International Journal of Eating Disorders最新文献

Objective: Despite public health advice to limit phone use during mealtimes, research describing the benefits of family meals and the potential vulnerability of individuals with binge eating to use phones as a distraction from mealtime stress, associations of mealtime phone use and binge eating are understudied. The current study examined the role of phones in family meals by (1) describing proportions of children and parents (including those with binge eating) using phones during family meals and (2) examining associations of parent phone use with eating/weight-focused parenting practices.

Method: Parents (N = 210) completed a cross-sectional survey. Parents reported how often they and their children used phones during family meals. Parents also reported motivations for mealtime phone use, parenting practices, and binge eating.

Results: Phone use during family meals was common, particularly among parents, and was largely unrelated to demographic characteristics. Parents reported phone use was most strongly motivated by sharing a positive moment with their child. Binge eating was associated with phone use among both parents and children. Parents with binge eating reported phone use more strongly motivated by emotion regulation and parenting stress than unaffected parents. Parent phone use was associated with stronger parental overvaluation of weight/shape and more frequent negative weight talk.

Discussion: Although there were associations between phone use at family meals and eating/weight-focused parenting, findings also suggested nuance such that not just the use of phones but the motivation for the use of phones at mealtimes is an important area to study.

Objective: This study explored the flexible use of family-based treatment (FBT) and the unified protocol for the transdiagnostic treatment of emotional disorders in adolescents (FBT + UP-A) to address the diverse needs of those with avoidant/restrictive food intake disorder (ARFID).

Method: Adolescents (n = 13, age range 13-18 years) diagnosed with ARFID were sequentially recruited from a publicly funded eating disorder program and were offered 9 months of outpatient treatment. After achieving initial weight gain using FBT, adolescents were given the option to receive the UP-A to work on self-identified treatment goals.

Results: The study enrolled 100% of eligible participants and all completed treatment. All participants received the minimum required dose of FBT and most chose to engage in UP-A (84.62%). Completion of research measures was inconsistent across participants and those choosing FBT-only were lost to research follow-up. Exploratory analysis of treatment response pre-to post-treatment demonstrated moderate to large treatment effect sizes in terms of weight, ARFID symptoms, and depression, but only small effect sizes for anxiety.

Discussion: The current study explored the sequential use of an eating disorder and a transdiagnostic emotional disorder intervention for the treatment of ARFID and co-occurring emotional concerns identified by adolescents. These findings suggest that FBT + UP-A has the potential to treat ARFID and depression but requires further testing in a larger controlled study.

Background: There is a critical gap between the need for eating disorder (ED) treatment and provider availability. Single-Session Interventions (SSIs) are structured programs intentionally designed for a single client encounter and show promise for filling ED-treatment and prevention gaps by enhancing accessibility of evidence-based intervention. Recent studies have started to examine the efficacy of SSIs for various ED concerns, ranging from prevention to symptom reduction. A robust examination of the efficacy of SSIs in addressing ED concerns is thus needed.

Objective: This review assessed whether, and to what degree, ED SSIs are efficacious. Further, this study examined whether the efficacy of SSIs was moderated by SSI function (i.e., treatment versus prevention), SSI implementation format (i.e., self-guided versus provider delivered), SSI administration method (i.e., remote versus in-person), and follow-up duration after SSI completion.

Method: Systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A multi-level random effects meta-analysis using a restricted maximum likelihood estimator was conducted to synthesize effect sizes from 22 primary studies (k = 331 effect sizes). Multi-level meta-regression was conducted to test moderators of ED SSI efficacy. Findings from non-randomized trial design studies were qualitatively synthesized.

Results: Overall Hedge's g effect size for efficacy of ED SSIs from 22 studies was significant with a small effect (g = -0.23, 95% CI = -0.40 to -0.05, p < 0.01). There was no heterogeneity between studies (between-study σ² = 0.00), but there was high heterogeneity in effect sizes within studies (within-study σ² = 2.65). Moderator analyses demonstrated that ED SSIs were significantly efficacious for reducing ED-related symptoms, reducing other mental health concerns, and enhancing quality of life. ED SSI efficacy was significantly different from zero for self-guided SSIs and remotely delivered SSIs. Finally, ED SSIs demonstrated efficacy immediately following intervention completion, and the efficacy did not strengthen or weaken at follow up.

Discussion: Findings supported that SSIs reduced ED concerns, which suggests that SSIs have the potential to reduce the public-health burden of EDs by improving scalability of prevention and treatment.

Objective: Eating disorders are associated with high morbidity and mortality, requiring timely treatment by a competent workforce. Dietitians are important members of the eating disorders health care team. This study aimed to explore the perceived and changing eating disorders education and training needs of practising dietitians in Australia and New Zealand across two time points.

Method: A cross-sectional survey was administered to Australian and New Zealand dietitian members of professional associations in 2009 and 2022. The 2022 survey was administered online via Microsoft Forms and contained 51 items, including Likert scale, tick-box and open-ended responses. Descriptive analysis and logistic regression models were used to identify predictors of perceived knowledge, skill, comfort, confidence and educational need. Qualitative data was analyzed using reflexive thematic analysis.

Results: 286 dietitians completed the 2009 survey and 147 the 2022 survey. In 2022 98% were female and 74% aged 20-40 years. Compared with 2009, dietitians in 2022 undertook more eating disorders education and training, reported greater knowledge and skill, and were more likely to express a need for education and training. Across both surveys, prior training, clinical experience and workplace setting predicted knowledge, skill, comfort or confidence. Prevention, detection, referral and a broad range of treatment aspects were identified as important educational areas.

Discussion: Improvements over time in access to eating disorders training and perceived knowledge and skill were evident. Key educational areas of prevention, detection, referral and treatment require action as a priority to ensure dietitians are well equipped to practice in eating disorders.

Objective: Inpatient treatment aimed at weight restoration and psychiatric stabilization is often required for individuals with anorexia nervosa (AN). This study aimed to identify distinct trajectories of change in body mass index (BMI) and depressive symptoms during inpatient treatment, examine clinical predictors and outcomes, and test reciprocal associations between BMI and depressive symptom changes.

Method: Weekly BMI and depressive symptom data were collected from 156 inpatients with AN (mean treatment duration = 11.6 weeks). Growth mixture modeling identified trajectory classes. Baseline clinical variables were examined as predictors, and discharge outcomes were compared across classes. A joint Bayesian growth model was used to examine longitudinal associations between BMI and depressive symptoms.

Results: Three BMI trajectories were identified: steady increase (58.3%; higher baseline BMI with consistent gains), gradual weight gain (28.9%; low baseline BMI with steady gains), and rapid response (12.8%; low baseline BMI with early rapid gain followed by slowing or decline). Two depressive symptom trajectories emerged: severe-stable and moderate-improving. The severe-stable group was predicted by higher trauma-related comorbidity (OR 11.11, p = 0.009) and eating psychopathology (OR 3.23, p < 0.001). Depressive symptom class was associated with initial BMI but not BMI change, while BMI classes predicted the curvature of depressive symptom trajectories. No credible week-to-week associations emerged between BMI and depressive symptom changes.

Discussion: Findings highlight substantial heterogeneity in treatment response. Rapid early weight gain in patients with extremely low BMI and high severity may not indicate sustained improvement. Persistent depressive symptoms, especially in those with trauma histories, underscore the need for trauma-informed care alongside weight restoration.

Objective: Binge-eating disorder (BED) is a serious psychological condition, often associated with trauma, as well as many critical physical and psychological consequences. Despite the availability of several evidence-based treatments, full remission rates and long-term recovery rates remain suboptimal. Eye movement desensitization and reprocessing (EMDR) therapy has demonstrated early promise in the treatment of eating disorders (EDs) but has yet to be examined in those with BED. To our knowledge, the current study was the first pilot randomized controlled trial to examine the feasibility and preliminary efficacy of EMDR therapy in the treatment of core BED symptomatology.

Method: The clinical trial protocol was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR Registration Number: ACTRN12614000894695, 05/08/2014). A two-arm (EMDR vs. waitlist control), single-blind, pilot RCT was utilized to examine the feasibility and preliminary efficacy of this approach. Eligible participants (N = 38) were fluent English-speaking Australian adults (18+ years) who met the diagnostic criteria for BED. An existing EMDR treatment protocol for bulimia nervosa (BN) was adapted for BED (10 sessions). Outcomes were examined before and immediately after treatment completion.

Results: A treatment completion rate of 68.8% supported the feasibility of the treatment protocol. Intention-to-treat (ITT) analyses demonstrated largely positive effects in favor of the intervention, including significantly larger reductions in binge eating (symptoms, days, and frequency), meta-cognitive beliefs about eating, eating and shape concerns, anxiety, and sleep disturbance. However, there was no significant benefit of the intervention over control for dietary restraint, weight concerns, self-esteem, or sexual problems. There were mixed findings for depressive symptoms and dissociative symptoms between the ITT sample and treatment-completers.

Discussion: This pilot RCT supports the feasibility of applying this protocol to a larger-scale, well-powered effectiveness trial. It also addresses a critical gap in the literature by being one of the first to examine the potential efficacy of EMDR therapy for adults with BED, and thus contributes foundational preliminary data in support of an additional model of care for those with BED.

Objective: Research on the incidence trends of eating disorders remains limited in Asia. This study aims to analyze the annual incidence rates and incident case characteristics in the Korean general population.

Method: The National Health Insurance Service database was used to examine the incidence rates of eating disorders from 2012 to 2021. A total of 34,615 patients with incident eating disorders aged 0-49 years were analyzed. Comorbidity and medication analyses used a 2013-2020 subset. Linear regression analyses and Mann-Kendall trend tests were conducted to examine temporal trends across age and sex. Chi-square and Wilcoxon rank-sum tests were applied for epidemiological and clinical characteristics of the 0-19 and ≥ 20 age groups.

Results: Adults' annual incidence rates increased over the study period (τ = 0.689, p = 0.007). The 20-24 age group had the highest incidence (16.75-38.38 per 100,000 person-years). Individuals aged 0-19 years showed a stable incidence rate (τ = 0.244, p = 0.371), although males aged 0-19 years demonstrated a decreasing trend (B = -0.272, SE = 0.091, p = 0.018, 95% CI = [-0.483, -0.061]). Mood and anxiety disorders were the most frequent comorbidities. The 0-19 age group more frequently utilized tertiary healthcare institutions. Antidepressants were prescribed more frequently than antipsychotics. Fluoxetine and aripiprazole were the most common antidepressant and antipsychotic, respectively.

Discussion: The findings show distinct age- and sex-specific patterns in eating disorder incidence, underscoring the need for a tailored approach. Worldwide differences may offer etiological insights. A limitation is the aggregation of eating disorder subtypes.