ORCID Profile
0000-0001-8405-381X
Current Organisations
Curtin University
,
University of North Carolina at Chapel Hill
,
University of Western Australia
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 29-11-2022
DOI: 10.1002/EAT.23858
Abstract: To compare in iduals who have experienced binge‐eating disorder (BED) and anorexia nervosa (AN) (BED AN+) to those who have experienced BED and not AN (BED AN–). Participants ( N = 898) met criteria for lifetime BED and reported current binge eating. Approximately 14% had a lifetime diagnosis of AN. Analyses compared BED AN+ and BED AN– on sociodemographic variables and clinical history. The presence of lifetime AN was associated with more severe eating disorder symptoms, including earlier onset, more frequent, more chronic, and more types of eating disorder behaviors over the lifetime, as well as a higher lifetime prevalence of bulimia nervosa ( BN ). Participants with lifetime AN reported being more likely to have received treatments for BED or BN , had significantly lower minimum, current, and maximum BMIs , had more severe general anxiety, and were significantly more likely to be younger and female. In the full s le, the lifetime prevalence of unhealthy weight control behaviors was high and treatment utilization was low, despite an average 15‐year history since symptom onset. Gastrointestinal disorders and comorbid anxiety, depression, and attention‐deficit/hyperactivity disorder symptoms were prevalent. In iduals fared poorly on a wide array of domains, yet those with lifetime AN fared considerably more poorly. All patients with BED should be screened for mental health and gastrointestinal comorbidities and offered referral and treatment options. In iduals experiencing binge‐eating disorder have severe symptomology, but those who have experienced binge‐eating disorder and anorexia nervosa fare even more poorly. Our study emphasizes that patients with binge‐eating disorder would benefit from being screened for mental health and gastrointestinal comorbidities, and clinicians should consider history of unhealthy weight control behaviors to inform treatment and relapse prevention.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.EATBEH.2019.101305
Abstract: The aim was to examine in children and adolescents with eating disorders the relationship between perfectionism, anxiety, and depression at intake assessment and whether intake perfectionism was significantly associated with anxiety and depression at 6 months and 12 months post-intake review. Participants were 167 females aged 10-17 years (M = 14.6, SD = 1.20) with a diagnosis of an eating disorder, who were assessed at intake to an eating disorders treatment program to receive either inpatient, day or outpatient care. Participants were re-assessed at 6 and 12 months post-intake review. At intake and 6 and 12 months post intake review perfectionism had a significant positive correlation with anxiety and depression. Perfectionism did not however determine change in anxiety and depression over time at 6 and 12 months post-intake review. Despite perfectionism being significantly associated with anxiety and depression, further research is required to explore the relationships between perfectionism, anxiety and depression over time.
Publisher: Springer Science and Business Media LLC
Date: 15-07-2019
Publisher: Wiley
Date: 12-11-2016
DOI: 10.1002/EAT.22644
Publisher: Wiley
Date: 08-07-2018
DOI: 10.1002/EAT.22888
Abstract: Clinical perfectionism has been found to be a risk and maintaining factor in eating disorders (EDs), compulsive exercise, and athlete burnout. This study investigated whether an unguided internet cognitive-behavioral treatment (ICBT) for perfectionism would reduce ED pathology, compulsive exercise, and burnout in in iduals who engage in regular exercise. Participants were randomly allocated to intervention (n = 38) or waitlist control (n =29). A generalized linear mixed model (GLMM) analysis was conducted pre and post treatment. A follow-up analysis was conducted with the intervention group at 3 and 6 months. The intervention group experienced a significant reduction in perfectionism (FMPS-CM: F[1,117] = 17.53, p = < .001, Cohen's d = .82), ED symptomology (EDE-Q: F[1,55] = 7.27, p = .009,Cohen's d = .53) and compulsive exercise (CET: F[1,116] = 10.33, p < .001,Cohen's d = .63). The changes attained post-treatment were maintained within the intervention group at 3-month (FMPS-CM (t[1,100] = 3.67, p < . 001, Cohen's d = .85) (EDE-Q (t[1,50] = 2.20, p = .03, Cohen's d = 1.26) and 6-month follow-up (FMPS (t[1,100] = 2.74, p = 007, Cohen's d = .70) (EDE-Q (t[1,50] = 2.18, p = .03, Cohen's d = 1.26). The results indicate unguided ICBT for perfectionism can have a significant impact on perfectionism, compulsive exercise, and ED symptomatology.
Publisher: Wiley
Date: 15-06-2012
Publisher: Cambridge University Press (CUP)
Date: 20-11-2012
DOI: 10.1017/S0033291712002516
Abstract: We internally validated previously published rates of remission, continuation and incidence of broadly defined eating disorders during pregnancy in the Norwegian Mother and Child Cohort (MoBa) at the Norwegian Institute of Public Health. A total of 77 267 pregnant women enrolled at 17 weeks gestation between 2001 and 2009 were split into a training s le ( n = 41 243) from the version 2 dataset and a validation s le ( n = 36 024) from the version 5 dataset who were not in the original study. Internal validation of original rate models involved fitting a calibration model to compare model parameters between the two s les and bootstrap estimates of bias in the entire version 5 dataset. Remission, continuation and incidence estimates remained stable. Pre-pregnancy prevalence estimates in the validation s le were: anorexia nervosa (AN 0.1%), bulimia nervosa (BN 1.0%), binge eating disorder (BED 3.3%) and eating disorder not otherwise specified-purging disorder (EDNOS-P 0.1%). In early pregnancy, estimates were: BN (0.2%), BED (4.8%) and EDNOS-P ( .01%). Incident BN and EDNOS-P during pregnancy were rare. The highest rates were for full or partial remission for BN and EDNOS-P and continuation for BED. We validated previously estimated rates of remission, continuation and incidence of eating disorders during pregnancy. Eating disorders, especially BED, during pregnancy were relatively common, occurring in nearly one in every 20 women. Pregnancy was a window of remission from BN but a window of vulnerability for BED. Training to detect eating disorders by obstetricians/gynecologists and interventions to enhance pregnancy and neonatal outcomes warrant attention.
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.EATBEH.2018.05.008
Abstract: The link between perfectionism and eating disorders is well established in adults, however little research has been conducted in children and adolescents. The aim was to examine if perfectionism was a predictor of eating disorder symptoms at intake assessment, and 6 and 12 month review. There were 175 children and adolescents aged 10-17 years (M = 14.47 years, SD = 1.31) who were assessed using the Eating Disorders Inventory-3 perfectionism subscale and the child adapted Eating Disorders Examination at intake, 6 and 12 months review. There was a significant association between perfectionism and symptoms of eating disorders at intake assessment and at 6 and 12 month review. Higher perfectionism at intake predicted a lower likelihood of remission at 12 months. The findings suggest that similar to adult s les, perfectionism is significantly associated with eating disorder symptoms in children and adolescents. Further research is required to examine the impact of perfectionism on eating disorder symptoms in longitudinal research with children and adolescents with eating disorders.
Publisher: Elsevier BV
Date: 10-2013
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.BRAT.2011.01.006
Abstract: The aim of this study was to examine the effectiveness of Enhanced Cognitive Behaviour Therapy (CBT-E) for eating disorders in an open trial for adults with the full range of eating disorders found in the community. The only previously published trial of CBT-E for eating disorders was a randomised controlled trial (RCT) conducted in the U.K. for patients with a BMI ≥ 17.5. The current study represents the first published trial of CBT-E to include patients with a BMI<17.5. The study involved 125 patients referred to a public outpatient clinic in Perth, Western Australia. Patients attended, on average, 20-40 in idual sessions with a clinical psychologist. Of those who entered the trial, 53% completed treatment. Longer waiting time for treatment was significantly associated with drop out. By the end of treatment full remission (cessation of all key eating disorder behaviours, BMI ≥ 18.5 kg/m(2), not meeting DSM-IV criteria for an eating disorder) or partial remission (meeting at least 2 these criteria) was achieved by two thirds of the patients who completed treatment and 40% of the total s le. The results compared favourably to those reported in the previous RCT of CBT-E, with one exception being the higher drop-out rate in the current study. Overall, the findings indicated that CBT-E results in significant improvements, in both eating and more general psychopathology, in patients with all eating disorders attending an outpatient clinic.
Publisher: Wiley
Date: 24-01-2014
DOI: 10.1002/EAT.22252
Abstract: To provide normative data on the Multidimensional Anxiety Scale for Children (MASC) for female adolescents presenting for eating disorder (ED) treatment. This study is part of the Helping to Outline Paediatric Eating Disorders Project registry (N ∼ 1,000), a prospective ongoing registry study comprising consecutive pediatric tertiary ED referrals. Female adolescents (N = 278 13-17 years) with EDs completed the MASC at intake. Summary data including percentiles are given for the MASC total and subscales. MASC scores were higher than community norms as expected and increased with age (p <.001) and an anorexic spectrum diagnosis (p < .001). The norms reported will aid clinicians in the understanding and interpretation of in idual MASC scores among female adolescents with EDs and could assist future research to better understand the role of anxiety in the onset and maintenance of EDs.
Publisher: Physicians Postgraduate Press, Inc
Date: 07-07-2016
DOI: 10.4088/PCC.16M01939
Publisher: Wiley
Date: 20-04-2013
DOI: 10.1002/EAT.22137
Abstract: In light of prior inconsistent findings, this study revisits the relationship between weight suppression and treatment outcome in bulimia nervosa. Aside from differences in methodology, we propose that moderator effects may assist the field in interpreting previous inconsistency. In this study, we considered moderators that might place in iduals at risk of broad cognitive and biobehavioral mechanisms implicated in weight (dys)regulation and binge eating, and that within the context of a history of weight suppression, might be associated with especially poor outcomes. Participants were 117 female outpatients aged 16-54 years (M = 25.5) with bulimic disorders treated with enhanced cognitive behavioral therapy. Logistic regression indicated that higher pretreatment weight suppression did not predict drop-out or poor treatment outcome (nonabstinence from binging and purging). Moderators of parental history of overweight, childhood body shape, pretreatment body mass index, and the difference between highest and lowest ever adult body weight were analyzed, but no moderator effects were apparent. This study, along with other negative studies, calls into question the association between weight suppression and treatment outcome. We maintain that moderators may account for inconsistencies, but no candidates were identified in this study. Moderator models could assist us to refine conceptualizations of why some patients high in weight suppression may be vulnerable to poor treatment adherence and outcome and to establish clinical interventions that enhance prognosis.
Publisher: Elsevier BV
Date: 10-2022
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.EATBEH.2017.11.005
Abstract: Research suggests that in iduals with high liking for sweets are at increased risk for binge eating, which has been minimally investigated in in iduals with binge-eating disorder (BED). Forty-one adults (85% female, 83% white) with binge eating concerns completed a sweet taste test and measures of eating disorder behaviors and food cravings. A subset of participants with BED completed an oral glucose tolerance test (OGTT N=21) and a 24-hour dietary recall (N=26). Regression models were used to compare highest sweet preferers (HSP [N=18]) to other sweet preferers (OSP [N=23]) and were used to assess associations between sweet taste preference and outcome variables. Effect sizes (ηp
Publisher: Wiley
Date: 26-04-2022
DOI: 10.1002/ERV.2898
Abstract: Cognitive‐behavioural therapy (CBT) delivered face‐to‐face and via the internet reduces bulimia nervosa (BN) symptoms. However, our empirical understanding of factors affecting patient outcomes is limited. Using data from a randomised, controlled trial comparing internet‐based (CBT4BN, n = 78) with face‐to‐face (CBTF2F, n = 71) group CBT (97% female, M = 28 years), we examined general treatment (across conditions) and modality‐specific predictors of end‐treatment and 1‐year outcomes (abstinence, binge‐eating frequency, purging frequency). Improved eating disorder‐related quality of life (EDQOL) during treatment and follow‐up predicted abstinence at end‐treatment and 1‐year assessments. Improved EDQOL, disordered eating cognitions, and anxiety symptoms predicted less frequent binge eating and purging. Previous CBT and being employed predicted more frequent binge eating and purging at both assessments. Higher self‐transcendence and self‐directedness predicted less frequent binge eating. More severe binge eating and purging at baseline and end‐treatment predicted more frequent binge eating and purging at subsequent assessments. Improved EDQOL was more strongly associated with positive outcome in CBT4BN improved depressive symptoms and health‐related QOL predicted positive outcome in CBT4BN but not CBTF2F. Symptom improvement and certain character traits predicted positive outcome, whereas more severe presentation and prior CBT experience predicted poorer outcome. Consideration of intreatment symptom improvement may facilitate care recommendations, particularly for internet‐based modalities.
Publisher: Informa UK Limited
Date: 21-10-2021
DOI: 10.1080/10640266.2019.1677130
Abstract: Measurement of compulsive exercise is important for the study of eating pathology in in iduals who regularly participate in sport and exercise. The current study examined the factor structure, internal consistency and validity of the compulsive exercise test (CET) in regular exercisers. Participants were recruited via the internet and from sport clubs (
Publisher: Wiley
Date: 12-2008
DOI: 10.1002/JCLP.20524
Abstract: Gender in cognitive-behavioral therapy (CBT) for outcome for depression has been inadequately examined in previous research. Thirty-five men and 55 women diagnosed with a depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV American Psychiatric Association, 1994) completed in idual CBT at an outpatient community mental health clinic and 56 men and 105 women completed group CBT. Depression severity was measured before treatment and at endpoint using the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996) along with secondary outcomes of anxiety (Beck Anxiety Inventory Beck, Epstein, Brown, & Steer, 1988) and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire Endicott, Nee, Harrison, & Blumenthal, 1993). Men and women demonstrated equivalent pretreatment and posttreatment illness severity, a comparable gradient of improvement on outcomes, and attainment of clinically meaningful benchmarks.
Publisher: Wiley
Date: 20-03-2019
DOI: 10.1002/EAT.23073
Publisher: BMJ
Date: 28-11-2014
DOI: 10.1136/ARCHDISCHILD-2012-303272
Abstract: To determine the relationship between serum ferritin and malnutrition in newly assessed patients at a paediatric eating disorders clinic. This was a prospectively assessed clinical cohort study. Intake assessment clinic of a tertiary eating disorders service for children and adolescents. Clinical, anthropometric and laboratory features of children and adolescents were systematically measured. The relationship of serum ferritin to other clinical, anthropometric and laboratory measures was determined using linear regression. A total of 121 female patients aged 9.5–17.6 years were included, with body mass index (BMI) z score −5.7 to 1.9 (median −1.3). Using multiple regression, serum ferritin was inversely associated with BMI z score (regression coefficient (β)=−0.234, 95% CI −0.413 to −0.055) and serum insulin-like growth factor 1 (IGF-1) (β=−0.476, 95% CI −0.884 to −0.068) and positively associated with alanine aminotransferase (β=0.357, 95% CI 0.055 to 0.659, controlling for age, pubertal stage and serum iron). In malnourished adolescents with eating disorders increased serum ferritin is associated with lower BMI z score and serum IGF-1.
Publisher: Elsevier BV
Date: 11-2018
Publisher: Springer Science and Business Media LLC
Date: 12-01-2013
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JPSYCHORES.2018.02.011
Abstract: Capturing trends in healthcare utilization may help to improve efficiencies in the detection and diagnosis of illness, to plan service delivery, and to forecast future health expenditures. For binge-eating disorder (BED), issues include lengthy delays in detection and diagnosis, missed opportunities for recognition and treatment, and morbidity. The study objective was to compare healthcare utilization and expenditure in people with and without BED. A case-control design and nationwide registers were used. All in iduals diagnosed with BED at eating disorder clinics in Sweden between 2005 and 2009 were included (N = 319, 97% female, M age = 22 years). Ten controls (N = 3190) were matched to each case on age-, sex-, and location of birth. Inpatient, hospital-based outpatient, and prescription medication utilization and expenditure were analyzed up to eight years before and four years after the index date (i.e., date of diagnosis of the BED case). Cases had significantly higher inpatient, hospital-based outpatient, and prescription medication utilization and expenditure compared with controls many years prior to and after diagnosis of BED. Utilization and expenditure for controls was relatively stable over time, but for cases followed an inverted U-shape and peaked at the index year. Care for somatic conditions normalized after the index year, but care for psychiatric conditions remained significantly higher. In iduals with BED had substantially higher healthcare utilization and costs in the years prior to and after diagnosis of BED. Since previous research shows a delay in diagnosis, findings indicate clear opportunities for earlier detection and clinical management. Training of providers in detection, diagnosis, and management may help curtail morbidity. A reduction in healthcare utilization was observed after BED diagnosis. This suggests that earlier diagnosis and treatment could improve long-term health outcomes and reduce the economic burden associated with BED.
Publisher: Wiley
Date: 28-07-2020
DOI: 10.1002/EAT.23353
Publisher: Wiley
Date: 12-12-2022
DOI: 10.1002/EAT.23870
Abstract: The COVID‐19 pandemic and public health mitigation measures have negatively impacted in iduals with eating disorders (ED). We evaluated changes in and predictors of ED symptoms, pandemic‐related ED concerns, and anxiety symptoms across the first 12 months of the COVID‐19 pandemic among in iduals with self‐reported EDs in the United States (US), Sweden (SE), and the Netherlands (NL). Participants in the US ( N = 510), SE ( N = 982), and NL ( N = 510) completed an online survey assessing ED symptoms (binge eating, restriction, compensatory behaviors, and anxiety about being unable to exercise), general anxiety symptoms, and pandemic‐related ED concerns about accessing food, lack of structure and social support, being in a triggering environment, and food and treatment costs. In the US and NL, respondents completed surveys beginning April 2020 and continuing monthly for a year. In SE, respondents completed baseline surveys in May 2020, a six‐month follow‐up around December 2020, and a 12‐month follow‐up in May 2021. Three patterns emerged: (1) a curvilinear course with the highest level of symptoms at baseline, declining through November 2020, and increasing through the rest of the year (2) a linear declining course over time and (3) a stable course with no changes. Worries about COVID‐19 infection, lockdown, concerns about lack of structure and social support, and concerns about accessing food consistent with one's recovery meal plan predicted increases in ED symptoms. ED symptoms tracked with pandemic‐related concerns in people with EDs. Conceptualizing predictors of symptoms may inform therapy and public health resources that reduce the impact of pandemics on mental health. Our findings suggest that the COVID‐19 pandemic had negative impacts on people with eating disorders, including lification of mental health symptoms and stressors around peak periods of infection and COVID‐19 restrictions. These findings inform medical providers, policy‐makers, and community‐based supports about the information and resource needs of this group to ensure efficient dissemination in future public health emergencies and during the ongoing COVID‐19 pandemic.
Publisher: Springer Science and Business Media LLC
Date: 12-08-2013
Publisher: Cambridge University Press (CUP)
Date: 03-03-2015
DOI: 10.1017/S1352465814000629
Abstract: Background: Clinical perfectionism is a risk and maintaining factor for anxiety disorders, depression and eating disorders. Aims: The aim was to examine the psychometric properties of the 12-item Clinical Perfectionism Questionnaire (CPQ). Method: The research involved two s les. Study 1 comprised a nonclinical s le ( n = 206) recruited via the internet. Study 2 comprised in iduals in treatment for an eating disorder ( n = 129) and a community s le ( n = 80). Results: Study 1 factor analysis results indicated a two-factor structure. The CPQ had strong correlations with measures of perfectionism and psychopathology, acceptable internal consistency, and discriminative and incremental validity. The results of Study 2 suggested the same two-factor structure, acceptable internal consistency, and construct validity, with the CPQ discriminating between the eating disorder and control groups. Readability was assessed as a US grade 4 reading level (student age range 9–10 years). Conclusions: The findings provide evidence for the reliability and validity of the CPQ in a clinical eating disorder and two separate community s les. Although further research is required the CPQ has promising evidence as a reliable and valid measure of clinical perfectionism.
Publisher: Wiley
Date: 25-04-2018
DOI: 10.1002/EAT.22869
Publisher: Wiley
Date: 19-09-2016
DOI: 10.1002/EAT.22624
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.EATBEH.2011.01.005
Abstract: To compare the goodness-of-fit of five models of Eating Disorder Examination-Questionnaire (EDE-Q) data, in clinical and community s les. The EDE-Q was administered to 228 eating disorder patients and 211 non-eating disordered university students. Confirmatory factor analysis was used to compare the validity of the original four EDE-Q subscales with that of brief one-factor, extended one-factor, two-factor, and three-factor models. Measurement invariance across the two s les was considered. The only model to provide an acceptable fit to the data was the brief one-factor model consisting of eight Weight and Shape Concern items. Scores on this scale correlated highly with the original EDE-Q subscales. The reliability of the EDE-Q may be increased if a modified scoring system is used. This complements findings from recent research with the Eating Disorder Examination (EDE).
Publisher: Wiley
Date: 27-12-2017
DOI: 10.1002/JCLP.22435
Abstract: The clinical significance of 2 main dimensions of perfectionism (perfectionistic strivings and perfectionistic concerns) was examined via a meta-analysis of studies investigating perfectionism in the psychopathology literature. We investigated relationships between psychopathology outcomes (clinical diagnoses of depression, anxiety disorders, obsessive-compulsive disorder, and eating disorders symptoms of these disorders and outcomes related to psychopathology, such as deliberate self-harm, suicidal ideation, and general distress) and each perfectionism dimension. The relationships were examined by evaluating (a) differences in the magnitude of association of the 2 perfectionism dimensions with psychopathology outcomes and (b) subscales of 2 common measures of perfectionism. A systematic literature search retrieved 284 relevant studies, resulting in 2,047 effect sizes that were analysed with meta-analysis and meta-regression while accounting for data dependencies. Findings support the notion of perfectionism as a transdiagnostic factor by demonstrating that both dimensions are associated with various forms of psychopathology.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.COMPPSYCH.2010.07.006
Abstract: To compare quality of life (QoL) in mental health outpatients to non-clinical norms, and examine the associations between QoL and principal diagnosis, number of comorbid Axis I diagnoses, and type of comorbidity. Consecutively referred and assessed patients (n = 2024) formed the study s le pool. Of these, 1486 in iduals who had completed a QoL instrument at intake and had a principal diagnosis amenable to comparison by group analysis were included in the study. Principal diagnoses were unipolar mood disorder (n = 687), eating disorder (n = 226), bipolar disorder (n = 165), social anxiety disorder (n = 165), generalized anxiety disorder (n = 125), and panic disorder (n = 118). QoL for psychiatric groups was compared to non-clinical norms using a valid and reliable measure. QoL was significantly impaired in all psychiatric groups compared to nonclinical norms. There was a significant interaction between principal diagnosis and number of comorbid Axis I disorders, controlling for age, sex, marital status, employment, and years of school. The addition of one comorbidity significantly attenuated QoL in social anxiety disorder, panic disorder, and bipolar disorder. For all other conditions, a significant loss in QoL occurred with two or more comorbidities. Axis I depressive and anxiety comorbidity significantly attenuated QoL across all diagnostic groups. QoL is significantly impaired in psychiatric outpatients and diagnostic groups vary in the extent to which they experience additional QoL burden with increasing comorbidities.
Publisher: Cold Spring Harbor Laboratory
Date: 11-04-2019
DOI: 10.1101/587196
Abstract: Genome-wide association study (GWAS) analyses, at sufficient s le sizes and power, have successfully revealed biological insights for several complex traits. RICOPILI, an open sourced Perl-based pipeline was developed to address the challenges of rapidly processing large scale multi-cohort GWAS studies including quality control, imputation and downstream analyses. The pipeline is computationally efficient with portability to a wide range of high-performance computing (HPC) environments. RICOPILI was created as the Psychiatric Genomics Consortium (PGC) pipeline for GWAS and has been adopted by other users. The pipeline features i) technical and genomic quality control in case-control and trio cohorts ii) genome-wide phasing and imputation iv) association analysis v) meta-analysis vi) polygenic risk scoring and vii) replication analysis. Notably, a major differentiator from other GWAS pipelines, RICOPILI leverages on automated parallelization and cluster job management approaches for rapid production of imputed genome-wide data. A comprehensive meta-analysis of simulated GWAS data has been incorporated demonstrating each step of the pipeline. This includes all of the associated visualization plots, to allow ease of data interpretation and manuscript preparation. Simulated GWAS datasets are also packaged with the pipeline for user training tutorials and developer work. RICOPILI has a flexible architecture to allow for ongoing development and incorporation of newer available algorithms and is adaptable to various HPC environments (QSUB, BSUB, SLURM and others). Specific links for genomic resources are either directly provided in this paper or via tutorials and external links. The central location hosting scripts and tutorials is found at this URL: /broadinstitute.org/RICOPILI/home sripke@broadinstitute.org Supplementary data are available.
Publisher: Cambridge University Press (CUP)
Date: 15-02-2021
DOI: 10.1017/S0033291720005474
Abstract: Enabled by advances in high throughput genomic sequencing and an unprecedented level of global data sharing, molecular genetic research is beginning to unlock the biological basis of eating disorders. This invited review provides an overview of genetic discoveries in eating disorders in the genome-wide era. To date, five genome-wide association studies on eating disorders have been conducted – all on anorexia nervosa (AN). For AN, several risk loci have been detected, and ~11–17% of the heritability has been accounted for by common genetic variants. There is extensive genetic overlap between AN and psychological traits, especially obsessive-compulsive disorder, and intriguingly, with metabolic phenotypes even after adjusting for body mass index (BMI) risk variants. Furthermore, genetic risk variants predisposing to lower BMI may be causal risk factors for AN. Causal genes and biological pathways of eating disorders have yet to be elucidated and will require greater s le sizes and statistical power, and functional follow-up studies. Several studies are underway to recruit in iduals with bulimia nervosa and binge-eating disorder to enable further genome-wide studies. Data collections and research labs focused on the genetics of eating disorders have joined together in a global effort with the Psychiatric Genomics Consortium. Molecular genetics research in the genome-wide era is improving knowledge about the biology behind the established heritability of eating disorders. This has the potential to offer new hope for understanding eating disorder etiology and for overcoming the therapeutic challenges that confront the eating disorder field.
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.EATBEH.2009.07.001
Abstract: A confirmatory factor analysis of the factor structure of the Distress Tolerance Scale (DTS) created by Corstorphine et al. [Corstorphine, E., Mountford, V., Tomlinson, S., Waller, G., & Meyer, C. (2007). Distress tolerance in the eating disorders. Eating Behaviors, 8, 91-97.] was conducted to assess whether the scale's purported three factors emerged in a clinical s le of patients with a DSM-IV diagnosed eating disorder. The original three-factor model was generally considered to be a poor fit for the data. Subsequent exploratory factor analysis indicated that a better fit emerged using a four-factor structure. Significant associations were observed between behavioral avoidance of positive affect and eating disorder psychopathology. Implications for use of the DTS with eating disorder patients are discussed.
Publisher: Wiley
Date: 26-11-2016
DOI: 10.1002/EAT.22478
Abstract: The factor structure of the eating disorder examination (EDE) has never been tested in a clinical pediatric s le, and no normative data exist. The factor structure of an adapted EDE was examined in a clinical s le of 665 females aged 9-17 years with anorexia nervosa spectrum (70%), bulimia nervosa spectrum (12%), purging disorder (3%), and unspecified feeding and eating disorders (15%). The original four-factor model was a good fit in a confirmatory factor analysis as well a higher order model with three dimensions of restraint, eating concern, and combined weight concern/shape concern. Normative data are reported for clinicians to identify the percentiles in which their patients' score. The findings support dimensions of restraint, eating concern, weight concern, and shape concern in a clinical pediatric s le. This supports the factorial validity of the EDE, and the norms may assist clinicians to evaluate symptoms in females under 18 years.
Publisher: Informa UK Limited
Date: 16-05-2011
DOI: 10.3109/09638237.2011.562259
Abstract: Accurate diagnosis of eating disorders may facilitate appropriate management of the conditions. Currently, little information is available regarding the accuracy of eating disorder diagnoses made in routine primary care. To evaluate the accuracy of eating disorder diagnoses made in primary care settings, and to compare the accuracy of primary care diagnoses with those generated using patient self-report questionnaires. Participants were 212 consecutive referrals to an outpatient eating disorder programme, who were found to have a DSM-IV eating disorder upon assessment with the Eating Disorder Examination (EDE). Primary care diagnoses were taken from referral letters and forms. Self-report diagnoses were generated using self-report responses to the Eating Disorder Examination-Questionnaire (EDE-Q). Primary care practitioners were accurate in identifying anorexia and bulimia nervosa, but inaccurate in identifying atypical presentations (e.g. eating disorders not otherwise specified [EDNOS]). Convergence between the EDE and the EDE-Q was modest, and the EDE-Q tended to overestimate the incidence of EDNOS. 'Atypical' eating disorder presentations tend to be misdiagnosed in primary care settings, although practitioners are generally accurate in distinguishing between anorexia-like and bulimia-like presentations. This has implications for the management of eating disorders in primary care settings.
Publisher: Wiley
Date: 27-10-2014
DOI: 10.1002/EAT.22359
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.EATBEH.2012.07.002
Abstract: The aim of this study was to investigate the mediating effect of shape and weight overvaluation and conditional goal-setting on the relationship between perfectionism and eating pathology among women in the general community. Results from structural equation modeling indicated that the full mediation model previously established with a clinical s le (Watson et al., 2011), generalized to the present community s le (n=202). The indirect effect of self-oriented perfectionism on eating disorder pathology was .25 (p<.001) via shape and weight overvaluation, and .10 (p<.01) via conditional goal-setting, supporting the hypothesis that self-oriented perfectionism increased eating disorder psychopathology via each mechanism. Shape and weight overvaluation was the stronger mediator. The findings provide evidence to support existing cognitive-behavioral formulations of eating pathology and clinical perfectionism, and have implications for the prevention of eating pathology.
Publisher: Springer New York
Date: 2011
Publisher: Springer Science and Business Media LLC
Date: 27-04-2020
Publisher: Wiley
Date: 28-05-2009
DOI: 10.1002/CPP.588
Abstract: Studies have shown that psychiatric patients have significantly impaired quality of life (QOL) in comparison to community s les who are not suffering a mental illness. Despite an increase in research in the mental health field, there still remains little consensus as to the merit of using such questionnaires within a mental health population. There is a concern that QOL is redundant with affective state and symptomatology. We investigated the usefulness of the Quality of Life Enjoyment and Satisfaction Questionnaire-short form (QLESQ-SF) in a depressed outpatient s le receiving time-limited, standardized group cognitive-behavioural therapy. QLESQ-SF ratings were examined at admission and 10-week endpoint in an intention-to-treat (N = 212) and completers (N = 164) s le. QLESQ-SF ratings and symptom ratings (Beck Depression Inventory-II Beck Anxiety Inventory) improved significantly over time. Hierarchical regression analyses revealed that, although affective state and change in symptomatology were significantly correlated with QOL and change in QOL, a large proportion of variance was unexplained. These results are inconsistent with the theory of measurement redundancy. QOL appears to be a useful measure that provides additional treatment outcome information distinct from affective state and symptomatology.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.EATBEH.2016.11.001
Abstract: The aim of this study was to examine whether compulsive exercise mediates the relationship between clinical perfectionism and eating pathology, based on the cognitive behavioral model of compulsive exercise. Participants were 368 adults who participated regularly in sport/exercise and completed online measures of perfectionism, compulsive exercise and eating disorders. In support of the well-established link between perfectionism and eating disorders, clinical perfectionism predicted eating pathology both directly and indirectly mediated by compulsive exercise. In addition, there were also direct effects of clinical perfectionism on the avoidance/rule-driven behavior, weight control, and mood improvement subscales of the Compulsive Exercise Test (CET). There was a direct effect of the CET weight control subscale on eating pathology and a negative direct effect of the CET subscale mood improvement on eating pathology. Findings lend support to the cognitive behavioral model of compulsive exercise in which clinical perfectionism is conceptualized as related to eating disorders directly and indirectly through the mediation of compulsive exercise. Compulsive exercise was also found to have a direct effect on eating disorders. Compulsive exercise may be a symptom of eating pathology, rather than an antecedent, however causal inferences could not be established given the correlational design. Longitudinal research using cross-lagged panel designs to examine a bidirectional relationship between compulsive exercise and eating disorders is needed.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: Springer Science and Business Media LLC
Date: 25-07-2017
DOI: 10.1038/MP.2017.88
Abstract: Anorexia nervosa (AN) is a complex neuropsychiatric disorder presenting with dangerously low body weight, and a deep and persistent fear of gaining weight. To date, only one genome-wide significant locus associated with AN has been identified. We performed an exome-chip based genome-wide association studies (GWAS) in 2158 cases from nine populations of European origin and 15 485 ancestrally matched controls. Unlike previous studies, this GWAS also probed association in low-frequency and rare variants. Sixteen independent variants were taken forward for in silico and de novo replication (11 common and 5 rare). No findings reached genome-wide significance. Two notable common variants were identified: rs10791286, an intronic variant in OPCML ( P =9.89 × 10 −6 ), and rs7700147, an intergenic variant ( P =2.93 × 10 −5 ). No low-frequency variant associations were identified at genome-wide significance, although the study was well-powered to detect low-frequency variants with large effect sizes, suggesting that there may be no AN loci in this genomic search space with large effect sizes.
Publisher: Wiley
Date: 27-10-2014
DOI: 10.1002/EAT.22361
Publisher: Wiley
Date: 25-02-2013
DOI: 10.1002/EAT.22085
Abstract: Traditionally, drop-out has been investigated subsequent to treatment entry yet some in iduals "exit early," attending assessment but failing to commence the treatment offered. Early exit burdens administrative and clinical resources and means that in iduals may not receive the care needed for recovery. This study aimed to describe the prevalence and characteristics associated with early exit at a statewide, outpatient eating disorder service. From a pool of 972 consecutive referrals of adults and youth (16+ years), two groups were formed an "early exit" group of in iduals who attended assessment but chose to exit the service prior to treatment entry and a "non-early exit" group that attended assessment and entered treatment. The groups were compared on sociodemographic, clinical, and administrative features. The prevalence of early exit was 18.7%. The early exit group exhibited less pathology compared with the non-early exit group specifically, a lower presence of Axis I comorbidity (p = .04) and self-induced vomiting (p = .04). The findings, considered in the context of previous research, suggest that there are no measured features to date that are robustly associated with early exit from outpatient eating disorder services. Future research should investigate decision-making processes at assessment, to inform patient-centered approaches that optimize transition to treatment.
Publisher: Routledge
Date: 03-2013
Publisher: Wiley
Date: 2010
DOI: 10.1002/EAT.20788
Abstract: To examine mediators of the relationship between perfectionism and eating disorder (ED) psychopathology in a clinical s le. Participants were 201 women with a DSM-IV diagnosed ED consecutively referred to a specialist outpatient treatment clinic. Participants completed measures of perfectionism, ED psychopathology, shape and weight overvaluation, and conditional goal-setting (CGS). Evaluation of a multivariate mediator model using Baron and Kenny's (1986) four-step mediation methodology showed that shape and weight overvaluation and CGS significantly and uniquely mediated the relation between self-oriented perfectionism (SOP) and restraint, eating concern, shape concern, and weight concern. The mediator model furthered the proportion of explained variance in outcomes beyond the direct effects model by 28-49%. The findings support the conclusion that the relationship between SOP and ED psychopathology in women with a clinically diagnosed ED is mediated by shape and weight overvaluation and CGS.
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.BRAT.2019.103429
Abstract: Perfectionism is a risk factor for the development and maintenance of eating disorders. The objective of this study was to examine the efficacy of unguided Internet cognitive behaviour therapy for perfectionism (ICBT-P) as a treatment and prevention for perfectionism and symptoms of eating disorders, anxiety, depression and self-esteem in female adolescents. Young women (N = 94, 14-19 years) who self-identified as having difficulties with perfectionism but did not have a clinical eating disorder diagnosis were recruited. Participants were randomly allocated into one of three groups: unguided ICBT-P, unguided ICBT for nonspecific stress management (ICBT-S), or waitlist control. All analyses were intent-to-treat. ICBT-P resulted in the most favorable outcomes at post-treatment and 3- and 6-months follow-up. ICBT-P was superior to control on all outcome measures at 3- and 6-months and superior to ICBT-S on all outcomes over most time points (ds = 0.13-0.94). Clinical significance analysis demonstrated that the treatment prevented symptom increases over 6-month follow-up, with ICBT-P superior to ICBT-S in prevention of clinical perfectionism and depressive symptoms, and ICBT-P superior to waitlist control in prevention of eating disorder symptoms. There was relatively high attrition, although there were no differences in attrition between the groups at 3- and 6-month follow-up and rates were commensurate with other Internet interventions. The findings support unguided ICBT-P as a useful target for preventing eating disorder and associated symptoms in female youth who self-identify as perfectionistic. ACTRN12615001098527.
Publisher: S. Karger AG
Date: 25-11-2016
DOI: 10.1159/000449025
Abstract: b i Objective: /i /b Although cognitive-behavioral therapy (CBT) represents the first-line evidence-based psychotherapy for bulimia nervosa (BN), most in iduals seeking treatment do not have access to this specialized intervention. We compared an Internet-based manualized version of CBT group therapy for BN conducted via a therapeutic chat group (CBT4BN) to the same treatment conducted via a traditional face-to-face group therapy (CBTF2F). b i Method: /i /b In a two-site, randomized, controlled noninferiority trial, we tested the hypothesis that CBT4BN would not be inferior to CBTF2F. A total of 179 adult patients with BN (2.6% males) received up to 16 sessions of group CBT over 20 weeks in either CBT4BN or CBTF2F, and outcomes were compared at the end of treatment and at the 12-month follow-up. b i Results: /i /b At the end of treatment, CBT4BN was inferior to CBTF2F in producing abstinence from binge eating and purging. However, by the 12-month follow-up, CBT4BN was mostly not inferior to CBTF2F. Participants in the CBT4BN condition, but not CBTF2F, continued to reduce their binge-eating and purging frequency from the end of treatment to the 12-month follow-up. b i Conclusions: /i /b CBT delivered online in a group chat format appears to be an efficacious treatment for BN, although the trajectory of recovery may be slower than face-to-face group therapy. Online chat groups may increase accessibility of treatment and represent a cost-effective approach to service delivery. However, barriers in service delivery such as state-specific license and ethical guidelines for online therapists need to be addressed.
Publisher: Wiley
Date: 26-07-2012
DOI: 10.1002/ERV.1131
Abstract: To evaluate the effectiveness of a motivation-focused intervention prior to in idual cognitive behavioural eating disorder treatment. Enhanced cognitive-behavioural therapy (CBT-E) in its usual form was compared with CBT-E preceded by four sessions of motivation-focused therapy (MFT) (MFT + CBT-E). Participants were adult outpatients seen at a specialist eating disorder clinic in Western Australia, who met criteria for a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition eating disorder. A sequential trial of CBT-E as usual (n = 43) and MFT + CBT-E (n = 52) was conducted over a 40-month period. The MFT phase was associated with significant increases in readiness to change. There were no significant between-group differences in treatment completion rates, and treatment completers in both conditions reported comparable reductions in eating disorder symptoms over time. In this s le, MFT + CBT-E was not associated with superior treatment outcome when compared with CBT-E as usual.
Publisher: Informa UK Limited
Date: 04-03-2019
Publisher: Wiley
Date: 22-06-2012
DOI: 10.1002/ERV.2186
Abstract: Quality of life (QOL) is the degree of enjoyment and satisfaction experienced in life, and embraces emotional well-being, physical health, economic and living circumstances, and work satisfaction. QOL recovery with eating disorder treatment has received sparse attention, and until now, no study has investigated QOL recovery with enhanced cognitive behaviour therapy (CBT-E). Patients (n = 196) admitted to a specialist eating disorders outpatient programme and receiving CBT-E completed measures of QOL, eating disorder psychopathology, depression, anxiety and self-esteem, before and after treatment. QOL at intake was compared with community norms, and QOL below the norm was predicted from sociodemographic and clinical correlates with logistic regression. Baseline QOL below the norm was associated with depression and anxiety Axis I comorbidity, and severity of depressive symptoms. Predictors of post-treatment QOL were baseline QOL and level of depressive symptoms and self-esteem at post-treatment. CBT-E was associated with gains in QOL over the course of treatment, in addition to eating disorder symptom relief.
Publisher: Center for Open Science
Date: 04-03-2021
Abstract: Anorexia nervosa (AN) polygenic liability has been associated with mental health traits, eating problems, and body mass index (BMI) in adolescence and adulthood, but little is known about its manifestations in early childhood. We explore AN polygenic score (PGS) associations with six childhood domains: BMI, eating problems, neurodevelopment, emotional problems, disruptive/aggressive behaviour, and temperament ersonality in 15,205 children from the Norwegian Mother, Father and Child Cohort Study. Results did not support associations between AN PGS and developmental phenotypes in girls. For boys, we observed an association between AN PGS and higher temperamental fussiness at 6 months, (b= 0.036 [95% CI=0.010,0.061]). Our results suggest that genetic risk for AN as indexed by the PGS has few observable manifestations in key neurodevelopmental domains in the first 8 years of life. Future studies with more powerful PGS that track children longer may aid in understanding how and when genetic risk for AN manifest developmentally.
Publisher: Wiley
Date: 17-10-2014
DOI: 10.1002/EAT.22205
Abstract: Eating disorders are common but underdiagnosed illnesses. Help-seeking for co-occurring issues, such as anxiety and depression, are common. To identify the prevalence of eating problems, using the SCOFF, and eating disorders when screening positive on the SCOFF (i.e., ≥2), among patients seeking help for anxiety and depression at a community-based mental health service. Patients (N = 260) consecutively referred and assessed for anxiety and depression treatment were administered the SCOFF screening questionnaire and a semi-structured standardized diagnostic interview during routine intake. 18.5% (48/260) scored ≥2 on the SCOFF, indicating eating problems. Of these, 41% (19/48) met criteria for an eating disorder. Thus, overall, 7.3% (19/260) of the s le met criteria for a DSM-IV eating disorder. Those scoring ≥2 on the SCOFF were more likely to: be female (p = 0.001), younger (p = 0.003), and have a history of self-harm (p < 0.001). This study confirms that eating disorders are a hidden phenomenon in general outpatient mental health. By using a standardized diagnostic interview to establish diagnosis rather than self- or staff-report, the study builds on limited previous findings. The naturalistic study setting shows that screening for eating disorders can be easily built into routine intake practice, and successfully identifies treatment need.
Publisher: Wiley
Date: 07-04-2008
DOI: 10.1111/J.1469-7610.2007.01875.X
Abstract: To conduct a meta-analysis on randomized, controlled treatment trials of pediatric obsessive-compulsive disorder (OCD). Studies were included if they employed randomized, controlled methodology and treated young people (19 years or under) with OCD. A comprehensive literature search identified 13 RCTs containing 10 pharmacotherapy to control comparisons (N = 1016) and five cognitive-behavioral therapy (CBT) to control comparisons (N = 161). Random effects modeling yielded statistically significant pooled effect size (ES) estimates for pharmacotherapy (ES = .48, 95% CI = .36 to .61, p < .00001) and CBT (ES = 1.45, 95% CI = .68 to 2.22, p = .002). The results were robust to publication bias. This is the first meta-analysis of treatment RCTs for pediatric OCD. CBT and pharmacotherapy were the only treatments effective beyond control in alleviating OCD symptoms. CBT showed a greater ES than pharmacotherapy. Previous meta-analyses that included uncontrolled trials exaggerated the efficacy of both treatments.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Wiley
Date: 04-05-2014
DOI: 10.1002/EAT.22294
Abstract: Given the importance of assessing depressive symptoms and suicidal ideation in adolescents with eating disorders (EDs), the aim was to provide normative data on the Children's Depression Inventory (CDI) for female adolescents presenting for treatment of an ED. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project registry (N = 1000), a prospective, ongoing registry study comprising consecutive pediatric tertiary ED referrals. Females (N = 256 12-17 years) with DSM-5 EDs completed the CDI at intake. Results on the CDI revealed a pattern of increasing depressive scores with age and higher scores among patients with anorexic spectrum disorders. The prevalence of suicidal ideation was high and had the same pattern as CDI scores. The mean score on the CDI in the s le was higher than community s les and clinical s les of adolescents with post-traumatic stress disorder, obsessive compulsive disorder, and other clinical disorders. Females adolescents with EDs are at high-risk of depression and suicidal ideation. These data provide information about variation in CDI scores to guide clinicians in interpretation of scores.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.EATBEH.2011.04.003
Abstract: This study examined the role of perfectionism (self-oriented and socially prescribed), shape and weight overvaluation, dichotomous thinking, and conditional goal setting in eating disorder psychopathology. Perfectionism and shape and weight overvaluation have had longstanding implication in the development and maintenance of eating disorders. A leading evidence-based theory of eating disorders (Fairburn, Cooper & Shafran, 2003) outlines perfectionism as a maintaining mechanism of eating disorder psychopathology and as a proximal risk factor for the development of shape and weight overvaluation. These constructs have been linked to other cognitive processes relevant to eating disorders, specifically, dichotomous thinking and conditional goal setting. Women with DSM-IV eating disorders (N=238) were compared to women in the general community (N=248) and, as hypothesised, scores on measures of these constructs were pronounced in the clinical s le. Hierarchical regression analyses predicting eating disorder psychopathology showed that for both groups, dichotomous thinking and conditional goal setting significantly improved model fit beyond perfectionism and shape and weight overvaluation alone. Self-oriented perfectionism, but not socially prescribed perfectionism, was relevant to eating disorder psychopathology. We discuss the implications for current treatment protocols and early intervention.
Publisher: Wiley
Date: 22-08-2012
DOI: 10.1002/EAT.22052
Abstract: 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. Treatment-seeking adults with BN (N = 112), SBN (N = 28), anorexia nervosa restricting type (AN-R) (N = 45), and AN-binge urge type (AN-B/P) (N = 24) were compared. 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. In iduals 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.
Publisher: Wiley
Date: 14-03-2018
DOI: 10.1002/EAT.22857
Abstract: There are few evidence-based guidelines for inpatient pediatric eating disorders. The aim was to gain perspectives from those providing and receiving inpatient pediatric eating disorder care on the essential components treatment. A modified Delphi technique was used to develop consensus-based opinions. Participants (N = 74) were recruited for three panels: clinicians (n = 24), carers (n = 31), and patients (n = 19), who endorsed three rounds of statements online. A total of 167 statements were rated, 79 were accepted and reached a consensus level of at least 75% across all panels, and 87 were rejected. All agreed that families should be involved in treatment, and thatpsychological therapy be offered in specialist inpatient units. Areas of disagreement included that patients expressed a desire for autonomy in sessions being available without carers, and that weight gain should be gradual and admissions longer, in contrast to carers and clinicians. Carers endorsed that legal frameworks should be used to retain patients if required, and that inpatients are supervised at all times, in contrast to patients and clinicians. Clinicians endorsed that food access should be restricted outside meal times, in contrast to patients and carers. The findings indicate areas of consensus in admission criteria, and that families should be involved in treatment, family involvement in treatment, while there was disagreement across groups on topics including weight goals and nutrition management. Perspectives from patients, carers, and clinicians may be useful to consider during future revisions of best practice guidelines.
Publisher: Springer Science and Business Media LLC
Date: 17-09-2018
DOI: 10.1007/S11920-018-0970-3
Abstract: Our primary goal in this article is to review recent findings (from 2015 and on) concerning children of parents with eating disorders. This review addresses the question of whether the offspring of parents with past or present eating disorders have adverse outcomes. This update is timely and informative because recent research includes controlled studies and large cohort designs and earlier reviews relied on case report evidence. Despite substantial ersity in study design, s le size, and parental eating disorder definition, overall, existing research suggests that the children of parents with eating disorders exhibit compromised development: a greater risk of perinatal complications a tendency toward extremes of growth at birth greater problems in feeding and eating behaviors and greater incidence of eating disorder symptoms more psychological and socioemotional difficulties and more negative qualities to parent-child interactions. Data on children's cognitive outcomes is thus far inconsistent. Given the relatively high incidence of eating disorder history in in iduals of childbearing age, research into its potential effects on children is necessary. However, the methodological shortcomings and a limited evidence base caution in drawing conclusions. Nevertheless, mental health services should address the possible problems that these children face and offer tailored programs.
Publisher: Wiley
Date: 19-11-2014
DOI: 10.1002/ERV.2334
Publisher: Wiley
Date: 08-03-2018
DOI: 10.1002/EAT.22856
Abstract: The aim of the study was to compare the DSM-IV, DSM-5, and ICD-10 eating disorders (ED) nomenclatures to assess their value in the classification of pediatric eating disorders. We investigated the prevalence of the disorders in accordance with each system's diagnostic criteria, diagnostic concordance between the systems, and interrater reliability. Participants were 1062 children and adolescents assessed at intake to a specialist Eating Disorders Program (91.6% female, mean age 14.5 years, SD = 1.75). Measures were collected from routine intake assessments. DSM-5 categorization led to a lower prevalence of unspecified EDs when compared with DSM-IV. There was almost complete overlap for specified EDs. Kappa values indicated almost excellent agreement between the two coders on all three diagnostic systems, although there was higher interrater reliability for DSM-5 and ICD-10 when compared with DSM-IV. DSM-5 nomenclature is useful in classifying eating disorders in pediatric clinical s les.
Publisher: Wiley
Date: 13-10-2022
DOI: 10.1002/EAT.23824
Abstract: We assessed eating disorder (ED) illness status, symptomatology, treatment access, anxiety, and depression in the first year of the COVID‐19 pandemic among in iduals with a pre‐existing ED in the United States (US), the Netherlands (NL), and Sweden (SE). Participants completed online surveys in April–July 2020, at the early stage of the pandemic, and one year later. At one‐year follow‐up, we added questions addressing retrospective changes in ED symptoms, treatment, and anxiety/depression since the start of the COVID‐19 pandemic. We present descriptive statistics and assess change in ED symptomatology, treatment, and anxiety/depression among those with an active or lingering ED. Participants (US n = 132 NL n = 219 SE n = 702) were mostly young and female with a history of anorexia nervosa ( % in all three countries). Across countries, respondents reported impact of COVID‐19 on ED symptoms at both time points, with improvement in US and NL at one‐year follow‐up, and stable but less impact on ED symptoms in SE. Furthermore, at one‐year follow‐up, roughly half of those in treatment reported reduced treatment access and quality, and the majority of the s le reported increased anxiety and depressive mood since the start of the pandemic. Our findings suggest that the self‐perceived impact of COVID‐19 changed over time but remained concerning even one year after the start of the pandemic. Clinicians, community organizations, and policy makers are encouraged to address potentially changing treatment needs in the face of public health emergency events. Our findings suggest that the impact of COVID‐19 on in iduals with eating disorders decreased over time but remained concerning even one year after the start of the pandemic and that the impact differed across countries. Clinicians, community organizations, and policy makers are encouraged to incorporate this knowledge to address potentially changing treatment needs in the face of public health emergency events.
Publisher: Wiley
Date: 02-2013
DOI: 10.1111/AJR.12007
Abstract: To determine whether an outreach community-based training program on eating disorders enhances perceived capacity of rural health and education professionals to respond to and manage eating disorders. Survey conducted upon completion of outreach training. Rural Western Australia. Health and education professionals working in rural Western Australia. Questionnaire responses analysed via descriptive statistics and inferential tests. There was a significant increase in perceived ability to identify, support and/or treat people with eating disorders among health and education professionals. Outreach training up-skilled rural gatekeepers and introduced systemic health system benefits of increased consultation and liaison, a fine-tuning of referral processes, a reduction in hospital admissions and better uptake of local services by patients discharged from hospital.
Publisher: Informa UK Limited
Date: 11-2013
DOI: 10.1111/CP.12012
Publisher: Wiley
Date: 18-07-2016
DOI: 10.1002/EAT.22577
Abstract: This systematic review evaluated the efficacy of universal, selective, and indicated eating disorder prevention. A systematic literature search was conducted in Medline, PsycINFO, Embase, Scopus, and the Cochrane Collaboration Library databases to January 2016. Studies were included if they were randomized, controlled trials (RCT) and tested an eating disorder prevention program. We retrieved 13 RCTs of universal prevention (N = 3,989 participants, 55% female, M age = 13.0 years), 85 RCTs of selective prevention (N = 11,949 participants, 99% female, M age = 17.6 years), and 8 RCTs of indicated prevention (N = 510 participants, 100% female, M age = 20.1 years). Meta-analysis was performed with selective prevention trials. As there were a limited number of universal and indicated trials, narrative synthesis was conducted. Media literacy had the most support for universal prevention. Most universal approaches showed significant modest effects on risk factors. Dissonance-based was the best supported approach for selective prevention. Cognitive-behavior therapy (CBT), a healthy weight program, media literacy, and psychoeducation, were also effective for selective prevention and effects were maintained at follow-up. CBT was supported for indicated prevention and effects were maintained at follow-up. The modest effects for universal prevention were likely due to floor effects. The evidence for selective prevention suggests that empirically supported approaches should be disseminated on a wider basis. Our findings suggest CBT should be offered for indicated populations. Overall, results suggest efficacy of several prevention programs for reducing risk for eating disorders, and that wider dissemination is required. © 2016 Wiley Periodicals, Inc.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2013
Abstract: To describe the rates, indications, and adverse effects of psychotropic drug prescription in a specialist tertiary hospital child and adolescent eating disorder service. Retrospective case note study of all active eating disorder patients ( N = 115) over the period of treatment from referral to time of study ( M = 2 years), covering patient demographics, clinical characteristics, drug prescriptions, indications, and adverse effects. Psychotropic drugs were prescribed in 45% of cases, most commonly antidepressants (41%), followed by anxiolytics (29%) and antipsychotics (22%), with 8% initiated before referral to the specialist eating disorder program. Common indications were depressed mood, agitation, anxiety, and insomnia. Patient clinical severity and complexity was associated with prescribing. Adverse effects, mostly minor, were recorded in 23% of antidepressant prescriptions, 39% of antipsychotic prescriptions, and 13% of anxiolytic prescriptions. Second generation antipsychotic prescription was associated with subsequent new onset binge eating, in this preliminary observational study. Self-harm by overdose of psychotropics occurred in 11% of patients prescribed medication. Psychotropic medications were frequently prescribed to adolescent eating disorder patients to treat distressing symptoms. Prospective randomised controlled trials to clarify efficacy and safety are needed. Given the difficulties of conducting clinical trials in this population, services are encouraged to monitor and audit medication safety and efficacy in everyday practice, and to report their findings.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Publisher: Routledge
Date: 22-04-2016
Publisher: Wiley
Date: 30-03-2015
DOI: 10.1016/J.ADOLESCENCE.2015.02.005
Abstract: To examine the prevalence and importance of psychological, behavioural, and situational correlates of impending psychiatric inpatient admissions in children and adolescents with eating disorders. The s le consisted of 285 patients (8–17 years, M = 14.4, SD = 1.49) with DSM‐5 eating disorders assessed between 2006 and 2013 from the Helping to Outline Pediatric Eating Disorders (HOPE) Project. The s le was split into two groups, those with ( n = 38) and without ( n = 247) impending psychiatric admission Discriminant function analysis was used to examine correlates. The prevalence of impending psychiatric admission was 13.3%. Suicidal ideation provided the greatest discriminating power, followed by eating pathology, depressive symptoms, anxiety, multiple methods of weight control, binge eating, and family functioning. Earlier recognition of comorbid symptoms in eating disorders in the community may reduce the number of young people with eating disorders who present needing critical psychiatric care.
Publisher: Springer Science and Business Media LLC
Date: 09-08-2018
DOI: 10.1007/S11920-018-0932-9
Abstract: This review delineates issues in the conceptualization and operationalization of eating disorder recovery, highlights recent findings about recovery (since 2016), and proposes future directions. A longstanding problem in the field is that there are almost as many different definitions of recovery in eating disorders as there are studies on the topic. Yet, there has been a general shift to accepting that psychological/cognitive symptoms are important to recovery in addition to physical and behavioral indices. Further, several operationalizations of recovery have been proposed over the past two decades, and some efforts to validate operationalizations exist. However, this work has had limited impact and uptake, such that the field is suffering from "broken record syndrome," where calls are made for universal definitions time and time again. It is critical that proposed operationalizations be compared empirically to help arrive at a consensus definition and that institutional/organizational support help facilitate this. Themes in recent recovery research include identifying predictors, examining biological/neuropsychological factors, and considering severe and enduring anorexia nervosa. From qualitative research, those who have experienced eating disorders highlight recovery as a journey, as well as factors such as hope, self-acceptance, and benefiting from support from others as integral to the process of recovery. The field urgently needs to implement a universal definition of recovery that is backed by evidence, that can parsimoniously be implemented in clinical practice, and that will lead to greater harmonization of scientific findings.
Publisher: American Psychiatric Association Publishing
Date: 09-2017
Publisher: American Psychological Association (APA)
Date: 07-2017
DOI: 10.1037/ABN0000241
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.EATBEH.2014.08.013
Abstract: The objective of this study was to evaluate the factor structure, validity, and reliability of the Compulsive Exercise Test (CET) in an adolescent clinical eating disorder population. The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project, a prospective ongoing registry study comprising consecutive pediatric tertiary eating disorder referrals. Adolescents (N=104 12-17years) with eating disorders completed the CET and other measures. Factor structure, convergent validity, and internal consistency were evaluated. Despite failing to identify a factor structure, the study provided clear evidence of the multidimensionality of the measure. The total score correlated significantly with measures of eating pathology, perfectionism, and frequency of exercise for shape and weight control (r=0.32-0.70, ps<0.05). More research into the multidimensional nature of compulsive exercise in clinical populations is needed. Further, research into compulsive exercise offers promise as an addition to existing cognitive behavioral models and treatments for eating disorders.
Publisher: Wiley
Date: 13-12-2014
DOI: 10.1002/EAT.22224
Abstract: This study examined the experience of parents of children with eating disorders after having participated in a skills-based training intervention. Eleven parents were interviewed and transcripts were analysed using inductive thematic analysis. Parent responses were organised around key themes of (1) effectiveness and acceptability of the intervention (2) interpersonal experience of the group process and (3) feedback on intervention content. Overall, the transfer of specialist skills was highly valued by parents and applied within the home and hospital setting. This study contributes preliminary evidence that skills-based training may improve parent self-efficacy,psychological distress, anxiety, and burden.This intervention can also be a cost-effective method for supporting carers,and future research is required to contribute data on treatment efficacy for patients in addition to parents.
Publisher: Cambridge University Press (CUP)
Date: 05-07-0027
DOI: 10.1017/BEC.2016.6
Abstract: Perfectionism is a risk and maintaining factor across psychopathology and has been proposed to be a transdiagnostic process. The aim of this study was to examine the reliability and validity of the Clinical Perfectionism Questionnaire (CPQ) in 32 adults (75% female, M age = 35.54 years, SD = 9.71) with a range of psychological disorders, presenting for treatment of clinical perfectionism. There was evidence that the CPQ was correlated with established measures of perfectionism and theoretically related constructs including self-criticism and dichotomous thinking. The CPQ was also able to predict treatment outcome. The internal consistency was not adequate in the current study however, the s le size was small. Future studies should examine the psychometric properties of the CPQ in a larger s le of in iduals with a range of psychological disorders.
Publisher: Wiley
Date: 16-08-2019
DOI: 10.1002/EAT.23153
Abstract: This pilot study examined the validity of a comprehensive definition of recovery (physical, behavioral, and cognitive recovery indices) for the first time in men. Men with an eating disorder history were recruited from former patients at eating disorder centers, university c uses, and fitness centers/gyms. At baseline and a 12-month follow-up, data were collected via online surveys, diagnostic interviews, and measured weight and height from men with an eating disorder history (n = 36) and men with no eating disorder history (n = 27). Of the men with an eating disorder history, 15 met criteria for an eating disorder, 7 met criteria for partial recovery, and 5 for full recovery. Men who met criteria for full recovery did not differ significantly from men with no eating disorder history and had significantly lower levels of broad eating pathology, thinness and restricting expectancies, body shame, difficulties in stopping thoughts about body, food, or exercise, and male body attitudes related to muscularity and body fat than men with an eating disorder. Men meeting criteria for full recovery had higher levels of body acceptance and intuitive eating than men who met criteria for partial recovery or an eating disorder. In terms of predictive validity, of those fully recovered at baseline, 60% also met full recovery criteria at follow-up. Preliminary findings suggest that a comprehensive definition of recovery applies to men. Although research with larger s les is needed, this research provides some optimism for the potential of recovery in men.
Publisher: Informa UK Limited
Date: 04-08-2022
DOI: 10.1080/16506073.2021.1952302
Abstract: Perfectionism is a transdiagnostic process across anxiety, depression, and eating disorders. The aim of this systematic review was to examine the efficacy of self-help and face to face CBT for perfectionism in reducing perfectionism and anxiety, depression, and eating disorders. A total of 15 randomised controlled trials of CBT for perfectionism were identified (
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.EATBEH.2009.12.002
Abstract: The aim of this study was to develop and validate a self-report measure of Conditional Goal Setting (CGS) for use among in iduals with eating disorders, the Conditional Goal Setting in Eating Disorders Scale (CGS-EDS). The CGS-EDS assesses the degree to which an in idual believes that the achievement of happiness is contingent upon the attainment of body shape and weight goals. Women with a DSM-IV diagnosed eating disorder consecutively referred to a specialist outpatient clinic (N=238) completed the CGS-EDS and self-report measures of theoretically related constructs. Exploratory factor analysis indicated a one-factor solution, which accounted for 65% of the variance. The CGS-EDS correlated positively with theoretically related measures of overvaluation of shape and weight, concern with shape and weight, dichotomous thinking, and depression. The alpha reliability of the scale was .92. The CGS-EDS is a valid and reliable measure of CGS in eating disorders and is relevant to cognitive and behavioral models of maintenance and intervention.
Publisher: Norwegian University of Science and Technology (NTNU) Library
Date: 22-12-2014
Abstract: This review summarizes studies on eating disorders in pregnancy and the postpartum period that have been conducted as part of the broader Norwegian Mother and Child Cohort Study (MoBa). Prior to the 2000s, empirical literature on eating disorders in pregnancy was sparse and consisted mostly of studies in small clinical s les. MoBa has contributed to a new era of research by making population-based and larges le research possible. To date, MoBa has led to 19 eating disorder studies on erse questions including the prevalence, course, and risk correlates of eating disorders during pregnancy and the postpartum. The associations between eating disorder exposure and pregnancy, birth and obstetric outcomes, and maternal and offspring health and well-being, have also been areas of focus. The findings indicate that eating disorders in pregnancy are relatively common and appear to confer health risks to mother and her child related to sleep, birth outcomes, maternal nutrition, and child feeding and eating.
Publisher: Springer Science and Business Media LLC
Date: 09-11-2015
Publisher: Elsevier BV
Date: 04-2023
Publisher: Springer Science and Business Media LLC
Date: 30-10-2014
Publisher: Elsevier BV
Date: 10-2019
Publisher: Wiley
Date: 11-07-2013
DOI: 10.1002/EAT.22158
Abstract: The aim of this study was to examine parent-youth concordance in reporting of eating disorder pathology, as assessed by the Eating Disorder Examination (EDE) in a clinical pediatric s le. The s le comprised 619 parent-youth dyads of youth (8-18 years) presenting for treatment at a specialist eating disorder clinic. A cross-sectional correlational design was used to examine the association between parent and youth symptom reports. On the whole, parent-youth inter-rater agreement was poor to moderate. Agreement was acceptable for the presence of behavioral symptoms, with the exception of excessive exercise (PAK = 0.48-0.98). There was poor inter-rater agreement on frequency of behavioral symptoms, with parents providing lower estimates than youth (ICC = 0.07-0.52). Although we predicted that inter-rater agreement on cognitive symptoms would by higher with adolescents than children, both groups were discordant with parent reports. Younger children identified less severe eating disorder cognitions than parents and the opposite occurred for adolescents. An anorexia nervosa presentation and lower malnutrition were not associated with lower inter-rater agreement, as might have been expected through ego syntonicity. Youth with bulimia nervosa presentations reported significantly higher severity of cognitive symptoms and more frequent disordered eating behaviors compared with their parents. Results support the utility of parent-youth assessment via the EDE to obtain a wider clinical picture of eating disorder psychopathology in children and adolescents, particularly for younger children. Clinical implications pertinent to administration of the EDE and parent literacy regarding eating disorder symptoms are discussed.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2014
Publisher: Cambridge University Press (CUP)
Date: 12-12-2019
DOI: 10.1017/S1352465819000729
Abstract: Perfectionism is a transdiagnostic risk factor across psychopathology. The Clinical Perfectionism Questionnaire (CPQ) was developed to assess change in order to provide clinical utility, but currently the psychometric properties of the CPQ with adolescents is unknown. To assess the factor structure and construct validity of the CPQ in female adolescents. The CPQ was administered to 267 females aged 14–19 years of age. Confirmatory factor analysis (CFA) was used to examine the validity of the two-factor model and a second-order factor model. Pearson correlations were used to evaluate the relationships between the CPQ and a wide range of measures of perfectionism, psychopathology and personality traits. The study demonstrated internal consistency, construct validity and incremental validity of the CPQ in a s le of female adolescents. The CFA in the present study confirmed the two-factor model of the CPQ with Factor 1 relating to perfectionistic strivings and Factor 2 representing perfectionistic concerns. The second-order two factor model indicated no deterioration in fit. The two-factor model of the CPQ fits with the theoretical definition of clinical perfectionism where the over-dependence of self-worth on achievement and concern over mistakes are key elements. The CPQ is suitable for use with female adolescents in future research that seeks to better understand the role of perfectionism in the range of mental illnesses that impact youth.
Publisher: Wiley
Date: 17-06-2014
DOI: 10.1002/EAT.22318
Publisher: American Psychological Association (APA)
Date: 04-2017
DOI: 10.1037/ABN0000254
Publisher: Wiley
Date: 05-2017
DOI: 10.1002/EAT.22712
Abstract: To investigate the quality of randomized controlled trials (RCTs) of eating disorder prevention. A systematic literature search was conducted in Medline, PsycINFO, Embase, Scopus, and the Cochrane Collaboration Library to January 2016. Studies were included if they were RCTs that tested an eating disorder prevention program. We identified 96 studies with a total 15,350 participants (91% female, M age = 17 years) and rated quality with the Quality Rating Scale (QRS Moncrieff et al., 2001). The mean QRS score was 62% (SD = 13%). Several standards of quality were not frequently fulfilled (i.e., failed to achieve an optimal rating), for ex le, power calculation (85%), intent-to-treat analysis (54%), blinding of assessor (75%), representative s le (78%), adequate s le size (75%), and appropriate duration of trial including follow-up (67%). QRS was positively and significantly associated with publication year, number of authors, and PubMed-indexation. Given the majority of eating disorder prevention studies had problems with trial quality, it is recommended that future RCTs follow quality checklists and CONSORT guidelines, that RCTs are registered, and protocols published in advance. In addition, funding bodies are called on to deliver the support needed to ensure that preventions for eating disorders are efficiently and cost-effectively achieved.
Publisher: Wiley
Date: 27-12-2023
DOI: 10.1002/EAT.23888
Abstract: The COVID‐19 pandemic created significant challenges in accessing and receiving treatment for in iduals with eating disorders (EDs). The purpose of this study is to explore perceptions of and experiences with ED treatment during the first year of the pandemic among in iduals with past and self‐reported EDs in the United States. Online surveys were administered to adults ( N = 510) with a past or current self‐reported ED at 13 timepoints between April 2020 and May 2021. Using longitudinal qualitative analysis, 5651 free‐text responses were examined to capture experiences with ED treatment and generate inferences of change over time. We categorized results into four sequential, temporal quarters and identified patterns that explained participants' perceptions of facilitators, barriers, and experiences with ED treatment over time: Quarter 1. Treatment Disruption and Reorienting Recovery Quarter 2. Accumulating COVID‐19 Stress and Virtual Treatment Woes Quarter 3. A Continuation of Inadequate Care and Quarter 4. Ongoing Adaptation and Adjustment to Uncertainty. Participant experiences were marked by numerous barriers to accessing care, challenges adjusting to virtual treatment, unmet treatment needs, and beginning acceptance of telehealth. Our findings present a timeline to help evaluate challenges related to navigating the switch to virtual care which created significant disruption to ED recovery. Participants spent much of the first year trying to adjust to unemployment, loss of insurance, and lack of access to in‐person treatment. Future research should identify additional strategies to improve the receipt and experience of care for EDs. Our findings suggest that in iduals with eating disorders were significantly challenged by accumulating COVID‐19 stress, worsening symptomatology, and limited access to effective treatment during the first year of the pandemic. This knowledge can guide clinicians, treatment centers, and policy makers in addressing the behavioral health needs of in iduals impacted by disordered eating amidst emergent public health crises.
Publisher: Cambridge University Press (CUP)
Date: 10-12-2012
DOI: 10.1017/S0033291712002620
Abstract: Anorexia nervosa is a potentially deadly psychiatric illness that develops predominantly in females around puberty but is increasingly being recognized as also affecting boys and men and women across the lifespan. The aim of this environmental scan is to provide an overview of best practices in anorexia nervosa treatment across the age spectrum. A triangulation approach was used. First, a detailed review of randomized controlled trials (RCTs) for anorexia nervosa published between 1980 and 2011 was conducted second, clinical practice guidelines were consulted and reviewed third, information about RCTs currently underway was sourced. This approach facilitated a comprehensive overview, which addressed the extant evidence base, recent advances in evidence and improvements in treatment, and future directions. The evidence base for the treatment of anorexia nervosa is advancing, albeit unevenly. Evidence points to the benefit of family-based treatment for youth. For adults no specific approach has shown superiority and, presently, a combination of renourishment and psychotherapy such as specialist supportive clinical management, cognitive behavioral therapy, or interpersonal psychotherapy is recommended. RCTs have neither sufficiently addressed the more complex treatment approaches seen in routine practice settings, such as multidisciplinary treatment or level of care, nor specifically investigated treatment in ethnically erse populations. Methodological challenges that hinder progress in controlled research for anorexia nervosa are explained. The review highlights evidence-based and promising treatment modalities for anorexia nervosa and presents a triangulated analysis including controlled research, practice guidelines, and emerging treatments to inform and support clinical decision making.
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.BRAT.2011.04.002
Abstract: An interactive model implicating high perfectionism, high weight and shape concern, and low self-esteem in the onset and maintenance of bulimic symptoms (Bardone, Vohs, Abramson, Heatherton, & Joiner, 2000 Vohs, Bardone, Joiner, Abramson, & Heatherton, 1999) has received mixed support. This study aimed to replicate the cross-sectional model in a clinical s le of women with eating disorders, and to investigate whether the model could predict changes in binge eating and purging at the end of treatment. Eating disorder outpatients (n=353) completed measures of perfectionism, weight/shape concern, self-esteem, and bulimic symptoms at pre-treatment and discharge. Contrary to the hypotheses, the three-way interaction did not predict binge eating or purging cross-sectionally or prospectively as a moderator of psychotherapy outcome. It was concluded that the robustness of the interactive model seems questionable and may be impacted by an inadequate conceptualization of the perfectionism construct.
Publisher: Physicians Postgraduate Press, Inc
Date: 21-02-2018
DOI: 10.4088/JCP.16M11314
Publisher: Wiley
Date: 05-08-2013
DOI: 10.1002/EAT.22169
Abstract: This study examined whether rapid response to enhanced cognitive behavioral therapy (CBT-E) was associated with superior treatment outcomes in a transdiagnostic s le of patients with an eating disorder. Participants were 105 patients with a primary eating disorder diagnosis who received in idual CBT-E at a community-based outpatient clinic. Patients completed measures of eating disorder and related pathology at baseline and post-treatment. The Eating Disorder Examination-Questionnaire (EDE-Q) was administered at baseline and again, on average, 4.6 weeks after commencing treatment to assess rapid response to CBT-E. Patients achieving reliable change on the EDE-Q at this point were classified as rapid responders. No baseline differences distinguished rapid and nonrapid responders. Rapid responders had significantly lower scores on EDE-Q global at post-treatment, were more likely to achieve full remission, and required significantly fewer treatment sessions than nonrapid responders. One-quarter of the nonrapid responders went on to achieve full remission. There were no group differences on measures of anxiety and depression symptoms at the end of treatment. Early change in treatment is encouraged to achieve the best possible prognosis in CBT-E. Those who did not achieve rapid response still had an overall significant improvement in symptoms from pretreatment to post-treatment, but a lower rate of full remission. Nonrapid responders are an important group of patients to study because they offer researchers an opportunity to improve clinical decision-making and treatment outcomes for patients who are at risk of suboptimal response.
Publisher: Wiley
Date: 28-10-2014
DOI: 10.1002/EAT.22201
Abstract: To examine child and adolescent differences in the clinical presentation of eating disorders (EDs) at referral to a specialist pediatric program. This study compared cognitive, behavioral, and physical and medical features of children (≤ 12 years) and adolescents (13-18 years) with EDs presenting to a state-wide specialist pediatric ED service over two decades (N = 656 8-18 years 94% female). Significant differences were found between the groups. Children were more commonly male (p < .001), had lower eating pathology scores (p < .001), were less likely to binge eat (p = .02), purge (p < .001) or exercise for shape and weight control (p .05). The clinical presentation of EDs differs among children and adolescents, with eating pathology and behavioral symptoms less prominent among children. Frontline health professionals require knowledge of these differences to assist with early detection, diagnosis, and prognosis.
Location: United States of America
No related grants have been discovered for Hunna Watson.