scholarly journals Overcoming limitations of self-report: an assessment of fear of weight gain in anorexia nervosa and healthy controls using implicit association tests

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Tiana Borgers ◽  
Nathalie Krüger ◽  
Silja Vocks ◽  
Jennifer J. Thomas ◽  
Franziska Plessow ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Normal Weight ◽  
Self Report ◽  
Healthy Controls ◽  
Drive For Thinness ◽  
Implicit Association ◽  
Association Tests ◽  
Implicit Assessment ◽  
Fear Of Weight Gain

Abstract Background Fear of weight gain is a characteristic feature of anorexia nervosa (AN), and reducing this fear is often a main target of treatment. However, research shows that 20% of individuals with AN do not report fear of weight gain. Studies are needed that evaluate the centrality of fear of weight gain for AN with a method less susceptible to deception than self-report. Methods We approximated implicit fear of weight gain by measuring implicit drive for thinness using implicit association tests (IATs). We asked 64 participants (35 AN, 29 healthy controls [HCs]) to categorize statements as pro-dieting vs. non-dieting and true vs. false in a questionnaire-based IAT, and pictures of underweight vs. normal-weight models and positive vs. negative words in a picture-based IAT using two response keys. We tested for associations between implicit drive for thinness and explicitly reported psychopathology within AN as well as group differences between AN and HC groups. Results Correlation analyses within the AN group showed that higher implicit drive for thinness was associated with more pronounced eating disorder-specific psychopathology. Furthermore, the AN group showed a stronger implicit drive for thinness than HCs in both IATs. Conclusion The results highlight the relevance of considering fear of weight gain as a continuous construct. Our implicit assessment captures various degrees of fear of weight gain in AN, which might allow for more individually tailored interventions in the future.

scholarly journals A mixed-methods approach to conceptualizing friendships in anorexia nervosa

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0254110
Author(s):  
Nandini Datta ◽  
Molly Foukal ◽  
Savannah Erwin ◽  
Hannah Hopkins ◽  
Kate Tchanturia ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Mixed Methods ◽  
Attachment Styles ◽  
Negative Evaluation ◽  
Self Report ◽  
Healthy Controls ◽  
Care Seeking ◽  
Drive For Thinness ◽  
Attachment Figure ◽  
Mixed Methods Approach

Background Individuals with anorexia nervosa have reported feelings of loneliness, social anhedonia, and interpersonal difficulties. This study sought to clarify the nature of interpersonal relationships in adults with anorexia, which may help improve existing interventions while also facilitating the attainment of something that might compete with the drive for thinness: friendships. Methods The present study used a mixed-methods approach to investigate friendship experiences in three groups: anorexia (n = 27), participants with a history of anorexia who are weight restored (n = 20), and healthy controls (n = 24). Thematic analysis was used to isolate the most prevalent themes that emerged from an open-ended interview of experiencing friendships in a subset of participants. Three self-report questionnaires investigating friendship valuation and attachment styles were also administered. Results 11 unique themes emerged in the data: social comparison, reciprocity, trust, fear of negative evaluation, perceived skills deficit, logistical barriers, reliability, identity issue, low interest, similarity, and conflict avoidance. Only 17% of those with anorexia reported experiencing friendships as positive, relative to 82% of healthy controls and 52% of weight restored participants. Lastly, on self-report measures, participants with anorexia reported greater reliance on themselves versus others, greater use of care-seeking behaviors, and more fear/anger at the thought of losing an attachment figure (p < .05 in all cases). Conclusion Results suggest that individuals with anorexia have particular challenges which interfere with the formation and maintenance of friendships, such as viewing friendships negatively and struggling with social comparisons in friendships. Assessing and addressing barriers to intimacy may motivate those with anorexia to relinquish dangerous symptoms that maintain the illness.

scholarly journals Antimicrobial peptides in patients with anorexia nervosa: comparison with healthy controls and the impact of weight gain

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Marie-Christin Bendix ◽  
Michael Stephan ◽  
Mariel Nöhre ◽  
Wally Wünsch-Leiteritz ◽  
Hagen Schmidt ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Antimicrobial Peptides ◽  
Pathogenic Bacteria ◽  
Innate Immune ◽  
Effect Sizes ◽  
Healthy Controls ◽  
Clinical Observations ◽  
The Impact

AbstractClinical observations show that patients with anorexia nervosa (AN) are surprisingly free from infectious diseases. There is evidence from studies in Drosophila melanogaster that starvation leads to an increased expression of antimicrobial peptides (AMPs). AMPs are part of the innate immune system and protect human surfaces from colonization with pathogenic bacteria, viruses and fungi. We compared the expression of AMPs between patients with AN and healthy controls (HC) and investigated the influence of weight gain. Using a standardized skin rinsing method, quantitative determination of the AMPs psoriasin and RNase 7 was carried out by ELISA. Even though non-significant, effect sizes revealed slightly higher AMP concentrations in HC. After a mean weight gain of 2.0 body mass index points, the concentration of psoriasin on the forehead of patients with AN increased significantly. We could not confirm our hypotheses of higher AMP concentrations in patients with AN that decrease after weight gain. On the contrary, weight gain seems to be associated with increasing AMP concentrations.

Identifying neuroanatomical signatures of anorexia nervosa: a multivariate machine learning approach

2015 ◽  
Vol 45 (13) ◽  
pp. 2805-2812 ◽  
Author(s):  
L. Lavagnino ◽  
F. Amianto ◽  
B. Mwangi ◽  
F. D'Agata ◽  
A. Spalatro ◽  
...  
Keyword(s):  
Machine Learning ◽  
Anorexia Nervosa ◽  
Predictive Accuracy ◽  
Third Ventricle ◽  
Healthy Controls ◽  
Drive For Thinness ◽  
Individual Subject ◽  
Machine Learning Approach ◽  
Scan Data ◽  
Selection Operator

BackgroundThere are currently no neuroanatomical biomarkers of anorexia nervosa (AN) available to make clinical inferences at an individual subject level. We present results of a multivariate machine learning (ML) approach utilizing structural neuroanatomical scan data to differentiate AN patients from matched healthy controls at an individual subject level.MethodStructural neuroimaging scans were acquired from 15 female patients with AN (age = 20, s.d. = 4 years) and 15 demographically matched female controls (age = 22, s.d. = 3 years). Neuroanatomical volumes were extracted using the FreeSurfer software and input into the Least Absolute Shrinkage and Selection Operator (LASSO) multivariate ML algorithm. LASSO was ‘trained’ to identify ‘novel’ individual subjects as either AN patients or healthy controls. Furthermore, the model estimated the probability that an individual subject belonged to the AN group based on an individual scan.ResultsThe model correctly predicted 25 out of 30 subjects, translating into 83.3% accuracy (sensitivity 86.7%, specificity 80.0%) (p < 0.001; χ2 test). Six neuroanatomical regions (cerebellum white matter, choroid plexus, putamen, accumbens, the diencephalon and the third ventricle) were found to be relevant in distinguishing individual AN patients from healthy controls. The predicted probabilities showed a linear relationship with drive for thinness clinical scores (r = 0.52, p < 0.005) and with body mass index (BMI) (r = −0.45, p = 0.01).ConclusionsThe model achieved a good predictive accuracy and drive for thinness showed a strong neuroanatomical signature. These results indicate that neuroimaging scans coupled with ML techniques have the potential to provide information at an individual subject level that might be relevant to clinical outcomes.

scholarly journals Increased plasticity of the bodily self in eating disorders

2011 ◽  
Vol 42 (4) ◽  
pp. 819-828 ◽  
Author(s):  
E. Eshkevari ◽  
E. Rieger ◽  
M. R. Longo ◽  
P. Haggard ◽  
J. Treasure
Keyword(s):  
Eating Disorders ◽  
Visual Processing ◽  
Subjective Experience ◽  
Emotional Dysregulation ◽  
The Body ◽  
Self Report ◽  
Healthy Controls ◽  
Drive For Thinness ◽  
Maintenance Factors ◽  
Self Objectification

BackgroundThe rubber hand illusion (RHI) has been widely used to investigate the bodily self in healthy individuals. The aim of the present study was to extend the use of the RHI to examine the bodily self in eating disorders (EDs).MethodThe RHI and self-report measures of ED psychopathology [the Eating Disorder Inventory – 3 (EDI-3) subscales of Drive for Thinness, Bulimia, Body Dissatisfaction, Interoceptive Deficits, and Emotional Dysregulation; the 21-item Depression, Anxiety and Stress Scale (DASS-21); and the Self-Objectification Questionnaire (SOQ)] were administered to 78 individuals with an ED and 61 healthy controls.ResultsIndividuals with an ED experienced the RHI significantly more strongly than healthy controls on both perceptual (i.e. proprioceptive drift) and subjective (i.e. self-report questionnaire) measures. Furthermore, both the subjective experience of the RHI and associated proprioceptive biases were correlated with ED psychopathology. Approximately 23% of the variance for embodiment of the fake hand was accounted for by ED psychopathology, with interoceptive deficits and self-objectification significant predictors of embodiment.ConclusionsThese results indicate that the bodily self is more plastic in people with an ED. These findings may shed light on both aetiological and maintenance factors involved in EDs, particularly visual processing of the body, interoceptive deficits, and self-objectification.

Investigation of Salivary Cortisol Response to Awakening in Underweight and Weight-Restored Patients with Anorexia Nervosa

2017 ◽  
Vol 41 (S1) ◽  
pp. S283-S283
Author(s):  
F. Pellegrino ◽  
A.M. Monteleone ◽  
M. Nigro ◽  
V. Ruzzi ◽  
M. Cimino ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Hpa Axis ◽  
Normal Weight ◽  
Cortisol Awakening Response ◽  
Healthy Controls ◽  
State Trait Anxiety Inventory ◽  
State Dependent ◽  
Competing Interest ◽  
First Time ◽  
Primary Phenomenon

IntroductionAnorexia nervosa (AN) is characterized by dysregulated eating that leads to chronic malnutrition, which may be responsible for several physical complications, including endocrine alterations, such as hyperactivity of the hypothalamus-pituitary-adrenal (HPA) axis.ObjectivesSeveral studies have shown a dysregulation of the cortisol awakening response (CAR) in symptomatic AN patients. However, it has not been established if the deranged CAR of underweight AN patients is a primary phenomenon or an alteration secondary to malnutrition.AimsThe aim of this study was to explore the salivary CAR in both underweight and weight-restored patients with AN.MethodsWe recruited 59 women: 18 undernourished AN patients, 15 weight-restored AN women and 26 normal-weight healthy controls. Saliva samples were collected in the morning, immediately after awakening and after 15, 30 and 60 minutes, in order to measure saliva levels of cortisol. Participants filled in the state-trait anxiety inventory (STAI) to test their anxiety levels in the morning of the test.ResultsCompared to healthy controls, underweight AN patients showed an enhanced CAR whereas the weight recovered patients had a normal CAR. These results were not correlated with levels of anxiety.ConclusionsFor the first time, our results demonstrate that the deranged CAR found in acute AN patients is not present in weight-restored ones, suggesting that altered activity of the HPA axis of symptomatic AN patients is a state-dependent phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Early within-person weight gain and variability during inpatient treatment for anorexia nervosa: Age-dependent effects on treatment outcome

2021 ◽  
Author(s):  
David R. Kolar ◽  
Adrian Meule ◽  
Silke Naab ◽  
Ulrich Voderholzer
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Weight Gain ◽  
Body Dissatisfaction ◽  
Inpatient Treatment ◽  
Average Weight ◽  
Drive For Thinness ◽  
Early Weight Gain ◽  
Age Dependent ◽  
Weight Restoration

Background: Early weight gain during inpatient treatment for anorexia nervosa (AN) is an important predictor of overall treatment outcome. However, weight gain is a dynamic process characterized by within-person variability that may also be age-dependent. Therefore, we examined whether age moderates the effect of within-person weight gain and variability on treatment outcome.Methods: Within-person level estimates of N = 2881 underweight adolescents and adults with AN for daily average weight gain (linear slope) and variability (root mean squared errors) were obtained using random-effects modelling. Linear and logistic regression analyses at the between-person level were calculated to assess their effects on weight, core eating disorder psychopathology and weight restoration. Results: Higher weight gain during the first two weeks of inpatient treatment predicted higher discharge weight, lower drive for thinness and lower body dissatisfaction at discharge, but was not associated with changes in bulimic symptoms. Moreover, higher early weight gain predicted a higher probability of weight restoration at discharge. Moderation analyses revealed that younger age was significantly associated with a stronger effect of early weight gain on weight, drive for thinness and body dissatisfaction at discharge, but was not associated with a higher likelihood of weight restoration. Weight variability was not associated with any treatment outcome. Conclusion: Age moderated the effect of early weight gain on treatment outcome, with larger effects for younger patients. Weight variability did not substantially influence treatment outcome across age and should be of lesser clinical concern during early inpatient treatment when patients gain weight on average.

Agouti-related protein in patients with acute and weight-restored anorexia nervosa

2011 ◽  
Vol 41 (10) ◽  
pp. 2183-2192 ◽  
Author(s):  
J. V. Merle ◽  
V. Haas ◽  
R. Burghardt ◽  
N. Döhler ◽  
N. Schneider ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Negative Energy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Related Protein ◽  
The Central Nervous System ◽  
Plasma Leptin ◽  
Agouti Related Protein ◽  
Partial Weight

BackgroundAn imbalance in appetite-regulating neuropeptides of the central nervous system has been associated with anorexia nervosa (AN), but the mechanisms of action are poorly understood. Agouti-related protein (AGRP), an orexigenic mediator of the hypothalamus, increases food intake and decreases energy expenditure in times of negative energy balance. The aim of the present study was to investigate AGRP in acute and fully weight-restored patients with AN, as well as during weight gain.MethodPlasma AGRP and leptin levels were assessed using an enzyme-linked immunosorbent assay kit in a total of 175 female participants, including 75 patients with acute AN, 37 weight-restored AN patients and 63 healthy controls. Of the patients with acute AN, 33 were reassessed after partial weight gain.ResultsIn weight-restored AN patients plasma AGRP levels were similar to those in healthy controls, whereas in patients with acute AN, AGRP was elevated. AGRP was inversely correlated with indicators of undernutrition such as body mass index and plasma leptin. In addition, AGRP levels normalized during weight gain of longitudinally assessed AN patients.ConclusionsOur results underline the significance of undernutrition and hypoleptinemia for the interpretation of peripheral AGRP concentrations. This provides support for the hypothesis that abnormal AGRP plasma levels in AN patients reflect undernutrition, rather than disease-specific traits.

scholarly journals Invalid Claims About the Validity of Implicit Association Tests by Prisoners of the Implicit Social-Cognition Paradigm

2021 ◽  
Vol 16 (2) ◽  
pp. 435-442
Author(s):  
Ulrich Schimmack
Keyword(s):  
Social Cognition ◽  
Predictive Validity ◽  
Structural Equation ◽  
Racial Bias ◽  
Self Report ◽  
Equation Modeling ◽  
Implicit Association ◽  
Implicit Social Cognition ◽  
Association Tests ◽  
Psychometric Evidence

In a prior publication, I used structural equation modeling of multimethod data to examine the construct validity of Implicit Association Tests. The results showed no evidence that IATs measure implicit constructs (e.g., implicit self-esteem, implicit racial bias). This critique of IATs elicited several responses by implicit social-cognition researchers, who tried to defend the validity and usefulness of IATs. I carefully examine these arguments and show that they lack validity. IAT proponents consistently ignore or misrepresent facts that challenge the validity of IATs as measures of individual differences in implicit cognitions. One response suggests that IATs can be useful even if they merely measure the same constructs as self-report measures, but I find no support for the claim that IATs have practically significant incremental predictive validity. In conclusions, IATs are widely used without psychometric evidence of construct or predictive validity.

scholarly journals Possible role of the gut microbiota in the pathogenesis of anorexia nervosa

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nobuyuki Sudo
Keyword(s):  
Eating Disorders ◽  
Weight Loss ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Weight Gain ◽  
Gut Microbiota ◽  
Psychosocial Factors ◽  
Biological Factors ◽  
Fear Of Weight Gain

AbstractAnorexia nervosa (AN), an eating disorder, is characterized by extreme weight loss and fear of weight gain. Psychosocial factors are thought to play important roles in the development and progression of AN; however, biological factors also presumably contribute to eating disorders. Recent evidence has shown that the gut microbiota plays an important role in pathogenesis of neuropsychiatric disorders including AN. In this article, we describe the possible role of the gut microbiota in the development and persistence of AN, based on the latest research works, including those of our group.

Self-Serving Bias in the Implicit and Explicit Evaluation of Partners and Exes as Parents

2016 ◽  
Vol 118 (1) ◽  
pp. 251-265 ◽  
Author(s):  
Valeria Verrastro ◽  
Irene Petruccelli ◽  
Pierluigi Diotaiuti ◽  
Filippo Petruccelli ◽  
Francesco Dentale ◽  
...  
Keyword(s):  
Sex Differences ◽  
Self Report ◽  
Implicit Association ◽  
Association Tests ◽  
Explicit Evaluation ◽  
Parenting Role ◽  
Implicit And Explicit ◽  
Explicit Measures ◽  
Better Than

The quality of partners’ relationship can be influenced by the reciprocal respect of the other’s parenting role, especially when the couple breaks up. This study is aimed at investigating the implicit versus explicit self-serving biases in the evaluation of partners and exes as parents (or potential parents), exploring sex differences and possible relationships with dyadic cohesion. Two Implicit Association Tests and two semantic differentials, comparing each respondent with current partners and last significant exes, and also a scale measuring dyadic cohesion were administered to 108 participants (40 men; M age = 28.1 yr., SD = 8.7). As expected, participants assessed themselves as better than others on both IAT and self-report evaluations, with larger effects toward exes than toward partners and on implicit than explicit measures. Women devalued exes, but not partners, more than men. Dyadic cohesion scores were negatively correlated with the explicit evaluations of partners but not with implicit ones. Theoretical interpretations in terms of self-serving bias were discussed.

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