International Journal of Eating Disorders最新文献

Artificial intelligence (AI) has been increasingly recognized for its potential in mental health management, including detecting, preventing, and treating eating disorders (EDs). Linardon et al. investigated current practices and perspectives on AI in ED treatment from professionals and community participants. While their work provides valuable insights into AI's role in ED management in the treatment phase, the applications of AI at earlier stages, particularly for case detection, and perspectives of key groups involved in this early-stage implementation (e.g., health professionals and individuals with or at risk of EDs) remain underexplored. Given the large volume of multimodal data available on social media platforms, together with their widespread use and accessibility, the integration of AI and social media provides an ideal opportunity for conducting large-scale, population-based detection for EDs. Thus, in this commentary, we discuss AI's potential to leverage social media data for case detection, highlight related ethical considerations (e.g., bias and data privacy), and propose future research directions.

Objective: This bibliometric study analyzed eating disorder research from 1975 to 2024, examining publication trends, research themes, and the relationship between public engagement and academic attention over five decades.

Methods: Data were collected from PubMed, Web of Science, APA PsycInfo, and CINAHL. Publication trends were analyzed, and leading journals were identified. Network analysis using VOSviewer identified thematic clusters, while a bump chart visualized changes in key research terms over time. Trends, associations, and influencing factors of public engagement and academic attention were assessed using Altmetric Attention Scores per Year (AASPY) and citations per year (CPY).

Results: A total of 101,993 publications were analyzed. Research output increased significantly, with the International Journal of Eating Disorders as the leading contributor. Six major research clusters were identified, and eight key terms (humans, female, anorexia nervosa, adult, adolescent, male, feeding and eating disorders, and child) remained dominant across all decades. AASPY and CPY increased over time but showed a weak correlation (R² = 9.09%), suggesting that digital engagement was not strongly associated with scholarly attention. Studies on young adults and those published in multidisciplinary journals had higher online engagement, while research on female and young adult populations, as well as neuroscience, received greater academic attention.

Conclusions: The findings highlight the sustained growth of research output, the persistence of core thematic areas, and the divergence between public engagement and academic attention. By examining trends from past to present, this study provides a basis for understanding research developments and their implications for future directions in eating disorder research.

Objective: This study aimed to examine the psychometric properties, including factor structure, internal consistency, and measurement invariance of the Eating Pathology Symptoms Inventory (EPSI) in a large national sample of transgender and gender-diverse (TGD) adults.

Method: The sample consisted of 2098 TGD adults-including transgender men (n = 599), transgender women (n = 293), and gender-diverse individuals (n = 1206)-who completed online self-report surveys. Using a subset of the sample, exploratory factor analysis (EFA) was conducted to identify underlying factor structures, followed by confirmatory factor analysis (CFA) to confirm the model fit within each population in the remainder of the sample. Multi-group confirmatory factor analysis (MG-CFA) was used to assess measurement invariance across transgender men, transgender women, and gender-diverse individuals.

Results: The EPSI's eight-factor structure was supported across all three TGD groups with strong model fit: transgender men (CFI = 0.985, RMSEA = 0.047, SRMR = 0.078), transgender women (CFI = 0.948, RMSEA = 0.048, SRMR = 0.085), and gender-diverse individuals (CFI = 0.962, RMSEA = 0.040, SRMR = 0.060). Measurement invariance analyses supported that the EPSI was invariant across the groups, facilitating meaningful group comparisons using the inventory. Internal consistency, assessed using McDonald's omega, was acceptable for all subscales (ω = 0.74-0.94).

Discussion: This study provides psychometric support for the EPSI in TGD groups. The results indicate that the EPSI performs reliably and consistently across these groups for assessing eating pathology among gender minority people.

Objective: This study explored the drivers of binge eating in people with food insecurity and recurrent binge eating.

Method: Participants were 28 adults, ages 26-69 (M = 46.22, SD = 11.94; 64.3% female), who endorsed current food insecurity and recurrent binge eating (≥ 12 episodes in the past 3 months). Individual semi-structured interviews were conducted to assess the relationship between food access and binge eating. Data were analyzed using thematic analysis.

Results: Participants reported binge-eating drivers unique to individuals with food insecurity (fluctuating food access) and drivers commonly observed in those who binge eat, such as binge-promoting narratives and drivers related to mental health (e.g., stress) and physical health (e.g., sleep deprivation). The themes "fluctuating food access" and "negative impacts of mental and physical health" also interacted to promote binge eating, such that financial uncertainty promoted stress, which led to binge eating.

Discussion: This qualitative assessment of individuals' lived experience with food insecurity and binge eating suggests the relevance of considering food insecurity-specific factors, mental and physical health, and binge-promoting narratives when addressing binge eating in this subpopulation. Future research should explore whether improving access to nutritious foods and enhancing coping strategies address binge eating in individuals with food insecurity.

Objective: To determine the extent to which anorexia nervosa is associated with premature mortality.

Method: We carried out a matched cohort study of 7332 male and female patients with anorexia nervosa and 73,215 patient controls who were admitted between 1989 and 2023 in hospital centers of Quebec, Canada. We tracked the patients longitudinally over time to identify premature deaths before age 75 years and determined the cause of death. We used stratified Cox regression models adjusted for patient characteristics to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between anorexia nervosa and premature mortality.

Results: Overall, 186 (2.5%) patients with anorexia nervosa and 615 (0.8%) matched controls died before age 75 years. Compared with no anorexia, anorexia nervosa was associated with 3.02 times the risk of premature mortality among females (95% CI 2.50-3.65) and 2.23 times the risk among males (95% CI 1.35-3.70). Patients with a first anorexia nervosa admission between age 20 and 29 years were most at risk of premature mortality (HR 8.00, 95% CI 4.30-14.88), as were patients hospitalized ≥ 3 times for anorexia nervosa (HR 4.72, 95% CI 3.25-6.84). Anorexia nervosa was associated with premature mortality due to metabolic and other endocrine disorders, suicide, and a range of other causes.

Discussion: Anorexia nervosa is associated with an elevated risk of premature mortality from metabolic disorders, suicide, and other causes. Patients who are female, hospitalized as young adults, or have repeated admissions for anorexia nervosa are most at risk.

Objective: Disordered eating and unhealthy weight control behaviors (UWCBs) among United States teens are critical yet understudied public health issues, disproportionately affecting diverse demographic groups. This study examines trends in UWCBs among Arizona youth from 2011 to 2021 and documents differences by demographics and weight perception.

Method: Data from the 2011-2021 Arizona Youth Risk Behavior Survey (YRBS), a biennial survey conducted among students in grades 9-12 (N = 1181 in 2021), were analyzed, with the focus on the 2021 data. This multi-year cross-sectional data include questions about weight perception, desire to control weight, and engagement in UWCBs. Logistic regressions were then conducted to examine their associations.

Results: A notable increase in UWCBs was revealed from 2011 to 2021 (19.4%-29.1%), particularly post-2017. In 2021, 44.3% of girls and 53.1% of LGBQ+ (lesbian, gay, bisexual, questioning, and other identities) teens reported UWCBs. Teens aspiring to lose weight were 9.6 times more likely to engage in UWCBs than their peers who did not desire weight change (OR = 9.6, 95% CI [4.6-20.0]) after adjusting for demographics and body mass index.

Discussion: These findings underscore the urgency of comprehensive interventions to mitigate UWCBs and the need for strategies addressing contributing factors in diverse youth populations.

Objective: Little is known about the timing of behavioral versus cognitive change in 10-session cognitive-behavioral therapy for non-underweight eating disorders (CBT-T). We aimed to: (a) evaluate the magnitude of behavioral and cognitive symptom reduction across treatment; and (b) investigate the relation between early behavioral change and subsequent cognitive change. We hypothesized: (a) large and significant reductions in behavioral and cognitive symptoms from pre- to mid-treatment and from pre- to post-treatment; and (b) that early behavioral change would predict subsequent cognitive change over the course of treatment.

Method: Patients (N = 63) were offered CBT-T and completed the Eating Disorder-15 on a weekly basis. We used intent-to-treat analyses. For Aim 1, we conducted a series of fixed-effect multilevel models for each outcome variable, accounting for repeated measures (pre-, mid-, and post-treatment) within individuals. For Aim 2, we conducted a linear regression using early behavioral change as the predictor and subsequent cognitive change as the outcome.

Results: We observed large and significant reductions in most behavioral and all cognitive symptoms pre- to mid-treatment and pre- to post-treatment. Early changes in behavioral symptoms did not significantly predict subsequent cognitive changes.

Discussion: Behavioral improvements occurred rapidly and were sustained throughout treatment, whereas cognitive changes followed a more gradual trajectory. The absence of a significant predictive relationship between early behavioral change and subsequent cognitive change suggests that these domains may improve independently. Future research should investigate the mechanisms linking behavioral and cognitive changes.

Objective: Abrupt onset restrictive food intake can be a cardinal symptom of pediatric acute-onset neuropsychiatric syndrome (PANS). However, few reports detail eating restriction patterns and baseline eating behaviors in patients with PANS, which we aim to address. Additionally, we aim to compare PANS eating restriction with ARFID.

Methods: Retrospective chart review of 130 patients with PANS, aged 4-18 years, presenting for initial assessment at Stanford's PANS/Immune Behavioral Health (IBH) Clinic. Data were abstracted from electronic medical records (EMR) and parent/child questionnaires which included symptom ratings and psychometric scores. Baseline eating restriction and abrupt onset changes in eating associated with PANS flares were studied.

Results: Over half (56%) of the PANS patients developed abrupt-onset restricted food intake during flare prompting clinic entry. Of youth with restricted intake, 48% had selective eating, 41% had low appetite/interest in food, 37% feared aversive consequences (26% swallowing/choking/vomiting concerns, 16% feared contamination), and 4% overweight concerns. Youth with restricted intake had high levels of emotional lability and/or depression (96%), irritability, aggression, or oppositional behaviors (89%), behavioral/developmental regression (60%), cognitive impairment (69%), and sensory amplification (64%). Baseline eating restriction was noted in 16 (12%), with 9 altering eating behaviors during flare.

Conclusions: Eating restriction is common during PANS flares, reasons align with 3 main presentations of ARFID: Selective eating, low appetite/interest, and fear of aversive consequences. High levels of other neuropsychiatric symptoms are noted in youth with PANS and eating restriction during flares. Twelve percent of PANS patients have baseline eating restriction; over half of whom alter eating behaviors during the flare.