International Journal of Eating Disorders最新文献

Objective: Despite growing interest in leveraging motivational techniques to address restrictive eating, it is not yet clear how to most effectively promote motivation to reduce this behavior. Drawing from a behavioral economic framework, the present study evaluates a novel approach for increasing motivation to address disordered eating by amplifying the potential benefits of reducing dietary restriction and the consequences of maintaining disordered behaviors.

Method: A sample of 126 undergraduate students engaging in restrictive eating participated in a 7-day online experiment. Participants were randomized to one of four conditions: Amplified Benefits and Consequences, Amplified Benefits, Amplified Consequences, or a control condition. Growth curve models were estimated to examine the extent to which experimental conditions led to changes in eating pathology and motivation over the study period.

Results: Initial reductions in dietary restraint were observed in conditions where the benefits of reducing restriction were amplified; however, these reductions were not sustained over the 7-day study period. The greatest increases in motivation were observed when both the benefits of reducing restriction and the consequences of maintenance were amplified.

Discussion: Interventions designed to enhance motivation alone are unlikely to yield sustained reductions in eating disorder symptoms and therefore should be accompanied or followed by targeted interventions which directly address restrictive eating behaviors and maladaptive cognitions about shape and weight.

Objective: Binge-eating disorder is characterized by recurrent episodes of consumption of large amounts of food within a short period of time, without compensatory purging behaviors. This disease is a major public health issue and is associated with numerous comorbidities, encompassing anxiety and depression. The gut microbiota has been proposed to be an important player in the onset or maintenance of eating disorders. Here, we aim to better delineate the potential role of the gut microbiota in binge-eating disorder.

Method: We used a model of intermittent limited access to palatable food where eight-week-old C57Bl/6 female mice had access during 2 h, every 2 days over a 10-day period, to a high-fat/high-sucrose diet. Half of the animals received antibiotics to deplete their gut microbiota. Eating behavior and other behavioral parameters were compared between groups.

Results: We observed an increase in food intake as well as tachyphagia during the intermittent access to high-fat/high-sucrose diet. We demonstrate that gut microbiota depletion further increases food intake during these episodes and promotes binge-eating behavior. No impact on anxiety or depressive-like behavior was observed in animals.

Discussion: These results show that the gut microbiota is involved in the control of food intake during episodes of binge-eating. This strengthens the potential role of the gut bacteria in binge-eating disorder and the interest in therapeutic strategies aiming at modulating the patients' gut microbiota to treat this eating disorder.

Objective: Avoidant/restrictive food intake disorder (ARFID) is a relatively new formal diagnosis for which empirical classification research (defined here as studies using latent class/latent profile analysis-type methods) is still emerging. Such research focused on ARFID is an important gap to fill given questions about (1) the boundaries between ARFID and phenotypically similar presentations (e.g., eating disorders [EDs] such as anorexia nervosa [AN], and pediatric feeding disorder [PFD]), and (2) within-ARFID heterogeneity. These questions have practical implications, including diagnostic reliability and treatment selection.

Method: This forum synthesizes the limited empirical classification literature seeking to quantitatively distinguish ARFID from non-ARFID EDs or from PFD, and/or characterize within-ARFID heterogeneity.

Results: To our knowledge, only five studies in clinical samples have used empirical classification methods to delineate ARFID from non-ARFID EDs and/or characterize within-ARFID heterogeneity; no studies have used such methods to delineate ARFID from PFD. Existing studies are mixed in determining how well ARFID can be distinguished from other EDs (particularly AN), but converge in identifying several potential ARFID subclasses (i.e., sensory sensitivity, low appetite, feared eating-related consequences, and subclass representing a combination of these) with some overlapping features.

Discussion: The existing ARFID empirical classification literature should guide future ARFID classification research priorities (e.g., incorporating mechanistic variables as classification indicators, incorporating longitudinal variables as classification validators) to inform differences between ARFID and other disorders and between ARFID presentations. Dimensional approaches to conceptualizing, studying, and modeling psychopathology (namely, the Hierarchical Taxonomy of Psychopathology [HiTOP] and the Research Domain Criteria [RDoC]) may offer useful insights.

Objective: We aimed to compare use of, and outcomes from, programme-led and focused interventions (guided self-help and 10 session cognitive behavioral therapy for eating disorders [CBT-T]) relative to other psychological therapies (including group and individual CBT for eating disorders [CBT-ED]) in a national sample of emerging adults receiving early intervention for a non-underweight binge/purge eating disorder.

Method: Data were drawn from 54 English eating disorder services using the First Episode Rapid Early Intervention for Eating Disorders (FREED) model. Participants (N = 1097) had a mean age of 18.95 years (SD 2.42) and diagnoses of bulimia nervosa (n = 506; 45%), binge eating disorder (n = 121; 11%), another specified feeding or eating disorder (n = 460; 42%), or an eating disorder, unspecified (n = 10, 1%). Linear mixed models were used to assess for effects of time and treatment on binge eating and purging, eating disorder psychopathology, depression/anxiety, and body mass index.

Results: 11% (n = 117) of patients received guided self-help and 24% (n = 268) received CBT-T. Baseline eating disorder psychopathology and depressive/anxiety symptoms did not differ significantly across the guided self-help, CBT-T, group CBT-ED, and individual CBT-ED conditions. All treatments were associated with significant reductions in symptoms over time. GSH and CBT-T performed comparably to longer CBT-ED.

Discussion: We provide additional evidence for the effectiveness of GSH and CBT-T in the treatment of non-underweight binge/purge eating disorders. Programme-led and focused interventions may be under-utilized and future research should explore when they are offered, and when not, both within and outside of early intervention settings.

Objective: Current treatments for eating disorders have limited effectiveness, leaving over half of patients unremitted. The evaluation of emerging interventions to support recovery is therefore critical. This study evaluated the efficacy and acceptability of an innovative, virtual intervention for eating disorders (Eat Breathe Thrive; EBT-R).

Method: Participants recovering from eating disorders from 27 different countries (N = 277) were randomly allocated to EBT-R or waitlist conditions. Assessments were completed at baseline, postintervention, and three-month follow-up. Primary outcomes were eating disorders and co-occurring psychopathology; secondary outcomes included measures of positive embodiment.

Results: Compared with controls, participants in EBT-R demonstrated significant improvements in eating disorders and associated psychopathology (i.e., depression, anxiety) than controls. Participants also reported increased appreciation for the body, interoception, interoceptive attunement, intuitive eating, emotion regulation, mindful self-care, and integrity.

Discussion: This study evaluated the efficacy of a brief, virtual, embodiment-focused intervention for eating disorders. The findings suggest that EBT-R may be an effective intervention to support recovery from eating disorders and development of positive embodiment.

The study by Grilo and Pittman highlights two related controversies affecting the eating disorders field: (1) Is it ever appropriate to recommend behavioral weight loss (BWL) interventions to patients with binge-eating disorder (BED); and (2) Is dietary restraint beneficial or harmful? This paper explores reasons underlying these controversies and underscores the important nuances within these constructs within the context of Grilo and Pittman's findings. For example, people often subsume BWL as part of the umbrella term "dieting," but extensive research shows clear differences between self-directed "dieting" and BWL intervention on both weight loss efficacy and on eating disorder psychopathology. In addition, it is critical to consider and understand the different types of dietary restraint. Increases in rigid restraint are often considered a negative outcome in the eating disorder field; however, Grilo and Pittman identify increases as beneficial for individuals with BED and obesity participating in a BWL intervention. There is a critical need in the eating disorders field to work together to better understand the nuance underlying these frequently used constructs.

Objective: Transition to parenthood is a vulnerable period for individual health and partnership quality. This study investigated parental health and partnership after childbirth in families with and without maternal eating disorder (ED) history. We report longitudinal data on parental ED psychopathology, depressive symptoms, and adjustment, including dyadic associations.

Method: Data derived from the prospective multi-method cohort study EMKIE. Women with (n = 24) and without (n = 33) ED history and their partners took part from late pregnancy to 10 months postpartum and completed the Eating Disorder Examination Questionnaire, the Patient Health Questionnaire, and the Maternal Adjustment and Maternal Attitudes Questionnaire or the paternal equivalent.

Results: ED psychopathology increased in mothers in both groups. Mothers in the ED group had more severe ED psychopathology, higher depression scores, and lower levels of adjustment to motherhood compared to the control group across all measurement points. No group differences emerged between partners, but ED psychopathology increased in partners of women with ED history over time. A negative correlation between maternal ED severity and paternal adjustment was observed in the ED group.

Discussion: After childbirth, mothers with ED history experienced mental health deterioration and adjustment difficulties and fathers struggled with paternal adjustment if their partner was affected by severe ED symptoms. These results emphasize the need for close monitoring and consistent care of women with ED during this vulnerable period and highlight adjustment needs of partners of severely affected women. Further qualitative approaches are needed to deepen the knowledge of paternal experiences during this period.

Objective: Bulimia nervosa (BN) is a highly prevalent psychiatric disorder that has negative effects on the physical and psychological health of sufferers. Father-specific factors have been understudied in the context of BN. This systematic review aims to understand the psychosocial and psychopathological features of fathers of people with BN and their associations with the offspring's outcomes.

Method: A literature search on APA PsycINFO, ISI Web of Science, PubMed, Google Scholar, ResearchGate, and Open Science Framework yielded 2421 studies. These papers were independently evaluated based on the eligibility criteria. 29 studies were included in this review. The Joanna Briggs Institute Critical Appraisal Tools were used for the assessment of the methodological quality of the eligible studies.

Results: Across studies, no significant differences were found in perceptual body-size distortion, self-ideal discrepancy, eating-/weight-/body-related attitudes, several personality and ED traits, and general psychological functioning between fathers of the BN group and those of the comparison groups. However, significant differences were found in certain psychological aspects (e.g., impulse regulation) and ED-associated features (e.g., body dissatisfaction). Finally, significant relationships were found between the fathers' food attitudes, muscularity ratings, personality traits, and substance abuse and their offspring's risk of developing BN, greater body dissatisfaction, ED symptoms, and poor end-of-treatment outcome.

Discussion: Although the existing literature does not seem to strongly suggest a particular paternal factor pertaining to BN, several father-specific variables may be associated with the offspring's BN symptomatology and related characteristics. Further research is necessary to clearly understand paternal features in the context of BN.

The recent mixed-methods review by Nimbley et al. (2024) raises important and concerning, yet not unexpected, insights into the usefulness of eating disorder (ED) treatment for autistic populations. In their review, Nimbley et al. find that ED treatments may be less effective for autistic groups, proposing a need for a greater understanding of ED in autistic populations, and more autism-informed measures and interventions for EDs. We take the opportunity in this commentary to further expand on the next steps that must be taken to inform future ED interventions for autistic populations. We reflect on similar observations of the impact of co-occurrence on intervention efficacy in autism, draw on contemporary movements in relation to interventions in the context of autism, and align with the conclusions of Nimbley et al., who propose that future ED interventions may need to be tailored to autistic populations. We present participatory and co-creation research approaches as a means to achieve this.

The recent systematic review and meta-analysis by Inal-Kaleli et al. is situated within a growing area of research, investigating the relationship between anorexia nervosa and autistic characteristics. Their synthesis of research within the topic finds support for elevated autistic characteristics and autism in individuals with anorexia nervosa and a small but significant correlation between autistic traits and level of eating disorder symptoms. In this commentary, we discuss the findings of Inal-Kaleli and colleagues and propose further research to generate insights into the nature of this link. We focus on the potential origins of the observed relationship, specific mechanisms, and manifestation of anorexia nervosa in autistic populations, and the influence of sex and gender on the intersection of eating disorders and autism. By addressing these largely unexplored research avenues, future investigations can go beyond the phenotypic correlations and facilitate the development of prevention and intervention suited for individuals experiencing both disordered eating and elevated autistic traits.