Eating Disorders最新文献

This study explored the relationship between eating disordered symptoms and in-person (ISV) and cyber sexual violence (CSV) by recruiting young women (N = 145) on Prolific with current eating disordered symptoms. Having experienced some sexual violence was ubiquitous (91.7%), and 73.8% of the participants had experienced both ISV plus CSV, suggesting that a history of polyvictimization is common in this population. The number of total types of polyvictimization was correlated with eating disordered symptom severity (EDE-Q-13). For each sub-categorical ISV and CSV type of violence, women were asked if it occurred before, during, or after their disordered eating began with 87% reporting ISV and CSV victimization preceded dysfunctional eating. This study documents the pervasiveness of sexual violence among women and links eating disordered symptom severity to multiple types of sexual violence experiences. Further, this study displays how sexual violence experiences occurred prior to eating dysfunction for most of these women with a victimization history. Given the rise in social media use allowing for more CSV, this is a timely study with eating disorder prevention and treatment implications using trauma-informed approaches.

This review of 20 prevention-related publications in Eating Disorders during 2024 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. Nine articles were in the category of prevention rationale (including screening studies) and gaps/shortcomings in the prevention field; three addressed correlates and putative risk factors for eating pathology; and eight articles involved creation, adaptation, or upscaling of programs: three pilot projects, one efficacy study, and four investigations of effectiveness. Seven implications for prevention improvement are presented. For example, because multidimensional sociocultural factors are of paramount importance to risk for the spectrum of disordered eating, all forms of prevention should be designed, from the outset, to establish and maintain non-hierarchical, participatory collaboration between academic researchers and inclusive groups of stakeholders. In this process, it is essential to include people (including academic researchers) whose voices are typically ignored (e.g. LGBTQ+ people of color, low income and unmarried working mothers, and adolescents of ages 11 through 14).

Objective: While prior research has found links between anxiety sensitivity (AS) and eating disorder (ED) symptoms, there has been limited research exploring how specific aspects of AS are related to specific dimensions of eating pathology. To inform candidate targets of specific aspects of AS in future interventions, the current study identified associations between AS and ED constructs in a sample of individuals with elevated eating pathology.

Method: N = 382 undergraduate students (89.3% White, 2.6% Hispanic/Latine) with elevated eating pathology completed surveys as part of a larger study. Participants completed the Anxiety Sensitivity Index-3 (ASI-3 subscales: Physical, Cognitive, and Social Concerns) and Eating Pathology Symptoms Inventory (EPSI).

Results: Separate Bonferroni-corrected regression models were run for each EPSI subscale with covariates (age, BMI, and sex) included in step 1 and ASI-3 subscales in step 2. ASI Social was associated with EPSI Body Dissatisfaction (p < .001), and ASI Cognitive was significantly associated with Binge Eating, Purging, and Muscle Building (ps < .006), above and beyond other ASI subscales.

Discussion: Results support that different aspects of AS are associated with different ED symptoms. Future research should explore these constructs longitudinally to inform potential targets for intervention.

In order to identify factors that may impede youth access to evidence-based treatment, the current study examined child and adolescent mental health therapists' use of Family-Based Treatment (FBT) and other psychotherapeutic approaches to treat adolescents with restrictive eating disorders. A sample of 91 therapists from a variety of backgrounds (e.g. social workers, doctoral-level psychologists, masters-level counselors, marriage and family therapists) completed a 74-item survey regarding their attitudes and beliefs about adolescent eating disorders and its treatment, as well as their use of FBT and other psychotherapeutic approaches. Only 5% of therapists indicated that they treat restrictive eating disorders and, of those who do provide care, few endorsed using FBT strategies. The majority of therapists reported using other psychotherapeutic approaches that may dilute the effect of FBT principles or may prove ineffective. Having more formal training in eating disorders was associated with FBT-consistent beliefs and the use of FBT strategies. Findings have implications for dissemination efforts that target common beliefs that can undermine the care of adolescent eating disorders. Finally, the field must consider disseminating treatments to general therapists in ways that are more accessible, such as a focus on basic over specialized competencies, and consider innovative approaches to engage other professionals in supporting families caring for young people with restrictive eating disorders.

Support groups are a promising resource, but eating disorder (ED) support group research is scarce. This study aimed to examine associations between support group utilization, psychosocial health, and ED symptoms to guide future research on this resource. Participants (N = 494) were sampled from virtual, clinician-moderated ED support groups. Benjamini-Hochberg-corrected partial correlations tested associations of past-month attendance and participation frequency with measures of psychosocial health and ED symptoms. Participants additionally completed descriptive questions regarding perceived support group benefits. Adjusting for past-month ED treatment, more frequent support group participation was positively related to social companionship and emotional and informational support. More frequent attendance was negatively related to body dissatisfaction, binge eating, purging, restricting, excessive exercise, and negative attitudes toward obesity, but these associations were no longer significant after adjusting for psychosocial health variables. Descriptively, one-third to one-half of participants reported various positive changes from support group utilization. Utilizing and participating in clinician-moderated ED support groups could provide a low-burden outlet for ED symptom management, which may be due to provision of social support. Prospective examination of observed associations is a critical next step to investigate outcomes directly and build a testable model of group processual factors.

The DSM-5 introduced severity ratings in 2013 for anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) based on BMI, compensatory behaviour frequency, and binge eating frequency, respectively. While several studies have assessed the validity of these ratings, little is known about their use in clinical practice. This study examined clinicians' use of DSM-5 severity ratings and their views on their clinical value. A sample of 38 clinicians (mean age = 38.5, 97.37% female) completed an online survey on the usage of DSM-5 severity ratings in clinical practice, and six participated in one-on-one interviews for further insights. Results showed that 60% of clinicians do not use these ratings. Qualitative findings obtained from both survey and one-on-one interviews found that clinicians perceive these ratings as invalidating, pathology-reinforcing, and lacking clinical relevance. However, some noted that these ratings can aid in triage and communication among clinicians in tertiary settings. This study highlights substantial concerns about the clinical utility of DSM-5 severity ratings for EDs, suggesting the need for a more comprehensive approach that considers broader psychological, medical, and cognitive indicators.

Eating Disorders (EDs) in Mexicans have been associated with an elevated psychiatric comorbidity, highlighting the necessity for a reliable assessment tool. However, previous validations of the Eating Disorders Examination Questionnaire (EDE-Q) in Mexico yielded diverse results regarding its underlying factor structure, leading to uncertainty and complexity in understanding its latent models. This study will evaluate multiple previously proposed EDE-Q models in a sample of 173 patients with EDs undergoing various standard-of-care programs in Monterrey, Mexico. Through Confirmatory Factor Analysis, eight models were scrutinized. Different coefficients were considered to assess the internal consistency of the retained model. Concurrent and convergent validity were assessed using measures of EDs, body image, and clinical parameters. A brief 7-item 3-factor model demonstrated the optimal fit to the data. Internal consistency indices, including Cronbach's alpha, Omega and Spearman-Brown coefficients, exhibited adequate values. Concurrent and convergent validity were supported by significant associations with measures of ED, body appreciation, body dissatisfaction, clinical impairment, and depression. This study comprehensively assessed multiple EDE-Q models, identifying a brief 7-item 3-factor model, consistent with previous findings among Mexicans. The establishment of a robust EDE-Q model holds promise for enhancing EDs prevention, treatment, and research efforts in Mexico.

Anorexia nervosa (AN) is a severe eating disorder and among the mental disorders with the highest mortality rate. To date, not much is known about its development and maintenance, and treatment outcomes are improvable. At the same time, research on psychological interventions for AN is a complicated endeavor, often characterized by small sample sizes and methodological heterogeneity, which impedes the comparison and evaluation of treatment outcomes. In this paper, several population-related, therapist-related and methodological challenges that may be encountered during research on psychological interventions for AN are discussed. The use of single case experimental designs (SCEDs), which could account for several of these challenges, is suggested as a complementary approach to current methods of assessing treatment efficacy. The use of SCEDs could be beneficial to the field, by contributing to the knowledge about AN and to the development and evaluation of better treatments, which are sorely needed.

Eating disorders are a persistent and debilitating problem, especially among college age men and women. This problem is exacerbated in occupations such as the military, where maintenance of strict standards regarding weight, fitness and appearance is important for job retention and promotion. Also, previous research confirms that stress is a contributing element to eating disorders. It is thus important to identify factors that may assist individuals to remain resilient and avoid stress-related health and eating difficulties. The present study utilizes historical data to examine the impact of stress on health and eating disorder symptoms in a representative sample of West Point military academy cadets, while testing the role of gender and hardiness as stress moderators in this relation. A survey containing measures of stress, hardiness and eating disorders symptoms was completed by 387 cadets in the fall and spring of 2000-2001. Moderation effects were tested with advanced conditional process analysis procedures developed recently by Hayes (2022). Results show that hardiness was a significant moderator, with cadets low in hardiness showing increased eating disorder symptoms and more general health symptoms. While gender was not a significant moderator with respect to eating disorder symptoms, it was significant for general health symptoms; female cadets showed more stress-related health symptoms than their male counterparts. These results suggest that eating disorder symptoms in military academy cadets and college students more generally may be reduced through programs aimed at developing hardiness attitudes and stress coping approaches.

Cognitive Behavioural Therapy for Avoidant and Restrictive Food Intake Disorder (CBT-AR; ARIFD) is a psychological treatment that targets many of the core symptoms of ARFID. Although a growing literature supports the efficacy of behavioural interventions for paediatric feeding and eating disorders, including ARFID, the applicability of these methods to adults remains undetermined. Telehealth delivery of CBT-AR in adults with autism has yet to be tested. With this study, we conduct a preliminary evaluation of CBT-AR delivered virtually to a 26-year-old white British female, with mixed ARFID and elevated autistic traits. She attended 23 remote CBT-AR sessions facilitated through a dedicated telehealth platform. Adjustments were made to accommodate her lived experience of neurodiversity. Using a pre-post treatment design, changes on measures of subjective goal attainment, eating-related and general psychosocial impairment, general anxiety, and depression were evaluated. Following treatment, the participant had made significant progress towards personally meaningful goals, with improvements observed in nutritional intake, general well-being, and reductions in eating-related psychosocial impairment and general anxiety. The results offer preliminary insights into acceptability and efficacy of virtual CBT-AR for neurodiverse individuals.