Development and validation of the Accommodation and Enabling Scale for Eating Disorders (AESED) for caregivers in eating disorders

Background  

Families of people with eating disorders are often caught up in rule bound eating and safety behaviours that characterise the illness. The main aim of this study was to develop a valid and specific scale to measure family accommodation in the context of having a relative with an eating disorder.     

Three factor eating questionnaire-R18 as a measure of cognitive restraint, uncontrolled eating and emotional eating in a sample of young Finnish females

Background  

The aim of the study was to examine the construct validity of the Three-Factor Eating Questionnaire -R18 (TFEQ-R18), a measure of eating behaviour, and to evaluate cognitive restraint, uncontrolled eating and emotional eating in a sample of adolescent and young adult females of different weights.     

Executive function in eating disorders: The role of state anxiety

Objective:

We examined the influence of depression and anxiety on executive function in individuals with a DSM‐IV diagnosis of anorexia nervosa‐restricting type, anorexia nervosa‐binge‐eating/purging type, bulimia nervosa, or eating disorder not otherwise specified.

Method:

We assessed 106 women after their inpatient treatment in an eating disorders program. All participants were nutritionally stable at the time of testing.

Results:

Thirty percent of the total sample showed impaired performance on one or more tests of executive function. No differences in executive function were observed among diagnostic groups. Anxiety scores accounted for significant variance in performance for all groups.

Discussion:

Executive function deficits were found in a minority of our sample, with significant variance in performance accounted for by self‐reported anxiety. State anxiety appears to contribute to diminished executive function in women with eating disorders. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)     

Course and predictors of maternal eating disorders in the postpartum period

Objective:

To investigate course and predictors of eating disorders in the postpartum period.

Method:

A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM‐IV criteria for prepregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS‐P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum.

Results:

Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS‐P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED.

Discussion:

This is the first large‐scale population‐based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with prepregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)     

Gender,school and academic year differences among Spanish university students at high-risk for developing an eating disorder: An epidemiologic study

Background  

The aim of this study was to assess the magnitude of the university population at high-risk of developing an eating disorder and the prevalence of unhealthy eating attitudes and behaviours amongst groups at risk; gender, school or academic year differences were also explored.     

A placebo‐controlled pilot study of the novel opioid receptor antagonist ALKS‐33 in binge eating disorder

Objective:

To assess preliminarily the effectiveness of a novel opioid antagonist, ALKS‐33, in binge eating disorder (BED).

Method:

In this randomized, placebo‐controlled, flexible dose, proof‐of‐concept trial, 62 outpatients with BED and obesity received ALKS‐33 (N = 26) or placebo (N = 36) for 6 weeks. Outcome measures of binge eating, body weight, and eating pathology were assessed.

Results:

A large decrease in binge eating episode frequency was observed following both ALKS‐33 and placebo treatment. There was no significant difference between treatment groups in binge eating episode frequency or any other measure of binge eating, body weight, or eating pathology.

Discussion:

In this preliminary proof‐of‐concept study in BED, ALKS‐33 did not separate from placebo. Although a failed trial cannot be excluded, the finding is consistent with earlier observations in bulimia nervosa with other opioid antagonists and suggests ALKS‐33, at least when administered daily for 6 weeks, may not be efficacious for BED. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)     

Long-term health-related quality of life in eating disorders

Objective

There is limited evidence on the long-term development of health-related quality of life (HRQoL) in eating disorders and its relation to eating disorder symptoms. Our objective was to measure long-term change in the HRQoL of eating disorder patients and compare it to normal population.

Methods

Fifty-four bulimia nervosa (BN) and forty-seven anorexia nervosa (AN) patients (ICD-10 diagnosis) entering treatment completed the 15D HRQoL questionnaire and the Eating Disorder Inventory (EDI) before and approximately 8 years after the start of treatment.

Results

Baseline HRQoL was severely impaired in the patients. During follow-up, mean HRQoL, body mass index (BMI) and EDI improved statistically significantly in both groups. BMI of AN patients reached normal values, but HRQoL was still severely impaired in both AN and BN compared to general population.

Conclusions

The long-term HRQoL after treatment continues to improve, but is still after 8 years poor. Eating disorders are very serious conditions with long-lasting impact on quality of life even after symptom remission.

     

Adolescent–Adult discrepancies on the eating disorder examination: A function of developmental stage or severity of illness?

Objective:

Across studies, adolescents score lower on measures of eating disorder pathology than adults, but it is unclear whether such findings reflect discrepancies inherent to site/study or true developmental differences. The aim of this study was to determine whether age predicts subscale and diagnostic scores of the Eating Disorder Examination (EDE) in adolescents and adults with anorexia nervosa (AN) admitted to a single research center within the same period of time.

Method:

The sample consisted of 16 adolescent and 20 adult consecutive admissions to parallel, age‐specific, research‐based AN treatment programs. Participants completed a baseline evaluation at admission that included the EDE, depression measures, and global assessment of functioning scales.

Results:

Age significantly predicted EDE scores in univariate regression analyses. However, in multivariate models that included severity indices of general and specific psychopathology as covariates, age was no longer a significant predictor of severity of eating disorder symptoms.

Discussion:

This study adds to the growing body of data showing lower scores on the EDE for adolescents with AN relative to their adult counterparts, while eliminating potential site confounds. Results indicate that the higher adult scores may be carried in part by a more overall severe and chronic general clinical profile. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011)     

Mediators of longitudinal associations between television viewing and eating behaviours in adolescents

Background  

Television viewing has been associated with poor eating behaviours in adolescents. Changing unhealthy eating behaviours is most likely to be achieved by identifying and targeting factors shown to mediate the association between these behaviours. However, little is known about the mediators of the associations between television viewing and eating behaviours. The aim of this study was to examine mediators of the longitudinal associations between television viewing (TV) and eating behaviours among Australian adolescents.     

Subjective binge eating with compensatory behaviors: A variant presentation of bulimia nervosa

Objectives:

To determine whether a variant bulimic‐type presentation, whereby one meets criteria for bulimia nervosa (BN) except that binge eating episodes are not objectively large (i.e., “subjective bulimia nervosa,” SBN), has comparable clinical severity to established eating disorders, particularly BN.

Method:

Treatment‐seeking adults with BN (N = 112), SBN (N = 28), anorexia nervosa restricting type (AN‐R) (N = 45), and AN‐binge/purge type (AN‐B/P) (N = 24) were compared.

Results:

Overall, SBN could not be meaningfully distinguished from BN. SBN and BN had equivalent eating pathology, depression and anxiety symptoms, low quality of life, impulsivity, Axis I comorbidity, and lifetime psychiatric history, and comparable clinical severity to AN‐R and AN‐B/P.

Discussion:

Individuals with SBN, differing from BN only by the smaller size of their binge eating episodes, had a form of eating disorder comparable in clinical severity to threshold AN and BN and warranting clinical attention. Health professionals and the community require greater awareness of this variant to optimize detection, treatment‐seeking, and outcomes. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)     

Validation of a measure of the Satter eating competence model with low-income females

Background  

The purpose of this study was to evaluate the construct validity of a version of the ecSatter Inventory (ecSI), a measure of eating competence (EC), as adapted for use in a low-income (LI) population.     

Comparative prevalence,correlates of impairment,and service utilization for eating disorders across US ethnic groups: Implications for reducing ethnic disparities in health care access for eating disorders

Objective:

The study compared the prevalence, correlates of functional impairment, and service utilization for eating disorders across Latinos, Asians, and African Americans living in the United States to non‐Latino Whites.

Method:

Pooled data from the NIMH Collaborative Psychiatric Epidemiological Studies (CPES;NIMH, 2007) were used.

Results:

The prevalence of anorexia nervosa (AN) and binge‐eating disorder (BED) were similar across all groups examined, but bulimia nervosa (BN) was more prevalent among Latinos and African Americans than non‐Latino Whites. Despite similar prevalence of BED among ethnic groups examined, lifetime prevalence of any binge eating (ABE) was greater among each of the ethnic minority groups in comparison to non‐Latino Whites. Lifetime prevalence of mental health service utilization was lower among ethnic minority groups studied than for non‐Latino Whites for respondents with a lifetime history of any eating disorder.

Discussion:

These findings suggest the need for clinician training and health policy interventions to achieve optimal and equitable care for eating disorders across all ethnic groups in the United States. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2011)

     

Quality of life in Brazilian obese adolescents: effects of a long-term multidisciplinary lifestyle therapy

Background  

Obesity has adverse physical, social, and economic consequences that can negatively affect quality of life (QOL). Thus the aim of this study was to verify the effects of a long-term multidisciplinary lifestyle intervention on QOL, body image, anxiety, depression and binge eating in obese adolescents.     

Muscle dysmorphia and the DSM‐V conundrum: Where does it belong? A review paper

Objective

Muscle dysmorphia is a relatively recently identified psychological condition that, since its inception, has been variously conceptualized as an eating disorder and subsequently as a type of body dysmorphic disorder within the somatoform disorders. This review aims to inform and encourage ongoing debate surrounding the diagnostic placement of this disorder.

Method

We present a review and synthesis of the extant literature with a view to informing future decisions regarding the conceptualization of muscle dysmorphia.

Results

The validity of muscle dysmorphia as a clinical entity has been empirically demonstrated. While the condition bears little semblance to somatization as currently conceptualized, the research suggests a strong conceptual similarity with anorexia nervosa. However, future research needs to utilize more appropriate measures of male eating disorder pathology. Muscle dysmorphia is also inclusive of obsessive compulsive features that are typical to those seen in eating disorder presentations.

Discussion

We suggest that muscle dysmorphia be reanalyzed through the lens of an eating disorder spectrum. Recognition of muscle dysmorphia as an eating disorder may offer more clinical utility in recognizing the male experience of eating disorder pathology and also help reduce the number of current male cases falling into the EDNOS category. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010; 43:483–491     

Effects of reducing the frequency and duration criteria for binge eating on lifetime prevalence of bulimia nervosa and binge eating disorder: implications for DSM-5

Objective:

We assessed the impact of reducing the binge eating frequency and duration thresholds on the diagnostic criteria for bulimia nervosa (BN) and binge eating disorder (BED).

Method:

We estimated the lifetime population prevalence of BN and BED in 13,295 female twins from the Swedish Twin study of Adults: Genes and Environment employing a range of frequency and duration thresholds. External validation (risk to cotwin) was used to investigate empirical evidence for an optimal binge eating frequency threshold.

Results:

The lifetime prevalence estimates of BN and BED increased linearly as the frequency criterion decreased. As the required duration increased, the prevalence of BED decreased slightly. Discontinuity in cotwin risk was observed in BN between at least four times per month and at least five times per month. This model could not be fit for BED.

Discussion:

The proposed changes to the DSM‐5 binge eating frequency and duration criteria would allow for better detection of binge eating pathology without resulting in a markedly higher lifetime prevalence of BN or BED. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)     

Body weight dissatisfaction and communication with parents among adolescents in 24 countries: international cross-sectional survey

Background  

Parents have significant influence on behaviors and perceptions surrounding eating, body image and weight in adolescents. The aim of this study was to examine the prevalence of body weight dissatisfaction, difficulty in communication with the parents and the relationship between communication with parents and adolescents' dissatisfaction with their body weight (dieting or perceived need to diet).     

Do eating attitudes predict early change in eating behaviors among women with bulimic disorders who are treated with cognitive behavioral therapy?

Objective:

This study examined the eating attitudes that are associated with a reduction in bulimic behaviors during the key early stage of cognitive behavioral therapy (CBT).

Method:

A case series of 41 patients with bulimia nervosa (full or partial syndrome) took part. They were drawn from the case loads of CBT therapists working in an outpatient specialist eating disorders team. Each patient completed the Eating Disorder Examination‐Questionnaire and recorded the frequency of objective binges, the frequency of vomiting and the number of laxatives taken between Sessions 1 and 6.

Results:

The participants' reduction in behaviors suggested that the early part of CBT was effective. Correlational analyses showed that those with poorer eating attitudes at the outset of therapy were likely to show the greatest behavioral change by Session 6, in keeping with findings relating to the full duration of CBT.

Discussion:

Patients with relatively unhealthy eating attitudes are more likely to show positive behavioral change in the early part of course of CBT. Clinicians might need to encourage patients with bulimic disorders to work harder on behavioral change when the individual has less pathological eating attitudes at the outset. © 2011 by Wiley Periodicals, Inc.     

Effectiveness and cost-effectiveness of lifestyle interventions on physical activity and eating habits in persons with severe mental disorders: A systematic review

Background  

There is a high prevalence of overweight and obesity in persons with severe mental disorders and this has serious implications on the short and long term health outcomes of these patients. The aim of this review was to evaluate the effectiveness of lifestyle interventions targeting physical activity and eating habits in persons with severe mental disorders. Special attention was given if any of the included studies in the review also examined the cost-effectiveness of these health promotion interventions.     

Fear of food as a treatment target: exposure and response prevention for anorexia nervosa in an open series

Objective:

Anorexia nervosa (AN) is a severe mental illness with high rates of relapse and rehospitalization. New treatment approaches are needed. We aimed to evaluate the potential utility of addressing eating‐related fear in the treatment of AN using psychotherapy techniques known to be effective in the treatment of anxiety disorders and obsessive compulsive disorder, namely exposure therapy and response prevention.

Method:

We developed a brief treatment intervention for AN (AN‐EXRP) and evaluated its effects in an open series of nine individuals with AN towards the end of acute weight restoration. We focused on eating behavior as the primary outcome, as it is related both to anxiety and to longer term course.

Results:

Change in anxiety with AN‐EXRP was associated with greater caloric intake.

Discussion:

These findings support the anxiety‐centered model of AN and suggest the potential utility of further developing this treatment approach. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)     

+Psychometric evaluation of the MacDQoL individualised measure of the impact of macular degeneration on quality of life

Background  

The MacDQoL is an individualised measure of the impact of macular degeneration (MD) on quality of life (QoL). There is preliminary evidence of its psychometric properties and sensitivity to severity of MD. The aim of this study was to carry out further psychometric evaluation with a larger sample and investigate the measure's sensitivity to MD severity.