Eating Disorders最新文献

Shame is a painful, self-conscious emotion that is implicated in the onset and maintenance of eating disorders. However, there is a dearth of research examining shame outcomes in clinically acute eating disorder samples. The primary purpose of this study is to evaluate the outcomes and moderators of internal shame in female (adolescent and adult) residential patients diagnosed with a range of eating disorders. Participants (N = 176) were attending residential eating disorder treatment for eating disorders and were assessed for internal shame, self-esteem, eating disorder diagnosis, duration of eating disorder, body mass index, depression, and anxiety. Multilevel models were use to explore outcomes and moderators of shame from intake to discharge. Shame (g = 1.21) and self-esteem (g = -0.86) significantly improved from intake to discharge. Changes in shame were moderated by eating disorder diagnosis, BMI, depression, and anxiety, but not duration of eating disorder. These findings suggest that shame and self-esteem significantly improve during eating disorder residential treatment, with specific eating disorder diagnoses and baseline psychological characteristics moderating these changes. Future research is needed to replicate these findings in larger samples to further explore the mechanisms underlying changes in shame in eating disorder residential treatment.

Rates of eating disorders increase during young adulthood, but access to evidence-based intervention is limited in routine healthcare settings such as on college campuses. A preventive approach and task-shifting eating disorder interventions to peer educators trained by on-campus supervisors might increase access, but may introduce changes as they move further from developer oversight. Modifications are commonplace during implementation in routine care settings; understanding the nature of these modifications can help to clarify whether they improve intervention fit or undermine fidelity. Peer education supervisors from 63 colleges that implemented an evidence-based preventive intervention for eating disorders (Body Project) as part of a larger randomized trial completed semi-structured interviews about modifications made to the Body Project when it was delivered by peer educators. Thematic analyses of the interviews using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) suggested that modifications were primarily fidelity-consistent, adherent, planned/proactive, and made to improve fit with recipients. Results support prior work suggesting that delivery of evidence-based interventions in routine settings may require at least minor modifications to meet recipient needs without compromising fidelity. This study was preregistered with ClinicalTrials: https://clinicaltrials.gov/ct2/show/NCT03409809.

Eating disorder (ED) caregivers endorse substantial caregiver strain and psychological distress, and without adequate support may struggle to help their loves ones in adaptive ways. Caregiver interventions can be time-intensive and costly, potentially compounding strain, and thus there is need to examine alternative resources such as support groups. Data from 181 participants who attended virtual, clinician-moderated ED caregiver support groups were used to examine associations between past-month group attendance and participation frequency, psychological distress, caregiver strain, and caregiving skill. Adjusting for duration of support group attendance, Pearson partial correlations indicated that attendance frequency was positively related to several aspects of adaptive caregiving while verbal and chat participation frequency were positively related to within-group emotional support, social companionship (i.e. social cohesion), and informational support. Findings suggest that ED caregiver support groups have potential to support caregiver efficacy and provide access to social support, which could mitigate caregiver strain and thus also improve the wellbeing of people with EDs. However, results are preliminary and not an indication that ED caregiver support groups produce changes in wellbeing. Rather, results provide important foundational information that should be used to inform prospective examination of caregiver distress and skill outcomes with support group utilization.

Eating disorders (EDs) are often associated with mood disorders due to a number of negative predictive factors. However, no studies have been found to compare the frequency of EDs in major depressive disorder (MDD) and bipolar disorder (BD) patients. This cross-sectional study included patients diagnosed with BD (n = 173) and MDD (n = 90). All participants underwent structured interviews to verify clinical diagnosis and concomitant EDs during lifetime. The frequency of EDs during lifetime among patients with BD was 38.8% (n = 67), among patients with MDD-8.9% (n = 8). All types of EDs were more associated with BD than MDD, even adjusted for sex and age. The frequency of EDs during lifetime did not significantly differ between patients with BD type I and BD type II. EDs is more associated with BD than MDD. It is important to consider the results in the differential diagnosis of these disorders. Screening for EDs in patients with mood disorders and, conversely, screening of mood disorders in patients with EDs is important in diagnosis to determine appropriate treatment strategies and improve clinical outcomes.

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.

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.