Eating Disorders最新文献

Although eating disorders (EDs) affect individuals of all races and ethnicities, racially/ethnically minoritized individuals are less likely to receive ED treatment than White individuals. The present study aimed to compare ED treatment experiences in a sample of racially/ethnically minoritized individuals vs. White participants. As a secondary aim, we explored how acculturation and mental health stigma factors were associated with treatment experiences. We recruited 41 White and 27 racially/ethnically minoritized individuals with a history of EDs (with all racially/ethnically minoritized individuals having to be categorized into one group due to limited power to conduct analyses across groups). Participants completed an assessment of their treatment experiences, ratings of the helpfulness of each treatment, self-reported barriers to treatments, their level of acculturation, and their tolerance towards stigma. We found that racially/ethnically minoritized participants reported receiving a significantly lower total number of ED treatments than White participants. Second, racially/ethnically minoritized participants were significantly less likely to seek out inpatient and day treatment/partial hospitalization than White participants. Third, racially/ethnically minoritized rated nutritionists and residential treatment as significantly less helpful than White participants. Fourth, racially/ethnically minoritized participants identified the lack of cultural competence among providers as a significantly more substantial barrier to treatment than White participants. Finally, among racially/ethnically minoritized participants, higher immersion in dominant society correlated positively with perceived helpfulness of ED treatment. These insights can guide the development of targeted interventions aimed at mitigating treatment barriers and enhancing treatment outcomes for racially/ethnically minoritized individuals affected by EDs.

This study examined demographic and military factors related to probability of hospitalization among military-affiliated adolescents and young adults (AYA) with an eating disorder (ED) diagnosis. Participants were military-affiliated AYA (spouses not included), ages 10-26 years. De-identified data were extracted from the Military Health System Data Repository from 2016-2021. Kaplan-Meier risk estimates determined the proportion of participants with a hospitalization following their initial ED diagnosis across time. Cox proportional hazard models evaluated adjusted associations of demographic and military-specific factors with probability of hospitalization. Of 7,705 participants with an ED diagnosis, approximately one in five (n = 1,569) had a hospitalization during the study period. Weight categories were only recorded for 35% (n = 2,675) of participants. Adjusting for other variables, hospitalization was more likely for: participants 15-17 years old (versus other age groups), females (versus males), those with underweight (versus higher weights), those who received care at civilian facilities (versus directly within the Military Health System), and those with a parent serving in the Navy (versus the Army). There was no significant difference by ED diagnosis. Results indicate disparities related to hospitalization among AYA with EDs within the Military Health System. More research is needed to understand access to and engagement with ED-related healthcare among military-affiliated AYA.

With an elevated prevalence of disordered eating in low-income settings, efforts to optimize the detection of eating disorders (EDs) in such settings are necessary. A significant barrier relates to the scarcity of training for clinicians not working in specialized ED settings. This manuscript assessed the impact of an ED screening tool and an ED assessment workshop upon the detection of EDs in publicly insured psychiatry settings. Leveraging a case series design to assess 165 consecutive adult patients in outpatient psychiatry settings, we indexed the prevalence of ED diagnoses rendered by psychiatrists when assessing patients (i) without prior knowledge of ED symptoms, (ii) after being made aware of patient scores from an ED screening measure, and (iii) after undergoing an ED assessment workshop, and being made aware of patient screening scores. While 27% of the sample reported clinically significant ED symptoms on the screening measure, ED diagnoses were only rendered in 2% of the sample when psychiatrists were not made aware of ED symptoms prior to assessment. In contrast, incorporating a screening tool altered the rates of ED diagnoses, with 18% of the sample receiving an ED diagnosis. Moreover, the combinatorial introduction of both the ED screening measure and an ED assessment workshop further altered diagnostic practice-with this resulting in ED diagnoses in 27% of the sample. The findings suggest that ED screening and training workshops can have significant impacts on diagnostic accuracy and, with little cost, can provide patients with diagnoses that would otherwise go undetected.

Quantitative research has demonstrated that many individuals with eating disorders (EDs) present with PTSD (ED-PTSD). Cognitive processing therapy (CPT) has been integrated into the overall treatment for ED-PTSD, but qualitative data on the effectiveness of this approach is lacking. Ten patients with ED-PTSD completed 12 sessions of CPT during residential treatment (RT). After sessions 1 and 11, patients wrote an "impact statement" clarifying their beliefs about why their trauma occurred and how it has impacted their life. Two coders using MAXQDA2020 software evaluated these statements using a structured coding protocol to assess changes in trauma-related cognitions over time. Analyses of these cognitive changes demonstrated shifts in the appraisal process regarding why trauma occurred from stances of self-blame to external fault. Exploratory analyses also indicated that perceptions of control and safety were associated with a greater frequency of reference to EDs and body image. Qualitative findings demonstrated that trauma-related cognitions became more realistic and adaptive following CPT as evidenced by a significant reduction in assimilated and overaccommodated cognitions, and an increase in accommodated cognitions. Last, there was a notable shift in perceived responsibility for trauma and improvements in control and safety in relation to EDs.

Posttraumatic stress disorder (PTSD) and eating disorders (EDs) frequently co-occur, with PTSD potentially worsening ED treatment outcomes. Integrated and concurrent interventions that treat both conditions together have been recommended, but no best practices exist. This case series of nine patients provides preliminary data on Written Exposure Therapy (WET), a brief, low-resource PTSD intervention, delivered concurrently with inpatient or day hospital ED treatment. Results showed reductions in PTSD symptoms, with most patients experiencing clinically significant improvements. Changes in ED symptoms varied, but no patients experienced deterioration. These findings suggest WET is a promising, efficient method for treating PTSD alongside ED treatment, supporting the need for clinical trials to assess its acceptability and efficacy for ED-PTSD.

Peer support is where individuals with the same shared experience provide mutual support. Using a non-controlled repeated measure design, this study evaluates initial efficacy of one-to-one email peer support. Young people with an eating disorder were matched with a recovered volunteer befriender, for up to one year, providing 1-3 email contacts a week. All participants completed measures (self-esteem, self-efficacy, wellbeing) at start of service, two and four-month intervals for recipients (n = 92) and peer befrienders (n = 86) respectively, and at end of service. Recipients also completed measures of social connectedness, impact of eating disorder, and goal-based outcomes. Multilevel mixed-effects linear regression models indicated significant improvements across all outcomes for recipients by 4 months, apart from self-esteem, and improvements self-efficacy, eating disorder impact and goal-based outcomes maintained at end of service. Peer befrienders did not show changes in self-esteem or self-efficacy, but there was a small significant reduction in wellbeing. The study provides evidence for email peer support for young people with eating disorders and highlights the need for robust support for befriending roles.

Objective: Family involvement (FI) in the treatment of eating disorders (EDs) is critical for children/adolescents, yet its role during residential treatment (RT) in adults is uncharted. PTSD may play a role in influencing FI but is also unexplored.

Method: We examined the role of FI in 2786 ED patients (89% F) admitted to RT with and without provisional PTSD. At discharge, staff rated the degree of FI as follows: 1) Not at all; 2) Slightly/somewhat; 3) Very much/extremely. Changes in ED, depression, anxiety, PTSD, and quality of life measures from admission to discharge were examined via multivariate analyses of covariance using degree of FI as an independent variable and age, gender, admission BMI, age of ED onset, and baseline symptom levels as covariates.

Results: Patients with the highest FI were the youngest, had the lowest BMIs and the oldest ages of ED onset. Rates of provisional PTSD were greatest in individuals with no FI and least in those with the highest FI. Those with no FI did significantly worse on all measures than those with higher levels of FI.

Conclusion: FI is an important component in ED treatment of adults in RT and is especially needed in patients with PTSD.

Yoga is commonly used as an adjunct to psychological therapy to support ED recovery as it can improve body responsiveness and awareness, interoception, and embodiment, mindfulness, self-compassion, self-efficacy, body satisfaction, body appreciation and body image. Research suggests that using yoga as an adjunct intervention may augment and reinforce psychology therapy, enhancing recovery outcomes. This research aimed to describe and appraise a systematic, sequential approach to integrating scientific evidence, expert knowledge and experience, and community engagement in co-designing and developing a therapeutic yoga group intervention for young people engaged in ED treatment. A four-phase approach to developing this intervention included planning, conducting, evaluating, and reporting phases. This paper reports on the development of the initial YEDRi prototype and co-design workshop conducted with carers (n = 3), consumers (n = 3) and clinicians (n = 3) to test and iterate the intervention. The resulting program is an 8-week therapeutic group yoga program for ED recovery where consumers and their carers attend together. This is the first study to systematically engage consumers and carers with a lived experience of EDs in a co-design process to develop a therapeutic yoga program for ED recovery.

This review of 15 prevention-related publications in Eating Disorders during 2025 is framed by three models: (1) Mental Health Intervention Spectrum: health promotion → types of prevention → case identification/referral for treatment; (2) the prevention cycle: rationale and theory, shaped by critical reviews → clarifying risk and protective factors → program innovation and feasibility studies → efficacy and effectiveness research → program dissemination; and (3) definitions of and links between eating disorder psychopathology, disordered eating behavior, and eating disorders. Four articles were categorized as prevention theory, methodology, or ethics; three articles were categorized as prevention rationale (including screening studies); six articles addressed correlates and putative risk factors for eating disorders or eating pathology; and one article each addressed protective factors and the upscaling/adaptation of the Body Project prevention program, respectively. Seven implications for prevention improvement are presented. For example, we must do more than acknowledge a spectrum of disordered eating. In many countries, eating pathology in girls and boys is a pressing public health problem that is almost certainly in place before age 13. Consequently, the developmental trajectories of eating pathology in children and adolescence, and the creation of effective school-based prevention programs for youth ages 10 through 15, are two under-studied areas that deserve research priority.

Type 1 diabetes (T1D) is associated with significant psychological burden and an elevated prevalence of Disordered Eating Behaviors (DEBs) among persons with T1D (PWT1D). This study examined the frequency of DEBs in PWT1D and investigated their clinical, psychological, and psychiatric aspects, including depressive and anxiety symptoms, as well as glycemic outcomes, in a Brazilian population. A cross-sectional study was conducted from March to July 2022 with adolescents and young adults with T1D (ages 13-39) recruited nationwide in Brazil via social media. Participants completed an online questionnaire, the Diabetes Eating Problem Survey Revised-BR (DEPS-R-BR), and the Hospital Anxiety and Depression scale. Descriptive analyses were performed. Two hundred and seventeen PWT1D met eligibility criteria, eighty-nine % were female, with a mean age 28.5 (SD = 6.83) years and a mean HbA1c 7.4% (SD = 1.7). Sixty-four % scored ≥20 on DEPS-R-BR. DEBs risk (DEPS-R-BR ≥20) was associated with fixed insulin dosing (p = .035), higher anxiety (p < .001), having a family member with an eating disorder (EDs) (p = .039. Higher DEPS-R-BR scores were associated with insulin restriction and omission (p < .001), depressive symptoms (p < .001), higher BMI (p = .007), higher HbA1c (p = 0.001), and female sex (p < .001). In this sample of PWT1D, DEBs were common and aligned with adverse psychological profiles and suboptimal clinical markers. Routine screening for DEBs risk detection is crucial for timely therapeutic interventions.