Eating Disorders最新文献

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.

Leading treatments for binge eating target dietary restraint, but up to 35% of the people with binge eating report low restraint. This study examined the roles of reward sensitivity and emotion dysregulation in relation to low-restraint binge eating. Women with binge eating (low-restraint: n = 22; high-restraint: n = 69) and controls (n = 49) completed self-report measures of generalized reward sensitivity and emotion dysregulation and a picture-viewing task assessing craving and pleasure for high-calorie food. As expected, food-related craving and emotion dysregulation were greater in the clinical than in the control group, but no differences emerged between high- and low-restraint binge eating groups. However, correlational analyses found that, within the clinical group, the number of restraint days related to greater anticipatory sensitivity for generalized rewards and lower pleasure ratings of food. Results suggest that emotion dysregulation characterizes both high- and low-restraint binge eating. As self-reported food liking was linked with lower restraint, greater enjoyment of palatable foods may uniquely contribute to low-restraint binge eating. Increasing emphasis on emotion regulation and food-related reward sensitivity may enhance treatment outcomes for individuals with low-restraint binge eating.

The purpose of the present study was to examine the efficacy of online Dialectical Behavior Therapy for Binge Eating Disorder (DBT-BED) in reducing eating psychopathology and investigate the factors that influence the severity and frequency of binge eating. Seventy-three individuals seeking treatment for BED participated in 20 two-hour group sessions. Participants completed the Emotional Eating Scale (EES), Binge Eating Scale (BES), and Eating Disorder Examination Questionnaire (EDE-Q) before and after the treatment and at three- and six-month follow-ups. Results from 58 participants were analyzed. The study results indicated a significant decrease in objective binge eating (OBE) days, as well as in all EES, BES, and EDE-Q subscales (except the Restraint subscale), and global EDE-Q score at the end of treatment and follow-ups. Moreover, the Body Mass Index (BMI) reduced at the end of treatment and during the follow-up period. Except for the Restraint subscale, more OBE days were linked with higher EES, BES, and EDE-Q scores. Overall, the study suggests that online DBT-BED is an effective approach to treating Binge Eating Disorder (BED) for individuals who cannot receive in-person therapy. Further research is necessary to compare the efficacy of online DBT-BED with other interventions.

Male mental health professionals (e.g. social workers, psychologists) are a minority of providers in eating disorder treatment spaces, and there is a drastic need to increase their representation in this clinical area. This Last Word outlines the barriers that impede male mental health professionals from specializing in eating disorder treatment, such as masculine gender norms, and provides four specific recommendations to enhance training, hiring, retention, and the development of male mental health professionals in the treatment of people with eating disorders. These recommendations include, developing gender awareness, specialized training, talking about gender, and gender and relationships. Building the representation of male mental health professionals in eating disorder treatment may reduce stigma and myths about these disorders and have positive impacts on clients across genders.

Eating disorders (EDs) are associated with numerous comorbidities and deleterious outcomes (e.g. medical complications, high rates of death by suicide). The complexities of EDs are further compounded by treatment dropout, poor treatment outcomes, and relapse. One way to better understand these complexities is to investigate broad, transdiagnostic risk factors that contribute to the etiology and maintenance of EDs, such as emotion regulation (ER) difficulties. We longitudinally tested the relationship between ER difficulties and ED outcomes in a sample of 101 female ED patients in a southeastern U.S. residential ED treatment facility. Consistent with hypothesis, there were significant improvements in both ER difficulties and eating pathology from admission to discharge. Further, improvement in ER difficulties was associated with improvements in eating pathology. These findings further substantiate the role of ER difficulties in eating disorders and provide further evidence for the relationship between ER difficulties and eating pathology among residential eating disorder patients.

The aims of this quality improvement programme were to enable providers of mental health in-patient services for children and young people in England to review their prescribing practice alongside the views and experiences of children, young people and their parent carers. Three online tools were developed. First was a medication census tool to be completed by provider clinicians to capture prescribing practices around psychotropic medication. The two other online tools were questionnaires that provided an opportunity for inpatient children and young people and their parent carers to express their views of the medication. 193 children and young people had a primary diagnosis of eating disorders. Antidepressants were the most widely prescribed (56%), followed by antipsychotics (41%), benzodiazepines, and antihistamines as sedatives (18%) and hypnotics (11%). Of those receiving regular psychotropic medications, 67% were prescribed two or more. Both the children and young people and their parent carers expressed concerns about the high level of psychotropic medication, the number of prn administrations, the number of psychotropic medications prescribed and the extent of side effects. Psychotropic medications are widely prescribed both on a regular and on a prn basis for children and young people with eating disorders in mental health in-patient services.

Peer support is a promising approach to increasing hope, engagement, and connection for those with eating disorders (EDs). Emerging literature explores peer mentors' experiences of providing support, suggesting that mentors often benefit from providing peer support, particularly when well trained and supervised. We conducted semi-structured interviews or focus groups with 15 individuals providing peer support (one-on-one, group, or chat) to individuals with EDs. We identified 3 themes using reflexive thematic analysis (RTA) through a critical realist lens. Participants emphasized the importance of ongoing training and support to help them deliver high-quality peer support. They highlighted the importance of value-alignment in this work in terms of organizational valuing of lived experience and alignment with social justice. Participants reflected on how doing this work contributed to a sense of "giving back" and providing the kind of support they wished they had experienced. Providing peer support was described as emotion work; a challenging and rewarding experience for peer mentors. Findings carry implications for integrating peer support into the continuum of care for EDs, providing insight into approaches that can support peer support delivery in a way that promotes safety for those providing and receiving it.

While diagnostic pathways for identifying Autism in eating disorder (ED) populations have been developed, the field continues to lack validated psychometric tools to measure EDs for use in the Autistic population. Many commonly used measures for EDs potentially lack validity and reliability in the Autistic population limiting theoretical and practical advancements in the field. This paper outlines current conflicts in autism and ED research and how these can be addressed through psychometric methodology. We discuss: (1) the lack of differentiation between ED pathology and Autistic eating behaviours, as well as the limited inclusion of autism-specific mechanisms in existing tools; (2) the subsequent theoretical and practical implications for researchers, clinicians, and Autistic people; and (3) future directions for psychometric research. Scholars are encouraged to employ participatory designs with autistic people before carefully considering which analytical strategies are used in the Autistic population.

Cognitive-behavioral therapy (CBT) is the best examined treatment for eating disorders. However, previous meta-analyses of cognitive-behavioral therapy have not examined absolute outcomes, which are important from a clinical perspective. We updated a meta-analysis and conducted new searches in PubMed, Embase, PsycINFO and CINAHL. We included randomized trials comparing CBT with control conditions in adults with a diagnosed eating disorder. We used random effects models in all analyses. We included 36 trials with 44 comparisons between CBT and controls (2,809 participants), 22 trials on binge eating disorder (BED), 11 on bulimia nervosa (BN), and three on anorexia nervosa and mixed disorders. The overall effect of CBT compared to controls was g = 0.88 (95% CI: 0.71; 1.04), with high heterogeneity (I² = 74; 95% CI: 65; 81; PI: -0.06; 1.81) and no significant difference between BED and BN. Effects were smaller studies with low risk of bias. The absolute abstinence rate was 0.36 (95% CI: 0.31; 0.43) for CBT and 0.10 (95% CI: 0.08; 0.12) in controls. CBT is probably effective in the treatment of bulimia nervosa and binge-eating disorder, but there is also a large group of patients who do not respond sufficiently.