Eating Disorders最新文献

Objective: Trauma exposure is associated with disordered eating, with recent evidence suggesting PTSD symptoms may be a more proximal predictor. Intuitive eating is a well-established protective factor against disordered eating; however, no previous studies have assessed whether intuitive eating buffers the association between PTSD symptoms and disordered eating.

Methods: Two hundred sixteen women who had experienced intimate partner violence (IPV) and were residing at a domestic violence shelter completed a survey. The current study assessed the moderating role of intuitive eating in the associations between PTSD symptoms and two types of disordered eating behaviors: binge eating and compensatory behaviors.

Results: Intuitive eating did not moderate the association between PTSD symptoms and a dichotomous measure of binge eating (no binge eating vs. any binge eating). However, intuitive eating did moderate the association between PTSD symptoms and binge frequency, among participants endorsing any degree of binge eating, such that PTSD symptoms were significantly associated with binge frequency at low, but not moderate or high, levels of intuitive eating. Intuitive eating did not moderate the association between PTSD symptoms and compensatory behaviors.

Discussion: Results suggest intuitive eating may be protective against binge eating frequency among women who have experienced IPV.

Those with eating disorders (EDs) characterized by purging behaviors tend to show more impulsivity than those diagnosed with restrictive eating, who tend to show more compulsivity. Impulsive choice (i.e. a type of impulsivity) is a common factor among eating disorders that is less understood. Delay discounting is a measure of choice impulsivity, examining the decrease in value of delayed outcomes. In this exploratory study, we examined associations between eating disorder type, age and delay discounting among patients at a residential ED treatment center (N = 178). Our findings showed that those diagnosed with bulimia nervosa had higher delay discounting (i.e. more impulsivity) at intake compared to anorexia nervosa, binge eating disorder, and other eating types but there were no significant differences. Those diagnosed with bulimia nervosa, as well as those with ARFID and unspecified ED showed a preference for delayed rewards at discharge, but there were no significant differences among ED types. Moderation analyses showed that age, ED type, nor the interaction did not significantly predict delay discounting at intake or discharge. To conclude, those with bulimia nervosa demonstrate less impulsive choice at discharge from a residential ED treatment center. However, additional research is needed given the variability of sample sizes in this study.

This article discusses the important yet under-addressed issue of clinician bodies within eating disorder services. I would like to further the discussion on a particular correspondence in, where a professional who was perceived as dangerously thin was challenged and confronted by their colleagues in a work setting. This article will consider the issue from four perspectives, being the implications for the therapeutic relationship, how we approach biases and assumptions about weight and body size, ethical and legal issues, and how to manage lived experience. I argue for a more nuanced, considered approach towards professionals in the field before decisions are made to manage or confront them.

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.