Eating Disorders最新文献

Avoidant/restrictive food intake disorder (ARFID) is distinct from other restrictive eating disorders in that body image disturbance or fear of weight gain do not drive restrictive eating. ARFID occurs across the full weight spectrum and youth with ARFID may still experience body weight/shape concerns, not necessarily pathological like body image disturbance is, but research is currently very limited. The current study examined how body weight/shape concerns vary across the full weight spectrum in youth with ARFID. As an exploratory aim, this study also assessed whether body weight/shape concerns differ by ARFID subtypes, age, and gender. Participants included 272 youth between the ages of 8 and 19 presenting for ARFID care at an urban pediatric hospital. Non-parametric Kruskal-Wallis tests were used to examine relations between weight/shape concerns and weight status (i.e. underweight, normal weight, overweight/obesity), ARFID subtypes, age, and gender. Results showed that youth with ARFID and overweight/obesity weight status endorsed greater weight/shape concerns than those with ARFID and normal and underweight statuses (p = .009). Youth who identified as gender identity other than male or female endorsed greater weight/shape concerns than those identifying as cis-male or cis-female (p = .01). However, there were no differences in weight/shape concerns by age or ARFID subtype. These findings demonstrate body weight/shape concerns among youth with ARFID, especially those with overweight/obesity weight status and who are gender diverse.

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.

Research has found that difficulties in emotion regulation negatively impact mental health, whereas cognitive flexibility may promote stress resilience and positive mental health. Little is known about cognitive flexibility and emotion regulation in people with comorbid eating disorder (ED) and anxiety and stress disorders. A transdiagnostic ED population (N = 227) at an outpatient ED treatment facility completed several self-report instruments that measured cognitive flexibility, emotion regulation difficulties, posttraumatic stress disorder (PTSD) symptoms, and generalized anxiety disorder (GAD) symptoms upon admission. We investigated cognitive flexibility and emotion regulation differences for those with an ED without comorbidity and those with various combinations of comorbidity. In a one-way between-groups ANOVA, we investigated differences in cognitive flexibility for those with GAD, PTSD, neither, and both comorbidities. We found a statistically significant difference between these groups, with mean cognitive flexibility inventory scores being the lowest in the group with both comorbidities. However, when controlling for emotion regulation, a one-way between-groups ANCOVA indicated no significant differences in cognitive flexibility between comorbidity groups F(3, 222) = 1.20, p = .31 Partial η² = .02. Though self-reported cognitive flexibility levels differ among ED patients with and without comorbidities, it appears that these differences are better explained by emotion regulation. Therefore, addressing emotion regulation early in treatment for all individuals with EDs, regardless of comorbidity, is recommended as a future research focus to enhance treatment outcomes. Further research is needed to understand the impact of treating emotion regulation on ED treatment engagement, dropout, and effectiveness.

Trauma is a risk factor for eating disorders (EDs). Enhanced understanding of the pathways from trauma to EDs could identify important treatment targets. Guided by theory, the present study sought to replicate previous findings identifying posttraumatic stress disorder (PTSD) symptoms and shape/weight overvaluation as important pathways between trauma and ED symptoms and extend this work by investigating the role of posttraumatic cognitions in these associations. The sample included 825 female and 565 male post-9/11 veterans who completed cross-sectional survey measures of trauma, posttraumatic cognitions, PTSD symptoms, shape/weight overvaluation, and ED symptoms. Gender-stratified structural equation models were used to examine direct and indirect pathways from trauma exposure to EDs via PTSD symptoms and shape/weight overvaluation (replication) and posttraumatic cognitions (extension). Results suggested that trauma exposure was indirectly associated with ED symptoms via shape/weight overvaluation and posttraumatic cognitions. There was no indirect association between trauma exposure and ED symptoms via PTSD symptoms. Overall, findings from this study highlight the potential role of posttraumatic cognitions in understanding the association between trauma and ED symptoms. However, future longitudinal research is needed to verify the directionality of these associations and investigate cognitions as a potentially targetable risk mechanism in co-occurring trauma and EDs.

Muscularity-oriented disordered eating (MODE) is a novel class of eating behaviors characterised by abnormal dietary alterations aimed towards building lean muscle. Although traditionally shown to affect men, emerging evidence suggests that increasingly more women are striving for the muscular and lean ideal, resulting in engagement of MODE behaviors. Prior research examining MODE in women is limited, yet emerging evidence from cross-sectional studies have established associations between MODE and poor mental health indices in this population. However, the temporal order of these associations in women is not yet known. Thus, the current study examined possible bi-directional associations between MODE behaviors and common mental health outcomes (depression, anxiety, loneliness). Adult women completed online study measures at baseline (Time 1 [T1]; n = 1760) and three-month follow-up (Time 2 [T2]; n = 1180). Cross-lagged panel models were computed to test for possible bi-directional relationships between MODE and the relevant mental health constructs. Findings showed that higher MODE levels at T1 significantly predicted increased depressive and anxiety symptoms (but not loneliness) at T2, and loneliness at T1 (but not depression/anxiety) significantly predicted MODE at T2. Effect sizes were small, so findings should be interpreted with this in mind. This is the first study to establish temporal relationships between MODE and mental health outcomes in adult women. Findings suggest that clinicians may benefit from inquiring about MODE behaviors for proper screening, assessment, and intervention, and potentially addressing loneliness to decrease risk of MODE.

The COVID-19 pandemic has required a shift to telehealth services. However, not all patients are similarly satisfied with this shift, with some studies finding that midlife and older adults are less comfortable with telehealth. The current study examined patient satisfaction with a virtual intensive outpatient program (VIOP) for eating disorders (EDs) among 305 adults (ages 18-25, ages 26-39, and ages 40+), and compared adult satisfaction to satisfaction among children/adolescents (n = 33) receiving VIOP treatment between August 2020 and March 2022 from a large ED treatment facility. It was hypothesized that adults aged 40+ would report lower satisfaction than younger age groups. Patients completed several questions regarding satisfaction with treatment upon discharge, including a question about likelihood of recommending the program, which was used to calculate a Net Promoter Score (NPS). The NPS was 33.3 for children/adolescents, 33.3 for 18-25 year-olds, 57.7 for 26-39 year-olds, and 30.9 for the 40+ year age group. NPS of 31-50 = quality services; 51-70 = excellent customer experiences. Satisfaction was high, with no statistically significant differences between age groups after Bonferroni correction. The current study adds to the limited literature on the treatment experiences of midlife adults with EDs.

This study assessed the rate of a.) the total and b.) specific psychiatric comorbidities among the three severity ratings for Anorexia Nervosa (AN): DSM-5, ICD-11 and overvaluation of weight and shape (OWS). The sample comprised 312 treatment-seeking patients with AN (mean age = 26.9). Weight and height were taken at intake to calculate BMI, the foundation for the DSM-5 and ICD-11 severity indices. The EDE-Q was used to assess OWS, and the Mini International Neuropsychiatric Interview was conducted to assess psychiatric comorbidities. For the DSM-5, the mild severity group showed a higher total number of psychiatric comorbidities, especially for panic, social anxiety, generalised anxiety, and post-traumatic stress disorders compared to the severe and extremely severe groups. ICD-11 and OWS severity groups did not significantly differ in total comorbidities, except for major depressive disorder and obsessive-compulsive disorders being more prevalent in the "significantly low BMI" ICD-11 group. The high OWS group displayed a notably higher rate of major depressive disorder than the low OWS group. The study underscores inconsistent patterns across the three severity systems, emphasising the need to recognise the current limitations of the assessed severity classification systems in AN assessment and guiding treatment.

This study aimed to explore disordered eating behaviors in gender-affirming treatment (GAT)-seeking transgender (TG) adults and cisgender people, in addition to analyzing the association between gender dysphoria intensity, body mass index, and disordered eating behaviors. Data were collected from 132 GAT-seeking TG people with gender dysphoria who had never received GAT (91 TG men, 41 TG women), and 153 cisgender (99 cisgender men, 54 cisgender women) participants from Turkey. The Utrecht Gender Dysphoria Scale was used to evaluate the intensity of gender dysphoria. Eating Disorder Examination Questionnaire and Questionnaire on Eating and Weight Patterns-5 were utilized to assess disordered eating. There was no difference between TG women and TG men in terms of ED psychopathology. The most prominent characteristic in all four groups was shape concern, which was significantly higher in TG men and TG women when compared to cisgender men and cisgender women. Binge eating was notably more frequent in TG men and TG women compared to cisgender men, with 11% of the TG men and 7.3% of the TG women meeting the criteria for possible binge eating disorder. Screening for disordered eating behaviors, particularly binge eating, may be recommended in routine care for TG people.