Eating Disorders最新文献

This study reports the outcome of a low intensity pre-treatment intervention (a guided e-health podcast) for patients with anorexia nervosa and bulimia nervosa, delivered between assessment and the start of the full outpatient treatment programme. A case series design was used. A total of 254 patients at a specialist eating disorder service were offered a pre-treatment three-week psychoeducational intervention (Keeping Myself Safe; KMS), and 203 undertook the intervention. The intervention consisted of six podcasts (107 mins), an accompanying workbook, and a follow-up review appointment. Body Mass Index and Eating Disorder Examination-Questionnaire scores were taken at assessment, end of the KMS intervention (mean duration = 21.9 days) and start of treatment (mean = 79.8 days post KMS intervention). Generalised Linear Mixed Models were used to test main and interaction effects (diagnosis x time). There were improvements on most variables following the KMS intervention. The effects were more pronounced for patients with bulimia nervosa across several measures. Pre-treatment guided e-health psychoeducational interventions can be associated with early attitudinal and behavioural change in patients with bulimia nervosa and anorexia nervosa whilst on the waiting list for treatment. They allow greater, affordable accessibility to effective psychoeducation and enhance potential engagement. More research is required to investigate the longer-term impact on retention and outcome, particularly in anorexia nervosa.

The Pica, ARFID, and Rumination Disorder ARFID Questionnaire (PARDI-AR-Q) and the Eating Disorders in Youth Questionnaire (EDY-Q) were developed to assess avoidant/restrictive food intake disorder (ARFID), but research is ongoing regarding their discriminant validity. This study examined scores of adult inpatients with ARFID or anorexia nervosa, restricting type (AN-R) on the PARDI-AR-Q, EDY-Q, and Eating Disorder Examination Questionnaire (EDE-Q) at admission to a medical stabilization unit for severe eating disorders. Response differences between 78 adult inpatients with ARFID or AN-R were analyzed using a two-sample t-test or Fisher's exact test. Sensitivity and specificity of self-report measures were examined using receiver operating characteristic curves. Patients with AN-R had significantly higher severity of impact and lower concern about aversive consequences scores than patients with ARFID on the PARDI-AR-Q (p < .001), with no significant differences on sensory-based avoidance or lack of interest or EDY-Q total score. Patients with AN-R scored significantly higher on all domains of the EDE-Q (p's < .001) and the EDE-Q subscales had better discrimination than ARFID measures. This study provides further evidence of the need for assessments that can distinguish ARFID from AN, and may also highlight the need for future research on the nosological accuracy of differentiating these disorders.

To date, little data exist about the stability of networks, which is an important limitation given the interest in applying network approaches for evaluating and informing treatment and intervention. Thus, the aim of the present study was to examine the stability of the eating disorder symptom network in a clinical eating disorder sample across two timepoints, on average 18 months apart. The sample included 99 eating disorder patients from a transdiagnostic sample. Findings from network analyses revealed that the networks exhibited both structural and global strength invariance over time. These findings suggest that in this clinical transdiagnostic sample, some support for differences over time in the network structure and strength at the group level existed despite null formal invariance tests. These findings are consistent with the change in clinical presentations within the sample.

This study aimed to examine the association between eating disorders and emotion regulation difficulties in a sample of adolescent boys and young adult men in Canada and the United States (2024; N = 925). Multiple linear regression analyses were used to explore whether boys and men with any probable eating disorder (i.e. anorexia nervosa/atypical anorexia nervosa, bulimia nervosa, binge-eating disorder) had higher scores on the Difficulties in Emotion Regulation-18 (DERS-18) measure, while adjusting for relevant sociodemographic confounders. Participants with any probable eating disorder, compared to those without, had significantly higher total DERS-18 scores (B = 9.03, 95% CI 6.66, 11.39), and higher scores on the clarity (B = 1.14, 95% CI 0.59, 1.69), goals (B = 1.63, 95% CI 0.97, 2.28), impulse (B = 1.43, 95% CI 0.96, 1.90), nonacceptance (B = 2.48, 95% CI 1.79, 3.18), and strategies (B = 2.30, 95% CI 1.71, 2.90) subscales. These findings largely align with and expand prior research on eating disorders and emotion regulation that has predominantly focused on females. Treatment methods that address adaptive emotion regulation abilities of boys and men with eating disorders may have utility, with a particular focus on increasing acceptance of emotions and developing strategies for emotion regulation.

Mindfulness, emotion regulation, and distress tolerance are hypothesised mechanisms that underpin Dialectical Behaviour Therapy (DBT) for binge eating, yet their role in app-based interventions is unclear. This study examined whether (1) a digital DBT app improved these skills compared to a control condition and (2) baseline skill levels predicted post-treatment symptom change. This secondary analysis drew on data from a randomised controlled trial (n = 576) of adults with recurrent binge eating. Participants in the intervention (n = 287) completed a six-week self-guided DBT app, while controls (n = 289) were waitlisted. Mindfulness, emotion regulation, and distress tolerance were assessed at baseline, post-test, and 12-week follow-up. Outcomes were binge eating episodes and the Eating Disorder Examination Questionnaire (EDEQ). Linear mixed models tested treatment effects, while univariate and multivariate models assessed baseline predictors. The app produced small-to-moderate improvements in four emotion regulation facets-lack of emotional clarity (d = -0.33), limited strategies (d = -0.22), difficulty with goal-directed behaviour (d = -0.28), and non-acceptance (d = -0.30)-and in the mindfulness facet of observing (d = 0.28). No group differences emerged for distress tolerance. Baseline non-acceptance predicted EDEQ improvement in univariate analyses, but not objective binge eating or multivariate models. A self-guided DBT app may strengthen components of mindfulness and emotion regulation. These results may point towards possible mechanisms through which DBT treatments work. That core DBT skills at baseline were unrelated to outcomes suggesting that they may bear little prognostic value, however may be suitable for broad implementation.

Early identification of factors that predict readmission could enhance treatment planning and reduce re-hospitalization. This study evaluated the predictive value of the Eating Disorder Examination-Questionnaire (EDE-Q) for inpatient readmission for adolescents with AN. This retrospective longitudinal study included 226 adolescent participants admitted to an inpatient eating disorder unit. Adolescents completed the EDE-Q within the first 14 days of admission; demographic variables, anxiety and mood comorbidities, and readmission status within 1 year of discharge were obtained through chart review. While higher scores on the EDE-Q global score and subscales for Eating, Shape, and Weight Concerns were significantly associated with readmission, when controlling for demographic variables and length of hospital stay in multivariate regressions, both Eating Concerns and Weight Concerns subscales were trending toward significance (p = .11, p = .06, respectively). Multivariate logistic regression adjusting for demographic variables showed that higher scores on the EDE-Q global score, and Eating Concern, Shape Concern, and Weight Concern subscales were associated with increased odds of comorbid mood or anxiety disorders with an OR of 1.27 (1.03, 1.57), p = .02; OR of 1.47 (CI 1.17, 1.83), p = .001; OR 1.27 (CI 1.05, 1.54), p = .02; and OR 1.22 (CI 1.02, 1.47), p = .03, respectively. These findings underscore how self-report measures like the EDE-Q can highlight more complex psychopathology with regard to comorbidities. Future research with larger sample sizes will be necessary to establish the predictive validity of the EDE-Q for readmissions of adolescents with Anorexia Nervosa.

Research into the factors that drive the development, maintenance, and recovery from eating disorders (EDs) has established that social processes play an integral part in helping or hindering one's recovery from an ED. In a world where social processes have increasingly moved online, this research aimed to better understand themes within ED recovery content on TikTok. A thematic analysis of n = 312 of the most popular TikTok videos about ED recovery was conducted using a snowball sampling method to find common hashtags related to ED recovery and a codebook to compile deductive and inductive codes. Content related to suicide/self-harm or pro-anorexia beliefs was uncommon across the videos, but four themes were generated from the inductive thematic analysis: recovery milestones, the social nature of ED recovery, bodies as evidence of recovery, and the all-powerful ED. The findings from this research contribute to understandings about the shifting online landscape for ED recovery, where platforms like TikTok are increasingly becoming a source of support and community. The findings of this research will assist individuals in ED recovery and those supporting them when deciding whether engaging with recovery content on TikTok is right for their recovery journey.

The present study aimed to comprehensively evaluate the psychometric properties and clinical utility of the revised Eating Disorder Core Beliefs Questionnaire (ED-CBQ-R) in a clinical sample of individuals seeking treatment for an eating disorder (ED), as well as to examine potential differences in ED core beliefs across distinct diagnostic groups. Treatment-seeking adults (N =150) were recruited from specialist ED private practices throughout Australia and New Zealand, as a part of the Clinical Quality Registry for Eating Disorder Treatment (the "TrEAT Registry", Australian Register of Clinical Registries: #ACSQHC-ARCR-279). Further, undergraduate data (N = 294) was collected at T1 and T2 (after a four-week interval) to examine test-retest reliability of the ED-CBQ-R. In the treatment-seeking sample, the total ED-CBQ-R, Self-loathing, Unassertive, Demanding and Abandoned subscales displayed good internal consistency, discriminative ability, and the four-factor structure showed acceptable to good fit. Treatment-seeking participants displayed significantly higher scores on all ED-CBQ-R subscales than those in the undergraduate sample. There were no significant differences on the ED-CBQ-R between diagnostic groups, except for the AN-R group displaying higher self-loathing than those with BED. Finally, the ED-CBQ-R demonstrated good test-retest reliability in the undergraduate sample. The outcomes of the present study support the validity, reliability, and clinical utility of the ED-CBQ-R in those seeking treatment for an ED and supports researchers and clinicians in utilising the ED-CBQ-R to identify and monitor critical cognitive targets for treatment and guide clinical decision making.

This acceptability and feasibility study utilized a mixed methods approach to examine patient and clinician perspectives on telehealth across multiple eating disorder presentations and evidence-based treatment modalities. Youth ages 6-19 received psychotherapy for eating disorders in an outpatient specialty clinic. The Telehealth Expectations Questionnaire (TEQ) assessed baseline expectations of telehealth. Satisfaction with telehealth was assessed monthly through the Telehealth Satisfaction Questionnaire (TSQ). Experiences with telehealth were measured at end of treatment through the Telehealth Usability Questionnaire (TUQ) and Implementation of Telehealth Treatment Questionnaire. The Eating Disorder Examination Questionnaire (EDE-Q) measured clinical improvement. Use of telehealth services was associated with clinically significant reductions in eating disorder symptoms. Qualitatively, patients and families reported advantages of telehealth, specifically saving time and ease of use, and identified disadvantages, including technological difficulties and feeling disconnected from therapists. Clinicians reported benefits of telehealth, such as insight into the home environment, and challenges, such as managing distractions and reading body language. Clinicians identified specific adaptations for telehealth when conducting one-on-one time with patients and taking weights. The perspectives of youth, families, and clinicians highlight important clinical considerations in the utilization of telehealth to promote accessible and effective care for eating disorders.