Eating Disorders最新文献

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.

Eating disorders (EDs) have a harmful impact on the lives of millions of individuals in the United States. Research indicates that comorbid trauma could negatively impact treatment outcomes, reinforcing ED symptomology. Transdiagnostic approaches underscore experiential avoidance as a maintaining factor for EDs and other comorbid concerns, while mindfulness and adaptive coping help disrupt avoidance of emotional experiences. In addition to treatment approaches, clinicians must consider cultural identity factors, such as religion and spirituality (R/S), to engage in culturally responsive treatment. In the present study, we examined transdiagnostic factors in a clinical sample of 1153 individuals with comorbid EDs and post-traumatic stress disorder (99.6% of the sample), specifically considering differences between those who identified as religious, spiritual, or neither. Using a one-way analysis of variance, we found statistically significant differences in ED symptomology and adaptive coping scores across groups. Conversely, we found no statistically significant differences in mindfulness and experiential avoidance scores across groups. Despite the small effect sizes, these preliminary findings add to the existing body of research on R/S using a transdiagnostic framework, supporting the integration of spirituality into ED treatment to promote adaptive coping. Future research is needed to address the study's limitations, such as exploring adaptive coping styles that may further explain these relationships.

Community evidence indicates high eating disorder (ED) and comorbid symptom severity among LGBTQ+ compared to cisgender heterosexual (CH) individuals. Little is known about such disparities in ED treatment samples, especially in outpatient treatment. We aimed to descriptively characterize and investigate baseline group differences in symptom severity between LGBTQ+ and CH ED outpatients at treatment intake. Data from 60 (22.3%) LGBTQ+ and 209 (77.7%) CH ED outpatients were used to examine: (1) demographic and diagnostic differences; (2) differences in ED, depressive, and emotion dysregulation symptoms. Objectives were tested using Fisher-Freeman-Halton exact and independent samples t-tests, and analyses of covariance adjusted for age and diagnosis, respectively. Most LGBTQ+ outpatients were bisexual (55.2%), and 6.5% identified as transgender and non-binary. LGBTQ+ outpatients presented to treatment at younger ages (Mean Difference [MD] = -3.39, p = .016) and reported more severe depressive symptoms (MD = 5.73, p = .004) than CH patients, but endorsed similar ED symptom and emotion dysregulation severity. Groups did not differ in other demographic or diagnostic characteristics. LGBTQ+ individuals may develop more severe depression and similarly severe EDs at earlier ages but seek outpatient care sooner than CH peers. Managing depressive symptoms may be particularly important for LGBTQ+ ED patients.

Refeeding syndrome (RS) is defined as fluid and electrolyte shifts as a result of aggressive nutritional rehabilitation and these electrolyte imbalance can result in several cardiac complications. We aimed to evaluate the incidences of RS and hypercholesterolemia in children with anorexia nervosa (AN) and related factors for that. We retrospectively evaluated the medical records of 51 patients aged 10-18 years diagnosed with AN between January 2015 and May 2020. RS and hypercholesterolemia were seen in 21 (41.2%) and 39 (76.5%) of patients, respectively. Patients with RS had an older mean age (16.3 vs. 13.7 years, p = .021), lower body mass index (BMI) percentile on admission (0.1 vs. 1.6^th, p = .023), and a higher degree of weight loss (16.5 vs. 12.7 kg, p = .005) than those without RS. Age (odds ratio [OR], 3.49; 95% confidence interval [CI], 0.913-8.790; p = .021), initial BMI percentile (OR, 0.55; 95% CI, 0.286-1.853; p = .036), and BMI z-score (OR, 0.56; 95% CI, 0.256-1.987; p = .045) were predictors of RS. For identifying occurrence of RS, the area under the curve for BMI was 0.679 and the optimal BMI cutoff value and was 11.8 kg/m². RS and hypercholesterolemia were frequently observed in patients with AN, and low BMI percentile and older age were significantly associated with RS. Therefore, serum phosphate levels should be monitored more frequently in patients with severe malnutrition.

The mental health field, and more recently, the eating disorders field specifically, has witnessed a paradigm shift towards collaborative research which is conducted in partnership with individuals possessing lived and living experiences of mental health conditions (i.e. those with personal lived or living experience and those who are family, carers, or other supports). However, despite this shift, the challenge of engaging individuals with lived experiences in a manner that avoids tokenism, manages power imbalances, and ensures meaningful involvement persists. This paper aims to encourage those working in the eating disorders field to establish authentic, equitable partnerships with lived experience contributors. To provide clarity and to encourage researchers to engage in effective and authentic lived experience collaborations, this paper describes different types of lived experience involvement in research, using real-life examples from a study that is currently being established.