Proof of Concept for a Mindfulness-Informed Intervention for Eating Disorder Symptoms, Self-Efficacy, and Emotion Regulation among Bariatric Surgery Candidates

2020 ◽  
pp. 1-14
Author(s):  
Ashley N. Felske ◽  
Tamara M. Williamson ◽  
Joshua A. Rash ◽  
Jo Ann Telfer ◽  
Kirsti I. Toivonen ◽  
...  
2021 ◽  
Author(s):  
Rachel Strimas

Evidence suggests high rates of psychiatric disorders in bariatric surgery candidates (e.g., Kalarchian et al., 2007; Mitchell et al., in press), although no rigorous studies have examined the prevalence in a Canadian sample. As such, the first purpose of this study was to assess the prevalence of Axis I disorders, and associations with quality of life, in a sample of consecutively referred bariatric surgery candidates at the Toronto Western Hospital Bariatric Surgery Program. In light of emerging evidence linking emotion regulation difficulties with diverse psychiatric symptoms, the second purpose of this study was to examine whether emotion regulation difficulties were common or specific determinants of mood, anxiety, and eating psychodiagnostic categories, as such information would help inform interventions. Three hundred and twenty-one bariatric surgery candidates (80.1% female; M age = 44.37 years) were assessed using a structured psychodiagnostic interview and completed questionnaires of health-related quality of life and emotion regulation difficulties. Results indicated that 54.5% of patients met DSM-IV-TR criteria for a lifetime psychiatric diagnosis and 18.4% met criteria for a current psychiatric disorder. Major depressive disorder was the most common lifetime psychiatric disorder and binge eating disorder was the most prevalent current psychiatric disorder. Compared to patients without a current Axis I disorder, participants diagnosed with a current Axis I disorder reported significantly worse functioning on most mental and physical health domains (p’s < .01). Overall, a series of regression analyses revealed that difficulties regulating emotions accounted for unique variance in current mood and anxiety disorder status (p’s < .001). Difficulties in emotion regulation were not significantly associated with current eating disorder status after Bonferroni correction. Taken together, these results confirm the high rates of psychiatric disorders in a Canadian sample of bariatric surgery candidates and provide evidence for associated functional health impairment. The data also add to the growing body of literature demonstrating emotion regulation difficulties across psychodiagnostic categories and are consistent with suggestions that psychosocial interventions for bariatric patients might benefit from directly targeting difficulties in emotion regulation. Further study of these associations is needed to replicate these findings and elucidate how difficulties in emotion regulation interact with psychopathology to affect patients’ post-operative outcomes.


2021 ◽  
Author(s):  
Marsha Rowsell ◽  
Danielle E. MacDonald ◽  
Jacqueline C. Carter

Background Difficulties with emotion regulation have been established as a core deficit in anorexia nervosa (AN). However, limited research has evaluated whether weight gain is associated with improvements in emotion regulation difficulties in AN and whether improvements in emotion regulation are associated with reductions in eating disorder psychopathology. The aims of this study were threefold: 1) to examine the nature and extent of emotion regulation difficulties in AN; 2) to determine whether these difficulties improved during intensive treatment for the eating disorder; and 3) to study whether improvements in emotion regulation were associated with improvements in eating disorder psychopathology. Method The participants were 108 patients who met DSM-IV-TR criteria for AN and were admitted to a specialized intensive treatment program. Self-report measures of eating disorder symptoms and difficulties with emotion regulation were administered at admission to and discharge from the program. Results Patients with the binge-purge subtype of AN reported greater difficulties with impulse control when upset and more limited access to emotion regulation strategies when experiencing negative emotions than those with the restricting subtype. Among those who completed treatment and became weight restored, improvements in emotion regulation difficulties were observed. Greater pre-to-post treatment improvements in emotional clarity and engagement in goal directed behaviours when upset were associated with greater reductions in eating disorder psychopathology during treatment. Conclusions These findings add to growing evidence suggesting that eating disorder symptoms may be related to emotion regulation difficulties in AN and that integrating strategies to address emotion regulation deficits may be important to improving treatment outcome in AN.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachel F. Rodgers ◽  
Morgan Hines ◽  
Alaina Martens ◽  
Emily Zimmerman

Abstract Background The post-partum period is a vulnerable time for mothers in terms of eating disorder symptoms and is critical for the establishment of feeding patterns in infants. This study aimed to investigate the relationships between maternal eating disorder symptoms and objective indices of feeding regulation at 3 months, as well as perceived breastfeeding self-efficacy. Methods A sample of n = 73 full-term mother-child dyads (44% female) participated in the study. Mothers self-reported eating disorder symptoms and breastfeeding self-efficacy and objective indices of infant feeding regulation were obtained in the home. Results Findings revealed the existence of relationships between higher maternal eating disorder symptoms, and objective indices of infant feeding regulation with substantial gender differences in the patterns emerging. Among mother-daughter dyads, maternal weight and shape concerns were associated with higher infant transfer volume and rate during bottle feeding. In contrast, among mother-son dyads, higher maternal eating disorder symptoms, including weight, shape, and eating concern, were associated with lower infant transfer volume and rate as well as lower levels of proficiency while taking their bottle. Conclusion Relationships emerged between higher maternal eating disorder symptoms and feeding regulation with substantial gender differences in these patterns. Additional research clarifying the underlying mechanisms of these associations is warranted and further efforts should be directed towards supporting mothers during the postpartum period.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caroline Cohrdes ◽  
Claudia Santos-Hövener ◽  
Katja Kajikhina ◽  
Heike Hölling

Abstract Background Eating disorder symptoms (EDs) have been discussed as a prominent problem among late adolescent girls with serious health risks and long-term consequences. However, there is a lack of population-based evidence on EDs comprising the age range from early adolescence to emerging adulthood as well as considering both females and males equally. Additionally, the differential role of a comprehensive set of several relevant risk factors and particularly weight- and appearance-related discrimination warrants further attention. Thus, we aimed to contribute to a better understanding of sex- and age-related differences in associations between discrimination experience and other relevant personal risk factors (body image, social media use, self-efficacy, social support) with EDs. Furthermore, we were interested in the exploration of underlying mechanisms enhancing the risk of EDs by taking discrimination experience into account. Methods Based on a logistic regression model, we investigated associations between weight- and appearance-related discrimination and EDs while controlling for other relevant personal risk factors in a subsample of N = 8504 adolescents and emerging adults (54.4% female, mean age = 20.71 years, SD = 4.32 years) drawn from a German representative health survey (KiGGS Wave 2). In a second step, we investigated the mediating role of discrimination experience between the other risk factors and EDs with the help of a path model. Results While controlling for other relevant personal risk factors, weight- and appearance-related discrimination was significantly related to EDs. Whereas the risk of EDs was significantly enhanced in males and emerging adults frequently experiencing weight-related discrimination, adolescents showed a higher risk of EDs when experiencing appearance-related discrimination. Moreover, discrimination experience partly explained the associations between body image dissatisfaction, low self-efficacy, high media use and ED symptoms. Conclusions The results highlight weight- and appearance-related discrimination as one central factor to be considered in the pathogeneses of EDs and underpin the need for discrimination prevention as well as the promotion of adaptive coping with discrimination experience to reduce the risk of developing ED symptoms. Males and emerging adults need particular attention when facing weight-related discrimination whereas risk constellations and EDs particularly affecting females need further investigation.


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