Showing papers in "European Eating Disorders Review in 2014"

Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery.

Abstract: There is increasing evidence that patients who have problems with binge eating (BE) or BE disorder (BED) are quite common among the severely obese, including bariatric surgery candidates. The literature suggests that in many cases such eating behaviours improve after bariatric surgery, although this is not uniformly true. The current paper reviews the data on the development of BE, BED and loss of control (LOC) eating after bariatric surgery and the impact of these problems on long-term weight outcome. A search was made of various databases regarding evidence of BE, BED and LOC eating post-operatively in bariatric surgery patients. The data extracted from the literature suggests that 15 research studies have now examined this question. Fourteen of the available 15 studies suggest that the development of problems with BE, BED or LOC eating post-bariatric surgery is associated with less weight loss and/or more weight regain post-bariatric surgery. These data suggests that it is important to identify individuals at high risk for these problems, to follow them post-operatively, and, if appropriate interventions can be developed if such behaviours occur in order to maximize weight loss outcomes.

Eating disorder examination questionnaire: psychometric properties and norms for the Portuguese population.

Abstract: Objective The first aim of the current study was to establish general population norms for the Portuguese version of the Eating Disorder Examination Questionnaire (EDE-Q) in a large community sample of female adolescents and young women, as well, for a diverse Eating Disorder (ED) clinical sample, and for women with obesity without an ED. A second aim of the study was to assess the discriminant validity of the EDE-Q and providing cut-off scores for the total scale and subscales. Method A sample of female adolescents and young women (N = 4091) from the general population, 416 women who met diagnostic criteria for an ED and 138 women seeking obesity treatment completed the EDE-Q. Results Norms for the EDE-Q global subscale were provided. Within the community sample, norms were provided for both high school and college samples. Receiver operating characteristic analysis showed that the EDE-Q total score accurately discriminate between participants with and without an ED. Current norm contributes to the clinical utility of the EDE-Q, providing both a cut-off score and reliable change index. Results showed that the EDE-Q is a reliable instrument, but the theorized four subscales structure was not supported by an explorative factor analysis. Conclusion Results will help both researchers and clinicians interpreting the EDE-Q scores and to establish comparison with data produced in different countries. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Cognitive remediation in anorexia nervosa and related conditions: a systematic review.

Abstract: Research evidence for cognitive remediation therapy's (CRT) effectiveness for anorexia nervosa (AN) has been gathering. This approach is also increasingly being implemented in other disorders including major depressive disorder, obsessive–compulsive disorder and autistic spectrum disorder that share commonalities with AN in neuropsychological profiles and clinical presentations. This systematic literature review identified and appraised the current evidence base to see whether evidence from related conditions could be integrated into the theoretical understanding of CRT for AN as well as future AN treatment developments and research. Overall, CRT studies in AN report promising findings, and CRT appears to be associated with improvements in set-shifting and in central coherence. Cognitive remediation approaches in other conditions also show promising evidence in associated improvements in areas of executive functioning and information processing; links are made between AN treatment and what future treatment developments could consider. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa.

Abstract: 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. Language: en

Food addiction in a Spanish sample of eating disorders: DSM-5 diagnostic subtype differentiation and validation data.

Abstract: Although the concept of 'food addiction' (FA) has raised growing interest because of evidence for similarities between substance dependence and excessive food intake, there is a lack of studies that explore this construct among the wide spectrum of eating disorders (EDs). Besides providing validation scores of a Spanish version of the Yale FA Scale (YFAS-S), this study examined the prevalence of 'FA' among ED subtypes compared with healthy-eating controls (HCs) and the association between 'FA' scores, eating symptomatology and general psychopathology. A sample of 125 adult women with ED, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders 5 criteria, and 82 healthy-eating women participated in the study. All participants were assessed with the YFAS-S, the ED Inventory-2 and the Symptom Checklist-Revised. Results showed that the internal structure of the one-dimensional solution for the YFAS-S was very good (α = 0.95). The YFAS-S has a good discriminative capacity to differentiate between ED and controls (specificity = 97.6% and sensitivity (Se) = 72.8%; area under receiver operating characteristic curve = 0.90) and a good Se to screen for specific ED subtypes. YFAS-S scores were associated with higher levels of negative affect and depression, higher general psychopathology, more severe eating pathology and greater body mass index. When comparing the prevalence of 'FA' between ED subtypes, the lowest prevalence of 'FA', measured with the YFAS-S, was for the anorexia nervosa (AN) restrictive subtype with 50%, and the highest was for the AN binge-purging subtype (85.7%), followed by bulimia nervosa (81.5%) and binge eating disorder (76.9%). In conclusion, higher YFAS-S scores are associated with bingeing ED-subtype patients and with more eating severity and psychopathology. Although the 'FA' construct is able to differentiate between ED and HC, it needs to be further explored.

Prevalence of Eating Disorders amongst Dancers: A Systemic Review and Meta-Analysis

Abstract: Eating disorders in dancers are thought to be common, but the exact rates remain to be clarified. The aim of this study is to systematically compile and analyse the rates of eating disorde rs in dancers. A literature search, appraisal and meta-analysis were conducted. Thi rty-three relevant studies were published between 1966 and 2013 with sufficient data for extraction. Primary data were extracted as raw numbers or confidence intervals. Risk ratios and 95% confidence intervals were calculated for controlled studies. The overall prevalence of eating disorders was 12.0% (16.4% for ballet dancers), 2.0% (4% for bal let dancers) for anorexia, 4.4% (2% for ballet dancers) for bulimia and 9.5% (14.9% for ballet dancers) for eating disorders not otherwise specified (EDNOS). The dancer group had higher mean scores on the EAT-26 and the Eating Disorder Inventory subscales. Dancers, in general, had a higher risk of suffering from eating disorders in general, anorexia nervosa and EDNOS, but no higher risk of suffering from bulimia nervosa. The study concluded that as dancers had a three times higher risk of suffering from eating disorders, particularly anorexia nervosa and EDNOS, specifically designed services for this population should be considered

Dimensions of Emotion Dysregulation in Bulimia Nervosa

Abstract: The goal of this study was to examine associations between dimensions of emotion dysregulation and eating disorder (ED) symptoms in bulimia nervosa (BN). This investigation used baseline data from a BN treatment study that included 80 adults (90% women) with full or subthreshold BN. Participants completed the Difficulties in Emotion Regulation Scale (DERS) and the Eating Disorders Examination (EDE) interview. The EDE global score was significantly correlated with the DERS total score, as well as several DERS subscales: Nonacceptance, Impulse, and Strategies. Further, the DERS Goals subscale was found to be uniquely associated with frequency of purging and driven exercise, although none of the subscales were associated with frequency of objective binge eating. Findings indicate that emotion dysregulation is associated with ED symptoms in BN, suggesting the utility of interventions that address emotion regulation skills deficits in the treatment of the disorder.

Food addiction and bulimia nervosa.

Abstract: In individuals with obesity and binge eating disorder (BED), eating patterns can show addictive qualities, with similarities to substance use disorders on behavioural and neurobiological levels. Bulimia nervosa (BN) has received less attention in this regard, despite their regular binge eating symptoms. The Yale Food Addiction Scale (YFAS) was developed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for substance use disorders, and food addiction can be diagnosed when at least three addiction symptoms are endorsed and a clinically significant impairment or distress is present. Although the prevalence of food addiction diagnoses is increased in individuals with obesity and BED, recent studies which used the YFAS showed that there are also individuals with normal weight who can be classified as being 'food addicted'. Based on self-reported eating disorder symptoms, women with current (n=26) or remitted (n=20) BN, and a control group of women matched for age and body mass index (n=63) completed the YFAS and other measures. Results revealed that all patients with current BN received a food addiction diagnosis according to the YFAS while only six (30%) women with remitted BN did. None of the women in the control group received a food addiction diagnosis. Results provide support for the notion that BN can be described as addiction-like eating behaviour and suggest that food addiction most likely improves when BN symptoms remit.

Executive functioning in overweight individuals with and without loss-of-control eating

Abstract: Objective: The current study sought to examine executive function (EF) in overweight individuals with and without loss-of-control (LOC) eating. Method: Eighty overweight and obese individuals entering a behavioural weight loss trial with (n=18) and without (n=62) LOC eating were administered a clinical interview and neuropsychological battery designed to assess self-regulatory control, planning, delayed discounting and working memory. Results: After controlling for age, IQ and depression, individuals with LOC eating performed worse on tasks of planning and self-regulatory control and did not differ in performance on other tasks. Discussion: Results indicate that overweight individuals with LOC eating display relative deficits in EF compared with overweight individuals without LOC eating. Planning and self-regulatory control deficits in particular may contribute to dysregulated eating patterns, increasing susceptibility to LOC episodes. Future research should examine how EF deficits relate to treatment outcome. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Increases in Weight during Chronic Stress are Partially Associated with a Switch in Food Choice towards Increased Carbohydrate and Saturated Fat Intake

Abstract: We examined if stress associated changes in weight and dietary restraint are associated with changes in the composition of foods consumed. Participants were 38 healthy women on a taught postgraduate university course. Data were obtained at the beginning of the semester and 15 weeks later just prior to a written course exam (the stressor). By using a within subject design, we measured the composition of food consumed, body mass index (BMI), levels of dietary restraint and salivary cortisol. In the larger study from which these data were obtained, it was shown that the effect of increased cortisol secretion on weight gain was mediated by a reduction in dietary restraint. The present data show that increased cortisol secretion, reduced dietary restraint and increased caloric intake, account for 73% of the variance in change in BMI. Further regression analysis indicated that the change in dietary restraint mediated the effect of change in cortisol on change in BMI. Final analysis revealed that the effect of these changes in dietary restraint on weight are partially mediated by increased caloric intake from carbohydrate and saturated fat, that is, a change in dietary composition partially accounts for the link between increased cortisol secretion through heightened hypothalamic-pituitary-adrenal activity resulting in weight gain. These data are consistent with a ‘comfort food hypothesis’, as they suggest that chronic stress can promote reward associated behaviour through reduced dietary restraint and consumption of food containing more carbohydrate and saturated fat. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Shame Memories and Eating Psychopathology: The Buffering Effect of Self‐Compassion

Abstract: Objective Research suggests that self-compassion may protect against shame in eating disorders. This study examines the association between shame memories, self-compassion, self-judgment and eating psychopathology severity and tests the moderator effect of self-compassion on the relationships between shame memories and eating psychopathology. Method Participants were 34 patients with the diagnosis of an eating disorder, who were assessed using Eating Disorder Examination and the Shame Experiences Interview and self-report instruments measuring the traumatic and centrality to identity features of shame memories, self-compassion and self-judgment. Results Self-compassion was negatively correlated to shame memory features and eating psychopathology, and self-judgment was positively associated with such variables. Self-compassion had a moderator effect on the association between shame traumatic and central memories and eating psychopathology severity. Conclusion This is the first study to explore the buffering effect of self-compassion against the pathogenic effects of shame memories on eating psychopathology severity in eating disorders, with relevant clinical and research implications. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Effectiveness of Cognitive Remediation and Emotion Skills Training (CREST) for Anorexia Nervosa in Group Format: A Naturalistic Pilot Study

Abstract: 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.

An investigation of interoceptive sensitivity in eating disorders using a heartbeat detection task and a self-report measure

Abstract: Background Interoception has been proposed to play an important role in the pathogenesis of eating disorders (EDs). Objective The aim of this study was to examine a heart beat detection task (HBDT) as an objective index of interoceptive sensitivity in individuals with an ED. Method The self-report interoceptive deficits subscale of the Eating Disorders Inventory 3 was also used. Results The results of the HBDT demonstrated no significant difference between individuals with an ED and healthy controls. However, performance on this task also did not appear to be different from that expected by chance. Thus, these results cast doubt on the utility of the present HBDT for measuring interoceptive sensitivity. Conclusion Overall, the findings indicate that further research is needed to develop valid, objective measures of interoceptive sensitivity to be used in EDs, so as to overcome the reliance on the Eating Disorders Inventory 3 self-report subscale and to determine how such measures relate to ED and general psychopathology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Physical activity correlates in persons with binge eating disorder: a systematic review.

Abstract: Understanding the factors that influence physical activity in persons with binge eating disorders can aid the design of more effective interventions. In order to address this, the present paper provides a systematic quantitative review of the correlates of physical activity in people with binge eating disorder. We searched PsycINFO, PubMed and PEDro from inception until June 2013. Keywords included 'binge eating' with 'physical activity' or 'exercise', or 'physical inactivity' or 'sedentary'. Nine papers involving 636 (489 women) persons with binge eating disorders and evaluating 24 correlates were included. No consistent physical activity correlates were reported in four or more studies. The only significant correlate with lower physical activity participation reported in more than one study was a negative body attitude. Further research is required to address this current gap in literature.

Temperament subtypes in treatment seeking obese individuals: a latent profile analysis.

Abstract: 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.

Emotional Eating Moderates the Relationship of Night Eating with Binge Eating and Body Mass

Abstract: Night eating syndrome is marked by substantial evening or nocturnal food intake, insomnia, morning anorexia, and depressed mood. Night eating severity has been positively associated with body mass index (BMI), binge eating frequency, and emotional eating tendencies. We conducted an online questionnaire study among students (N = 729) and explored possible interactive effects between those variables. Night eating severity, binge eating frequency, BMI and emotional eating were all positively correlated with each other. Regression analyses showed that night eating severity was particularly related to more frequent binge episodes and higher BMI at high levels of emotional eating but unrelated to those variables at low levels of emotional eating. Thus, eating as a means of emotion regulation appears to be an important moderator of the relationship between night eating and both binge eating and BMI. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Risk factors and antecedent life events in the development of anorexia nervosa: a Portuguese case-control study.

Abstract: ObjectiveThe 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 12months immediately preceding the onset of eating disorder (ED) symptoms. MethodA 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. ResultsWomen 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. DiscussionPerfectionism 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 (c) 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Paths to First Treatment and Duration of Untreated Illness in Anorexia Nervosa: Are There Differences According to Age of Onset?

Abstract: 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.

Subjective and Objective Binge Eating in Relation to Eating Disorder Symptomatology, Depressive Symptoms, and Self‐Esteem among Treatment‐Seeking Adolescents with Bulimia Nervosa

Abstract: 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

Central and peripheral peptides regulating eating behaviour and energy homeostasis in anorexia nervosa and bulimia nervosa: a literature review.

Abstract: A large body of literature suggests the occurrence of a dysregulation in both central and peripheral modulators of appetite in patients with anorexia nervosa (AN) and bulimia nervosa (BN), but at the moment, the state or trait-dependent nature of those changes is far from being clear. It has been proposed, although not definitively proved, that peptide alterations, even when secondary to malnutrition and/or to aberrant eating behaviours, might contribute to the genesis and the maintenance of some symptomatic aspects of AN and BN, thus affecting the course and the prognosis of these disorders. This review focuses on the most significant literature studies that explored the physiology of those central and peripheral peptides, which have prominent effects on eating behaviour, body weight and energy homeostasis in patients with AN and BN. The relevance of peptide dysfunctions for the pathophysiology of eating disorders is critically discussed.

Wernicke Encephalopathy in Subjects Undergoing Restrictive Weight Loss Surgery: A Systematic Review of Literature Data

Abstract: The use of weight loss surgery is progressively increasing, and in recent years, restrictive bariatric surgery procedures have been more often used. Although thought to be associated with a lower incidence of post-operative side effects than malabsorpitive surgery, some cases of micronutrients deficiency have been reported because of an acquired thiamine deficiency; in this clinical setting, some cases of Wernicke encephalopathy (WE) have been described. Major determinants and predictors of this major neurological complication are currently unknown. The aim of this systematic review was to analyse literature data in order to address this issue. The main result of our systematic review was that persistent vomiting is the major determinant of WE in patients undergoing restrictive weight loss surgery. In addition, early thiamine supplementation can rapidly improve the clinical conditions, avoiding permanent deficiencies. On the other hand, given the wide variability of clinical and demographic characteristics, definite prognostic factors of WE occurrence and of clinical outcome cannot be identified. In conclusion, although our results are suggestive, further ad hoc prospective studies evaluating changes in micronutrients levels according to different types of surgery are needed.

Ten session body image therapy: efficacy of a manualised body image therapy.

Abstract: 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.

Clinical Features of Night Eating Syndrome among Depressed Patients

Abstract: 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.

Autobiographical memory in adolescent girls with anorexia nervosa

Abstract: Objective The aim of the study is to investigate deficits in autobiographical memory in adolescents with anorexia nervosa (AN). Methods Sixty female individuals with AN and 60 healthy volunteers with an age range of 11–18 years were enrolled. The Autobiographical Memory Test (AMT), the Eating Disorder Inventory-3, the Toronto Alexithymia Scale-20 for the evaluation of alexithymia and Children's Depression Inventory to evaluate depressive traits were administered. In addition to classical AMT words, we proposed seven experimental cues, chosen from words often used by individuals with eating disorders in daily life. Results Girls with AN showed a massive overgeneral memory effect. This effect was not related to the presence of depression or alexithymia but increased with the duration of the disorder rather than with its severity. Discussion The alteration of autobiographical memory manifests in adolescence. Girls with AN showed a dysregulation of both negative and positive emotional experiences that seemed to be influenced by the disease duration. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Loss of Control over Eating: A Description of the Eating Disorder/Obesity Spectrum in Women

Abstract: 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. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Targeting perfectionism in anorexia nervosa using a group-based cognitive behavioural approach: a pilot study

Abstract: Objective This study aimed to explore whether a six session cognitive behavioural group intervention targeting perfectionism is efficacious in reducing perfectionism in adults with anorexia nervosa in an inpatient setting. Method Adults with anorexia nervosa received a group perfectionism intervention in an inpatient setting. Self-report and patient satisfaction questionnaires were completed at the beginning of the first session and end of the last session. Results Significant changes of moderate effect size were observed for overall perfectionism, concern over mistakes and personal standards dimensions of perfectionism following participation in the group. These changes were found to be independent of change in body mass index. Conclusions A group cognitive behavioural approach appears to be efficacious in reducing perfectionism in adults with anorexia nervosa. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Intrusive Thoughts in Obsessive–Compulsive Disorder and Eating Disorder Patients: A Differential Analysis

Abstract: 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.

Patient and parental self-reports of executive functioning in a sample of young female adolescents with anorexia nervosa before and after cognitive remediation therapy.

Abstract: 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.

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

Abstract: 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.

Trends in Anorexia Nervosa Research: An Analysis of the Top 100 Most Cited Works

Abstract: Analysis of highly cited papers provides unique insights into the status of research in a given field. We sought to identify the top 100 most highly cited papers in the field of anorexia nervosa (AN). A free, publically accessible software was used to conduct an online search of publications with accompanying citation data. Search terms were selected to focus on papers dealing predominantly with AN, and the results manually screened to exclude out-of-scope publications. Papers in bulimia nervosa, eating disorder not otherwise specified and binge-eating disorder, were not included. The top 100 most highly cited papers in the AN field were identified. Of these, 34 garnered greater than 400 citations, classifying them as 'citation classics'. These works were divided into five categories, those dealing with epidemiological trends, medical/psychiatric comorbidities, treatment, mechanisms of disease and measurement/classification. Publications examining the epidemiology and underlying mechanisms of AN account for the majority of the top 100 papers. Scales and measurement tools have had the greatest impact, garnering the greatest number of average citations per paper. Although reasonably diverse, the top 100 papers highlight areas still lagging behind, including the neuroscience of AN as well as research into novel treatment strategies.