suggest that reward-related processes may contribute to disorder maintenance in the low psychopathology group, indicating potentially meaningful targets for intervention.

Background: Binge eating, a type of disordered eating, is relatively common among youth and predisposes them to many adverse health outcomes. Diverse psychological and social factors may be associated with binge eating. The aim of this study was to examine child and parental psychosocial determinants of binge eating and its impact on indicators of obesity.

Methods: The sample consisted of 10 679 Finnish adolescents who participated in the Fin-HIT cohort study. The participants were 9-12 years at baseline, and they were followed-up for 2.6 years on average. At baseline, children's anthropometry was measured, and they reported binge eating, disordered eating attitudes and behaviors, self-esteem, and body shape satisfaction with validated questionnaires. Parents reported their own weight satisfaction, dieting, and depressive symptoms at baseline. Adjusted logistic and linear regressions were used in the analyses.

Results: Self-esteem was associated with lower odds (OR 0.88, 95% CI 0.85-0.91), and overall disordered eating attitudes and behaviors were associated with higher odds (OR 1.08, 95% CI 1.06-1.10) of binge eating. Additionally, child and parent body dissatisfaction were associated with binge eating but not in the fully adjusted model where the child's BMI was additionally considered. None of the parental factors were associated with binge eating in the fully adjusted model. Binge eating was associated with higher BMI z-scores and waist circumferences both cross-sectionally and longitudinally.

Conclusions: In support of previous findings, we found that low self-esteem, body dissatisfaction and other disordered eating attitudes and behaviors are associated with binge eating, but our results also highlight the impact of weight status as a potential moderator when the determinants of binge eating are examined. More studies on the role of parental factors in adolescent binge eating are needed.

Background: The long-lasting consequences of the COVID-19 pandemic on the psychological well-being of young people have become an emerging research topic, which still raises several questions for post-pandemic interventions at the individual and community levels. This research investigated the relationship between COVID-19 pandemic life events and the occurrence of binge eating behaviors in emerging adults, hypothesizing indirect effects of the emotional impact of pandemic events and social anxiety.

Methods: Data collection was conducted in November and December 2021 in Italy, involving 286 university students aged 18 to 30 years (M_age = 20.20; SD_age = 2.43; 69.6% women) who completed an online anonymous survey. Participants reported the pandemic-related stressors experienced in the last year (i.e., adverse life events; the number of days in quarantine), the long-lasting emotional impact of these experiences in the previous week (i.e., intrusive thoughts; avoidance of thoughts), social anxiety symptoms, and frequency of binge eating episodes. A serial mediation model was tested in line with the research hypotheses.

Results: Both the number of days in quarantine and the pandemic adverse life events in the last year were significantly and positively related to binge eating via the sequential indirect effects of (1) intrusive thoughts and (2) social anxiety.

Conclusion: Our findings provide support for the long-lasting effects of pandemic events and quarantine on emerging adults' mental health, with cascade effects on intrusive symptoms, social anxiety, and binge eating. The study has interesting research, practice, and public health policies implications.

Objective: Night eating syndrome (NES) is an eating disorder characterized by evening hyperphagia. Despite having a prevalence comparable to some other eating disorders, NES remains sparsely investigated and poorly characterized. The present study examined the phenotypic and genetic associations for NES in the clinical Mass General Brigham Biobank.

Method: Cases of NES were identified through relevant billing codes for eating disorders (F50.89/F50.9) and subsequent chart review; patients likely without NES were set as controls. Other diagnoses were determined from billing codes and collapsed into one of 1,857 distinct phenotypes based on clinical similarity. NES associations with diagnoses were systematically conducted in phenome-wide association scans using logistic regression models with adjustments for age, sex, race, and ethnicity. Polygenic scores for six related traits, namely for anorexia nervosa, depression, insomnia, sleep apnea, obesity, and type 2 diabetes were tested for associations with NES among participants of European ancestry using adjusted logistic regression models.

Results: Phenome-wide scans comparing patients with NES against controls (cases n = 88; controls n = 64,539) identified associations with 159 clinical diagnoses spanning 13 broad disease groups including endocrine/metabolic and digestive diseases. Notable associations were evident for bariatric surgery, vitamin D deficiency, sleep disorders (sleep apnea, insomnia, and restless legs syndrome), and attention deficit hyperactivity disorder. The polygenic scores for insomnia and obesity were associated with higher odds of NES (insomnia: odds ratio [OR], 1.24; 95% CI, 1.07, 1.43; obesity: 1.98; 95% CI, 1.71, 2.28).

Discussion: Complementary phenome-wide and genetic exploratory analyses provided information on unique and shared features of NES, offering insights that may facilitate its precise definition, diagnosis, and the development of targeted therapeutic interventions.