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European Eating Disorders Review

Impact factor: 1.943 5-Year impact factor: 2.287 Print ISSN: 1072-4133 Online ISSN: 1099-0968 Publisher: Wiley Blackwell (John Wiley & Sons)

Subject: Clinical Psychology

Most recent papers:

  • Family Functioning and Relationship Quality for Adolescents in Family‐based Treatment with Severe Anorexia Nervosa Compared with Non‐clinical Adolescents.
    Andrew Wallis, Jane Miskovic‐Wheatley, Sloane Madden, Paul Rhodes, Ross D. Crosby, Li Cao, Stephen Touyz.
    European Eating Disorders Review. October 16, 2017
    This longitudinal study explored family functioning and relationship quality for adolescents with severe anorexia nervosa (AN). An important outcome given healthy family functioning supports effective adolescent development. Fifty‐four female adolescents and their parents, treated with family‐based treatment after inpatient admission, and 49 non‐clinical age‐matched adolescents and their parents were compared at assessment and 6 months after session 20. At baseline, AN group mothers and fathers reported poorer family function. AN adolescents were notably similar to controls, reporting poorer function in only one domain. There were no changes for adolescents, an improvement for mothers in the AN group, but an increase in perceived impairment for fathers in both groups, with AN fathers more affected. The similarity in adolescent reports and the increase for fathers over time may indicate that normal adolescent family processes occur even in the midst of serious illness. There is a need to provide intervention to ameliorate the impact of treatment on parents. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 16, 2017   doi: 10.1002/erv.2562   open full text
  • Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates.
    Amador García‐Ruiz‐de‐Gordejuela, Zaida Agüera, Roser Granero, Trevor Steward, Asunción Llerda‐Barberá, Elena López‐Segura, Nuria Vilarrasa, Isabel Sanchez, Susana Jiménez‐Murcia, Nuria Virgili, Rafael López‐Urdiales, Mónica Montserrat‐Gil Bernabe, Pilar Garrido, Rosa Monseny, Carmen Monasterio, Neus Salord, Jordi Pujol‐Gebelli, Jose M. Menchón, Fernando Fernández‐Aranda.
    European Eating Disorders Review. October 02, 2017
    This study aimed to explore the empirical trajectories of body mass index (BMI) 1 year following bariatric surgery (BS) and to identify the risk factors for each trajectory. The study included 115 patients with severe obesity who underwent BS. Assessment included metabolic variables, psychopathological and personality measures. Growth mixture modelling identified four separated trajectories for the percentage of total weight loss course shape (namely, T1 ‘good‐fast’, T2 ‘good’, T3 ‘low’ and T4 ‘low‐slow’). After adjusting for BS subtype and metabolic baseline state, T1 and T2 registered less eating and general psychopathology. T1 was characterized by the lowest scores in novelty seeking and self‐transcendence, whereas T4 was defined by the highest scores in novelty seeking and the lowest scores in persistence. Our findings suggest that psychological state prior to BS is predictive of BMI trajectories during the 12 months following BS. These results could be useful in developing more efficient interventions for these patients. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 02, 2017   doi: 10.1002/erv.2558   open full text
  • An Adjunctive Multi‐family Group Intervention with or without Patient Participation during an Inpatient Treatment for Adolescents with an Eating Disorder: A Pilot Study.
    Lies Depestele, Laurence Claes, Eva Dierckx, Roos Colman, Katrien Schoevaerts, Gilbert M.D. Lemmens.
    European Eating Disorders Review. September 29, 2017
    This study reports on a pilot study of a family group intervention with or without patient participation adjunctive to a specialized inpatient treatment for eating disorders (EDs). Participants were 112 female adolescent ED inpatients and one or both of their parents. The parents were invited to participate in an adjunctive multi‐family group with patient (MFT) or in a similar multi‐parent group without patient participation (MPT). Questionnaires assessing ED symptoms, family functioning and caregiving experiences were administered before and after intervention. Post‐intervention results obtained from both patient and parent(s) indicated that improvement in ED symptoms and parental burden occurred after both types of interventions. Family functioning improved differently according to the informant: fathers reported an improvement of general family functioning, patients reported an improvement of problem solving and mothers reported a decrease in problem solving across both formats. This study emphasized the importance of including a multi‐informant approach in family interventions. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 29, 2017   doi: 10.1002/erv.2556   open full text
  • A Pilot, Multicentre Pragmatic Randomised Trial to Explore the Impact of Carer Skills Training on Carer and Patient Behaviours: Testing the Cognitive Interpersonal Model in Adolescent Anorexia Nervosa.
    John Hodsoll, Charlotte Rhind, Nadia Micali, Rebecca Hibbs, Elizabeth Goddard, Bruno Palazzo Nazar, Ulrike Schmidt, Simon Gowers, Pamela Macdonald, Gillian Todd, Sabine Landau, Janet Treasure.
    European Eating Disorders Review. September 25, 2017
    Aim The aim of the study is to establish the acceptability, feasibility and approximate size of the effect of adding a carer intervention [Experienced Caregivers Helping Others (ECHO)] to treatment as usual (TAU) for adolescents with anorexia nervosa. Methods The study is a pilot randomised trial comparing TAU (n = 50) alone or TAU plus ECHO with (n = 50) or without (n = 49) telephone guidance. Effect sizes (ESs) were regression coefficients standardised by baseline standard deviations of measure. Results Although engagement with ECHO was poor (only 36% of carers in the ECHO group read over 50% of the book), there were markers of intervention fidelity, in that caregivers in the ECHO group showed a moderate increase in carer skills (ES = 0.4) at 12 months and a reduction in accommodating and enabling behaviour at 6 months (ES = 0.17). In terms of efficacy, in the ECHO group, carers spent less time care giving (ES = 0.40, p = 0.04) at 1 year, and patients had a minor advantage in body mass index (ES = 0.17), fewer admissions, decreased peer problems (ES = −0.36) and more pro‐social behaviours (ES = 0.53). The addition of telephone guidance to ECHO produced little additional benefit. Conclusions The provision of self‐management materials for carers to standard treatment for adolescent anorexia nervosa shows benefits for both carers and patients. This could be integrated as a form of early intervention in primary care. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 25, 2017   doi: 10.1002/erv.2540   open full text
  • Sensitivity for Cues Predicting Reward and Punishment in Young Women with Eating Disorders.
    Annelies Matton, Peter Jong, Lien Goossens, Nienke Jonker, Eva Van Malderen, Myriam Vervaet, Nele De Schryver, Caroline Braet.
    European Eating Disorders Review. September 24, 2017
    Increasing evidence shows that sensitivity to reward (SR) and punishment (SP) may be involved in eating disorders (EDs). Most studies used self‐reported positive/negative effect in rewarding/punishing situations, whereas the implied proneness to detect signals of reward/punishment is largely ignored. This pilot study used a spatial orientation task to examine transdiagnostic and interdiagnostic differences in SR/SP. Participants (14–29 years) were patients with anorexia nervosa of restricting type (AN‐R, n = 20), binge/purge ED group [AN of binge/purge type and bulimia nervosa (n = 16)] and non‐symptomatic individuals (n = 23). Results revealed stronger difficulties to redirect attention away from signals of rewards in AN‐R compared with binge/purge EDs, and binge/purge EDs showed stronger difficulties to direct attention away from signals of punishment compared with AN‐R. Findings demonstrate interdiagnostic differences and show that the spatial orientation task is sensitive for individual differences in SP/SR within the context of EDs, thereby sustaining its usefulness as behavioural measure of reinforcement sensitivity. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 24, 2017   doi: 10.1002/erv.2541   open full text
  • Transition Care in Anorexia Nervosa Through Guidance Online from Peer and Carer Expertise (TRIANGLE): Study Protocol for a Randomised Controlled Trial.
    Valentina Cardi, Suman Ambwani, Emily Robinson, Gaia Albano, Pamela MacDonald, Viviana Aya, Katie Rowlands, Gill Todd, Ulrike Schmidt, Sabine Landau, Jon Arcelus, Jennifer Beecham, Janet Treasure.
    European Eating Disorders Review. September 24, 2017
    TRIANGLE is a multicentre trial investigating whether the addition of a novel intervention for patients and carers (ECHOMANTRA) to treatment as usual (TAU) improves outcomes for people with anorexia nervosa (AN). ECHOMANTRA is based on the cognitive interpersonal model of AN and includes assessments, workbooks, videos, online groups and joint Skype sessions for patients and carers. People receiving intensive hospital treatment (N = 380) will be randomised to TAU or TAU plus ECHOMANTRA. Participants will be assessed over an 18‐month period following randomisation. The primary outcome is patient psychological well‐being at 12 months postrandomisation. Secondary outcomes include (i) patient's weight, eating disorder symptoms, motivation to change, quality of life and number of days in hospital at 12 months postrandomisation and (ii) carer's psychological well‐being, burden and skills at 12 months (some outcomes will be assessed at 18 months postrandomisation). The results from this trial will establish the effectiveness of ECHOMANTRA. Trial registration: ISRCTN registry ISRCTN14644379, 08/12/2016. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 24, 2017   doi: 10.1002/erv.2542   open full text
  • Psychophysiological Changes during Pure vs Guided Mirror Exposure Therapies in Women with High Body Dissatisfaction: What Are They Learning about Their Bodies?
    Sandra Díaz‐Ferrer, Sonia Rodríguez‐Ruiz, Blanca Ortega‐Roldán, José Luis Mata‐Martín, M. Carmen Fernández‐Santaella.
    European Eating Disorders Review. September 24, 2017
    This study aimed to examine the psychophysiological changes resulting from two mirror exposure treatments that are effective at reducing body dissatisfaction. Thirty‐five university women with body dissatisfaction and subclinical eating disorders were randomly assigned to one of two groups: pure (n = 17) or guided exposure (n = 18). The participants received six sessions of treatment. Their thoughts, feelings and avoidance behaviours were assessed after each session. Their subjective discomfort, heart rate and skin conductance were assessed within the sessions. Both groups showed improvement in cognitive‐affective and avoidance behaviour symptoms. Nevertheless, the pure exposure group showed faster habituation of subjective discomfort and a greater physiological response than the guided exposure group. These findings suggest that both procedures are effective interventions for improving body image disturbances, although psychophysiological changes observed within session suggest that each technique would act through different processes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 24, 2017   doi: 10.1002/erv.2546   open full text
  • Improving Inhibitory Control Abilities (ImpulsE)—A Promising Approach to Treat Impulsive Eating?
    Hanna Preuss, Marlies Pinnow, Katja Schnicker, Tanja Legenbauer.
    European Eating Disorders Review. September 13, 2017
    Although there is preliminary evidence that inhibitory control training improves impulsive eating, less is known about the effects on eating behaviour and weight loss in clinical samples. Sixty‐nine treatment‐seeking adults with obesity (binge‐eating disorder 33.3%; other specific feeding and eating disorders 40.6%) were randomly blockwise allocated to ImpulsE, an intervention to improve inhibitory control and emotion regulation abilities or a guideline‐appropriate cognitive behavioural therapy (CBT)‐based treatment as usual. Self‐reported and performance‐based impulsivity, eating disorder pathology and BMI were compared at baseline (T1), post‐treatment (T2) and 1‐ or 3‐month follow‐up. ImpulsE led to better food‐specific inhibition performance (p = .004), but groups did not differ regarding improvements in global Eating Disorder Examination Questionnaire (EDE‐Q) score at T2. At 3‐month follow‐up, binge eaters benefited most from ImpulsE (p = .028) and completers of ImpulsE demonstrated a significantly greater weight reduction (p = .030). The current findings propose ImpulsE as a promising approach to treat obesity, illustrating acceptability and additional benefits for course of weight. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 13, 2017   doi: 10.1002/erv.2544   open full text
  • A Randomised Controlled Comparison of Second‐Level Treatment Approaches for Treatment‐Resistant Adults with Bulimia Nervosa and Binge Eating Disorder: Assessing the Benefits of Virtual Reality Cue Exposure Therapy.
    Marta Ferrer‐García, José Gutiérrez‐Maldonado, Joana Pla‐Sanjuanelo, Ferran Vilalta‐Abella, Giuseppe Riva, Massimo Clerici, Joan Ribas‐Sabaté, Alexis Andreu‐Gracia, Fernando Fernandez‐Aranda, Laura Forcano, Nadine Riesco, Isabel Sánchez, Neli Escandón‐Nagel, Osane Gomez‐Tricio, Virginia Tena, Antonios Dakanalis.
    European Eating Disorders Review. August 14, 2017
    A question that arises from the literature on therapy is whether second‐level treatment is effective for patients with recurrent binge eating who fail first‐level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive‐behavioural treatment (CBT) programme benefit from additional CBT (A‐CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e.g. urge to binge in response to a cue and anxiety experienced in the presence of binge‐related cues). We assessed the effectiveness of virtual reality‐CET as a second‐level treatment strategy for 64 patients with bulimia nervosa and binge eating disorder who had been treated with limited results after using a structured CBT programme, in comparison with A‐CBT. The significant differences observed between the two groups at post‐treatment in dimensional (behavioural and attitudinal features, anxiety, food craving) and categorical (abstinence rates) outcomes highlighted the superiority of virtual reality‐CET over A‐CBT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 14, 2017   doi: 10.1002/erv.2538   open full text
  • Neuropsychological and Cognitive Correlates of Recovery in Anorexia Nervosa.
    Jessica A. Harper, Brooks Brodrick, Erin Van Enkevort, Carrie J. McAdams.
    European Eating Disorders Review. August 11, 2017
    Objective To identify clinical or cognitive measures either predictive of illness trajectory or altered with sustained weight recovery in adult women with anorexia nervosa. Methods Participants were recruited from prior studies of women with anorexia nervosa (AN‐C) and in weight‐recovery following anorexia nervosa (AN‐WR). Participants completed a neuropsychological battery at baseline and clinical assessments at both baseline and follow‐up. Groups based on clinical outcome (continued eating disorder, AN‐CC; newly in recovery, AN‐CR; sustained weight‐recovery, AN‐WR) were compared by using one‐way ANOVAs with Bonferroni‐corrected post hoc comparisons. Results Women with continued eating disorder had poorer neuropsychological function and self‐competence at baseline than AN‐CR. AN‐CR showed changes in depression and externalizing bias, a measure of self‐related attributions. AN‐WR differed from both AN‐CC and AN‐CR at baseline in externalizing bias, but only from AN‐CC at outcome. Discussion Neuropsychological function when recently ill may be a prognostic factor, while externalizing bias may provide a clinical target for recovery. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 11, 2017   doi: 10.1002/erv.2539   open full text
  • Visual Attention to Ambiguous Emotional Faces in Eating Disorders: Role of Alexithymia.
    Esther Fujiwara, Veronica L. Kube, Daniel Rochman, Alexander K. Macrae‐Korobkov, Vanessa Peynenburg,.
    European Eating Disorders Review. August 01, 2017
    Eating disorders (EDs) are often accompanied by social–emotional problems. Recently, alexithymia has been suggested to explain objective emotion processing deficits in EDs. We tested if elevated levels of alexithymia may explain emotional face‐processing problems in a mixed ED group (N = 24, 19 with anorexia and five with bulimia), comparing them with high‐alexithymic (N = 25) and low‐alexithymic healthy controls (N = 25). Participants judged the mixture ratio of clear and ambiguous facial emotion blends while eye movements were recorded. The ED group was less accurate judging ambiguous blends containing anger or disgust and attended less to the faces compared with low‐alexithymic controls. Reduced attention to faces, in particular the eye region, was linked to confusion with ambiguous anger and disgust in the ED group only. Although significant group differences only emerged compared with low‐alexithymic controls, the visual attention patterns underlying the ED group's problems with subtle anger and disgust expressions were not driven by alexithymia. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 01, 2017   doi: 10.1002/erv.2535   open full text
  • Embodiment Mediates the Relationship between Avoidant Attachment and Eating Disorder Psychopathology.
    Alessio Maria Monteleone, Giovanni Castellini, Valdo Ricca, Umberto Volpe, Francesco De Riso, Massimiliano Nigro, Francesco Zamponi, Milena Mancini, Giovanni Stanghellini, Palmiero Monteleone, Janet Treasure, Mario Maj.
    European Eating Disorders Review. July 31, 2017
    Objective The overvaluation of body shape and weight of persons with eating disorders (EDs) is putatively explained by a disturbance in the way they experience their own body (embodiment). Moreover, attachment disorders seem to promote the use of body as source for self‐definition. Therefore, we assessed the role of embodiment in the connection between attachment styles and ED psychopathology. Method One‐hundred and thirteen ED patients and 117 healthy subjects completed the Identity and Eating Disorders (IDEA) Questionnaire, the Eating Disorder Inventory‐2 (EDI‐2) and the Experiences in Close Relationships Scale. Results Eating disorder patients displayed IDEA, EDI‐2 and Experiences in Close Relationships scores significantly higher than controls. IDEA total and subtotal scores mediated entirely the influence of avoidant attachment on EDI‐2 interoceptive awareness and impulsivity. Discussion These findings demonstrate a relationship between insecure attachment and disorders of identity and embodiment and point to embodiment as a possible mediator between avoidant attachment and specific ED psychopathological traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 31, 2017   doi: 10.1002/erv.2536   open full text
  • Social Rank and Rejection Sensitivity as Mediators of the Relationship between Insecure Attachment and Disordered Eating.
    Tara De Paoli, Matthew Fuller‐Tyszkiewicz, Emma Halliwell, Francis Puccio, Isabel Krug.
    European Eating Disorders Review. July 28, 2017
    Aim The current study assessed a new interpersonal model for eating disorders (EDs), in which interpersonal rejection sensitivity (RS), appearance‐based RS and social rank were hypothesised to mediate the relationship between insecure attachment and disordered eating. Method The sample comprised a clinical ED group (N = 122) and a control group (N = 622). Participants were asked to complete a number of self‐report measures related to the variables of interest. Results Invariance testing indicated that the model was structurally non‐invariant (different across groups). For the ED group, appearance‐based RS and social rank were significant mediators of the relationship between insecure attachment and disordered eating. For the controls, the relationship between insecure attachment and disordered eating was mediated through multiple pathways involving interpersonal RS, appearance‐based RS and social rank. Conclusion These findings may inform existing therapies such as interpersonal psychotherapy for EDs, by emphasising the role of sensitivity to rejection in the development and maintenance of disordered eating. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 28, 2017   doi: 10.1002/erv.2537   open full text
  • Subtypes of Personality and ‘Locus of Control’ in Bariatric Patients and their Effect on Weight Loss, Eating Disorder and Depressive Symptoms, and Quality of Life.
    Carolin Peterhänsel, Katja Linde, Birgit Wagner, Arne Dietrich, Anette Kersting.
    European Eating Disorders Review. July 18, 2017
    The present study subdivided personality types in a bariatric sample and investigated their impact on weight loss and psychopathology 6 and 12 months after surgery. One hundred thirty participants answered questionnaires on personality (NEO‐FFI), ‘locus of control’ (IPC), depression severity (BDI‐II), eating disorder psychopathology (EDE‐Q), and health‐related quality of life (HRQoL; SF‐12). K‐means cluster analyses were used to identify subtypes. Two subtypes emerged: an ‘emotionally dysregulated/undercontrolled’ cluster defined by high neuroticism and external orientation and a ‘resilient/high functioning’ cluster with the reverse pattern. Prior to surgery, the first subtype reported more eating disorder and depressive symptoms and less HRQoL. Differences persisted regarding depression and mental HRQoL until 12 months after surgery, except in the areas weight loss and eating disorders. Personality seems to influence the improvement or maintenance of psychiatric symptoms after bariatric surgery. Future research could elucidate whether adapted treatment programmes could have an influence on the improvement of procedure outcomes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 18, 2017   doi: 10.1002/erv.2534   open full text
  • Relationships Between Self‐Reported and Observed Parenting Behaviour, Adolescent Disordered Eating Attitudes and Behaviours, and the 5‐HTTLPR Polymorphism: Data From the Australian Temperament Project.
    Vanja Rozenblat, Joanne Ryan, Eleanor Wertheim, Ross King, Craig A. Olsson, Primrose Letcher, Isabel Krug.
    European Eating Disorders Review. July 10, 2017
    This study examined whether self‐reported and observationally measured parental behaviours were associated with disordered eating, and investigated possible moderation by a serotonin‐transporter polymorphism (5‐HTTLPR). Study 1 included 650 adolescents from the Australian Temperament Project who completed the Eating Disorder Inventory‐2 Drive for Thinness and Bulimia scales at 15/16 years and were genotyped for 5‐HTTLPR. Parents completed an Australian Temperament Project‐devised measure of parental warmth and harsh punishment. Study 2 included a subgroup of 304 participants who also engaged in a video‐recorded family interaction, with observed parental warmth and hostility coded by the Iowa Family Interaction Rating Scale. Greater self‐reported parental warmth was associated with lower bulimia scores. Conversely, observationally measured parental warmth was associated with lower drive for thinness, but not bulimia. Self‐reported parental harsh punishment was associated with bulimia only, with observed parental hostility associated with neither outcome. 5‐HTTLPR genotype did not moderate the relationship between parent behaviours and adolescent disordered eating. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 10, 2017   doi: 10.1002/erv.2530   open full text
  • Exploring Types of Family Environments in Youth with Eating Disorders.
    Sabrina M. Darrow, Erin C. Accurso, Emily R. Nauman, Andrea B. Goldschmidt, Daniel Le Grange.
    European Eating Disorders Review. July 04, 2017
    While many studies have explored the relationship between different eating disorder diagnoses and the familial social environment, current evidence does not support associations between distinct family interaction patterns (e.g. high enmeshment) and particular diagnoses (e.g. anorexia nervosa). The current study seeks to move beyond the current literature to explore whether empirically derived subtypes of family environment are associated with clinical features within a transdiagnostic sample of youth seeking treatment for eating disorders (n = 123). Latent class modelling of the Family Environment Scale identified three classes (i.e. different Family Environment Scale profiles): (1) Control‐Oriented; (2) System Maintenance‐Oriented; and (3) Conflict‐Oriented. Data are presented to characterize the classes (e.g. age, gender, rates of different eating disorders, severity of eating disorder pathology and rates of comorbid disorders). These preliminary results suggest that family interaction types may help personalize treatment for eating disorders and encourage future research to guide such efforts. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 04, 2017   doi: 10.1002/erv.2531   open full text
  • Development and Validation of a Decision Tool for Early Identification of Adult Patients with Severe and Complex Eating Disorder Psychopathology in Need of Highly Specialized Care.
    Alexandra E. Dingemans, Maartje Goorden, Freek J.B. Lötters, Clazien Bouwmans, Unna N. Danner, Annemarie A. Elburg, Eric F. Furth, Leona Hakkaart‐van Roijen.
    European Eating Disorders Review. June 29, 2017
    Patients with complex and severe eating disorders often receive a number of ineffective or/and insufficient treatments. Direct referral of these patients to highly specialized tertiary treatment facilities in an earlier stage of the disorder is likely to be more (cost)‐effective. The aim of the study was to develop a decision tool that aids clinicians in early identification of these patients. After identification of criteria that were indicative of severity and complexity of eating disorder psychopathology by means of a systematic review of literature and consultation of a focus group, a Delphi method was applied to obtain consensus from experts on the list of relevant criteria. Finally, the decision tool was validated in clinical practice, and cut‐off criteria were established. The tool demonstrated good feasibility and validity to identify patients for highly specialized tertiary care. The final decision tool consisted of five criteria that can easily be implemented in clinical practice. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 29, 2017   doi: 10.1002/erv.2528   open full text
  • Self‐Disgust within Eating Disordered Groups: Associations with Anxiety, Disgust Sensitivity and Sensory Processing.
    Katie Bell, Helen Coulthard, Diane Wildbur.
    European Eating Disorders Review. June 20, 2017
    This study aimed to assess the relationship between self‐disgust and sensory processing within eating psychopathology. Five hundred and ninety‐one women with a self‐reported diagnosis of anorexia nervosa, bulimia nervosa or who had no previous history of an eating disorder completed a battery of online questionnaires measuring disgust, emotion and sensory variables. Those with an eating disorder reported significantly higher rates of self‐disgust than those with no history of disordered eating. In groups of women with self‐reported bulimia, self‐disgust was associated with sensation avoidance and sensation seeking. Within the group with anorexia nervosa, self‐disgust was associated with low registration and sensation seeking. This report is the first to examine the expression of the emotion self‐disgust within eating psychopathology and examine associations of this factor with sensory processing. The emotion self‐disgust needs to be further examined to understand its possible role in the onset and maintenance of disordered eating. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 20, 2017   doi: 10.1002/erv.2529   open full text
  • RCT of a Video‐based Intervention Program for Caregivers of Patients with an Eating Disorder.
    Norbert Quadflieg, Daniela Schädler, Silke Naab, Manfred M. Fichter.
    European Eating Disorders Review. June 02, 2017
    Objective This paper presents the results of a randomized controlled trial measuring the efficacy of a video‐based skills training to decrease burden and psychological distress in caregivers of inpatients treated for an eating disorder in specialized hospital units. Method Two hundred eighty‐five caregivers were randomized to either the video intervention (N = 147) or the control group (N = 138). Caregivers' primary outcomes were assessed via Eating Disorder Symptom Impact Scale, Accommodation and Enabling Scale and General Health Questionnaire‐12 at baseline and three‐months follow‐up. Results Acceptability of the intervention was high. Receiving additional external professional help like psychotherapy or clinical counselling was identified as a moderator contributing to the efficacy of the intervention. Caregivers' burden (Eating Disorder Symptom Impact Scale) and psychological distress (General Health Questionnaire‐12) were reduced by the intervention but not caregivers' accommodating behaviours (Accommodation and Enabling Scale). Conclusion The video training is a promising approach and effective supplement for caregivers of patients with an eating disorder. Additional professional help to caregivers increases the effectiveness of the intervention. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 02, 2017   doi: 10.1002/erv.2521   open full text
  • Examining Maternal Psychopathology, Family Functioning and Coping Skills in Childhood Obesity: A Case–Control Study.
    Miriam Blanco, Ana R. Sepulveda, Tatiana Lacruz, Melissa Parks, Beatriz Real, Yolanda Martin‐Peinador, Francisco J. Román.
    European Eating Disorders Review. June 01, 2017
    The shared family environment is an important risk factor in the development of childhood obesity. This study aims to examine differences in maternal psychopathology, family functioning, expressed emotion and coping skills between families of a child with obesity and those with a normal‐weight child. This case–control study consisted of 50 mothers with a child (age 8–12 years) with obesity (p ≥ 97) and a control group of 50 mothers of a child with normal weight (p < 85), matched for age, sex and socio‐economic status. Compared with families with normal‐weight children, those with children with obesity showed significant differences in levels of trait anxiety, criticism and over‐protectiveness, and maladaptive coping skills. Structural equation modelling revealed that the mothers' psychopathology predicted children's body mass index (BMI) z‐scores through expressed emotion and maladaptive coping scores. There were significant direct and indirect relations among maternal BMI, psychopathology, expressed emotion and coping, which all together explained 26.5% of variance of children's BMI z‐scores. Considering this relation between maternal variables and child weight status, childhood obesity intervention programs may benefit from targeting maternal BMI, psychopathology, expressed emotion and coping skills. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 01, 2017   doi: 10.1002/erv.2527   open full text
  • Longitudinal Bi‐directional Effects of Disordered Eating, Depression and Anxiety.
    Francis Puccio, Matthew Fuller‐Tyszkiewicz, George Youssef, Sarah Mitchell, Michelle Byrne, Nick Allen, Isabel Krug.
    European Eating Disorders Review. June 01, 2017
    Objective The present study aims to explore the potentially longitudinal bi‐directional effects of disordered eating (DE) symptoms with depression and anxiety. Method Participants were 189 (49.5% male) adolescents from Melbourne, Australia. DE, depressive and anxiety symptoms were assessed at approximately 15, 16.5 and 18.5 years of age. Results Analysis of longitudinal bi‐directional effects assessed via cross‐lagged models indicated that DE symptoms of eating and shape/weight concerns were risk factors for anxiety. Results also showed that depression was a risk factor for eating concerns. Conclusion Our findings provide preliminary evidence that preventative measures designed to target concerns about eating and shape/weight might be most efficacious in reducing the transmission of effects between symptoms of DE, depression and anxiety. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 01, 2017   doi: 10.1002/erv.2525   open full text
  • Physical Activity in Bariatric Surgery Patients: Does Temperament Matter?
    Kerstin Gruner‐Labitzke, Laurence Claes, Merle Bartsch, Mareike Schulze, Svenja Langenberg, Hinrich Köhler, Michael Marschollek, Martina Zwaan, Astrid Müller.
    European Eating Disorders Review. May 08, 2017
    Objective Our aim was to investigate if physical activity (PA) in bariatric surgery patients is related to temperament. Methods Preoperative (n = 70) and post‐operative (n = 73) patients were categorized as being physically ‘active’ versus ‘inactive’ on the basis of objective PA monitoring. Assessment included the behavioural inhibition system (BIS)/behavioural activation system (BAS) scales, the effortful control (EC) subscale of the Adult Temperament Questionnaire‐Short Form, a numeric pain rating scale and measures for depressive and eating disorder symptoms. Results ‘Active’ did not differ from ‘inactive’ patients with regard to temperament (BIS, BAS, and EC). Regressions with PA grouping as dependent variable (adjusted for age, gender, body mass index (BMI), depressive or eating disorder symptoms, or pain intensity) indicated an association between lower BMI and more PA in the preoperative and the post‐operative group. In the post‐operative group, in addition to lower BMI, also lower age and higher BIS reactivity contributed to more PA. Furthermore, there was a significant interaction between BMI and BIS suggesting that low BMI was only associated with more PA in post‐operative patients with high BIS. Discussion The results indicate that temperament per se does not contribute to the level of PA in bariatric surgery patients. However, in post‐operative patients, lower BMI was associated with a higher likelihood of being physically active particularly in patients with anxious temperament. These preliminary findings need further investigation within longitudinal studies. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 08, 2017   doi: 10.1002/erv.2520   open full text
  • Short‐Term Treatment Outcomes and Dropout Risk in Men and Women with Eating Disorders.
    Zaida Agüera, Isabel Sánchez, Roser Granero, Nadine Riesco, Trevor Steward, Virginia Martín‐Romera, Susana Jiménez‐Murcia, Xandra Romero, Mariarita Caroleo, Cristina Segura‐García, José Manuel Menchon, Fernando Fernández‐Aranda.
    European Eating Disorders Review. May 04, 2017
    This study compared treatment outcomes between men and women with eating disorders (EDs) and analysed clinical predictors of treatment outcome. Our sample consisted of 131 male and 131 female ED patients who underwent cognitive behavioural therapy treatment. ED severity, personality and psychopathology were assessed using standard instruments. We found that the risk of dropout was higher for men with bulimia nervosa (BN) than for women with BN and that men with BN and other specified feeding and EDs were more likely to obtain full remission in comparison with their female counterparts. Predictive models of treatment outcome indicated that higher scores in novelty seeking were a shared factor associated with higher risk of dropout and not obtaining full remission for both men and women with ED. However, only in men, younger age and lower scores in reward dependence predicted higher dropout. Contrastingly, higher persistence scores were predictors of full remission. This study reinforces the effectiveness of using outpatient cognitive behavioural therapy as treatment as usual for men with ED. Nonetheless, placing greater emphasis on strategies targeting gender‐specific issues could enhance outcomes. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 04, 2017   doi: 10.1002/erv.2519   open full text
  • Classifying Adults with Binge Eating Disorder Based on Severity Levels.
    Antonios Dakanalis, Giuseppe Riva, Silvia Serino, Fabrizia Colmegna, Massimo Clerici.
    European Eating Disorders Review. April 20, 2017
    The clinical utility of the severity criterion for binge eating disorder (BED), introduced in the DSM‐5 as a means of addressing heterogeneity and variability in the severity of this disorder, was evaluated in 189 treatment‐seeking adults with (DSM‐5) BED. Participants classified with mild, moderate, severe and extreme severity of BED, based on their weekly frequency of binge eating episodes, differed significantly from each other in body mass index (BMI), eating disorder features, putative factors involved in the maintenance process of the disorder, comorbid mood, anxiety and personality disorders, psychological distress, social maladjustment and illness‐specific functional impairment (medium‐to‐large effect sizes). They were also statistically distinguishable in metabolic syndrome prevalence, even after adjusting for BMI (large effect size), suggesting the possibility of non‐BMI‐mediated mechanisms. The implications of the findings, providing support for the utility of the binge frequency as a severity criterion for BED, and directions for future research are outlined. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association
    April 20, 2017   doi: 10.1002/erv.2518   open full text
  • Eating‐related Psychopathology and Food Addiction in Adolescent Psychiatric Inpatients.
    Özgür Albayrak, Manuel Föcker, Josephine Kliewer, Simon Esber, Triinu Peters, Martina Zwaan, Johannes Hebebrand.
    European Eating Disorders Review. April 12, 2017
    Objective Our aims were to investigate the relationship between food addiction and mental disorders including eating disorders (ED), eating‐related psychopathology and body mass index‐standard deviation score in a sample of adolescent psychiatric inpatients. Methods Food addiction was assessed with the Yale Food Addiction Scale (YFAS). Eating‐related psychopathology was measured with the Three‐Factor Eating Questionnaire (TFEQ). Psychiatric diagnoses were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The sample consisted of n = 242 adolescent psychiatric inpatients, of which n = 37 (15.3%) met criteria for an ED. Multiple regression analysis was used to examine the association between YFAS symptom count, TFEQ scales and ED controlling for age and gender. Results Food addiction frequency was 16.5%, and the mean YFAS symptom count was 2.39 (SD: 1.60). In patients with food addiction, TFEQ scale scores were significantly higher than patients without food addiction. Frequency of ED was 42.9% in patients with and 9.9% in patients without food addiction. The TFEQ subscales disinhibition and hunger as well as diagnosis of ED were associated with YFAS symptom count. Discussion Food addiction in adolescent psychiatric inpatients occurs with rates higher than those seen in community samples of children, adolescents and adults. Food addiction might be associated with eating styles related to susceptibility to hunger and feelings of loss of control. The implications of high‐YFAS scores in restricting‐type anorexia nervosa warrant further investigations to explore which and how the respective items are interpreted in this ED subgroup. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 12, 2017   doi: 10.1002/erv.2509   open full text
  • Altered Reward Reactivity as a Behavioural Endophenotype in Eating Disorders: A Pilot Investigation in Twins.
    Natalie Kanakam, Isabel Krug, David Collier, Janet Treasure.
    European Eating Disorders Review. April 12, 2017
    Altered reward reactivity is a potential risk endophenotype for eating disorders (EDs). The aim of this study was to examine reward reactivity in female twins with EDs and compare it with a twin control group. A sample of 112 twins [n = 51 met lifetime DSM‐IV ED criteria (anorexia nervosa n = 26; bulimic disorders n = 24), n = 19 unaffected cotwins and n = 42 control twins] was administered measures assessing reward reactivity, including the Game of Dice Task, the Behavioural Inhibition/Activation (BIS/BAS) Scales and the Appetitive Motivation Scale (AMS). Within pair, correlations for monozygotic and dizygotic twins were calculated and generalised estimating equations compared probands with non‐ED cotwins and controls. The BAS and the AMS were reduced in EDs and negatively associated with restrictive symptoms. In addition, monozygotic twins pairs demonstrated significant within pair similarity for the BAS and AMS. Conversely, there was less evidence to support the BIS or risky decision‐making as measured by the Game of Dice Task as an endophenotype in EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 12, 2017   doi: 10.1002/erv.2512   open full text
  • Development of the Modified Yale Food Addiction Scale Version 2.0.
    Erica M. Schulte, Ashley N. Gearhardt.
    European Eating Disorders Review. March 29, 2017
    The Yale Food Addiction Scale (YFAS) operationalizes indicators of addictive‐like eating, originally based on the Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM‐IV‐TR) criteria for substance‐use disorders. The YFAS has multiple adaptations, including a briefer scale (mYFAS). Recently, the YFAS 2.0 was developed to reflect changes to diagnostic criteria in the DSM‐5. The current study developed a briefer version of the YFAS 2.0 (mYFAS 2.0) using the participant sample from the YFAS 2.0 validation paper (n = 536). Then, in an independent sample recruited from Mechanical Turk, 213 participants completed the mYFAS 2.0, YFAS 2.0, and measures of eating‐related constructs in order to evaluate the psychometric properties of the mYFAS 2.0, relative to the YFAS 2.0. The mYFAS 2.0 and YFAS 2.0 performed similarly on indexes of reliability, convergent validity with related constructs (e.g. weight cycling), discriminant validity with distinct measures (e.g. dietary restraint) and incremental validity evidenced by associations with frequency of binge eating beyond a measure of disinhibited eating. The mYFAS 2.0 may be an appropriate choice for studies prioritizing specificity when assessing for addictive‐like eating or when a briefer measurement of food addiction is needed. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 29, 2017   doi: 10.1002/erv.2515   open full text
  • Temporal Discounting and the Tendency to Delay Gratification across the Eating Disorder Spectrum.
    Savani Bartholdy, Samantha Rennalls, Hollie Danby, Claire Jacques, Iain C. Campbell, Ulrike Schmidt, Owen G. O'Daly.
    European Eating Disorders Review. March 27, 2017
    Bulimia nervosa (BN) and binge eating disorder (BED) have been associated with poorer reward‐related inhibitory control, reflected by a reduced tendency to delay gratification. The opposite has been reported in anorexia nervosa (AN), but differences have not been directly compared across eating disorders (EDs). This study investigated self‐reported (Delaying Gratification Inventory) and task‐based (temporal discounting) inhibitory control in 66 women with an ED and 28 healthy controls (HCs). Poorer task‐based inhibitory control was observed in the BN compared with the AN group and poorer self‐reported inhibitory control in the BN and in the BED groups compared with the AN and the HC groups, suggesting that reward‐related inhibitory control varies across EDs. Symptom severity correlated with poorer self‐reported (but not task‐based) inhibitory control across the EDs. These data provide some support for transdiagnostic mechanisms and highlight the importance of addressing perceived loss of control in the treatment of EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 27, 2017   doi: 10.1002/erv.2513   open full text
  • Reproductive and Appetite Hormones and Bulimic Symptoms during Midlife.
    Jessica H. Baker, Claire M. Peterson, Laura M. Thornton, Kimberly A. Brownley, Cynthia M. Bulik, Susan S. Girdler, Marsha D. Marcus, Joyce T. Bromberger.
    European Eating Disorders Review. March 09, 2017
    Eating disorders and related symptoms occur during midlife; however, little is known about their aetiology. It has been hypothesised that perimenopause represents a window of vulnerability for the development or exacerbation of eating disorder symptomatology because, like puberty, perimenopause is a period of reproductive hormone change. We compared symptoms of bulimia nervosa (bulimic symptomatology) assessed via mean scores on a self‐report questionnaire in premenopausal and perimenopausal women. We also examined the association between hormone concentrations (reproductive/appetite) and bulimic symptomatology. No mean differences in bulimic symptomatology were observed between premenopause and perimenopause. However, there was a significant positive association between leptin and binge eating. Although no significant associations between reproductive hormones and bulimic symptomatology were observed, additional research is needed to provide definitive information. It is essential to learn more about the aetiology of eating disorders and related symptomatology across the lifespan in order to develop age‐relevant treatment and prevention programs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 09, 2017   doi: 10.1002/erv.2510   open full text
  • Perception of Peripersonal and Interpersonal Space in Patients with Restrictive‐type Anorexia.
    Jean‐Louis Nandrino, Claire Ducro, Tina Iachini, Yann Coello.
    European Eating Disorders Review. March 05, 2017
    This study examines whether the perception of peripersonal action‐space and interpersonal social‐space is modified in patients with restrictive‐type anorexia in two experimental conditions using videos. First, participants stopped the video of an approaching stimulus when they felt the distance to be comfortable for interacting with it (first‐person perspective). Second, participants stopped the video when an observed individual approaching a stimulus, or being approached by it, was at a comfortable distance (third‐person perspective). In the first‐person perspective, the results showed an estimation of peripersonal space that did not differ from controls when an object was approaching and an increase in interpersonal space compared with controls when a male or female individual was approaching. In the third‐person perspective, both individual‐object and individual–individual distances were larger in anorexic patients. These results indicate a specific deficit in adjusting interpersonal distances in both the first‐person and third‐person perspectives. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 05, 2017   doi: 10.1002/erv.2506   open full text
  • Reward Dependence and Harm Avoidance among Patients with Binge‐Purge Type Eating Disorders.
    Sigal Gat‐Lazer, Ronny Geva, Eitan Gur, Daniel Stein.
    European Eating Disorders Review. February 23, 2017
    Introduction The Cloninger's Psychobiological Model of Temperament and Character includes temperamental dimensions such as reward dependence (RD) and harm avoidance (HA). Studies of RD differentiate between sensitivity to reward (SR) versus to punishment (SP). We investigated the interrelationship between HA and RD in acutely ill patients with binge/purge (B/P) type eating disorders (EDs) and following symptomatic stabilization. Methods Fifty patients with B/P EDs were assessed at admission to inpatient treatment, 36 of whom were reassessed at discharge. Thirty‐six controls were similarly assessed. Participants completed Tridimensional Personality Questionnaire (TPQ), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), and took the Gambling Task. Results Patients with B/P EDs had higher TPQ‐RD and lower TPQ‐HA accompanied by lower SPSRQ‐SR and SPSRQ‐SP. SPSRQ‐SP correlated positively and negatively with TPQ‐HA and TPQ‐RD, respectively. Conclusions Combination of lower TPQ‐HA, lower SPSRQ‐SP, and greater risk‐taking inclination may maintain disordered eating in patients with B/P EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 23, 2017   doi: 10.1002/erv.2505   open full text
  • Affective Responses in Different Stages of Anorexia Nervosa: Results from a Startle‐reflex Paradigm.
    Laurence Erdur, Cora Weber, Frank Zimmermann‐Viehoff, Matthias Rose, Hans‐Christian Deter.
    European Eating Disorders Review. February 20, 2017
    Objective There is an evolving debate about pathological affective responses in patients with anorexia nervosa (AN). We examined startle responses in different stages of AN. Methods We applied a startle reflex paradigm with standardized visual stimuli (International Affective Pictures System; food and body pictures) in 64 female participants (17 acute AN, 16 chronically ill AN, 15 long‐term recovered AN, 16 healthy controls). We measured subjective ratings of valence and anxiety, and electromyographic startle responses. Results Participants with acute and chronic AN displayed the same subjective valence ratings to affective stimuli but showed less startle reactivity to affective pictures (F(6, 116) = 2.75, p = .02) compared with healthy control. Food pictures were rated as more unpleasant and higher anxiety provoking by currently ill AN (F(3, 59) = 3.32, p=.03). Discussion We observed diverging subjective and psychophysiological reactions in different stages of AN. Psychophysiological methods can help to attain a more comprehensive understanding of biological alterations in the long‐term course of AN. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 20, 2017   doi: 10.1002/erv.2502   open full text
  • Follow‐up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study.
    Laura Herbrich, Betteke Noort, Ernst Pfeiffer, Ulrike Lehmkuhl, Sibylle Winter, Viola Kappel.
    European Eating Disorders Review. February 20, 2017
    Objective Cognitive remediation therapy (CRT) is a specialized treatment approach targeting cognitive weaknesses in anorexia nervosa (AN). Regarding follow‐up effects of CRT, there are only few studies available; for adolescents, there are no data. Methods Forty‐eight adolescents with AN were assigned to receive either CRT and treatment as usual (TAU) or TAU alone. Assessments were performed at baseline (n = 48) and compared with assessments at a 6‐month follow‐up (n = 33). Outcome measures were set‐shifting, central coherence, eating disorder and general psychopathology. Results The completion rate was higher in CRT compared with TAU. There were no significant differences in neuropsychological and clinical variables. Changes in body mass index percentile showed a trend towards significance for CRT. Dropout analyses revealed no significant predictors. Conclusions Results provide a first insight into follow‐up‐assessments of CRT in adolescent AN. More randomized controlled studies are needed to clarify the long‐term effects of CRT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 20, 2017   doi: 10.1002/erv.2501   open full text
  • Social Cognition and Emotional Functioning in Patients with Binge Eating Disorder.
    Matteo Aloi, Marianna Rania, Mariarita Caroleo, Pasquale De Fazio, Cristina Segura‐García.
    European Eating Disorders Review. February 17, 2017
    Objective This study aims to evaluate the theory of mind ability in a sample of obese patients with and without binge eating disorder (BED) and to explore the correlations between emotional and clinical assessments. Methods Overall, 20 non‐BED, 16 under‐threshold BED and 22 BED obese patients completed a battery of tests assessing social cognition and eating disorder psychopathology. Results Binge eating disorder, non‐BED and under‐threshold‐BED obese patients showed similar ability to recognise others' emotions, but BED obese patients exhibited a deficit in recognising their own emotions as demonstrated by more impaired levels of alexithymia and interoceptive awareness and were more depressed. High positive correlations were evident between binging, depression, interoceptive awareness and alexithymia. Conclusions Binge eating disorder patients have a comparable ability to understand others' emotions but a more impaired capacity to understand and code their own emotions compared with non‐BED obese patients. This impairment is highly correlated with depression. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 17, 2017   doi: 10.1002/erv.2504   open full text
  • The Prevalence of Past 12‐Month and Lifetime DSM‐IV Eating Disorders by BMI Category in US Men and Women.
    Alexis E. Duncan, Hannah N. Ziobrowski, Ginger Nicol.
    European Eating Disorders Review. January 27, 2017
    Objective This study aims to determine whether the prevalence of lifetime and past 12‐month DSM‐IV eating disorders (ED) diagnoses differed by body mass index category among men and women in a general population sample. Methods Data from the Collaborative Psychiatric Epidemiology Surveys (n = 12 337 adults) were analysed using logistic regression. Analyses were conducted separately by gender. Results Lifetime ED prevalence was 2.22% in men and 4.93% in women. In both genders, the prevalence of any lifetime and past 12‐month ED, binge eating disorder and recurrent binge eating was highest among obese individuals. Among obese men and women, lifetime and past 12‐month ED prevalence was highest among those with class III obesity. Conclusion Eating disorders were most prevalent among high‐weight individuals. This information is important for planning targeted public health ED and obesity prevention and intervention activities, as well as for informing the clinical care of obese individuals. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 27, 2017   doi: 10.1002/erv.2503   open full text
  • Rumination in Patients with Binge‐Eating Disorder and Obesity: Associations with Eating‐Disorder Psychopathology and Weight‐bias Internalization.
    Shirley B. Wang, Janet A. Lydecker, Carlos M. Grilo.
    European Eating Disorders Review. January 12, 2017
    Overvaluation of shape and weight in binge‐eating disorder (BED) is associated with greater eating‐disorder psychopathology and greater weight‐bias internalization, which are—in turn—associated with poorer mental and physical health. Little is known, however, about the significance of other cognitive processes, such as rumination, in BED. This study examined rumination and overvaluation of shape/weight with eating‐disorder psychopathology and weight‐bias internalization among 237 treatment‐seeking patients with BED and comorbid obesity. Hierarchical multiple regressions indicated that rumination was associated with eating‐disorder psychopathology and weight‐bias internalization above and beyond the influence of overvaluation of shape/weight. Findings suggest that, among patients with BED/obesity, rumination is an important cognitive process associated with severity of eating‐disorder psychopathology even after accounting for overvaluation of shape/weight. Patients with greater rumination might be more likely to dwell on weight‐based discrimination experiences and internalize these negative attitudes. Additional controlled examination could determine whether rumination represents another potential target for BED/obesity treatment. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 12, 2017   doi: 10.1002/erv.2499   open full text
  • Meaningful Memory in Acute Anorexia Nervosa Patients—Comparing Recall, Learning, and Recognition of Semantically Related and Semantically Unrelated Word Stimuli.
    Valentin Terhoeven, Ursula Kallen, Katrin Ingenerf, Steffen Aschenbrenner, Matthias Weisbrod, Wolfgang Herzog, Timo Brockmeyer, Hans‐Christoph Friederich, Christoph Nikendei.
    European Eating Disorders Review. December 29, 2016
    Objective It is unclear whether observed memory impairment in anorexia nervosa (AN) depends on the semantic structure (categorized words) of material to be encoded. We aimed to investigate the processing of semantically related information in AN. Method Memory performance was assessed in a recall, learning, and recognition test in 27 adult women with AN (19 restricting, 8 binge‐eating/purging subtype; average disease duration: 9.32 years) and 30 healthy controls using an extended version of the Rey Auditory Verbal Learning Test, applying semantically related and unrelated word stimuli. Results Short‐term memory (immediate recall, learning), regardless of semantics of the words, was significantly worse in AN patients, whereas long‐term memory (delayed recall, recognition) did not differ between AN patients and controls. Discussion Semantics of stimuli do not have a better effect on memory recall in AN compared to CO. Impaired short‐term versus long‐term memory is discussed in relation to dysfunctional working memory in AN. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    December 29, 2016   doi: 10.1002/erv.2496   open full text
  • Expressed Emotions and Depressive Symptoms in Caregivers of Adolescents with First‐Onset Anorexia Nervosa—A Long‐Term Investigation over 2.5 Years.
    Reinhild Schwarte, Nina Timmesfeld, Astrid Dempfle, Melanie Krei, Karin Egberts, Charlotte Jaite, Christian Fleischhaker, Christoph Wewetzer, Beate Herpertz‐Dahlmann, Jochen Seitz, Katharina Bühren.
    European Eating Disorders Review. December 12, 2016
    Objective High levels of expressed emotions (EE) and depressive symptoms (DS) are often found in caregivers of patients with anorexia nervosa (AN). Both parameters are considered to influence AN symptoms of the patient. Methods One hundred seventy adolescent women with AN and their caregivers were assessed at admission, discharge, at 1‐year and 2.5‐year follow up to evaluate AN symptoms of the patient and EE and DS of caregivers. Results The EE and DS were elevated at admission and decreased during treatment, criticism (as part of EE) exhibited again at the 2.5‐year follow up. Caregivers of more severely ill patients reported significantly greater levels of EE and DS. Mothers were more affected than fathers. EE and DS were interrelated. Conclusion Caregivers of adolescent AN patients suffer from elevated levels of EE and DS. Further studies are needed to examine whether therapeutic interventions to reduce caregivers' EE and DS might have a positive influence on treatment outcome. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    December 12, 2016   doi: 10.1002/erv.2490   open full text
  • Threat‐Detection and Attentional Bias to Threat in Women Recovered from Anorexia Nervosa: Neural Alterations in Extrastriate and Medial Prefrontal Cortices.
    Lasse Bang, Øyvind Rø, Tor Endestad.
    European Eating Disorders Review. December 04, 2016
    Objective Behavioral studies have shown that anorexia nervosa (AN) is associated with attentional bias to general threat cues. The neurobiological underpinnings of attentional bias to threat in AN are unknown. This study investigated the neural responses associated with threat‐detection and attentional bias to threat in AN. Methods We measured neural responses to a dot‐probe task, involving pairs of angry and neutral face stimuli, in 22 adult women recovered from AN and 21 comparison women. Results Recovered AN women did not exhibit a behavioral attentional bias to threat. In response to angry faces, recovered women showed significant hypoactivation in the extrastriate cortex. During attentional bias to angry faces, recovered women showed significant hyperactivation in the medial prefrontal cortex. This was because of significant deactivation in comparison women, which was absent in recovered AN women. Conclusions Women recovered from AN are characterized by altered neural responses to threat cues. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    December 04, 2016   doi: 10.1002/erv.2494   open full text
  • Aggression Regulation in Day Treatment of Eating Disorders: Two‐Centre RCT of a Brief Body and Movement‐Oriented Intervention.
    Cees Boerhout, Marte Swart, Marjon Voskamp, Nadine A. C. Troquete, Jooske T. Busschbach, Hans W. Hoek.
    European Eating Disorders Review. November 16, 2016
    Objective The objective is to evaluate a body and movement‐oriented intervention on aggression regulation, specifically aimed towards reducing anger internalization in patients with an eating disorder. Method Patients were randomized to treatment‐as‐usual (TAU) plus the intervention (n = 38) or to TAU only (n = 32). The intervention was delivered by a psychomotor therapist. TAU consisted of multidisciplinary day treatment (3–5 days per week during 3–9 months). Anger coping (Self‐Expression and Control Scale) and eating pathology (Eating Disorder Examination‐Self‐report Questionnaire) were measured at baseline and follow‐up. Differences between pre‐intervention and post‐intervention scores were tested by using repeated measures ANOVA. Results The intervention group showed a significantly larger decrease of anger internalization than the control group (η2 = 0.16, p = 0.001). Both groups showed a significant reduction in eating pathology, but differences between groups were not significant. Discussion A body and movement‐oriented therapy seems a viable add‐on for treating anger internalization in patients with an eating disorder. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    November 16, 2016   doi: 10.1002/erv.2491   open full text
  • Association Between Oxytocin Receptor Genotype, Maternal Care, and Eating Disorder Behaviours in a Community Sample of Women.
    Nadia Micali, Marta Crous‐Bou, Janet Treasure, Elizabeth A. Lawson.
    European Eating Disorders Review. November 14, 2016
    This study aimed to investigate associations between oxytocin receptor gene (OXT‐R) polymorphisms (rs53576 and rs2254298), their interaction with maternal care (GxE), and ED behaviours in a community sample. We studied 3698 women from the Avon Longitudinal Study of Parents and Children (ALSPAC) who participated in a two‐phase prevalence study of lifetime ED and had genotype data. The GG rs53576 genotype was associated with binge eating and purging, and the rs2254298 AG/AA genotype with restrictive eating lifetime. In addition, the rs2254298 AG/AA genotype interacted with poor maternal care to increase the odds of binge eating and purging (odds ratio = 4.40 (95% confidence intervals: 1.11–17.4)). This study replicates previous findings of an association between OXT‐R polymorphisms and ED, and it is the first to show an interaction between OXT‐R genotype and poor maternal care. As such, these findings highlight the important role of oxytocin in understanding the pathophysiology of ED. © 2016 The Authors European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd
    November 14, 2016   doi: 10.1002/erv.2486   open full text
  • Influence of Parental Expressed Emotions on Children's Emotional Eating via Children's Negative Urgency.
    Simone Munsch, Daniela Dremmel, Susanne Kurz, Jiske De Albuquerque, Andrea H. Meyer, Anja Hilbert.
    European Eating Disorders Review. October 27, 2016
    We investigated whether parental expressed emotion (criticism and emotional overinvolvement) is related to children's emotional eating and whether this relationship is mediated by children's negative urgency. One hundred children, aged 8 to 13 years, either healthy or have binge‐eating disorder and/or attention‐deficit/hyperactivity disorder, completed the questionnaires, along with their parents. Parental criticism and, to a lesser extent, parental emotional overinvolvement were both positively related to children's emotional eating, and this relationship was mediated by children's negative urgency. Further exploratory analyses revealed that the mediating role of children's negative urgency in the relationship between parental criticism and children's emotional eating was pronounced in the clinical group of children with binge‐eating disorder and attention‐deficit/hyperactivity disorder but almost absent in the healthy control group. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 27, 2016   doi: 10.1002/erv.2489   open full text
  • Differences in Cortisol Awakening Response between Binge‐Purging and Restrictive Patients with Anorexia Nervosa.
    Alessio Maria Monteleone, Palmiero Monteleone, Francesca Marciello, Francesca Pellegrino, Giovanni Castellini, Mario Maj.
    European Eating Disorders Review. October 27, 2016
    Malnutrition and childhood trauma were shown to affect in opposite way the cortisol awakening response (CAR) of patients with anorexia nervosa (AN). To assess the influence of binge‐purging behaviour on the CAR of AN patients, we measured the CAR of restrictive AN (ANR) or binge‐purging AN (ANBP) patients without history of childhood maltreatment. Seventeen ANBP women, 18 ANR women and 42 healthy women collected saliva samples at awakening and after 15, 30 and 60 min, and filled in the Eating Disorder Inventory‐2 (EDI‐2). ANR and ANBP patients exhibited a CAR significantly higher than healthy women. Moreover, the CAR of ANBP women was even higher than that of ANR women and positively correlated with the bulimia subitem scores of the EDI‐2. Present findings show, for the first time, differences in the CAR between ANBP and ANR subtypes, which may suggest a possible connection between the HPA axis functioning and binge‐purging. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 27, 2016   doi: 10.1002/erv.2485   open full text
  • Identity Processes and Statuses in Patients with and without Eating Disorders.
    Margaux Verschueren, Koen Luyckx, Erin A. Kaufman, Maarten Vansteenkiste, Philip Moons, Ellen Sleuwaegen, Ann Berens, Katrien Schoevaerts, Laurence Claes.
    European Eating Disorders Review. October 27, 2016
    Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age‐matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity‐related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non‐suicidal self‐injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 27, 2016   doi: 10.1002/erv.2487   open full text
  • Interaction Between Orexin‐A and Sleep Quality in Females in Extreme Weight Conditions.
    Sarah Sauchelli, Susana Jiménez‐Murcia, Jose C. Fernández‐García, Lourdes Garrido‐Sánchez, Francisco J. Tinahones, Felipe F. Casanueva, Rosa M. Baños, Cristina Botella, Ana B. Crujeiras, Rafael Torre, Jose M. Fernández‐Real, Gema Frühbeck, Roser Granero, Francisco J. Ortega, Amaia Rodríguez, Stephan Zipfel, Katrin E. Giel, Jose M. Menchón, Fernando Fernández‐Aranda.
    European Eating Disorders Review. October 26, 2016
    The current study examined the relationship between plasma orexin‐A and sleep in obesity. Concentrations of orexin‐A and sleep were evaluated in 26 obese, 40 morbid obese and 32 healthy‐weight participants. The sleep monitor Actiwatch AW7 and the Pittsburgh Sleep Quality Index were used to evaluate sleep. The Symptom Checklist‐90‐Revised was administered to assess symptoms of psychopathology. A higher weight status was associated with elevated orexin‐A levels (p = .050), greater depression, anxiety and somatization symptoms (all: p < .001), and impoverished self‐reported sleep quality (p < .001). A quadratic trend was found in objective sleep time, being longest in the obese group (p = .031). Structural equation modelling showed plasma orexin‐A to be related to poor total sleep quality, which in turn was associated with elevated body mass index. Our data confirm an interaction between elevated plasma orexin‐A concentrations and poor sleep that contributes to fluctuations in body mass index. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 26, 2016   doi: 10.1002/erv.2484   open full text
  • A Lack of Clinical Effect of High‐frequency rTMS to Dorsolateral Prefrontal Cortex on Bulimic Symptoms: A Randomised, Double‐blind Trial.
    Aurelia Gay, Isabelle Jaussent, Torrance Sigaud, Stephane Billard, Jerome Attal, Maude Seneque, Bogdan Galusca, Frederique Van Den Eynde, Catherine Massoubre, Philippe Courtet, Sebastien Guillaume.
    European Eating Disorders Review. September 15, 2016
    Studies suggest that stimulation of the left dorsolateral prefrontal cortex (DLPFC) reduces food craving in bulimic patients, but evidence supporting repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool is lacking. We investigated the safety and therapeutic efficacy of an adjunct high‐frequency rTMS programme targeting the left DLPFC. Forty‐seven women with bulimia nervosa were randomised to a real or sham stimulation group. The real group underwent 10 rTMS sessions, each consisting of 20 trains of 5 seconds with 55‐second intervals between trains, at a frequency of 10 Hz. The main outcome was the number of binge episodes in the 15 days following the end of stimulation. Overall, no significant improvement in bingeing and purging symptoms was noted after the programme. rTMS was well tolerated. This suggests that 10 sessions of high‐frequency rTMS to the left DLPFC provide no greater benefit than placebo. Future studies should consider methodological issues as well as alternative targets. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 15, 2016   doi: 10.1002/erv.2475   open full text
  • Predicting Dropout from Intensive Outpatient Cognitive Behavioural Therapy for Binge Eating Disorder Using Pre‐treatment Characteristics: A Naturalistic Study.
    Maartje S. Vroling, Femke E. Wiersma, Mirjam W. Lammers, Eric O. Noorthoorn.
    European Eating Disorders Review. September 04, 2016
    Background Dropout rates in binge eating disorder (BED) treatment are high (17–30%), and predictors of dropout are unknown. Method Participants were 376 patients following an intensive outpatient cognitive behavioural therapy programme for BED, 82 of whom (21.8%) dropped out of treatment. An exploratory logistic regression was performed using eating disorder variables, general psychopathology, personality and demographics to identify predictors of dropout. Results Binge eating pathology, preoccupations with eating, shape and weight, social adjustment, agreeableness, and social embedding appeared to be significant predictors of dropout. Also, education showed an association to dropout. Discussion This is one of the first studies investigating pre‐treatment predictors for dropout in BED treatment. The total explained variance of the prediction model was low, yet the model correctly classified 80.6% of cases, which is comparable to other dropout studies in eating disorders. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 04, 2016   doi: 10.1002/erv.2474   open full text
  • Food Addiction in Bulimia Nervosa: Clinical Correlates and Association with Response to a Brief Psychoeducational Intervention.
    Ines Hilker, Isabel Sánchez, Trevor Steward, Susana Jiménez‐Murcia, Roser Granero, Ashley N. Gearhardt, Rita Cristina Rodríguez‐Muñoz, Carlos Dieguez, Ana B. Crujeiras, Iris Tolosa‐Sola, Felipe F. Casanueva, José M. Menchón, Fernando Fernández‐Aranda.
    European Eating Disorders Review. September 04, 2016
    Food addiction (FA) has been examined in different populations. Although high FA levels are associated with greater eating disorder severity, few studies have addressed how FA relates to treatment outcome. Goals The study aims (1) to determine whether a brief intervention for bulimia nervosa (BN) reduces FA diagnosis or severity compared with baseline and (2) to determine if FA is predictive of treatment outcome. Method Sixty‐six female BN patients participated in the study. The Yale Food Addiction Scale was administered at two time points: prior to and following a 6‐week intervention. The number of weekly binging/purging episodes, dropout and abstinence from bulimic behaviour were used as primary outcome measures. Results This brief intervention reduced FA severity and FA diagnosis in the 55 patients who completed treatment. FA severity was a short‐term predictor of abstinence from binging/purging episodes after treatment (p = .018). Conclusions Food addiction appears to be prevalent in BN although FA severity can improve following a short‐term intervention. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 04, 2016   doi: 10.1002/erv.2473   open full text
  • What's in a Self‐report? A Comparison of Pregnant Women with Self‐reported and Hospital Diagnosed Eating Disorder.
    Pernille Stemann Larsen, Anne‐Marie Nybo Andersen, Else Marie Olsen, Nadia Micali, Katrine Strandberg‐Larsen.
    European Eating Disorders Review. August 11, 2016
    The aim of this study was to examine how similar pregnant women with self‐reported lifetime eating disorder (ED) were to pregnant women with a hospital diagnosis of ED. A total of 83 731 pregnant women enrolled in the Danish National Birth Cohort reported on ED, and by linkage to the Danish health registers, hospital diagnoses of ED were obtained. Characteristics of women with self‐reported ED, hospital diagnosed ED and without ED were compared using chi‐square tests, t‐test and logistic regression models with robust standard errors. In total, 4.8% women reported ED, and 0.5% had a hospital diagnosis of ED recorded in the health registers. Women with self‐reported ED were comparable with women with hospital diagnosed ED on most reproductive and health characteristics, while they differed from women without ED concerning all characteristics studied. Our findings highlight that women with self‐reported ED have impaired function and adverse health outcomes, consistent with diagnosable ED. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 11, 2016   doi: 10.1002/erv.2464   open full text
  • Cardiac Risk and Disordered Eating: Decreased R Wave Amplitude in Women with Bulimia Nervosa and Women with Subclinical Binge/Purge Symptoms.
    Melinda Green, Jennifer Rogers, Christine Nguyen, Katherine Blasko, Amanda Martin, Dominique Hudson, Kristen Fernandez‐Kong, Zauditu Kaza‐Amlak, Brandon Thimmesch, Tyler Thorne.
    European Eating Disorders Review. August 11, 2016
    The purpose of the present study was threefold. First, we examined whether women with bulimia nervosa (n = 12) and women with subthreshold binge/purge symptoms (n = 20) showed decreased mean R wave amplitude, an indicator of cardiac risk, on electrocardiograph compared to asymptomatic women (n = 20). Second, we examined whether this marker was pervasive across experimental paradigms, including before and after sympathetic challenge tasks. Third, we investigated behavioural predictors of this marker, including binge frequency and purge frequency assessed by subtype (dietary restriction, excessive exercise, self‐induced vomiting, and laxative abuse). Results of a 3 (ED symptom status) × 5 (experimental condition) mixed factorial ANCOVA (covariates: body mass index, age) indicated women with bulimia nervosa and women with subclinical binge/purge symptoms demonstrated significantly reduced mean R wave amplitude compared to asymptomatic women; this effect was pervasive across experimental conditions. Multiple regression analyses showed binge and purge behaviours, most notably laxative abuse as a purge method, predicted decreased R wave amplitude across all experimental conditions. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 11, 2016   doi: 10.1002/erv.2463   open full text
  • Brief Group Intervention Targeting Perfectionism in Adults with Anorexia Nervosa: Empirically Informed Protocol.
    Kate Tchanturia, Eva Larsson, James Adamson.
    European Eating Disorders Review. August 10, 2016
    Objective This study aimed to evaluate the perfectionism group intervention in adults with anorexia nervosa (AN) in an inpatient setting. Method Adults with AN (N = 35) received six weekly sessions of the empirically informed intervention with experiential exercises. Participants' self‐reported perfectionism and satisfaction were collected pre‐group and post‐group intervention. Results Statistically, significant differences were observed for overall perfectionism, concern over mistakes and personal standard dimensions of perfectionism. Participants found the sessions useful and felt confident in using the skills they had learnt. Conclusions The revised perfectionism group with experiential exercises seemed to be a practical and helpful intervention for patients with AN in an inpatient programme. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 10, 2016   doi: 10.1002/erv.2467   open full text
  • Psychosocial Well‐being of Siblings of Adolescents with Anorexia Nervosa.
    Tanja Langenberg, Susan M. Sawyer, Daniel Le Grange, Elizabeth K. Hughes.
    European Eating Disorders Review. August 08, 2016
    Objective Anorexia nervosa (AN) is often first diagnosed in the adolescent years. The treatment with the greatest evidence during this time is family‐based treatment (FBT). In FBT, siblings are expected to attend treatment sessions; however, sibling well‐being during this time has not been well researched. This study aimed to explore sibling well‐being when the ill child was initially diagnosed with AN and after FBT had been completed. Method Eighty‐five parents and 55 siblings of adolescents with AN completed the Strengths and Difficulties Questionnaire at diagnosis. In addition, 88 parents and 46 siblings completed the Strengths and Difficulties Questionnaire after finishing treatment. Results Mothers and fathers reported siblings to have lower levels of conduct problems in comparison with population norms. Mothers also reported lower levels of prosocial behaviours. Siblings reported higher levels of emotional difficulties and hyperactivity in comparison with their peers. There were no differences in reported psychosocial well‐being of siblings between diagnosis and following FBT. Conclusions Siblings of adolescents with AN have poorer psychosocial adjustment than their peers, both before and after FBT. Clinicians and parents are encouraged to be aware of sibling difficulties and seek additional support if required. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 08, 2016   doi: 10.1002/erv.2469   open full text
  • My Sister Myself: A Controlled Study of the Relationship Between Women with a Lifetime Diagnosis of Anorexia Nervosa and Their Sisters.
    Ada H. Zohar, Lilac Lev Ari, Rachel Bachner‐Melman.
    European Eating Disorders Review. August 08, 2016
    This study focused on the quality of the relationship between women with a lifetime anorexia nervosa (AN) diagnosis and their sisters, in the context of family functioning. Participants were 112 sister pairs including a woman with a lifetime diagnosis of AN, and 356 sister pairs with no history of an eating disorder. Participants completed the Sibling Relationship Questionnaire, Family Environment Scale and Eating Attitudes Test‐26. We hypothesised that sister relationships would be less favourably assessed by women with an AN diagnosis than by their sisters, and less favourably assessed overall in the AN sister pairs than in the healthy sib‐pair controls. These hypotheses were confirmed. Also, the AN sisters viewed the family as less cohesive and more conflicted than their non‐affected sisters. For the AN sisters, there was an inverse relationship between level of current pathology and how favourably they viewed the sister relationship. Sister relationships may suffer during AN and improve as the pathology recedes. This would mean that the quality of sister relationships has clinical significance and may serve as an indicator of recovery. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 08, 2016   doi: 10.1002/erv.2465   open full text
  • Does the Interpersonal Model Generalize to Obesity Without Binge Eating?
    Gianluca Lo Coco, Rachel Sutton, Giorgio A. Tasca, Laura Salerno, Veronica Oieni, Angelo Compare.
    European Eating Disorders Review. July 07, 2016
    The interpersonal model has been validated for binge eating disorder (BED), but it is not yet known if the model applies to individuals who are obese but who do not binge eat. The goal of this study was to compare the validity of the interpersonal model in those with BED versus those with obesity, and normal weight samples. Data from a sample of 93 treatment‐seeking women diagnosed with BED, 186 women who were obese without BED, and 100 controls who were normal weight were examined for indirect effects of interpersonal problems on binge eating psychopathology mediated through negative affect. Findings demonstrated the mediating role of negative affect for those with BED and those who were obese without BED. Testing a reverse model suggested that the interpersonal model is specific for BED but that this model may not be specific for those without BED. This is the first study to find support for the interpersonal model in a sample of women with obesity but who do not binge. However, negative affect likely plays a more complex role in determining overeating in those with obesity but who do not binge. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 07, 2016   doi: 10.1002/erv.2459   open full text
  • Early Maladaptive Schemas in Eating Disordered Patients With or Without Non‐Suicidal Self‐Injury.
    Els Pauwels, Eva Dierckx, Katrien Schoevaerts, Laurence Claes.
    European Eating Disorders Review. June 28, 2016
    This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non‐suicidal self‐injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self‐Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self‐control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 28, 2016   doi: 10.1002/erv.2460   open full text
  • Obsessional and Eating Disorder‐related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs.
    Amparo Belloch, María Roncero, Conxa Perpiñá.
    European Eating Disorders Review. June 08, 2016
    Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive‐compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no‐risk group (n = 100). EDITs were more frequent than OITs in the two risk groups. Within‐group comparisons showed that in the OCD‐risk group, the OIT had more negative consequences (interference, emotional distress, dysfunctional appraisals and neutralizing strategies) than the EDIT, whereas in the ED‐risk group, the OIT and the EDIT instigated similar negative consequences. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 08, 2016   doi: 10.1002/erv.2458   open full text
  • Blunted Cortisol Awakening Response and Poor Self‐Perceived Health in Informal Caregivers of People with Eating Disorders.
    Nicolás Ruiz‐Robledillo, Ángel Romero‐Martínez, Luis Moya‐Albiol.
    European Eating Disorders Review. May 18, 2016
    Caring for offspring diagnosed with eating disorders (EDs) entails being under high chronic stress, with negative consequences for health. However, most previous research has only evaluated self‐report measures of health, biological markers being poorly studied. In this regard, the evaluation of the cortisol awakening response (CAR) could add significant information about the biological basis of health disturbances in this population. The main aim of the present study was to compare CAR and self‐reported health between informal caregivers (ICs) of people with EDs and non‐caregivers. Furthermore, we explored the effect of the nature of the diagnosis, comparing ICs of people with anorexia and bulimia nervosa. ICs had a blunted CAR, and more anxiety and insomnia, and social dysfunction, together with poorer perceived general health than non‐caregivers. ICs of people with anorexia nervosa had higher levels of morning cortisol and burden, and more social dysfunction and severe depression than those of people with bulimia nervosa. Our results demonstrate marked health problems in ICs of people with EDs, especially when the care recipient has anorexia nervosa. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 18, 2016   doi: 10.1002/erv.2455   open full text
  • Neurofeedback Against Binge Eating: A Randomized Controlled Trial in a Female Subclinical Threshold Sample.
    Jennifer Schmidt, Alexandra Martin.
    European Eating Disorders Review. April 27, 2016
    Brain‐directed treatment techniques, such as neurofeedback, have recently been proposed as adjuncts in the treatment of eating disorders to improve therapeutic outcomes. In line with this recommendation, a cue exposure EEG‐neurofeedback protocol was developed. The present study aimed at the evaluation of the specific efficacy of neurofeedback to reduce subjective binge eating in a female subthreshold sample. A total of 75 subjects were randomized to EEG‐neurofeedback, mental imagery with a comparable treatment set‐up or a waitlist group. At post‐treatment, only EEG‐neurofeedback led to a reduced frequency of binge eating (p = .015, g = 0.65). The effects remained stable to a 3‐month follow‐up. EEG‐neurofeedback further showed particular beneficial effects on perceived stress and dietary self‐efficacy. Differences in outcomes did not arise from divergent treatment expectations. Because EEG‐neurofeedback showed a specific efficacy, it may be a promising brain‐directed approach that should be tested as a treatment adjunct in clinical groups with binge eating. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 27, 2016   doi: 10.1002/erv.2453   open full text
  • Expressive Suppression of Emotions and Overeating in Individuals with Overweight and Obesity.
    Mirja Gianna Görlach, Sebastian Kohlmann, Meike Shedden‐Mora, Winfried Rief, Stefan Westermann.
    European Eating Disorders Review. April 21, 2016
    Emotions have a considerable impact on eating behaviour; however, research addressing emotion regulation in obesity is rare. The present study is the first to investigate the association between emotional suppression and overeating in individuals with overweight. In total, 314 participants including 190 individuals with obesity filled in a cross‐sectional online survey, which assessed emotional suppression, eating behaviour and psychopathology. A hierarchical linear regression analysis was conducted to identify factors associated with overeating. Individuals with obesity reported more frequent overeating compared with individuals without obesity. The habitual use of emotional suppression was associated with more overeating; however, this link was moderated by increased body mass index (BMI). The results suggest that suppression of emotional expression contributes to overeating and is maladaptive especially in individuals with obesity. Further research should longitudinally investigate the predictive value of emotional suppression on overweight, as the training of emotion regulation could contribute to treating obesity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 21, 2016   doi: 10.1002/erv.2452   open full text
  • Childhood Anorexia Nervosa Compared with Low Weight Food Intake Disorder Without Weight and Shape‐Related Psychopathology: A Retrospective Study of 102 Patients.
    Ulf Wallin, Maria Råstam.
    European Eating Disorders Review. April 13, 2016
    Objective To compare the clinical presentation of children with anorexia nervosa (AN group) with that of children with low‐weight food intake disorder without weight and shape‐related psychopathology (non‐AN group). Method Medical and psychiatric data were obtained from the case records of a consecutive series of 102 children with an eating disorder and a pronounced low weight who were below the age of 13 at the start of treatment. Results Fifty‐eight patients constituted the AN group, and 44 constituted the non‐AN group. The non‐AN group was younger and had a longer duration of symptoms than the AN group. The non‐AN group also had a lower maximum premorbid weight and shorter stature. There were no differences in medical severity, but the AN group had more psychiatric treatment. Discussion The non‐AN group seems to have a medically equally severe disorder as the AN group, but is less often detected and properly treated. Copyright © 2016 The Authors European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd
    April 13, 2016   doi: 10.1002/erv.2447   open full text
  • Internal Structure and Measurement Invariance of the Dutch Eating Behavior Questionnaire (DEBQ) in a (Nearly) Representative Dutch Community Sample.
    Juan Ramón Barrada, Tatjana Strien, Ausiàs Cebolla.
    European Eating Disorders Review. April 13, 2016
    The Dutch Eating Behavior Questionnaire is a widely used instrument for assessment of emotional, external and restrained eating. The aim of the present study is to (i) analyse its internal structure using exploratory structural equation modelling; (ii) to assess its measurement invariance with respect to sex, BMI, age and level of education; and (iii) to evaluate the relations of the factors with these variables. Except that women were slightly over‐represented, the sample (n = 2173) closely followed the sociodemographic characteristics of the overall Dutch population. The three theoretical factors that emerged from the analysis were in close correspondence with the three scales for emotional, external and restrained eating. Only two items (item 3 — ‘desire to eat when nothing to do…’ and item 21 — ‘resist delicious food...’) presented problematic loadings. The questionnaire showed satisfactory measurement invariance, and expected patterns of mean differences and relations were found. All in all, the results highlight the adequate psychometric properties of the Dutch Eating Behavior Questionnaire. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 13, 2016   doi: 10.1002/erv.2448   open full text
  • Are Weight Status and Cognition Associated? An Examination of Cognitive Development in Children and Adolescents with Anorexia Nervosa 1 Year after First Hospitalisation.
    Gry Kjærsdam Telléus, Birgitte Fagerlund, Jens Richardt Jepsen, Mette Bentz, Eva Christiansen, Jan Brink Valentin, Per Hove Thomsen.
    European Eating Disorders Review. April 08, 2016
    Objective The aim of this study was to characterise the association between the cognitive profile and weight restoration in children and adolescents with anorexia nervosa. Methods The study was a longitudinal, matched case–control, multicentre study. An assessment of cognitive functions was conducted by using the Wechsler Intelligence Scale for Children–III/the Wechsler Adult Intelligence Scale–III, the Test of Memory and Learning–second edition, Trail Making Tests A and B, the Rey–Osterrieth Complex Figure Test and the Cambridge Neuropsychological Test Automated Battery. Results One hundred twenty individuals, 60 patients with anorexia nervosa with mean age of 14.65 (SD 1.820) years and 60 healthy controls with mean age of 14.76 (SD 1.704) years, participated. No association was found between weight recovery and cognitive functions. However, a significant increase in motor speed was found in Trail Making Test A (p = 0.004), Reaction Time (RTI) five‐choice movement time (p = 0.002) and RTI simple movement time (p = 0.011), resulting in a normalisation corresponding to that found in healthy controls. Furthermore, a significantly lower score in the perceptual organization index (p = 0.029) was found at follow‐up. Conclusions Weight recovery appears not to be associated with cognition. Copyright © 2016 The Authors European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd
    April 08, 2016   doi: 10.1002/erv.2445   open full text
  • Predictors of Positive Treatment Outcome in People With Anorexia Nervosa Treated in a Specialized Inpatient Unit: The Role of Early Response to Treatment.
    Jackie Wales, Nicola Brewin, Rebecca Cashmore, Emma Haycraft, Jonathan Baggott, Amy Cooper, Jon Arcelus.
    European Eating Disorders Review. April 04, 2016
    Objective To investigate factors which predict positive treatment outcome in inpatients with anorexia nervosa (AN), particularly the role of early treatment response. Method 102 patients entering specialist inpatient treatment were assessed for eating disorder history, psychopathology, and motivation to change. Predictive factors assessed were: early treatment response defined as weight increase of at least 0.5–1 kg/week during the first 6 weeks of treatment (n=87), admission body mass index (BMI), onset age, chronicity, motivation to change, diagnosis, and previous hospitalization for AN. Positive treatment outcome was defined as achieving a BMI of 17.5 kg/m2 within an individual time frame. Results Logistic regression indicated that patients were 18 times more likely to reach positive treatment outcome if they met the National Institute for Health and Care Excellence weight guidelines within the first 6 weeks of hospitalization. Higher admission BMI was also found to predict positive treatment outcome. Discussion Higher entry BMI and early weight gain predict positive treatment outcome in individuals receiving specialist AN inpatient treatment. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 04, 2016   doi: 10.1002/erv.2443   open full text
  • The Objective and Subjective Caregiving Burden and Caregiving Behaviours of Parents of Adolescents with Anorexia Nervosa.
    Charlotte Rhind, Laura Salerno, Rebecca Hibbs, Nadia Micali, Ulrike Schmidt, Simon Gowers, Pamela Macdonald, Elizabeth Goddard, Gillian Todd, Kate Tchanturia, Gianluca Lo Coco, Janet Treasure.
    European Eating Disorders Review. April 01, 2016
    Objective The study aimed to examine caregiving burden and levels of distress, accommodating behaviours, expressed emotion (EE) and carers' skills, in parents of adolescents with anorexia nervosa. Method A semi‐structured interview assessed the objective burden (time spent across caregiving tasks) in parents (n = 196) of adolescents (n = 144) receiving outpatient treatment for anorexia nervosa. Subjective burden (carers' distress), accommodating behaviours, EE and carers' skills were measured by self‐report. Results Mothers, on average, spent 2.5 h/day of care, mainly providing food and emotional support, compared with 1 h/day by fathers. The level of distress and accommodating behaviour was significantly lower in fathers than in mothers. Accommodating behaviours mediated the relationship between objective burden and subjective burden in mothers, whereas EE and carers' skills did not mediate this relationship for either parent. Discussion The objective burden for most mothers is high. In order to reduce subjective burden, it may be helpful to target accommodating behaviours. Trial Registration ISRCTN83003225 ‐ Expert Carers Helping Others (ECHO). Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association
    April 01, 2016   doi: 10.1002/erv.2442   open full text
  • The Influence of Personality Traits on Emotion Expression in Bulimic Spectrum Disorders: A Pilot Study.
    Cristina Giner‐Bartolomé, Trevor Steward, Ines Wolz, Susana Jiménez‐Murcia, Roser Granero, Salomé Tárrega, José Antonio Fernández‐Formoso, Carles Soriano‐Mas, José M. Menchón, Fernando Fernández‐Aranda.
    European Eating Disorders Review. March 29, 2016
    Facial expressions are critical in forming social bonds and in signalling one's emotional state to others. In eating disorder patients, impairments in facial emotion recognition have been associated with eating psychopathology severity. Little research however has been carried out on how bulimic spectrum disorder (BSD) patients spontaneously express emotions. Our aim was to investigate emotion expression in BSD patients and to explore the influence of personality traits. Our study comprised 28 BSD women and 15 healthy controls. Facial expressions were recorded while participants played a serious video game. Expressions of anger and joy were used as outcome measures. Overall, BSD participants displayed less facial expressiveness than controls. Among BSD women, expressions of joy were positively associated with reward dependence, novelty seeking and self‐directedness, whereas expressions of anger were associated with lower self‐directedness. Our findings suggest that specific personality traits are associated with altered emotion facial expression in patients with BSD. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 29, 2016   doi: 10.1002/erv.2446   open full text
  • Family Functioning and Quality of Life among Families in Eating Disorders: A Comparison with Substance‐related Disorders and Healthy Controls.
    Dimitra Anastasiadou, Ana R. Sepulveda, Julio César Sánchez, Melissa Parks, Tamara Álvarez, Montserrat Graell.
    European Eating Disorders Review. February 24, 2016
    The aim of this study was to compare the family functioning of Spanish parents of patients with an eating disorder (ED) with that of carers of patients with substance‐related disorders (SRDs) and families of healthy controls (HC). This cross‐sectional study included 48 mothers and 45 fathers of 48 adolescent patients with an ED, 47 mothers and 37 fathers of 47 patients with an SRD and 66 mothers and 50 fathers of 68 HCs. Families of ED patients reported lower levels of criticism, symptom accommodation and negative caregiving experience than families of SRD patients. However, relatives of both ED and SRD patients reported similar levels of quality of life related to their mental health. Furthermore, families of HCs generally exhibited better scores on all scales assessing their caregiving experiences. Regarding gender differences, there was a tendency in mothers, primarily those from the ED group, to report more adverse experiences as caregivers compared with fathers. Symptoms characteristic to each disorder may be associated with differential patterns of family functioning and may require specifically tailored family interventions. Early family intervention in adolescence is crucial, as relatives' quality of life does not seem to have been badly affected at this point in the course of the illness. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 24, 2016   doi: 10.1002/erv.2440   open full text
  • Evaluation of the Compulsive Exercise Test (CET) in Adolescents with Eating Disorders: Factor Structure and Relation to Eating Disordered Psychopathology.
    Ingemar Swenne.
    European Eating Disorders Review. February 19, 2016
    Objective The aims of this study were to explore the factor structure of the Compulsive Exercise Test (CET) in a clinical sample of Swedish adolescents with eating disorders (ED) and to study the relationship of CET with ED cognitions, body weight and exercise frequency. Methods The compulsive Exercise Test, the Eating Disorders Examination‐Questionnaire, body mass index (BMI) and exercise frequency were available at assessment of 210 adolescents (age 14.4 ± 1.6 years) with ED. Results Factor analysis generated four factors with close similarity to factors previously obtained in a community sample of adolescents samples and supported the use of the original version of CET. Exercise for weight control was strongly related to ED cognitions but less to exercise frequency and BMI. Exercise for regulation of mood was related to ED cognitions and exercise frequency but not to BMI. Discussion In adolescents with ED, different aspects of exercise are related to ED cognitions. This needs addressing in the treatment of adolescents with ED. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 19, 2016   doi: 10.1002/erv.2439   open full text
  • Disordered Eating, Compulsive Exercise, and Sport Participation in a UK Adolescent Sample.
    Huw Goodwin, Emma Haycraft, Caroline Meyer.
    European Eating Disorders Review. February 19, 2016
    The sport literature has produced equivocal results as to whether sport participation is a protective or risk factor for disordered eating. One mechanism by which it could be a risk factor is the increased drive or compulsion to exercise. This study compared the levels of disordered eating and compulsive exercise between adolescent sport and non‐sport participants. A sample of 417 male and female adolescents, aged 14–16 years old, was recruited from UK secondary schools. Participants completed questionnaire packs that included: the Eating Disorder Inventory; a measure of exercise behaviour; and the Compulsive Exercise Test (CET). Non‐sport participants reported significantly greater body dissatisfaction than sport participants, and this was true for boys and girls. Significant group differences were also reported for many of the CET scales, with sport participants generally reporting greater levels of compulsive exercise than non‐sport participants. Implications of these results are discussed. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 19, 2016   doi: 10.1002/erv.2441   open full text
  • Attention Disengagement Difficulties among Average Weight Women Who Binge Eat.
    Zhenyong Lyu, Panpan Zheng, Todd Jackson.
    European Eating Disorders Review. February 09, 2016
    In this study, we assessed biases in attention disengagement among average‐weight women with binge‐eating (n = 33) and non‐eating disordered controls (n = 31). Participants engaged in a spatial cueing paradigm task wherein they first observed high‐calorie food, low‐calorie food, or neutral images and then had to quickly locate targets in either the same or a different location. Within both groups, reaction times (RTs) were longer to valid‐cued trials (i.e. target appearing in location of preceding cue) than to invalid‐cued trials (i.e. targets appearing in location different from initial location), reflecting a general inhibition of return (IOR) effect. However, RT findings also indicated that women with BE had significantly more difficulty disengaging from high‐calorie food images than did controls, even though neither group had disengagement problems related to other image types. Selective attention disengagement difficulties related to high‐calorie food images suggested that increased reward sensitivity to such cues is related to binge eating risk. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 09, 2016   doi: 10.1002/erv.2438   open full text
  • Differential Neural Correlates of Set‐Shifting in the Bingeing–Purging and Restrictive Subtypes of Anorexia Nervosa: An fMRI Study.
    Sara Van Autreve, Wouter De. Baene, Chris Baeken, Kees Heeringen, Nikita Vancayseele, Myriam Vervaet.
    European Eating Disorders Review. February 09, 2016
    In this study, possible differences in the neural correlates of set‐shifting abilities between the restrictive (AN‐R) and bingeing/purging (AN‐BP) subtypes of anorexia nervosa have been explored. Three groups of participants performed a set‐shifting task during functional magnetic resonance imaging: patients with AN‐R (N = 16), AN‐BP (N = 13) and healthy control participants (N = 15). As in a typical set‐shifting experiment, participants had to switch between two easy tasks (i.e. ‘Is the presented number odd/even’ or ‘Is the presented number smaller/larger than 5’). The trials in which the task was repeated (repeat trials) were compared with trials in which the task was switched (switch trials). With regards to the level of task performance, no significant group differences could be established. However, when comparing switch specific brain activity across study groups, a stronger activation was found in the insula and the precuneus in AN‐R when compared to AN‐BP and HC. These results suggest that the both subtypes of AN might have different neurobiological correlates, and thus, might benefit from different treatment approaches. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 09, 2016   doi: 10.1002/erv.2437   open full text
  • Retrospective Correlates for Bulimia Nervosa: A Matched Case–Control Study.
    Sónia Gonçalves, Barbara C. Machado, Carla Martins, Hans W. Hoek, Paulo P. P. Machado.
    European Eating Disorders Review. February 03, 2016
    Objective There have been few studies investigating the risk factors for bulimia nervosa (BN), and most have been in Anglo‐Saxon countries. This study aimed to (i) replicate the uncontested retrospective correlates for BN and clarify the role of factors with inconsistent findings and (ii) evaluate the strength of these factors in a different culture. Method A case–control design was used to compare 60 women who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for BN to 60 healthy controls and 60 participants with other psychiatric disorders. Retrospective correlates were assessed by interviewing each person with the Oxford Risk Factor Interview. Results The primary retrospective correlates identified from the comparison of BN participants to healthy controls were general high maternal expectations, negative attitudes about parental weight and obesity in childhood and adolescence. Compared with participants with other psychiatric disorders, those with BN also reported higher rates of childhood obesity, deliberate self‐harm, family conflicts, general high maternal expectations and feeling fat in childhood. Conclusions The common findings across cultures suggest that, at least, individuals subjectively experience a number of similar factors that increase risk for developing BN. In addition, the difference regarding self‐harm is notable. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 03, 2016   doi: 10.1002/erv.2434   open full text
  • Cognitive Function in Adolescent Patients with Anorexia Nervosa and Unipolar Affective Disorders.
    Lea Sarrar, Martin Holzhausen, Petra Warschburger, Ernst Pfeiffer, Ulrike Lehmkuhl, Nora Schneider.
    European Eating Disorders Review. December 23, 2015
    Studies have shown impairments in cognitive function among adult patients with anorexia nervosa (AN) and affective disorders (AD). The association between cognitive dysfunctions, AN and AD as well as the specificity for these psychiatric diagnoses remains unclear. Therefore, we examined cognitive flexibility and processing speed in 47 female adolescent patients with AN, 21 female adolescent patients with unipolar affective disorders and 48 female healthy adolescents. All participants completed a neuropsychological test battery. There were no significant group differences regarding cognitive function, except for psychomotor processing speed with poorer performance in patients with AN. A further analysis revealed that all groups performed with the normal range, although patients with AN were over represented in the poorest performing quartile. We found no severe cognitive impairments in either patient group. Nevertheless, belonging to the AN group contributed significantly to poor performances in neuropsychological tasks. Therefore, we conclude that the risk for cognitive impairments is slightly higher for patients with AN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    December 23, 2015   doi: 10.1002/erv.2425   open full text
  • Biopsychosocial Correlates of Binge Eating Disorder in Caucasian and African American Women with Obesity in Primary Care Settings.
    Tomoko Udo, Marney A. White, Janet L. Lydecker, Rachel D. Barnes, Inginia Genao, Rina Garcia, Robin M. Masheb, Carlos M. Grilo.
    European Eating Disorders Review. December 07, 2015
    This study examined racial differences in eating‐disorder psychopathology, eating/weight‐related histories, and biopsychosocial correlates in women (n = 53 Caucasian and n = 56 African American) with comorbid binge eating disorder (BED) and obesity seeking treatment in primary care settings. Caucasians reported significantly earlier onset of binge eating, dieting, and overweight, and greater number of times dieting than African American. The rate of metabolic syndrome did not differ by race. Caucasians had significantly elevated triglycerides whereas African Americans showed poorer glycaemic control (higher glycated haemoglobin A1c [HbA1c]), and significantly higher diastolic blood pressure. There were no significant racial differences in features of eating disorders, depressive symptoms, or mental and physical health functioning. The clinical presentation of eating‐disorder psychopathology and associated psychosocial functioning differed little by race among obese women with BED seeking treatment in primary care settings. Clinicians should assess for and institute appropriate interventions for comorbid BED and obesity in both African American and Caucasian patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    December 07, 2015   doi: 10.1002/erv.2417   open full text
  • Lisdexamfetamine Dimesylate Effects on Binge Eating Behaviour and Obsessive–Compulsive and Impulsive Features in Adults with Binge Eating Disorder.
    Susan L. McElroy, James E. Mitchell, Denise Wilfley, Maria Gasior, M. Celeste Ferreira‐Cornwell, Michael McKay, Jiannong Wang, Timothy Whitaker, James I. Hudson.
    European Eating Disorders Review. December 01, 2015
    In a published 11‐week, placebo‐controlled trial, 50 and 70 mg/d lisdexamfetamine dimesylate (LDX), but not 30 mg/d LDX, significantly reduced binge eating days (primary endpoint) in adults with binge eating disorder (BED). This report provides descriptions of LDX effects on secondary endpoints (Binge Eating Scale [BES]; Three‐Factor Eating Questionnaire [TFEQ]; Yale–Brown Obsessive Compulsive Scale modified for Binge Eating [Y‐BOCS‐BE]; and the Barratt Impulsiveness Scale, version 11 [BIS‐11]) from that study. Week 11 least squares mean treatment differences favoured all LDX doses over placebo on the BES (p ≤ 0.03), TFEQ Disinhibition and Hunger subscales (all p < 0.05), and Y‐BOCS‐BE total, obsessive, and compulsive scales (all p ≤ 0.02) and on BIS‐11 total score at 70 mg/d LDX (p = 0.015) and the TFEQ Cognitive Restraint subscale at 30 and 70 mg/d LDX (both p<0.05). These findings indicate that LDX decreased global binge eating severity and obsessive–compulsive and impulsive features of BED in addition to binge eating days. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    December 01, 2015   doi: 10.1002/erv.2418   open full text
  • Inpatient Treatment for Adolescents with Anorexia Nervosa: Clinical Significance and Predictors of Treatment Outcome.
    Sandra Schlegl, Alice Diedrich, Christina Neumayr, Markus Fumi, Silke Naab, Ulrich Voderholzer.
    European Eating Disorders Review. November 24, 2015
    This study evaluated the clinical significance as well as predictors of outcome for adolescents with severe anorexia nervosa (AN) treated in an inpatient setting. Body mass index (BMI), eating disorder (ED) symptoms [Eating Disorder Inventory‐2 (EDI‐2)], general psychopathology and depression were assessed in 238 patients at admission and discharge. BMI increased from 14.8 + 1.2 to 17.3 + 1.4 kg/m2. Almost a fourth (23.6%) of the patients showed reliable changes, and 44.7% showed clinically significant changes (EDI‐2). BMI change did not significantly differ between those with reliable or clinically significant change or no reliable change in EDI‐2. Length of stay, depression and body dissatisfaction were negative predictors of a clinically significant change. Inpatient treatment is effective in about two thirds of adolescents with AN and should be considered when outpatient treatment fails. About one third of patients showed significant weight gain, but did not improve regarding overall ED symptomatology. Future studies should focus on treatment strategies for non‐responders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    November 24, 2015   doi: 10.1002/erv.2416   open full text
  • Exploring Parental Bonding in BED and Non‐BED Obesity Compared with Healthy Controls: Clinical, Personality and Psychopathology Correlates.
    Federico Amianto, Roberta Ercole, Giovanni Abbate Daga, Secondo Fassino.
    European Eating Disorders Review. November 24, 2015
    Early inadequate attachment experiences are relevant co‐factors in the development of obesity and Binge Eating Disorder (BED), which often concurs with obesity. The relationship of parental bonding with personality and psychopathology may influence treatment strategies for obese subjects, either affected or not with BED. In this study, 443 obese women (BMI ≥ 30 kg/m2), including 243 with and 200 without BED, and 158 female controls were assessed with regards to attachment, personality and eating psychopathology measures. Clusters obtained using the scores of the Parental Bonding Instrument (PBI) were compared with each other and with a control subjects' group. Lower scores of parental bonding distinguished obese subjects with respect to healthy controls. The cluster analysis revealed two clusters of parenting among obese subjects. The larger one displayed intermediate care and overprotection between controls and the smaller cluster, with the exception of paternal overprotection which is similar to controls. This larger cluster was characterized by low persistence and levels of psychopathology which are intermediate between healthy controls and the smaller cluster. The smaller cluster displayed lower care and higher overcontrol from both parents. It also displays more extreme personality traits (high novelty seeking and harm avoidance, and lower self‐directedness and cooperativeness) and more severe eating and general psychopathology. Different parenting dynamics relate to different personality patterns and eating psychopathology of obese subjects, but not to binge eating conducts. Personality differences between parenting clusters are more extensive than those between BED and non‐BED subgroups. The two different typologies of obese subjects based on parenting may be relevant for treatment personalization. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    November 24, 2015   doi: 10.1002/erv.2419   open full text
  • An Echocardiographic Study of Left Ventricular Size and Cardiac Function in Adolescent Females with Anorexia Nervosa.
    Carolina A. Escudero, James E. Potts, Pei‐Yoong Lam, Astrid M. De Souza, Gerald J. Mugford, George G. S. Sandor.
    European Eating Disorders Review. October 08, 2015
    Objective This retrospective case–control study investigated cardiac dimensions and ventricular function in female adolescents with anorexia nervosa (AN) compared with controls. Methods Echocardiographic measurements of left ventricular (LV) dimensions, LV mass index, left atrial size and cardiac index were made. Detailed measures of systolic and diastolic ventricular function were made including tissue Doppler imaging. Patients were stratified by body mass index ≤10th percentile (AN ≤ 10th) and >10th percentile (AN > 10th). Results Ninety‐five AN patients and 58 controls were included. AN and AN ≤ 10th groups had reduced LV dimensions, LV mass index, left atrial size and cardiac index compared with controls. There were no differences between groups in measures of systolic function. Measures of diastolic tissue Doppler imaging were decreased in AN and AN ≤ 10th. No differences in echocardiographic measurements existed between controls and AN > 10th. Discussion Female adolescents with AN have preserved systolic function and abnormalities of diastolic ventricular function. AN ≤ 10th may be a higher risk group. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 08, 2015   doi: 10.1002/erv.2409   open full text
  • Individualised Versus Standardised Assessment of Quality of Life in Eating Disorders.
    Carlota Las Hayas, Patricia Padilla, Andrés Gómez Barrio, Luís Beato‐Fernandez, Pedro Muñoz, Manuel Gámez‐Guadix.
    European Eating Disorders Review. October 07, 2015
    Individualised measures of quality of life (QoL) refer to instruments that encourage the respondent to actively elicit which areas of their life are most relevant for his/her QoL. The aim of this study is to compare individualised versus standard measures of QoL in a sample of patients with eating disorder (ED). The Schedule for the Evaluation of the Individual Quality of Life (SEIQoL) and a generic measure of QoL [World Health Organization Brief Quality of Life Assessment Scale (WHOQOL‐BREF)] were applied on two occasions (one‐year follow‐up) to a sample of 165 patients with ED, 57 recovered patients with ED, and 349 women from the general population. The areas of ‘family’, ‘education/career or job’, ‘friends’, ‘leisure’, ‘romantic partner’ and ‘health’ were identified as the most important for their QoL for all groups, both times. The WHOQOL‐BREF was more sensitive than the SEIQoL in detecting changes that occurred over time. Clinical interventions for ED should consider social components as objectives of intervention. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 07, 2015   doi: 10.1002/erv.2411   open full text
  • Prevalence of Alcohol and Other Substance Use in Patients with Eating Disorders.
    Farnaz Fouladi, James E. Mitchell, Ross D. Crosby, Scott G. Engel, Scott Crow, Laura Hill, Daniel Le Grange, Pauline Powers, Kristine J. Steffen.
    European Eating Disorders Review. September 29, 2015
    Objective The major aim of this study was to investigate any association between binge eating and purging and alcohol and substance use. Method The Eating Disorder Questionnaire was completed by 2966 patients. Each patient was assigned to an approximate diagnostic group based on a DSM‐5‐based algorithm. Results Patients with bulimia nervosa (BN) used alcohol/other substances with higher frequencies compared to patients with anorexia nervosa‐restricting type (AN‐R), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS; p < 0.001). Patients with anorexia nervosa‐binge eating/purging type (AN‐BP) were more likely to use alcohol/substances than those with AN‐R [odds ratio for alcohol use: 3.58 (p < 0.01); odds ratio for substance use: 30.14 (p < 0.01)]. Higher frequencies of binge eating and purging were associated with higher frequencies of substance use. Discussion Patients who manifest both binge eating and purging behaviour are at higher risk of substance use which may have important treatment implications. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 29, 2015   doi: 10.1002/erv.2410   open full text
  • Emotion Recognition in Blended Facial Expressions in Women with Anorexia Nervosa.
    Marcela Marin Dapelo, Simon Surguladze, Robin Morris, Kate Tchanturia.
    European Eating Disorders Review. September 14, 2015
    People with anorexia nervosa (AN) have difficulties in the social domain, and problems in the ability to recognise emotions in people's faces may contribute to these difficulties. This study aimed to investigate emotion recognition in women with AN and healthy controls (HC), using pictures of faces portraying blended emotions at different levels of ambiguity, which resemble real‐life expressions more closely than prototypical expressions used in past studies. Seventy‐seven participants (35 AN; 42 HC) completed the emotion recognition task. Results indicated that participants with AN were less accurate than HC recognising expressions of disgust, when shown less ambiguously. There were no differences in the recognition of other emotions. Participants with AN also showed response bias towards anger. These findings suggest a generally preserved ability to recognise emotions in women with AN, with the exception of disgust recognition. They also support previous findings of bias towards anger in AN patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 14, 2015   doi: 10.1002/erv.2403   open full text
  • Diagnosed Anxiety Disorders and the Risk of Subsequent Anorexia Nervosa: A Danish Population Register Study.
    Sandra M. Meier, Cynthia M. Bulik, Laura M. Thornton, Manuel Mattheisen, Preben B. Mortensen, Liselotte Petersen.
    European Eating Disorders Review. September 08, 2015
    Anxiety disorders and anorexia nervosa are frequently acknowledged to be highly comorbid conditions, but still, little is known about the clinical and aetiological cohesion of specific anxiety diagnoses and anorexia nervosa. Using the comprehensive Danish population registers, we aimed to determine the risk of anorexia nervosa in patients with register‐detected severe anxiety disorders. We also explored whether parental psychopathology was associated with offspring's anorexia nervosa. Anxiety disorders increased the risk of subsequent anorexia nervosa, with the highest risk observed in obsessive–compulsive disorder. Especially, male anxiety patients were at an increased risk for anorexia nervosa. Furthermore, an increased risk was observed in offspring of fathers with panic disorder. A diagnosis of an anxiety disorder, specifically obsessive–compulsive disorder, constitutes a risk factor for subsequent diagnosis of anorexia nervosa. These observations support the notion that anxiety disorders and anorexia nervosa share etiological mechanisms and/or that anxiety represents one developmental pathway to anorexia nervosa. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 08, 2015   doi: 10.1002/erv.2402   open full text
  • Depression and Personality Traits Associated With Emotion Dysregulation: Correlates of Suicide Attempts in Women with Bulimia Nervosa.
    Emily M. Pisetsky, Stephen A. Wonderlich, Ross D. Crosby, Carol B. Peterson, James E. Mitchell, Scott G. Engel, Thomas E. Joiner, Anna Bardone‐Cone, Daniel Le Grange, Marjorie H. Klein, Scott J. Crow.
    European Eating Disorders Review. August 27, 2015
    Objective The objective of this study was to identify personality traits and psychiatric comorbidities associated with a lifetime history of a suicide attempt in women with bulimia nervosa (BN). Method Data from two samples of women with BN (n = 204 and n = 133) were examined. Participants in both samples completed the Dimensional Assessment of Personality Pathology—Basic Questionnaire and reported whether they had ever had a lifetime suicide attempt. Comorbid psychopathology was based on self‐reported questionnaire and interview data. Univariate and multivariate logistic regression analyses were run, predicting a lifetime suicide attempt. Results Based on the Dimensional Assessment of Personality Pathology—Basic Questionnaire, identity problems were associated with a lifetime suicide attempt in both samples; cognitive dysregulation, anxiousness and insecure attachment were associated with a lifetime suicide attempt in one but not both samples. Lifetime anxiety disorder was associated with a lifetime suicide attempt in one sample, and depression was associated with a lifetime suicide attempt in both samples. Multivariate analyses revealed that only depression was uniquely associated with a lifetime suicide attempt in both samples. Discussion Although personality traits associated with aspects of emotion dysregulation were associated with a lifetime suicide attempt, depression was found to have the strongest association with a lifetime suicide attempt in two samples of women with BN. These findings suggest that depression severity may be the most important target of treatment and suicide prevention efforts in women with BN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 27, 2015   doi: 10.1002/erv.2401   open full text
  • Investigation of Oxytocin Secretion in Anorexia Nervosa and Bulimia Nervosa: Relationships to Temperament Personality Dimensions.
    Alessio Maria Monteleone, Pasquale Scognamiglio, Umberto Volpe, Virginia Di Maso, Palmiero Monteleone.
    European Eating Disorders Review. August 11, 2015
    Published studies suggested an implication of oxytocin in some temperament characteristics of personality. Therefore, we measured oxytocin secretion in 23 women with anorexia nervosa (AN), 27 with bulimia nervosa (BN) and 19 healthy controls and explored the relationships between circulating oxytocin and patients' personality traits. Plasma oxytocin levels were significantly reduced in AN women but not in BN ones. In healthy women, the attachment subscale scores of the reward dependence temperament and the harm avoidance (HA) scores explained 82% of the variability in circulating oxytocin. In BN patients, plasma oxytocin resulted to be negatively correlated with HA, whereas no significant correlations emerged in AN patients. These findings confirm a dysregulation of oxytocin production in AN but not in BN and show, for the first time, a disruption of the associations between hormone levels and patients' temperament traits, which may have a role in certain deranged behaviours of eating disorder patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    August 11, 2015   doi: 10.1002/erv.2391   open full text
  • Thermal Imaging of Body Surface Temperature Distribution in Women with Anorexia Nervosa.
    Monika Chudecka, Anna Lubkowska.
    European Eating Disorders Review. July 31, 2015
    The drastic reduction in body weight observed in anorexia nervosa (AN) leads to various endocrine changes and consequently to disturbance in thermoregulation mechanisms and body temperature. Thermography allows for a noninvasive diagnosis of the distribution of skin surface temperatures, which is especially important for difficult patients such as women with AN, who are often very sensitive and difficult to treat. The main aim of this study was to measure the mean temperatures (Tmean) of selected body areas in young women diagnosed with AN and identify those areas where the temperature differences were particularly significant between healthy women and them. Additionally, we determined the relationships between body mass index, body composition (especially subcutaneous and VFM) and the value of mean surface temperature (Tmean) in AN woman. In the subjects with AN, Tmean of the abdomen, lower back and thighs were significantly higher than in the reference group, while Tmean of the hands were significantly lower. Among other things, analysis showed a significant negative correlation between Tmean of the abdomen, lower back and thighs, and the mass of subcutaneous and visceral fat. The lower Tmean of the hand was directly proportional to the reduced anthropomorphic parameters. The direct evaluation of body surface temperature distribution could provide clinical implications for the treatment of anorexic patients, including the potential use of thermotherapy in stimulating the circulatory system, especially in hypothermia, bradycardia and hypotension. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 31, 2015   doi: 10.1002/erv.2388   open full text
  • Verbal Versus Figural Fluency Tests in Currently Ill and Weight Restored Anorexia Nervosa Patients.
    Eyal Heled, Dan Hoofien, Eytan Bachar, Richard P. Ebstein.
    European Eating Disorders Review. July 21, 2015
    Fluency tests allow domain‐specific assessment of verbal and non‐verbal executive functions (EF) comparison and also enable utilizing of both quantitative and qualitative scoring methods. Thirty‐five currently ill anorexia nervosa patients (PANs), 33 weight‐restored patients (WRAN) and 47 healthy controls (HCs) were administered the word fluency test and the five‐point test. Results show that WRANs tended to perseverate more than HCs in the verbal‐fluency test. In addition, PANs produced significantly less correct figures and perseverated more than HCs and WRANs; HCs used more strategy methods than PANs and WRANs. Additionally, a positive correlation was found in the HC group between the total number of words in the verbal phonemic test and the number of designs produced and the number of correct designs. No such correlations were found in both anorexia groups. In conclusion, there is a differentiation between verbal and non‐verbal EF in PANs and WRANs, showing a deficiency in the non‐verbal domain. These findings may contribute to our understanding of the cognitive nature of the disorder. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 21, 2015   doi: 10.1002/erv.2387   open full text
  • Expressed Emotion, Family Functioning, and Treatment Outcome for Adolescents with Anorexia Nervosa.
    Renee D. Rienecke, Erin C. Accurso, James Lock, Daniel Le Grange.
    European Eating Disorders Review. July 21, 2015
    The current study examined the relation between parental expressed emotion (EE) and treatment outcome among adolescents participating in a treatment study for adolescent anorexia nervosa, as well as its impact on family functioning. One hundred and twenty‐one families were assigned to family‐based treatment or adolescent‐focused therapy. Paternal criticism predicted lesser improvement in eating disorder psychopathology at end of treatment. There was also a significant interaction between maternal hostility and treatment, indicating that adolescents whose mothers displayed hostility had greater increases in percent of expected body weight in adolescent‐focused therapy than family‐based treatment. In addition, maternal hostility predicted less improvement in general family functioning and family communication at the end of treatment. Findings suggest that maternal and paternal EE may differentially impact treatment outcome and should be directly attended to in clinical settings. Future research is needed to further explore ways in which parental EE can be effectively modified in treatment. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 21, 2015   doi: 10.1002/erv.2389   open full text
  • Approach Bias Modification in Food Craving—A Proof‐of‐Concept Study.
    Timo Brockmeyer, Carolyn Hahn, Christina Reetz, Ulrike Schmidt, Hans‐Christoph Friederich.
    European Eating Disorders Review. July 02, 2015
    The aim of the present proof‐of‐concept study was to test a novel cognitive bias modification (CBM) programme in an analogue sample of people with subclinical bulimic eating disorder (ED) psychopathology. Thirty participants with high levels of trait food craving were trained to make avoidance movements in response to visual food stimuli in an implicit learning paradigm. The intervention comprised ten 15‐minute sessions over a 5‐week course. At baseline, participants showed approach and attentional biases towards high‐caloric palatable food that were both significantly reduced and turned into avoidance biases after the training. Participants also reported pronounced reductions in both trait and cue‐elicited food craving and in ED symptoms as well. The overall evaluation of the training by the participants was positive. The specific CBM programme tested in this pilot trial promises to be an effective and feasible way to alter automatic action tendencies towards food in people suffering from bulimic ED psychopathology. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 02, 2015   doi: 10.1002/erv.2382   open full text
  • Central Coherence, Visuoconstruction and Visual Memory in Patients with Eating Disorders as Measured by Different Scoring Methods of the Rey Complex Figure Test.
    Siri Weider, Marit Sæbø Indredavik, Stian Lydersen, Knut Hestad.
    European Eating Disorders Review. July 02, 2015
    Objective The aims of this study were to examine the performance of eating disorder (ED) patients on the Rey Complex Figure Test and to investigate the validity of the Q‐score as a new method for measuring central coherence (CC). Method Forty‐one patients with anorexia nervosa, 40 patients with bulimia nervosa and 40 healthy controls completed the Rey Complex Figure Test, which was scored both quantitatively and qualitatively. Results Both ED groups scored lower than the healthy controls on copy, recall and the Q‐score. For the anorexia nervosa group, performance on the Central Coherence Index was associated with the nadir body mass index. Performance on the recall measures was independently associated with the nadir body mass index and depressive symptoms for the bulimia nervosa group. There was a strong correlation between the Q‐score and the Central Coherence Index (r = 0.77). Discussion The study reveals different levels of CC and suggests that the Q‐score might be an applicable method for measuring CC in ED patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 02, 2015   doi: 10.1002/erv.2385   open full text
  • The Spanish Validation of the Accommodation and Enabling Scale for Eating Disorders Among Carers: A Pilot Study.
    Yolanda Quiles Marcos, María José Quiles Sebastián, Lidia Pamies Aubalat, Ana Rosa Sepúlveda García, Janet Treasure.
    European Eating Disorders Review. June 29, 2015
    Literature suggests that families may accommodate patients' symptoms in attempts to alleviate family conflict and stress. These accommodating and enabling behaviours may have a negative impact on carers and those they care for. There are no self‐report questionnaires validated in Spanish to measure accommodation among relatives of patients with an eating disorder. The aim of this study was to examine the psychometric properties of the Spanish version of the Accommodation and Enabling Scale for Eating Disorders (AESED‐S) among relatives of eating disorder patients. A cross‐sectional study of 90 relatives was carried out to explore the factor structure, reliability and validity of the AESED‐S. The internal consistency of the Spanish version of the AESED subscales was good, ranging from .89 to .81. The correlation of the five subscales with conceptually related measures (negative caregiving experience and distress) supports the convergent validity of this instrument in this sample. Results indicated that the Spanish version of the AESED provides a reliable and valid tool for assessing family accommodation in the context of having a relative with an eating disorder. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 29, 2015   doi: 10.1002/erv.2378   open full text
  • Temperament Dispositions, Problematic Eating Behaviours and Overweight in Adolescents.
    Mireille Walther, Anja Hilbert.
    European Eating Disorders Review. June 24, 2015
    Obesity, a common health condition in adolescence leading to severe medical complications, is assumed to be influenced by temperament factors. This paper investigates associations between reactive and regulative temperament, problematic eating behaviours and excess weight. Several self‐report instruments were completed by 130 adolescents (mean age 14.13 ± 0.61 years), including 27 overweight and obese individuals (20.8%). Bootstrap analysis revealed a mediating effect of restrained eating on the relation between reactive temperament and body mass index percentile, which differed according to gender: Restrained eating, which predicted weight gain, was more present in girls having a higher sensitivity to reward and in boys showing a higher sensitivity to punishment. No effect of regulative temperament was found. These results have important implications for weight management programmes, as they suggest that reducing restrained eating by working on temperament may help to control weight. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 24, 2015   doi: 10.1002/erv.2381   open full text
  • Eating Disorders in Adolescents with Celiac Disease: Influence of Personality Characteristics and Coping.
    Gudrun Wagner, Michael Zeiler, Gabriele Berger, Wolf‐Dietrich Huber, Angela Favaro, Paolo Santonastaso, Andreas Karwautz.
    European Eating Disorders Review. June 23, 2015
    Objectives Patients suffering from celiac disease (CD) have a higher risk of developing disturbed eating behaviour. Method In a multi‐centre study, 259 female adolescents with CD and without a chronic condition were analysed regarding their eating disorder (ED) status, depression, personality, coping strategies and quality of life. Results Patients with CD and comorbid EDs were older and more often non‐compliant with their diet and had a higher body mass index (BMI) and higher levels of depression. Differences in personality features disappear when controlling for age and depression. Higher ill‐being and lower joy in life were reported by patients with CD and ED compared with patients without EDs, even when controlling for age and depression levels. No differences between patients (with CD) with and without EDs in coping strategies were found. BMI and lower self‐directedness predicted ED status. Conclusions Early identification of EDs in patients with CD is suggested and should include BMI and personality factors. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 23, 2015   doi: 10.1002/erv.2376   open full text
  • Immediate Effects of Body Checking Behaviour on Negative and Positive Emotions in Women with Eating Disorders: An Ecological Momentary Assessment Approach.
    Nicole Kraus, Julia Lindenberg, Almut Zeeck, Joachim Kosfelder, Silja Vocks.
    European Eating Disorders Review. June 20, 2015
    Objectives Cognitive‐behavioural models of eating disorders state that body checking arises in response to negative emotions in order to reduce the aversive emotional state and is therefore negatively reinforced. This study empirically tests this assumption. Methods For a seven‐day period, women with eating disorders (n = 26) and healthy controls (n = 29) were provided with a handheld computer for assessing occurring body checking strategies as well as negative and positive emotions. Serving as control condition, randomized computer‐emitted acoustic signals prompted reports on body checking and emotions. Results There was no difference in the intensity of negative emotions before body checking and in control situations across groups. However, from pre‐ to post‐body checking, an increase in negative emotions was found. This effect was more pronounced in women with eating disorders compared with healthy controls. Discussion Results are contradictory to the assumptions of the cognitive‐behavioural model, as body checking does not seem to reduce negative emotions. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 20, 2015   doi: 10.1002/erv.2380   open full text
  • Characteristics of Disorder‐Related Autobiographical Memory in Acute Anorexia Nervosa Patients.
    Julia Huber, Carmen Salatsch, Katrin Ingenerf, Carolin Schmid, Imad Maatouk, Matthias Weisbrod, Wolfgang Herzog, Hans‐Christoph Friederich, Christoph Nikendei.
    European Eating Disorders Review. June 20, 2015
    Objective First studies revealed overgeneral autobiographical memories in anorexia nervosa (AN) patients. The aim of the present study was to investigate frequency, generalization and valence of autobiographical memories in AN patients in response to eating disorder‐related cue words. Method Autobiographical memory was examined in 21 AN patients and 21 healthy controls (HC) using a modified version of the Autobiographical Memory Test, incorporating body‐related, food‐related, perfectionism‐related, depression‐related and neutral cues. Results Anorexia nervosa patients recalled fewer and more general autobiographical memories compared with HC. For eating disorder‐related cues as against neutral ones, AN patients compared with HC showed fewer memories for food‐related and body‐related cues, an elevated overgeneralization for food‐related cues, while the valence of the retrieved memories was more negative in response to body‐related cues. Discussion This study detects disorder‐related autobiographical memory alterations in AN, which are intensified in response to symptom‐related cues. The findings are discussed with regard to their maladaptive function in emotion regulation. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 20, 2015   doi: 10.1002/erv.2379   open full text
  • Non‐suicidal Self‐injury in Different Eating Disorder Types: Relevance of Personality Traits and Gender.
    Mohammed A. Islam, Howard Steiger, Susana Jimenez‐Murcia, Mimi Israel, Roser Granero, Zaida Agüera, Rita Castro, Isabel Sánchez, Nadine Riesco, José M. Menchón, Fernando Fernández‐Aranda.
    European Eating Disorders Review. June 15, 2015
    The study explored lifetime prevalence of non‐suicidal self‐injury (NSSI) in female and male individuals with eating disorders (ED) and compared ED symptoms, general psychopathology and personality traits across individuals with and without a history of NSSI. The incremental discriminative capacity of gender on the manifestation of lifetime NSSI was also studied. A total sample of 1649 consecutively admitted ED patients (1515 women and 134 men) participated in the current study [339 ED + NSSI (ED with NSSI) and 1310 ED − NSSI (ED without NSSI)]. Specific self‐report measures were included and other clinical and psychopathological indices. The observed lifetime prevalence of NSSI was 20.6% (20.9% in women and 17.2% in men). NSSI was not associated with ED type or gender. However, ED + NSSI patients exhibited more impulsive behaviour, substance‐abuse disorders and additional impulse‐control disorders, were younger and had more previous treatments. Age was shown to affect the presentation of NSSI. Additionally, ED + NSSI patients exhibited more severe ED and general psychopathological symptoms and had more dysfunctional personality traits when compared with ED − NSSI. ED + NSSI was found to be positively associated with harm avoidance and self‐transcendence but negatively with reward dependence, self‐directedness and cooperativeness. Thus, the variables with stronger capacity to identify the presence of ED + NSSI were younger age, harm avoidance, self‐directedness and self‐transcendence. A lack of association between sex and ED subtype with the presence of NSSI was observed.
    June 15, 2015   doi: 10.1002/erv.2374   open full text
  • Craving for Food in Virtual Reality Scenarios in Non‐Clinical Sample: Analysis of its Relationship with Body Mass Index and Eating Disorder Symptoms.
    Marta Ferrer‐Garcia, Jose Gutierrez‐Maldonado, Janet Treasure, Ferran Vilalta‐Abella.
    European Eating Disorders Review. June 11, 2015
    Virtual reality (VR) technology has been successfully used to study the influence of specific and contextual food‐related cues on emotional, cognitive and behavioural responses in patients with eating disorders (ED) and healthy controls. Following this research line, the present study assesses the effect on reported food craving of the type of food (low calorie versus high calorie) and the presence or absence of other people (private versus social context) in VR environments. Relationships between craving and body mass index (BMI) and ED symptoms are also explored. Eighty‐seven female students were exposed to four VR scenarios presented in random order: a low‐calorie kitchen, a high‐calorie kitchen, a low‐calorie restaurant and a high‐calorie restaurant. After 2 minutes of exposure to each virtual scenario, food craving was assessed. Repeated measures analyses of covariance were conducted to assess changes in food craving following exposure to the different VR environments. Time elapsed since the last meal was introduced as a covariate to control for responses produced by food deprivation. Correlation and hierarchical multiple regression analyses were also conducted to assess the relationship between reported food craving and BMI and ED symptoms. Participants experienced higher levels of food craving after exposure to high‐calorie foods (in both the kitchen and restaurant environments) than after exposure to low‐calorie foods. Being alone in the kitchen or with friends in the restaurant had no effect on reported craving. Overall, neither BMI nor ED symptoms were related with reported food craving; only in the restaurant with low‐calorie food was a significant negative correlation found between BMI and food craving. The results suggest that cue exposure in virtual environments is an effective procedure for inducing food craving in healthy controls and may be useful as a research and therapeutic tool in clinical populations. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 11, 2015   doi: 10.1002/erv.2375   open full text
  • Eating Disorder Symptoms and Suicidal Ideation: The Moderating Role of Disgust.
    Carol Chu, Lindsay P. Bodell, Jessica D. Ribeiro, Thomas E. Joiner.
    European Eating Disorders Review. May 26, 2015
    Disgust has been implicated as a factor that maintains and exacerbates eating disorder (ED) symptoms. Emerging research suggests that disgust may be a risk factor for suicidality. Given the high rates of suicidality among individuals with EDs, we propose that disgust may contribute to the link between EDs and suicidality. To test this hypothesis, self‐report data were collected from 341 young adults (66% women). Cross‐sectional associations between disgust with the self, others and the world and disgust sensitivity and propensity, ED symptoms and suicidal ideation were examined using multivariate regression analyses. ED symptoms and body dissatisfaction were associated with increased suicidal ideation at high levels of disgust with the self and the world; at low levels of disgust, ED symptoms and body dissatisfaction did not significantly relate to suicidal ideation. Disgust may indicate risk for suicidal ideation among individuals with eating psychopathology. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 26, 2015   doi: 10.1002/erv.2373   open full text
  • Prevalence of Eating Disorder Risk and Associations with Health‐related Quality of Life: Results from a Large School‐based Population Screening.
    Michael Zeiler, Karin Waldherr, Julia Philipp, Martina Nitsch, Wolfgang Dür, Andreas Karwautz, Gudrun Wagner.
    European Eating Disorders Review. May 26, 2015
    Objective The objective of this study was to investigate the prevalence of eating disorder (ED) risk as well as associated psychopathology and health‐related quality of life (HrQoL) in a large population sample of Austrian adolescents. Method A sample of 3610 adolescents aged 10–18 years was recruited from 261 schools representative for the Austrian population. The SCOFF questionnaire was used to identify participants at risk for EDs, and the Youth Self‐Report and KIDSCREEN were used to assess general psychopathology and HrQoL. Results In total, 30.9% of girls and 14.6% of boys were screened at risk for EDs. SCOFF scores were significantly associated with internalising and externalising behavioural problems as well as HrQoL after controlling for sex, age and body mass index. The SCOFF score further turned out to be an independent predictor of HrQoL. Discussion The high prevalence of ED risk among Austrian adolescents points out the need for prevention in this field. Variables indicating eating pathology should be included in general mental health screenings. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 26, 2015   doi: 10.1002/erv.2368   open full text
  • Typical Versus Atypical Anorexia Nervosa Among Adolescents: Clinical Characteristics and Implications for ICD‐11.
    Yasmina Silén, Anu Raevuori, Elisabeth Jüriloo, Veli‐Matti Tainio, Mauri Marttunen, Anna Keski‐Rahkonen.
    European Eating Disorders Review. May 22, 2015
    There is scant research on the clinical utility of differentiating International Classification of Diseases (ICD) 10 diagnoses F50.0 anorexia nervosa (typical AN) and F50.1 atypical anorexia. We reviewed systematically records of 47 adolescents who fulfilled criteria for ICD‐10 F50.0 (n = 34) or F50.1 (n = 13), assessing the impact of diagnostic subtype, comorbidity, background factors and treatment choices on recovery. Atypical AN patients were significantly older (p = 0.03), heavier (minimum body mass index 16.7 vs 15.1 kg/m2, p = 0.003) and less prone to comorbidities (38% vs 71%, p = 0.04) and had shorter, less intensive and less costly treatments than typical AN patients. The diagnosis of typical versus atypical AN was the sole significant predictor of treatment success: recovery from atypical AN was 4.3 times (95% confidence interval [1.1, 17.5]) as likely as recovery from typical AN. Overall, our findings indicate that a broader definition of AN may dilute the prognostic value of the diagnosis, and therefore, ICD‐11 should retain its distinction between typical and atypical AN. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 22, 2015   doi: 10.1002/erv.2370   open full text
  • Day Hospital Treatment for Anorexia Nervosa: A 12‐Month Follow‐up Study.
    Giovanni Abbate‐Daga, Enrica Marzola, Carlotta De‐Bacco, Sara Buzzichelli, Annalisa Brustolin, Stefania Campisi, Federico Amianto, Giuseppe Migliaretti, Secondo Fassino.
    European Eating Disorders Review. May 14, 2015
    Day hospitals (DHs) represent a treatment option for anorexia nervosa (AN), a mental disorder that is difficult to treat and has no evidence‐based treatments available. We aimed to determine the effectiveness of a DH treatment that was specifically focused on the emotions of severe AN patients. Body mass index and eating psychopathology were the primary outcome measures. Fifty‐six adult patients with AN were assessed upon admission, at the end of treatment (EOT) and at a 12‐month follow‐up evaluation (T18) using Eating Disorders Inventory‐2, Beck Depression Inventory, Hamilton Rating Scale for Anxiety and Brief Social Phobia Scale. All participants received a multidisciplinary treatment programme that focused on psychodynamic psychotherapy. Seventy‐eight per cent of participants reported positive outcomes at EOT and 68% at T18. Moreover, 82.1% and 65.4% of long‐standing patients showed positive outcomes at EOT and T18, respectively. All measures of psychopathology were significantly improved at EOT and were maintained at follow‐up. Our DH was effective at treating severe AN patients; however, further investigations of the processes of change are warranted. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 14, 2015   doi: 10.1002/erv.2369   open full text
  • Experienced Carers Helping Others (ECHO): Protocol for a Pilot Randomised Controlled Trial to Examine a Psycho‐educational Intervention for Adolescents with Anorexia Nervosa and Their Carers.
    Charlotte Rhind, Rebecca Hibbs, Elizabeth Goddard, Ulrike Schmidt, Nadia Micali, Simon Gowers, Jennifer Beecham, Pamela Macdonald, Gillian Todd, Kate Tchanturia, Janet Treasure.
    European Eating Disorders Review. May 29, 2014
    Experienced Carers Helping Others (ECHO) is an intervention for carers of people with eating disorders. This paper describes the theoretical background and protocol of a pilot multicentre randomised controlled trial that will explore the use of two variants of ECHO for improving outcomes for adolescents with anorexia nervosa (AN) referred for outpatient care. Adolescent patients and their carers (typically parents and close others in a supportive role) will be recruited from 38 eating disorder outpatient services across the UK. Carers will be randomly allocated to receive ‘ECHOc’ guided self‐help (in addition to treatment as usual), ‘ECHO’ self‐help only (in addition to treatment as usual) or treatment as usual only. Primary outcomes are a summary measure of the Short Evaluation of Eating Disorders at 6‐ and 12‐month follow‐ups. Secondary outcomes are general psychiatric morbidity of AN patients and carer, carers' coping and behaviour, and change in healthcare use and costs at 6‐ and 12‐month follow‐ups. Therapist effects will be examined, and process evaluation of ECHOc will be completed. The findings from this pilot trial will be used in preparation for executing a definitive trial to determine the impact of the preferred variant of ECHO to improve treatment outcomes for AN. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 29, 2014   doi: 10.1002/erv.2298   open full text
  • Paths to First Treatment and Duration of Untreated Illness in Anorexia Nervosa: Are There Differences According to Age of Onset?
    Karolin Neubauer, Angelika Weigel, Anne Daubmann, Hanna Wendt, Maddalena Rossi, Bernd Löwe, Antje Gumz.
    European Eating Disorders Review. May 29, 2014
    This study examined paths to first treatment and the duration of untreated illness in 140 anorexia nervosa patients using validated questionnaires and a clinical interview. The differences between individuals with an early (≤14 years, n = 40), intermediate (15–18 years, n = 53) and late onset (≥19 years, n = 47) were investigated. Participants were most commonly informed about their diagnosis and first treatment facility through general practitioners and paediatricians. The duration of untreated illness exceeded 2 years in the complete sample (25.14 months) and was longest for individuals with an early onset. The early onset group was more often externally vs. internally motivated and more frequently informed about treatment options by their social network, e.g. parents, than patients with a late onset. The results emphasize the relevance of training general practitioners and paediatricians about anorexia, the need to include parents and teachers in eating disorder prevention and to improve targeting young individuals in early interventions. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 29, 2014   doi: 10.1002/erv.2300   open full text
  • Health‐related Quality of Life in Adult Inpatients Affected by Anorexia Nervosa.
    Giovanni Abbate‐Daga, Federico Facchini, Enrica Marzola, Nadia Delsedime, Cristina Giovannone, Federico Amianto, Secondo Fassino.
    European Eating Disorders Review. May 29, 2014
    ObjectivePoor awareness of illness in anorexia nervosa (AN) may render the assessment of health‐related quality of life (HRQoL) difficult. We aimed at evaluating severe AN patients' HRQoL at discharge using different instruments and correlating this measure with clinical variables. MethodsWe enrolled 71 adult AN inpatients admitted through the emergency department. At admission, all participants completed the following: Medical Outcome Short Form Health Survey, Eating Disorder Inventory‐2 and Temperament and Character Inventory. At admission and discharge, body mass index, EuroQoL Health Questionnaire/Visual Analogue Scale and Clinical Global Impression were evaluated. ResultsThe HRQoL was severely impaired at baseline, but it improved at discharge. HRQoL correlated with eating psychopathology and personality, but not with body mass index or Clinical Global Impression. ConclusionThe HRQoL effectively captured patients' improvement at discharge. Given its correlations with clinical variables, this instrument may be useful in clinical practice. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 29, 2014   doi: 10.1002/erv.2302   open full text
  • Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self‐Esteem among Treatment‐Seeking Adolescents with Bulimia Nervosa.
    Ellen E. Fitzsimmons‐Craft, Anna C. Ciao, Erin C. Accurso, Emily M. Pisetsky, Carol B. Peterson, Catherine E. Byrne, Daniel Le Grange.
    European Eating Disorders Review. May 23, 2014
    This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment‐seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self‐esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self‐esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self‐esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 23, 2014   doi: 10.1002/erv.2297   open full text
  • Childhood Obsessive–compulsive Traits in Anorexia Nervosa Patients, Their Unaffected Sisters and Healthy Controls: A Retrospective Study.
    Daniela Degortes, Tatiana Zanetti, Elena Tenconi, Paolo Santonastaso, Angela Favaro.
    European Eating Disorders Review. May 23, 2014
    Although there is evidence that childhood perfectionistic traits predate the onset of eating disorders, few studies to date have examined the prevalence and clinical correlates of these traits in patients with anorexia nervosa (AN) and their unaffected sisters. The aim of this work was to study the prevalence of childhood obsessive–compulsive traits in patients with lifetime AN, their unaffected sisters and healthy women. A total of 116 AN patients, 32 healthy sisters and 119 controls were assessed by the EATATE Interview to assess traits such as perfectionism, inflexibility, rule‐bound traits, drive for order and symmetry, and excessive doubt and cautiousness. Both self‐report and maternal reports were collected. AN patients reported more childhood obsessive–compulsive traits than their healthy sisters and controls. In contrast, no differences between healthy controls and unaffected sisters emerged. In patients with AN, a dose–response relationship was found between the number of childhood obsessive–compulsive traits and psychopathology, including body image distortion, thus indicating that these traits are an important feature to be considered in assessing and treating eating disorders. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 23, 2014   doi: 10.1002/erv.2295   open full text
  • Clinical Characteristics Associated with Premature Termination from Outpatient Psychotherapy for Anorexia Nervosa.
    Jennifer Jordan, Virginia V. W. McIntosh, Frances A. Carter, Peter R. Joyce, Christopher M. A. Frampton, Suzanne E. Luty, Janice M. McKenzie, Cynthia M. Bulik.
    European Eating Disorders Review. May 20, 2014
    AimThe literature on clinical characteristics associated with premature termination of treatment (PTT) is beset with conflicting and non‐replicated findings. This study explores clinical characteristics potentially associated with PTT in a randomised controlled outpatient psychotherapy trial for anorexia nervosa (AN). MethodsParticipants were 56 women aged 17–40 years with spectrum AN. The completer group (n = 35) included those completing at least 15/20 planned sessions with the remainder of the sample comprising the PTT group (n = 21). Variables examined included demographic factors, psychosocial functioning, psychiatric history, lifetime comorbidity, temperament and eating disorder characteristics. Logistic regression was used to examine significant variables. A Kaplan–Meier survival curve was used to illustrate time taken to PTT. ResultsThe mean number of sessions in the PTT group was 8.1. Lower self‐transcendence scores on the Temperament and Character Inventory were associated with PTT. ConclusionsRecognising and addressing personality factors have the potential to enhance retention in treatment. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 20, 2014   doi: 10.1002/erv.2296   open full text
  • Temperament Subtypes in Treatment Seeking Obese Individuals: A Latent Profile Analysis.
    Astrid Müller, Laurence Claes, Tom F. Wilderjans, Martina Zwaan.
    European Eating Disorders Review. May 09, 2014
    Objective This study aimed to investigate temperament subtypes in obese patients. Methods Ninety‐three bariatric surgery candidates and 63 obese inpatients from a psychotherapy unit answered the Behavioral Inhibition System/Behavioral Activation System Scale (BIS/BAS), the Effortful Control subscale of the Adult Temperament Questionnaire‐Short Form (ATQ‐EC), and questionnaires for eating disorder, depressive and attention deficit hyperactivity disorder (ADHD) symptoms and completed neurocognitive testing for executive functions. Binge eating disorder and impulse control disorders were diagnosed using interviews. Results A latent profile analysis using BIS/BAS and ATQ‐EC scores revealed a ‘resilient/high functioning’ cluster (n = 88) showing high ATQ‐EC and low BIS/BAS scores and an ‘emotionally dysregulated/undercontrolled’ cluster (n = 68) with low ATQ‐EC and high BIS/BAS scores. Patients from the ‘emotionally dysregulated/undercontrolled’ cluster showed more eating disorder, depressive and ADHD symptoms, and poorer performance in the labyrinth task. Conclusion The findings support the assumptions regarding the heterogeneity of obesity and the association between temperament subtypes and psychopathology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 09, 2014   doi: 10.1002/erv.2294   open full text
  • Set‐Shifting and its Relation to Clinical and Personality Variables in Full Recovery of Anorexia Nervosa.
    Susanne E. Lindner, Manfred M. Fichter, Norbert Quadflieg.
    European Eating Disorders Review. May 07, 2014
    Objective First, this study aimed to explore whether set‐shifting is inefficient after full recovery of anorexia nervosa (recAN). Second, this study wanted to explore the relation of set‐shifting to clinical and personality variables. Method A total of 100 recAN women were compared with 100 healthy women. Set‐shifting was assessed with Berg's Card Sorting Test. Expert interviews yielded assessments for the inclusion/exclusion criteria, self‐ratings for clinical and personality variables. Results Compared with the healthy control group, the recAN participants achieved fewer categories, showed more perseverations and spent less time for shifting set. Perfectionism is correlated with set‐shifting but in converse directions in the two groups. Discussion Our study supports the findings of inefficiencies in set‐shifting after full recovery from AN. Higher perfectionism in the recAN group is associated with better set‐shifting ability, whereas higher perfectionism in the healthy control group is related to worse set‐shifting ability. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 07, 2014   doi: 10.1002/erv.2293   open full text
  • Binge Eating in Interview Versus Self‐Report: Different Diagnoses Show Different Divergences.
    Andreas Birgegård, Claes Norring, David Clinton.
    European Eating Disorders Review. April 14, 2014
    Objective Binge eating (BE) is diagnostically important for eating disorders (EDs) but difficult to measure validly and reliably. The study compared interview and questionnaire formats regarding the proportion of patients in each diagnostic group who reported BE. Method Data came from the clinical Stepwise ED database (N = 3508 adults and 1354 children/adolescents), representing the full range of ED diagnoses. Methods used were the Structured ED Interview and the ED Examination Questionnaire. Results Opposite discrepancies were observed between methods depending on ED diagnosis, such that a higher number of restrictive patients reported BE on the questionnaire than the interview, whereas the opposite was true for bulimic patients. Discussion The findings have important clinical and theoretical implications and suggest that BE assessment is more complex than previously believed. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    April 14, 2014   doi: 10.1002/erv.2289   open full text
  • Outcome of Eating Disorders in a Japanese Sample: A 4‐ to 9‐year Follow‐up Study.
    Yoshikatsu Nakai, Kazuko Nin, Shun'ichi Noma, Seiji Hamagaki, Ryuro Takagi, Stephen A. Wonderlich.
    European Eating Disorders Review. March 14, 2014
    Objective The aim of this study was to compare the outcome of eating disorders (EDs) in Japan with that in Western countries. Method Two hundred and thirty‐three Japanese women with an ED were followed for 4 to 9 years. We identified fully recovered women (good outcome group), partially recovered women (intermediate outcome group) and women with an active ED (poor outcome group) based on physical, behavioural and psychological indices. Results Ninety‐seven subjects were categorized as having a good outcome, 58 as intermediate and 61 as poor, and 17 had died. There was a significant difference in outcome results among the types of ED at intake. Women with both anorexia nervosa and bulimia nervosa, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, at intake had the worst recovery rates. Conclusions These results suggest that the outcome of EDs in Japan is relatively similar to that in Western countries, irrespective of sociocultural background and health systems. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 14, 2014   doi: 10.1002/erv.2290   open full text
  • Effectiveness of Cognitive Remediation and Emotion Skills Training (CREST) for Anorexia Nervosa in Group Format: A Naturalistic Pilot Study.
    Kate Tchanturia, Eli Doris, Caroline Fleming.
    European Eating Disorders Review. March 11, 2014
    Objective This study aims to evaluate a novel and brief skills‐based therapy for inpatients with anorexia nervosa, which addressed ‘cold’ and ‘hot’ cognitions in group format. Method Adult inpatients with anorexia nervosa participated in the cognitive remediation and emotion skills training groups. Participants who attended all group sessions completed patient satisfaction and self‐report questionnaires. Results Analysis of the data showed that social anhedonia (measured by the Revised Social Anhedonia Scale) decreased significantly between pre‐ and post‐interventions, with small effect size (d = 0.39). Motivation (perceived ‘importance to change’ and ‘ability to change’) was found to have increased with small effect sizes (d = 0.23 and d = 0.16), but these changes did not reach statistical significance. The cognitive remediation and emotion skills training group had positive feedback from both the patients and therapists delivering this structured intervention. Conclusion Improved strategies are needed both in supporting inpatients to tolerate the group therapy setting and in helping them to develop the skills necessary for participation. Further larger‐scale research in this area is needed to consolidate these findings. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 11, 2014   doi: 10.1002/erv.2287   open full text
  • Intrusive Thoughts in Obsessive–Compulsive Disorder and Eating Disorder Patients: A Differential Analysis.
    Gemma García‐Soriano, Maria Roncero, Conxa Perpiñá, Amparo Belloch.
    European Eating Disorders Review. March 05, 2014
    The present study aims to compare the unwanted intrusions experienced by obsessive–compulsive (OCD) and eating disorder (ED) patients, their appraisals, and their control strategies and analyse which variables predict the intrusions' disruption and emotional disturbance in each group. Seventy‐nine OCD and 177 ED patients completed two equivalent self‐reports designed to assess OCD‐related and ED‐related intrusions, their dysfunctional appraisals, and associated control strategies. OCD and ED patients experienced intrusions with comparable frequency and emotional disturbance, but OCD patients experienced greater disruption. Differences appeared between groups on some appraisals and control strategies. Intolerance to uncertainty (OCD group) and thought importance (ED group) predicted their respective emotional disturbance and disruption. Additionally, control importance (OCD group) and thought–action fusion moral (OCD and ED groups) predicted their emotional disturbance. OCD and ED share the presence of intrusions; however, different variables explain why they are disruptive and emotionally disturbing. Cognitive intrusions require further investigation as a transdiagnostic variable. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    March 05, 2014   doi: 10.1002/erv.2285   open full text
  • Risk Factors and Antecedent Life Events in the Development of Anorexia Nervosa: A Portuguese Case‐Control Study.
    Bárbara C. Machado, Sónia F. Gonçalves, Carla Martins, Hans W. Hoek, Paulo P. Machado.
    European Eating Disorders Review. February 27, 2014
    Objective The aetiology of anorexia nervosa (AN) is considered to be multifactorial. This study aims to identify potential risk factors for AN and whether these factors are specific to AN or precede the development of psychiatric disorders in general and to identify specific life events in the 12 months immediately preceding the onset of eating disorder (ED) symptoms. Method A case‐control design was used to compare a group of women who meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 86) with healthy controls (N = 86) and with a group of controls with other psychiatric disorders (N = 68), each group matched to the AN patients by age and parental socioeconomic status bands. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. Results Women with AN reported significantly higher rates of perfectionism, negative attitudes toward parents' shape and weight, significant concern about feeling fat and a family history of AN or bulimia nervosa. Critical comments about weight, shape or eating was the most notable event in the year preceding AN onset. Discussion Perfectionism and a family history of ED emerged as the most convergent findings in the development of AN, along with being critical toward parents' shape and weight, and feeling fat. Critical comments about appearance and eating seem to be an important precipitating factor in AN onset. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 27, 2014   doi: 10.1002/erv.2286   open full text
  • Genetic and Environmental Factors Underlying Comorbid Bulimic Behaviours and Alcohol Use Disorders: A Moderating Role for the Dysregulated Personality Cluster?
    Jennifer D. Slane, Kelly L. Klump, Matthew McGue, G. Iacono.
    European Eating Disorders Review. February 24, 2014
    Women with bulimia nervosa (BN) frequently have co‐occurring alcohol use disorders (AUDs). Studies of shared genetic transmission of these disorders have been mixed. Personality heterogeneity among individuals with BN may explain discrepant findings. Cluster analysis has characterized women with BN in groups on the basis of personality profiles. One group, the Dysregulated cluster, characterized largely by behavioural disinhibition and emotional dysregulation may be more closely linked etiologically to AUDs. This study examined whether genetic associations between BN and AUDs are the strongest among the Dysregulated cluster. Symptoms of BN and AUDs were assessed in female twins at ages 17 and 25 years from the Minnesota Twin Family Study. Personality clusters were defined using the Multidimensional Personality Questionnaire. Twin moderation models suggested small‐to‐moderate common genetic transmission between BN and AUDs. However, shared genetic effects did not differ by personality cluster. Findings suggest that personality clusters are unlikely to account for inconsistent findings regarding their shared aetiology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 24, 2014   doi: 10.1002/erv.2284   open full text
  • The Prevalence of Binge Eating Disorder in a Sample of College Students in the North of Portugal.
    Mónica Ribeiro, Eva Conceição, Ana Rita Vaz, Paulo P. P. Machado.
    European Eating Disorders Review. February 07, 2014
    Binge eating disorder (BED) has important associated comorbidities and has been recently considered as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition. This study investigates the prevalence of BED in a sample of college students using a two‐stage design. Between October 2008 and July 2009, 805 students attending a public college campus completed the Questionnaire on Eating and Weight Patterns – Revised to screen for possible cases. Eighty‐five students meeting key criteria for BED were invited for a second stage interview using the Eating Disorder Examination. At stage 1, 9.6% of the subjects reported binge eating episodes. At stage 2, a prevalence rate of 0.5% for BED was found, and 1% if the criterion for large amount of food was excluded. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 07, 2014   doi: 10.1002/erv.2283   open full text
  • Perfectionism and Eating Psychopathology Among Dancers: The Role of High Standards and Self‐criticism.
    Huw Goodwin, Jon Arcelus, Nicole Geach, Caroline Meyer.
    European Eating Disorders Review. January 28, 2014
    This study examined the associations between conscientious perfectionism (high standards), self‐evaluative perfectionism (self‐criticism) and eating psychopathology among dancers. A sample of 244 female dancers, with a mean age of 20.11 years (standard deviation = 1.97) completed the Perfectionism Inventory and Eating Disorder Examination Questionnaire. Self‐evaluative perfectionism predicted eating psychopathology (eating restraint, eating concern, weight concern and shape concern). This relationship was not moderated by conscientious perfectionism. The mediation analyses showed that although conscientious perfectionism predicted eating psychopathology, this relationship was fully mediated by self‐evaluative perfectionism. These findings demonstrate the greater influence of self‐evaluative perfectionism, rather than conscientious perfectionism, on eating psychopathology in dancers. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 28, 2014   doi: 10.1002/erv.2282   open full text
  • Process Evaluation of the Maudsley Model for Treatment of Adults with Anorexia Nervosa Trial. Part II: Patient Experiences of Two Psychological Therapies for Treatment of Anorexia Nervosa.
    Anna Lose, Charlotte Davies, Beth Renwick, Martha Kenyon, Janet Treasure, Ulrike Schmidt,.
    European Eating Disorders Review. January 24, 2014
    Objective This study is the second part of a process evaluation, embedded in the MOSAIC study, a large randomised controlled trial comparing two different psychological therapies, the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM). The study adopted a qualitative approach to examine patient experiences of the two treatments. Method Seventeen semi‐structured interviews were conducted with Anorexia Nervosa and Eating Disorder Not Otherwise Specified‐Anorexia Nervosa type patients, and transcripts were analysed thematically. Results Patient responses yielded five main themes: positive and helpful aspects, beneficial outcomes, less helpful aspects, possible improvements to the treatments, and the therapeutic and external environment. The findings show clear differences and some overlaps between patients' views on MANTRA and SSCM. Discussion Both therapies were experienced by patients as credible and largely helpful, albeit in different ways. These results are in agreement with those of therapists' views on these treatments. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 24, 2014   doi: 10.1002/erv.2279   open full text
  • Process Evaluation of the MOSAIC Trial, Part I: Therapist Experiences of Delivering Two Psychological Therapies for Treatment of Anorexia Nervosa.
    Daniella Waterman‐Collins, Beth Renwick, Anna Lose, Martha Kenyon, Lucy Serpell, Lorna Richards, Nicky Boughton, Janet Treasure, Ulrike Schmidt,.
    European Eating Disorders Review. January 21, 2014
    Objectives Forming part of a process evaluation of a large randomised controlled trial (the Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related conditions, MOSAIC) comparing two outpatient therapies for Anorexia Nervosa (AN), the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM), this study adopted a qualitative approach to examine therapist experiences of treatment delivery. Method Twenty MOSAIC therapists completed semi‐structured interviews. Interviews were recorded, transcribed and analysed thematically. Results Themes of positive aspects, challenges and therapeutic fit emerged. MANTRA was seen as structured and flexible but could feel demanding on therapist time and skill. The slow pace and narrower focus of SSCM gave patients space to talk, but the lack of psychological tools and nutritional emphasis could create frustration. Views on the therapeutic relationship and patient‐therapy fit differed across treatments. Discussion Findings provide testable hypotheses about what works for whom, ideas for therapist training, treatment development and delivery. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 21, 2014   doi: 10.1002/erv.2278   open full text
  • Clinical Features of Night Eating Syndrome among Depressed Patients.
    Suat Kucukgoncu, Cenk Tek, Emrem Bestepe, Christie Musket, Sinan Guloksuz.
    European Eating Disorders Review. January 17, 2014
    Objective The aim of this study was to investigate the frequency and clinical features of night eating syndrome (NES) in a sample of patients with depression. Methods The study sample consisted of 155 depressed outpatients. Socio‐demographic Form, Beck Depression Inventory, Beck Anxiety Inventory, Maudsley Obsessive‐Compulsive Inventory, Pittsburgh Sleep Quality Index (PSQI) and Night Eating Questionnaire were utilised for data collection. Results Night eating syndrome was identified in 21.3% of the patients. Comparisons between NES and non‐NES patients revealed significant differences in BMI, smoking status, Beck Depression Inventory, Beck Anxiety Inventory, rumination and PSQI sub‐scores for sleep quality, latency, disturbances and daytime dysfunction. In our sample, the predictors of NES were BMI, smoking and the subject's score on the PSQI sleep disturbances subscale. Conclusions Night eating syndrome is negatively associated with sleep, severity of anxiety and depression. Our findings suggest that there is a complex relation between NES and depression, and it is recommended that depressed patients be evaluated for NES. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 17, 2014   doi: 10.1002/erv.2280   open full text
  • Placebo Response in Binge Eating Disorder: A Pooled Analysis of 10 Clinical Trials from One Research Group.
    Thomas J. Blom, Carolyn J. Mingione, Anna I. Guerdjikova, Paul E. Keck, Jeffrey A. Welge, Susan L. McElroy.
    European Eating Disorders Review. January 08, 2014
    Objective The aim of this study was to gain further understanding of placebo response in binge eating disorder. Method We pooled participant‐level data from 10 double‐blind, placebo‐controlled, randomized trials of medications for binge eating disorder. The primary outcomes were response (75% reduction in binge eating episodes), cessation of binge eating episodes, change in mean weekly binge eating episodes and binge eating episodes per week. Results Of 234 participants receiving placebo, 89 (38%) were responders and 59 (26%) attained cessation. Placebo‐treated participants significantly reduced their binge eating. The mean (SD) binge eating episodes per week at baseline was 5.2 (3.2) and at endpoint was 2.2 (2.6). Lower baseline binge eating episode frequency and longer study participation were significantly associated with response and cessation. Discussion Less severe eating pathology at baseline was associated with higher placebo response and cessation rates. Future clinical trials may want to stipulate that participants exceed a threshold of illness severity, which may lead to better placebo and drug separation. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    January 08, 2014   doi: 10.1002/erv.2277   open full text
  • The Clinical Implications of High Levels of Autism Spectrum Disorder Features in Anorexia Nervosa: A Pilot Study.
    Vanessa Huke, Jeremy Turk, Saeideh Saeidi, Andrew Kent, John. F. Morgan.
    European Eating Disorders Review. November 26, 2013
    Objective This study examined autism spectrum disorder (ASD) features in relation to treatment completion and eating disorder psychopathology in anorexia nervosa (AN). Method Thirty‐two adult women were recruited from specialist eating disorder services. Features of ASD and disordered eating were measured. Premature termination of treatment was recorded to explore whether ASD traits had impact on early discharge. A healthy control group was also recruited to investigate ASD traits between clinical and nonclinical samples. Results Significant differences were found between the AN group and the healthy control group in obsessive‐compulsive disorder traits, depression and anxiety and ASD traits, with significant differences between groups in Social Skill and Attention Switching. The AN group reported no significant relationship between disordered eating severity and ASD traits. No significant effect was found between ASD features and treatment completion. Discussion Raw data on premature termination of treatment, despite no statistic impact, showed that seven out of the eight participants with high features of ASD completed treatment as planned compared with 50% of those with low ASD traits. Unexpectedly, this suggests enhanced treatment adherence in ASD. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    November 26, 2013   doi: 10.1002/erv.2269   open full text
  • Prevalence and Severity of Categorical and Dimensional Personality Disorders in Adolescents with Eating Disorders.
    Ernesto Magallón‐Neri, Esther González, Gloria Canalda, Maria Forns, J. Eugenio De La Fuente, Estebán Martínez, Raquel García, Anais Lara, Antoni Vallès, Josefina Castro‐Fornieles.
    European Eating Disorders Review. November 14, 2013
    Objective The objective of this study is to explore and compare the prevalence of categorical and dimensional personality disorders (PDs) and their severity in Spanish adolescents with Eating Disorders (EDs). Method Diagnostic and Statistical Manual of Mental Disorders Fourth Edition and International Classification of Diseases, Tenth Revision‐10 modules of the International Personality Disorder Examination were administered to a sample of 100 female adolescents with EDs (mean age = 15.8 years, SD = 0.9). Results Thirty‐three per cent of the sample had at least one PD, in most cases a simple PD. The rate of PDs was 64–28% in anorexia and 25% in EDs not otherwise specified. The highest dimensional scores were observed in bulimia, mainly in borderline and histrionic PDs, and higher scores for anankastic PD in anorexia than in the other ED diagnoses. Overall, purging type EDs had higher cluster B personality pathology scores than restrictive type. Discussion Adolescent female patients with ED have a risk of presenting a comorbid PD, especially patients with bulimia and purging type EDs. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    November 14, 2013   doi: 10.1002/erv.2268   open full text
  • Loss of Control over Eating: A Description of the Eating Disorder/Obesity Spectrum in Women.
    Cynthia Villarejo, Susana Jiménez‐Murcia, Eva Álvarez‐Moya, Roser Granero, Eva Penelo, Janet Treasure, Núria Vilarrasa, Mónica Gil‐Montserrat de Bernabé, Felipe F. Casanueva, Francisco J. Tinahones, José Manuel Fernández‐Real, Gema Frühbeck, Rafael Torre, Cristina Botella, Zaida Agüera, José Manuel Menchón, Fernando Fernández‐Aranda.
    European Eating Disorders Review. November 12, 2013
    Goals This study aimed to analyse the association, commonalities and differences between obesity and eating disorders (ED). Method A total of 150 female patients [50 obese with bulimia nervosa (OB + BN), 50 obese with binge eating disorders (OB + BED), 50 obese without eating disorders (OB)] and 50 female healthy‐eating/weight control (CG) volunteers participated in this study. Assessment All participants were assessed by the Eating Disorders Inventory‐2 (EDI‐2), the Symptom Checklist‐Revised (SCL‐90‐R) and the Temperament and Character Inventory‐Revised. Results In general, all the groups differed significantly and showed linear trends (OB + BN > OB + BED > OB > CG) on general and eating psychopathology (SCL‐90‐R and EDI‐2). Regarding personality traits, statistically significant differences across all four groups were found on Harm Avoidance and Self‐Directedness. Whereas some symptoms were shared in extreme weight conditions, others were specifically related to ED. Conclusions The presence of binge and purge symptomatology in obese patients is clinically relevant. These findings help to understand the relationship between Obesity and ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    November 12, 2013   doi: 10.1002/erv.2267   open full text
  • Patient and Parental Self‐reports of Executive Functioning in a Sample of Young Female Adolescents with Anorexia Nervosa Before and After Cognitive Remediation Therapy.
    Camilla Lindvall Dahlgren, Bryan Lask, Nils Inge Landrø, Øyvind Rø.
    European Eating Disorders Review. October 16, 2013
    Objective Previous studies assessing the potency of cognitive remediation therapy (CRT) have largely focused on performance‐based assessments and how these change during the course of the intervention. Little is known of behavioural manifestations of such changes, and no previous studies have studied parental reports before and after CRT. Method Patient and parental self‐reports of executive function using the Behaviour Rating Inventory of Executive Function (BRIEF) were obtained for 17 adolescent patients in treatment for anorexia nervosa before and after CRT. Results Results indicated that patients scored significantly lower on the BRIEF shift subscale after CRT, whereas parental reports revealed significantly lower scores on the shift and emotional control subscales, and on the two composite indices Behavioural Regulation Index and Global Executive Composite. Case‐wise comparisons support variations in executive functions in adolescents with anorexia nervosa. Discussion Changes are evaluated in light of the relationship between patients and parents and with regard to the limitations of the study design. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 16, 2013   doi: 10.1002/erv.2265   open full text
  • Early Response as a Predictor of Success in Guided Self‐help Treatment for Bulimic Disorders.
    Ana R. Vaz, Eva Conceição, Paulo P. P. Machado.
    European Eating Disorders Review. October 04, 2013
    The aims of this study were to investigate the number of sessions and time required for a clinical meaningful symptomatic change with a guided self‐help treatment and to assess the predictive value of early response and other potential predictors of end‐of‐treatment clinical status. Participants were 42 patients with a diagnosis of bulimia nervosa or ED not otherwise specified. Survival analyses (Kaplan–Meier) were performed to estimate the median time required to attain a 51% reduction in bulimic symptoms. Logistic regression was used to assess predictors of symptom remission. Results showed that the median time to achieve a 51% reduction in binge and purge frequencies was 3.68 and 3.77, respectively. This change occurred at session 3 for 50% of the participants. Early response was the most significant predictor of binge eating remission. No pretreatment predictors of time to achieve early response were found. These results have implications for allocating treatment resources in a stepped‐care intervention model. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 04, 2013   doi: 10.1002/erv.2262   open full text
  • Primary Amenorrhea in Anorexia Nervosa: Impact on Characteristic Masculine and Feminine Traits.
    Jessica H. Baker, Cheryl L. Sisk, Laura M. Thornton, Harry Brandt, Steven Crawford, Manfred M. Fichter, Katherine A. Halmi, Craig Johnson, Ian Jones, Allan S. Kaplan, James E. Mitchell, Michael Strober, Janet Treasure, D. Blake Woodside, Wade H. Berrettini, Walter H. Kaye, Cynthia M. Bulik, Kelly L. Klump.
    European Eating Disorders Review. October 03, 2013
    Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    October 03, 2013   doi: 10.1002/erv.2263   open full text
  • Intellectual Function in Patients with Anorexia Nervosa and Bulimia Nervosa.
    Siri Weider, Marit Sæbø Indredavik, Stian Lydersen, Knut Hestad.
    European Eating Disorders Review. September 23, 2013
    Objective This study aimed to examine cognitive function in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) on the basis of IQ measures, indexes and subtests of the Wechsler Adult Intelligence Scale – Third Edition (WAIS‐III). Methods A total of 41 patients with AN, 40 patients with BN and 40 healthy controls (HC), matched for sex, age and education, were recruited consecutively to complete the WAIS‐III. Results The AN group showed a significantly lower performance than the HC group on most global measures and on eight of the 13 administered subtests. Minor differences in verbal function were detected between the BN group and the HC group. Conclusion The patients with eating disorders showed normal intellectual functions compared with the normative population. However, the AN group displayed a consistently lower performance than the matched HC group, which performed above normative means. The BN group performed at a level between that of the AN and HC groups. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 23, 2013   doi: 10.1002/erv.2260   open full text
  • Video Game Therapy for Emotional Regulation and Impulsivity Control in a Series of Treated Cases with Bulimia Nervosa.
    Ana B. Fagundo, Juan J. Santamaría, Laura Forcano, Cristina Giner‐Bartolomé, Susana Jiménez‐Murcia, Isabel Sánchez, Roser Granero, Maher Ben‐Moussa, Nadia Magnenat‐Thalmann, Dimitri Konstantas, Tony Lam, Mikkel Lucas, Jeppe Nielsen, Richard G. A. Bults, Salomé Tarrega, José M. Menchón, Rafael Torre, Valentina Cardi, Janet Treasure, Fernando Fernández‐Aranda.
    European Eating Disorders Review. September 20, 2013
    Although standard psychological treatments have been successful in treating several core features in eating disorders (ED), other characteristics such as emotional regulation or impulsivity appear to be more resistant to change. There is a growing body of evidence to support the efficacy of cognitive remediation for cognitive and emotional difficulties in ED. Playmancer/ Islands is a video game (VG) designed to specifically treat mental disorders, characterized by problems in impulse control. The objective of the game is to increase self‐control over emotions, decision making and behaviours. The aim of this study is to describe the results from a consecutive series of nine bulimia nervosa patients who were treated with the VG in addition to cognitive behaviour therapy (CBT). The outcomes included clinical and psychopathological questionnaires, and physiological measures were obtained during the VG. Emotional regulation improved, heart rate variability increased, and respiratory rate and impulsivity measures reduced after the treatment. These findings suggest that VG training may enhance treatment for ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 20, 2013   doi: 10.1002/erv.2259   open full text
  • Comorbid Psychiatric Disorders in Female Adolescents with First‐Onset Anorexia Nervosa.
    K Bühren, R Schwarte, F Fluck, N Timmesfeld, M Krei, K Egberts, E Pfeiffer, C Fleischhaker, C Wewetzer, B Herpertz‐Dahlmann.
    European Eating Disorders Review. September 12, 2013
    Objective Patients with anorexia nervosa (AN) exhibit high rates of psychiatric comorbidity. To disentangle the effects of duration of illness on comorbid psychiatric symptoms, we investigated the rates of comorbid psychiatric disorders, suicidality and self‐harm behaviour in adolescent patients with a first onset of AN. Methods In adolescent females (n = 148) with a first onset of AN, body mass index, psychiatric comorbidity (according to DSM‐IV), depressive symptoms, suicidality and self‐injurious behaviour were assessed. Results Seventy patients (47.3%) met the criteria for at least one comorbid psychiatric disorder. The binge‐purging subtype was associated with increased rates of psychiatric comorbidity, suicidality and self‐injurious behaviour. The severity of eating disorder‐specific psychopathology influenced current psychiatric comorbidity and suicidal ideation. Conclusion Prevalence rates of comorbid psychiatric disorders and suicidal ideation are considerably lower among adolescents with AN compared with adults. An early and careful assessment, along with adequate treatment of the eating disorder, might prevent the development of severe psychiatric comorbidities. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 12, 2013   doi: 10.1002/erv.2254   open full text
  • Ten Session Body Image Therapy: Efficacy of a Manualised Body Image Therapy.
    John F. Morgan, Stanimara Lazarova, Monique Schelhase, Saeideh Saeidi.
    European Eating Disorders Review. September 05, 2013
    Objective To determine the efficacy of 10 session body image therapy (BAT‐10) in the treatment of anorexia nervosa with adherence to the methodological guidance for complex interventions. Method Fifty‐five adult inpatients with anorexia nervosa at two national centres received the group‐based manualised body‐image therapy (BAT‐10). BAT‐10 was refined, developed and manualised over two decades, by using the mindfulness‐based cognitive behavioural therapy, including mirror exposure. Outcomes were evaluated using Body Checking Questionnaire, Body Image Avoidance Questionnaire, Physical Appearance State and Trait Anxiety Scale, Eating Disorders Examination Questionnaire and Quality of Life in Eating Disorders. Participant experience was evaluated qualitatively by an interpretative phenomenological analysis. Results Ten session body image therapy achieved highly statistically significant changes in body checking, body avoidance and anxiety, as well as shape‐concern and weight‐concern, without the between‐therapist effects. The quality of life improved globally but not in relation to the psychological subcategory. Discussion Ten session body image therapy delivers behavioural and cognitive improvements in body image in the short‐term, suggesting an effective, feasible and acceptable manual‐based therapy. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    September 05, 2013   doi: 10.1002/erv.2249   open full text
  • Rumination and Modes of Processing around Meal Times in Women with Anorexia Nervosa: Qualitative and Quantitative Results from a Pilot Study.
    Felicity A. Cowdrey, Anne Stewart, Jill Roberts, Rebecca J. Park.
    European Eating Disorders Review. July 26, 2013
    Objective The primary aim of this exploratory study was to examine qualitatively and quantitatively the effects of rumination, mindful breathing, and distraction on processing styles and the meal time experience in women with a history of anorexia nervosa (AN). Method A quasi‐experimental within‐participant design was employed. Thirty‐seven women with history of AN and all experiencing current eating disorder psychopathology listened to a single rumination, mindful breathing and distraction exercise before a meal time. Qualitative and quantitative analyses were employed. Results Specific themes were extracted for each exercise including avoidance, being in the moment and rumination. The rumination exercise led to significantly greater analytical self‐focus. Mindful breathing led to significantly greater experiential self‐focus compared with distraction in partially weight‐restored AN participants. Conclusions In AN, self‐material is processed in a ruminative way and avoidance is valued. It is difficult to shift individuals with AN out of a rumination around meal times using brief mindful breathing. Future research should investigate at what stage of AN illness mindful‐based and acceptance‐based strategies are useful and how these strategies could be incorporated in treatment. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 26, 2013   doi: 10.1002/erv.2236   open full text
  • Theory of Mind in Eating Disorders and Their Relationship to Clinical Profile.
    Fernanda Tapajóz Pereira de Sampaio, Sebastian Soneira, Alfredo Aulicino, Ricardo F. Allegri.
    European Eating Disorders Review. July 26, 2013
    Objective This study aimed to assess cognitive and affective theory of mind (ToM) in patients with eating disorders and to explore its relationship with the clinical and psychopathological profile. Method Theory of mind was assessed in 65 women, consisting of 22 with anorexia nervosa (AN), 19 with bulimia nervosa (BN), and 24 healthy controls (HC), using the Reading the Mind in the Eyes Test and the Faux Pas Test. These tasks evaluate affective and cognitive ToM, respectively. We also examined the correlations between performance on ToM tasks and the clinical psychopathological profile, which was extensively evaluated through self‐report instruments and clinical interviews. Results Patients with AN had poorer performance than BN patients and HCs had in the affective ToM task, particularly in recognizing negative emotions and emotions in male eyes. Moreover, this deficit showed no correlation with the psychopathological profile. Performance in the BN group was equivalent to that of HCs in both tasks. Conclusions In this study, patients with AN showed an impairment in affective ToM, independent of their clinical status. Consistent with other studies, our findings demonstrate a specific difficulty in social cognition in patients with AN. This may be a trait marker in this population and should be considered in treatment. Furthermore, patients with AN and BN have different difficulty profiles in this domain of social cognition. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 26, 2013   doi: 10.1002/erv.2247   open full text
  • Antisaccadic Training to Improve Impulsivity in Binge Eating Disorder.
    Katrin Elisabeth Giel, Kathrin Schag, Christian Plewnia, Stephan Zipfel.
    European Eating Disorders Review. July 25, 2013
    Patients with binge eating disorder (BED) show generally increased impulsivity and especially increased food‐related impulsivity. Both are closely linked to the core pathology of BED, which relates to regular binge eating episodes with experienced loss of control. The antisaccade task is an established paradigm assessing response inhibition as a pivotal component of impulsivity. It requires participants to execute antisaccades; that is, they are supposed to look in the opposite direction of a stimulus that automatically catches attention by appearing in the peripheral visual field. High rates of prosaccades to the peripheral stimuli are considered indicators of increased impulsivity. Presenting food pictures as peripheral stimuli, this task can be used to investigate food‐related impulsivity. We propose modifications of this task in order to design it as an antisaccadic training in which BED patients practise the suppression of food‐related responses, which should result in enhanced control over their eating behaviour. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 25, 2013   doi: 10.1002/erv.2245   open full text
  • Parent–Therapist Alliance in Family‐Based Treatment for Adolescents with Anorexia Nervosa.
    Sarah Forsberg, Elizabeth LoTempio, Susan Bryson, Kathleen Kara Fitzpatrick, Daniel Le Grange, James Lock.
    European Eating Disorders Review. July 17, 2013
    Objective This study aimed to describe the role of parent alliance in Family‐Based Treatment (FBT) for adolescents with anorexia nervosa (AN). Differences between parent and child alliance with the therapist, mothers' and fathers' alliance, and their relationship to outcome were examined. Method Independent observers rated audiotapes of early therapy sessions to assess the therapeutic alliance of parents and adolescents with AN in FBT. Outcome was defined using a previously established cut‐point for recovery from AN. Results Mothers' and fathers' alliance scores with the therapist were similar and significantly higher than adolescent alliance scores early in treatment. Combined parent alliance did not predict recovery at the end of treatment. Difference in alliance scores between mothers and fathers, and parents and their child also did not predict recovery at the end of treatment. Conclusions In FBT, parents developed a strong alliance with the therapist early in treatment. These scores were consistent with the focus in FBT on parental management of eating disorder symptoms, as was the fact that alliance between adolescents and therapists was lower. Although parental therapeutic alliance was likely important in FBT, its role in treatment response remains uncertain. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 17, 2013   doi: 10.1002/erv.2242   open full text
  • Psychological Factors Predict Eating Disorder Onset and Maintenance at 10‐year Follow‐up.
    Lauren A. Holland, Lindsay P. Bodell, Pamela K. Keel.
    European Eating Disorders Review. July 11, 2013
    The present study sought to identify psychological factors that predict onset and maintenance of eating disorders. Secondary analyses were conducted using data from an epidemiological study of health and eating behaviours in men and women (N = 1320; 72% female) to examine the prospective and independent influence of the Eating Disorder Inventory Perfectionism, Interpersonal Distrust, and Maturity Fears subscales in predicting the onset and maintenance of eating disorders at 10‐year follow‐up. Multivariate models indicated higher Perfectionism (p = .025), lower Interpersonal Distrust (p < .001), and higher Maturity Fears (p = .037) predicted increased risk for eating disorder onset at 10‐year follow‐up, but only Perfectionism (p = .004) predicted eating disorder maintenance. Differential prediction of eating disorder onset versus maintenance highlights potentially different psychological foci for prevention versus treatment efforts. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    July 11, 2013   doi: 10.1002/erv.2241   open full text
  • Alterations of the Olfactory–Gustatory Functions in Patients with Eating Disorders.
    Federico Dazzi, Serena De Nitto, Giampietro Zambetti, Camillo Loriedo, Andrea Ciofalo.
    European Eating Disorders Review. June 20, 2013
    Objective The purpose of this study was to assess olfactory–gustatory function impairment in patients with eating disorders. Methods Nineteen patients with a diagnosis of bulimia nervosa, 18 patients with a diagnosis of anorexia nervosa and a control sample of 19 healthy subjects were recruited from the day hospital service of the Complex Operative Unit for Alimentary Conduct Disorders of the Policlinico Umberto I in Rome. Evaluation of olfactory and gustatory functions was performed on patients through the ‘Sniffin' Sticks’ method in order to assess the olfactory threshold, the capacity for discriminating and identifying olfactory stimuli, and the overall olfactory function, and through the ‘taste strip’ kit method in order to assess the gustatory function. The results were processed statistically to assess differences between patients with anorexia nervosa, patients with bulimia nervosa and healthy controls. Results The two groups of patients with bulimia nervosa and anorexia nervosa showed a poorer olfactory and gustatory function compared with the healthy controls; discrimination of olfactory stimuli and overall olfactory function were reduced in both samples, as well as the overall gustatory function and the perception of bitter stimuli, whereas olfactory threshold was altered only in patients with bulimia nervosa. In both samples, scores for olfactory function fell within the range of hyposmia. Discussion Our data suggest that patients with eating disorders have an altered perception of olfactory and gustatory stimuli. The alterations observed are worth further investigation. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 20, 2013   doi: 10.1002/erv.2238   open full text
  • Poor Catch‐up Growth in Late Adolescent Boys with Eating Disorders, Weight Loss and Stunting of Growth.
    Ingemar Swenne.
    European Eating Disorders Review. June 04, 2013
    Objective The study aims to investigate the catch‐up growth of boys presenting with an eating disorder (ED) and a stunting of growth. Method Weight gain and growth of 46 boys with ED were followed up for 1–3 years. Results A total of 13 boys who had not started their pubertal growth spurt at presentation started catch‐up growth immediately following nutritional rehabilitation and weight gain. After 3 years, they had returned to their premorbid growth curve. Thirty‐three boys who had started their pubertal growth spurt prior to presentation never caught up in height but continued to catch down despite weight gain. After 3 years, they had lost 0.64 ± 0.55 height standard deviation scores corresponding to approximately 4.5 cm of potential height. Conclusions In prepubertal boys with EDs, catch‐up growth is possible. Pubertal boys are at a disadvantage in that catch‐up growth may not occur despite weight gain. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    June 04, 2013   doi: 10.1002/erv.2237   open full text
  • Eating Disorders with and without Comorbid Depression and Anxiety: Similarities and Differences in a Clinical Sample of Children and Adolescents.
    Elizabeth K. Hughes, Andrea B. Goldschmidt, Zandre Labuschagne, Katharine L. Loeb, Susan M. Sawyer, Daniel Le Grange.
    European Eating Disorders Review. May 16, 2013
    Objective This study aimed to describe and compare the demographic and clinical characteristics of children and adolescents with an eating disorder (ED) and comorbid depression or anxiety. Method Data were drawn from intake assessments of children and adolescents at a specialist ED clinic. Demographic characteristics (e.g. age and gender) and clinical characteristics (e.g. body mass, binge eating and purging) were compared between 217 ED participants without comorbidity, 32 with comorbid anxiety, 86 with comorbid depression and 36 with comorbid anxiety and depression. Results The groups with comorbid depression had more complex and severe presentations compared with those with an ED and no comorbid disorder and those with comorbid anxiety alone, especially in regard to binge eating, purging, dietary restraint and weight/shape concerns. Discussion Depression and anxiety were differentially related to clinical characteristics of EDs. The findings have implications for understanding the relations between these disorders and their potential to impact outcome of ED treatments. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    May 16, 2013   doi: 10.1002/erv.2234   open full text
  • Direct Experience and the Course of Eating Disorders in Patients on Partial Hospitalization: A Pilot Study.
    Joaquim Soler, José Soriano, Liliana Ferraz, Eva Grasa, Cristina Carmona, Maria J. Portella, Victoria Seto, Enric Alvarez, Víctor Pérez.
    European Eating Disorders Review. February 12, 2013
    Awareness of sensory experience in the present moment is central to mindfulness practice. This type of information processing, in contrast to an analytical evaluative style of processing, could be more beneficial for the course of those psychiatric disorders characterized by ruminative and content‐centred processing, such as eating disorders (EDs). We performed a pilot study to assess the relation between patients' approach to information processing and the duration and severity of EDs. Fifty‐seven patients with a diagnosed ED were included in the study and participated in a self‐guided eating activity to asses the primary information processing mode based on mindfulness concepts of ‘Direct Experience’ and ‘Thinking About’. Additionally, dispositional mindfulness was assessed by the Five Factors Mindfulness Questionnaire, and anxiety during the experiment was determined by means of a 10‐point visual analogue scale. We found that a higher level of self‐reported Direct Experience was inversely associated with several severity variables and with anxiety levels. Direct Experience was predicted by a low anxiety level, less severe illness, and higher scores on one mindfulness facet (Observing). Our results suggest that a Direct Experience processing approach is associated with better ED outcomes. Future studies should be carried out to clarify the repercussion of mindfulness training on EDs. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    February 12, 2013   doi: 10.1002/erv.2224   open full text