Journal of Eating Disorders最新文献

Body checking refers to the repeated evaluation of one's own body. As a safety mechanism, it is prevalent in various mental disorders, including eating disorders, body dysmorphic disorder, and illness anxiety disorder. While the type and manner of body checking behavior may differ between these disorders, cognitive-behavioral models highlight similar mechanisms underlying this behavior. According to the models, body checking is assumed to arise in response to negative affect, offer immediate relief, and increase psychopathology in the longer term as a mechanism of negative reinforcement. The objective of this review is to empirically evaluate these assumptions for eating disorders, body dysmorphic disorder, and illness anxiety disorder. Therefore, we conducted a systematic literature review across four electronic databases, with N = 43 studies meeting the inclusion criteria. The assumption that body checking occurs in response to negative affect was supported. However, findings regarding its short- and long-term role in maintaining negative affect were inconsistent. Therefore, our results may suggest the need to re-evaluate the etiologically proposed negative reinforcement mechanism of body checking in eating disorders, body dysmorphic disorder, and illness anxiety disorder. To facilitate the interpretation of study findings, future studies should distinguish between short- and long-term effects of body checking.

Background: Sexual minority adults are at elevated risk for eating disorders (EDs), yet existing screening tools have rarely been validated in this population. Most ED screening instruments have been validated in predominately cisgender, heterosexual female samples limiting their generalizability to populations with different symptom patterns. Validation studies in cisgender sexual minority (SM) adults are critical to improving detection and addressing disparities in ED identification. The present study evaluated the psychometric performance of the Brief Assessment of Stress and Eating (BASE), a validated 10-item screening tool that assesses DSM-5-aligned eating disorder symptoms and subclinical dysregulated eating behaviors, in a national sample of cisgender gay men and lesbian women.

Methods: Participants were 1,499 cisgender SM adults (61.7% gay men, 38.3% lesbian women) recruited from The PRIDE Study, a U.S.-based longitudinal cohort of sexual and gender minority adults. Respondents completed the BASE, SCOFF questionnaire, and the Eating Disorder Diagnostic Scale-5 (EDDS-5) which we used to derive probable DSM-5 eating disorder (probable ED) status. Receiver operating characteristic (ROC) and precision-recall (PR) curve analyses were conducted to evaluate classification accuracy and identify optimal thresholds.

Results: Both the BASE and SCOFF performed significantly above chance in detecting EDDS-5-derived probable EDs. Among gay men, the BASE (AUC: ROC = 0.785, PRC = 0.702) outperformed the SCOFF (ROC = 0.744, PRC = 0.630). In lesbian women, the two screeners performed similarly (BASE AUC = 0.807; SCOFF AUC = 0.806). Optimal BASE thresholds varied by group with higher sensitivity at lower cutoffs (e.g., ≥ 7).

Conclusions: The BASE provides a reliable, efficient alternative to traditional instruments for screening eating disorders in sexual minority adults, with good performance for identifying EDDS-5-derived probable EDs. Findings support the BASE as a reliable and valid screening tool for use with cisgender SM adults in community, healthcare, and research contexts.

Background: Negative emotional eating (EE) is overeating in response to emotions such as stress. Negative EE is a risk factor for obesity, which is, in turn, a risk factor for many non-communicable diseases (NCDs). While previous research has predominantly focused on younger or student populations, the prevalence and determinants of negative EE in middle-aged adults remain underexplored.

Methods: A systematic search was conducted in Medline, Embase, PsycINFO, Web of Science Core Collection, and Google Scholar for English language studies published from 2000 onwards reporting on the prevalence of negative EE in adults aged 35-64 years. Pooled prevalence estimates and corresponding 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed with the I² statistic. Subgroup analyses were performed by age, sex, country income classification, and assessment instrument.

Results: Of 1,390 identified records, 38 studies including 13,662 participants met the inclusion criteria. The pooled prevalence of negative EE among middle-aged adults was 16% (95% CI: 14%-19%). Prevalence was notably higher among younger middle-aged females compared to males and older individuals. Additionally, negative EE was more common in middle-aged adults residing in high-income countries compared to those in middle-income countries.

Conclusion: The global prevalence of negative EE among middle-aged adults highlights the need for targeted health promotion and behavioral interventions in this age group. Early identification and modification of unhealthy eating behaviors could help mitigate the risk of obesity and NCDs, particularly in high-income countries facing a growing burden of obesity-related health issues.

Objective: Obesity is a major global health challenge, particularly in Saudi Arabia (SA). Weight perceptions (WPs), how individuals perceive their body weight, are associated with psychological well-being. This study extends previous research by examining whether dispositional gratitude (DG), body appreciation (BA), and weight self-stigma (WSS) mediate the relationships between WPs and psychological well-being as measured by subjective well-being (SWB) and satisfaction with life (SWL).

Methods: 900 SA young adults (M_age= 24.79 years, SD = 8.46, 62% female) participated in a cross-sectional online survey assessing WPs, SWB, SWL, DG, BA, WSS. Structural Equation Modelling (SEM) using maximum likelihood estimation with bootstrap was employed to evaluate parallel mediation models, adjusting for age, sex, marital status, and education. Model fit was assessed via χ², CFI, TLI, RMSEA, and SRMR.

Results: Participants had a mean BMI of 24.88 (SD = 5.90) and 38% had body weight misperceptions. For SWL, full mediation was supported (χ²(1) = 6.94, p = .008, CFI = 0.994, TLI = 0.839, RMSEA = 0.082, SRMR = 0.010). WPs were negatively associated with DG (β = - 0.176, p < .001) and BA (β = - 0.334, p < .001), but positively associated with WSS (β = 0.408, p < .001). Indirect associations were significant through DG (β = -0.064, p < .001), BA (β = -0.059, p < .001), and WSS (β = -0.042, p = .008) with total indirect association (β = -0.166, p < .001), explaining 27.6% variance in SWL. Similar results for SWB showed full mediation, with significant total indirect association (β = -0.153, p < .001), explaining 21.6% variance in SWB.

Conclusion: These findings underscore the mediating roles of DG, BA, and WSS in the relationships between WPs and psychological well-being, suggesting that interventions targeting these factors could enhance psychological well-being among vulnerable young SA young adults living with obesity, especially those with weight misperceptions.

In their recent case report article, Peck and colleagues suggested that two patients recovered dissociated traumatic memories during psilocybin treatment for anorexia nervosa. These case reports are of clinical and scientific interest and confirm that psychedelics may induce vivid memory-like experiences. However, the reports warrant scrutiny. Here, based on what is known about recovered memories and the effects of psychedelics, we argue that the authors may not have adequately considered alternative explanations. The cases do not necessarily demonstrate that psilocybin induces recovery of dissociated traumatic memories or could treat dissociative amnesia. We further caution against the authors' suggestion of explicitly preparing patients for the emergence of forgotten material.

Background: Childhood maltreatment impacts expressions of mental disbalance, including disturbed eating behavior. Research into relationships between childhood abuse and neglect and other transdiagnostic factors, such as self-esteem and body experiences in eating disorders (EDs) is limited. This study investigates how childhood maltreatment relates to these other transdiagnostic factors and clinical measures in EDs.

Methods: Forty-nine women with an eating disorder (ED) and a control group of 50 women without an ED, aged 15-25 years, participated in an observational study with cross-sectional questionnaires and longitudinal measurements with the Experience Sampling Method (ESM). With ESM, real life, momentary self-esteem, body experience and ED behavior were longitudinally measured 10 times per day over 10 days. The ESM data were modelled at the momentary level using linear mixed-effects regression with random intercepts, to examine the associations between the person-level predictors (childhood maltreatment) and momentary self-esteem, body experience and ED behavior.

Results: The ED group reported more total childhood adversities, abuse, and neglect than the control group did. Childhood maltreatment was not associated with real life, momentary self-esteem, body experience and ED behavior, nor with ED severity. In controls, childhood maltreatment, specifically neglect, was associated with lower momentary self-esteem but not with momentary body experience. Body experience (cross-sectionally measured) was associated with childhood maltreatment in both the ED and control group.

Conclusions: Females with EDs reported more childhood maltreatment than controls did, but associations with body experience appeared more similar across groups. Notably, associations between childhood maltreatment and self-esteem were only found in controls. The findings highlight the relevance of self-esteem and body experience in females with childhood maltreatment, irrespective of psychopathology, and the need for further identification of transdiagnostic factors associated with childhood maltreatment in individuals with ED.

Background: Previous studies found an impairment in the capacity to mentalize (operationalized as "reflective functioning", RF) in patients with anorexia nervosa (AN), but only few studies used a validated interview procedure. The aim of this study was an assessment of RF in patients with anorexia nervosa in comparison to healthy controls (HCs), using both an expert-rated measure as well as a self-report measure. Further, the study aimed to explore the relationship between RF and various aspects of psychopathology.

Methods: 30 female patients with AN (mean age: 26.2 ± 10.1 years) and 30 matched HCs (mean age: 27.4 ± 9.9 years) were assessed and compared regarding their level of RF using the Brief Reflective Functioning Interview (BRFI) and the Mentalization Questionnaire (MZQ). The interrelations between RF values and eating disorder psychopathology (BMI, EDI, EDE-Q), body experience (DKB-35), general psychopathology (PHQ-9, PHQ-15, GAD-7) and impairment in personality functioning (OPD-SQS) were explored using correlation coefficients.

Results: On the RF-Scale (RF-BRFI), RF was M = 3.63 (SD = 0.67) in the AN group and M = 4.13 (SD = 0.94) in the HC group. It was significantly lower for patients with AN than for HCs (t(52.5) = 2.38; p = 0.011). Mentalizing in the AN group as assessed with the MZQ was M = 3.24 (SD = 0.71), demonstrating significantly worse self-reported mentalizing capacities compared to HCs (M = 1.73; SD = 0.45; p < 0.0001). RF as measured with the BRFI was only correlated to the EDI-subscale "weight concern", while RF values of the MZQ were correlated with various aspects of psychopathology except depressive symptoms and BMI.

Conclusion: The study confirmed the finding that patients with AN show impaired mentalizing. Strengthening the ability to mentalize might therefore be a relevant focus in treatment. However, associations of RF with psychopathology depend on the RF-measure used. Therefore, a better understanding of which aspects of mentalizing are captured by the RF-measures available would be an important basis for further research. Trial registration DRKS00031108.

Background: Caregivers of people with eating disorders (EDs) often support refeeding, behavioural monitoring, and co-ordinate therapeutic and medical appointments. Available support is often focused on the person with the ED and rarely on the caregiver. This study examined the impact of caregiving in New Zealand (NZ).

Methods: Current and previous caregivers completed an online, anonymous survey exploring their experience of caregiving and its psychological impact using the Depression, Anxiety, and Stress Scale (DASS-21), the Eating Disorders Symptom Impact Scale (EDSIS), and questions about the long-term impact of caregiving on caregivers' mental health. A comparison was made with data on Australian caregivers.

Results: Current caregivers reported higher levels of depression and stress than those not currently caregiving, as well as higher levels of depressive symptoms than Australian caregivers. The impact of ED symptoms were also generally higher in NZ participants compared with Australian caregivers.The perceived impact of the ED was associated with the psychological distress experienced by caregivers with greater impact being linked to more distress. Of those whose loved ones were in recovery, more than 25% experienced ongoing post-traumatic symptoms related to their caregiving experience.

Conclusion: NZ caregivers reported ongoing effects related to caregiving even when the person with the ED had recovered. NZ caregivers experience a high level of distress and burden that can persist once recovery is achieved. Comprehensive ED support should include interventions to improve caregivers' wellbeing.

Introduction: Body dissatisfaction is one of the maintaining factors of eating disorders and a well-known risk factor for their development. It was assumed that body dissatisfaction did not afflict non-Western countries. However, body dissatisfaction is reported in non-Western countries, and to what extent westernization is associated with body dissatisfaction and subsequent eating disorders is unknown. The purpose of the present study is to examine the association between Western acculturation and body dissatisfaction in Saudi Arabia and Turkey, and to determine the measurement invariance of the Body Shape Questionnaire.

Methods: The Body Shape Questionnaire and the adapted version of the Acculturation Rating Scale for Mexican-Americans II were administered to convenience samples in Saudi Arabia (n = 746) and Turkey (n = 363). A hierarchical multiple linear regression analysis was conducted with body dissatisfaction as the dependent variable and cultural orientation as the independent variable. Citizenship status, BMI, and sex were included as covariates. A multi-group CFA compared the item intercepts of the Body Shape Questionnaire in the two non-Western samples with a Dutch community sample (n = 1651).

Results: The Body Shape Questionnaire scores differed (p = 0.036) between individuals who had lived abroad in a Western country (M = 88.2, SD = 38.1) for at least six months and those who had not (M = 82.0, SD = 36.5). The BMI, but not cultural orientation, was associated with body dissatisfaction (B = 2.4, R = 0.4, R square = 0.18; p < 0.001). The multi-group CFA indicated that the Body Shape Questionnaire had a single-factor structure, and the item intercepts were similar across samples (CFI = 0.92; RMSEA = 0.059; RMSEA 90% CI 0.50-0.68; SRMR = 0.07).

Discussion: Future research should evaluate preventative programs targeting westernization-driven sedentary lifestyles. The Body Shape Questionnaire can be utilized across cultures and may help further the understanding of body dissatisfaction and eating disorders in the Middle East.