scholarly journals Adapting a neuroscience-informed intervention to alter reward mechanisms of anorexia nervosa: a novel direction for future research

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ann F. Haynos ◽  
Lisa M. Anderson ◽  
Autumn J. Askew ◽  
Michelle G. Craske ◽  
Carol B. Peterson
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Anxiety Disorders ◽  
Reward Processing ◽  
Future Research ◽  
Restrictive Eating ◽  
Eating Disorder Symptoms ◽  
Mood And Anxiety Disorders ◽  
Reward Responsivity ◽  
Eating Disorder Behaviors

AbstractAccumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.

scholarly journals Exploring the experience of being viewed as “not sick enough”: a qualitative study of women recovered from anorexia nervosa or atypical anorexia nervosa

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kari Eiring ◽  
Trine Wiig Hage ◽  
Deborah Lynn Reas
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Qualitative Study ◽  
Help Seeking ◽  
Severity Of Illness ◽  
Physical Sign ◽  
Structured Interviews ◽  
Restrictive Eating ◽  
Eating Disorder Symptoms ◽  
Atypical Anorexia Nervosa

Abstract Background Despite common misconceptions, an individual may be seriously ill with a restrictive eating disorder without an outwardly recognizable physical sign of the illness. The aim of this qualitative study was to investigate the perspectives of individuals who have previously battled a restrictive eating disorder who were considered “not sick enough” by others (e.g., peers, families, healthcare professionals) at some point during their illness, and to understand the perceived impact on the illness and recovery. Such misconceptions are potentially damaging, and have been previously linked with delayed help-seeking and poorer clinical outcomes. Methods Seven women who had recovered from anorexia nervosa or atypical anorexia nervosa participated in semi-structured interviews. Interviews were transcribed and interpretive phenomenological analysis was used. Results Three main themes emerged: (1) dealing with the focus upon one’s physical appearance while battling a mental illness, (2) “project perfect”: feeling pressure to prove oneself, and (3) the importance of being seen and understood. Participants reported that their symptoms were occasionally met with trivialization or disbelief, leading to shame, confusion, despair, and for some, deterioration in eating disorder symptoms which drove further weight loss. In contrast, social support and being understood were viewed as essential for recovery. Conclusion To facilitate treatment seeking and engagement, and to optimize chances of recovery, greater awareness of diverse, non-stereotypical presentations of restrictive eating disorders is needed which challenge the myth that weight is the sole indicator of the presence or severity of illness.

An Interactive, Graphical Tool for Retrospectively Assessing Symptom Frequency and Severity: An Illustration With Eating Disorder Behaviors, Body Weight, and Stress

Assessment ◽  
2016 ◽  
Vol 24 (7) ◽  
pp. 835-852 ◽  
Author(s):  
Kyle P. De Young ◽  
Drew A. Anderson
Keyword(s):  
Eating Disorder ◽  
Assessment Tool ◽  
Future Research ◽  
Eating Disorder Symptoms ◽  
Related Symptom ◽  
Graphical Tool ◽  
Symptom Frequency ◽  
Symptom Changes ◽  
Eating Disorder Behaviors ◽  
Better Than

There are few assessments that gather valid, highly detailed data on short-term (i.e., weekly) symptom frequency/severity retrospectively. In particular, methodologies that provide valid data for research investigating symptom changes are typically prospective, expensive, and burdensome. The purpose of this study was to evaluate a new interactive and graphical assessment tool for gathering detailed information about eating-related symptom frequency/severity retrospectively over a 3-month period. A mixed eating disorder sample ( N = 113) recruited from the community provided symptom data once weekly for 12 weeks and completed the Interactive, Graphical Assessment Tool (IGAT) assessing eating disorder symptoms on three occasions to determine the test–retest and concurrent validity of the IGAT. The IGAT performed marginally better than other measures for retrospective symptom frequency assessment in the eating disorders and did so at a greater level of detail than other available tools. Future research should evaluate the IGAT with other behaviors of interest.

Coping with childhood maltreatment: Avoidance and eating disorder symptoms

2020 ◽  
pp. 135910532093706
Author(s):  
Diane L Rosenbaum ◽  
Kamila S White ◽  
Tiffany M Artime
Keyword(s):  
Eating Disorder ◽  
Indirect Effect ◽  
Childhood Maltreatment ◽  
Additive Effect ◽  
Avoidant Coping ◽  
Future Research ◽  
Adaptive Coping ◽  
Eating Disorder Symptoms ◽  
Coping Patterns

Childhood maltreatment is associated with eating disorder symptoms; however, the nature of this association is unclear. We found those who experienced childhood maltreatment had higher avoidant coping and eating disorder symptoms. We also found an additive effect for maltreatment, such that with more types of maltreatment experienced, avoidant coping and eating disorder symptoms were greater. We also found evidence of an indirect effect such that childhood maltreatment was related to eating disorder symptoms through avoidant coping. Future research is needed to better understand factors that may promote development of adaptive coping patterns and prevention of eating disorder symptoms.

Association Between Paranoia And Anorexia Nervosa In Adolescents: What Factors Are Involved? 

2020 ◽  
Author(s):  
Gennaro Catone ◽  
Filomena Salerno ◽  
Giulia Muzzo ◽  
Valentina Lanzara ◽  
Antonella Gritti
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Social Anxiety ◽  
Associated Factors ◽  
Anxiety Symptoms ◽  
Pediatric Care ◽  
Eating Disorder Symptoms ◽  
Body Image Concerns

Abstract Background: psychiatric comorbidities are of particular interest in Eating disorders. The association between anorexia nervosa and psychotic disorders is less studied than that with affective disorders (anxiety/depression). The aim of this study is to describe a psychotic symptom (paranoia) in adolescents with Eating Disorders looking at several potential explicative associated factors: eating disorder symptoms, body image concerns, depression and social anxiety. Our hypothesis is that paranoia in AN patients is more explained by the concomitant depression and social anxiety symptoms than core symptoms of the disease (eating disorder symptoms or body image concerns). Methods: this is a retrospective cross sectional study and consecutive, help-seeking adolescents admitted to the Eating Disorder service of the Integrated Pediatric Care Department, Luigi Vanvitelli University Hospital constituted the sample. Data was obtained trough retrospective collection of clinical interviews and self – report questionnaires administered by trained and expert child and adolescent psychiatrists. Results: We obtained data from 92 adolescents with Eating Disorders. Paranoia was dimensionally distributed in the sample (mean: 22,17 SD: 17,7; median 18 IQR: 7/36; range: 0-62). Our regression model explained that paranoia in this population was better explained by depression (coefficient= 0,415 SD: 0,210, p=0,052) and social anxiety symptoms (coefficient= 0,253 SD: 0,060; p<0,001) than eating disorder symptoms (coefficient= 0,092 SD: 0,107; p=0,398) and body image concerns (coefficient= 1,916 SD: 2,079; p=0,359) that did not retain their significance when all our predictive factors entered in the model. Conclusion: This study has some theoretical, clinical and treatment implications. It is important to carrying out screening for the presence of psychotic symptoms in patients with Eating Disorders. These symptoms and associated factors (depression and social anxiety) may complicate the clinical picture of the disease with the need, in certain cases, of psychopharmacological drugs and, among these, anti-psychotics. Finally in the psychotherapy context, paranoid idea may be subject of treatment for patient with EDs.

scholarly journals Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury

2020 ◽  
Vol 10 (2) ◽  
pp. 104
Author(s):  
Kenneth J. D. Allen ◽  
M. McLean Sammon ◽  
Kathryn R. Fox ◽  
Jeremy G. Stewart
Keyword(s):  
Eating Disorder ◽  
Response Inhibition ◽  
Emotional Response ◽  
Emotional Reactions ◽  
Negative Urgency ◽  
Restrictive Eating ◽  
Eating Disorder Symptoms ◽  
Neurocognitive Deficit ◽  
Self Injury ◽  
Demographic Covariates

Eating disorder (ED) symptoms often co-occur with non-suicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. A total of 105 community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.

scholarly journals Children in Need—Diagnostics, Epidemiology, Treatment and Outcome of Early Onset Anorexia Nervosa

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1932 ◽  
Author(s):  
Herpertz-Dahlmann ◽  
Dahmen
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Psychological Assessment ◽  
Psychiatric Comorbidity ◽  
State Of The Art ◽  
Psychological Treatment ◽  
Young Patients ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Restrictive Eating

Knowledge of anorexia nervosa (AN) in childhood is scarce. This review gives a state-of-the-art overview on the definition, classification, epidemiology and etiology of this serious disorder. The typical features of childhood AN in comparison to adolescent AN and avoidant restrictive eating disorder (ARFID) are described. Other important issues discussed in this article are somatic and psychiatric comorbidity, differential diagnoses and medical and psychological assessment of young patients with AN. Special problems in the medical and psychological treatment of AN in children are listed, although very few studies have investigated age-specific treatment strategies. The physical and mental outcomes of childhood AN appear to be worse than those of adolescent AN, although the causes for these outcomes are unclear. There is an urgent need for ongoing intensive research to reduce the consequences of this debilitating disorder of childhood and to help patients recover.

Anorexia Nervosa and Pregnancy: A Case Report

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
L.C. Castro ◽  
S. Moreira ◽  
A. Lopes ◽  
M. Branco
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Pregnancy Complications ◽  
Eating Behaviour ◽  
Perinatal Outcomes ◽  
Obstetric Care ◽  
Future Research ◽  
Restrictive Eating ◽  
Risk Pregnancy ◽  
The Impact

Background:Several studies report that women with a history of eating disorders are at higher risk of pregnancy complications and major adverse perinatal outcomes.Aim:To report a case of anorexia nervosa during pregnancy, in order to underline the impact of eating disorders on pregnancy.Methods:Case study and review of the literature.Results:A 32 year old woman was hospitalized in an obstetric service of a general hospital for high risk pregnancy complications. She maintained a disturbed eating behaviour, with periods of restrictive eating and bulimic-purging episodes. She was underweight, did not reach the recommended weight gain during pregnancy and showed intrauterine growth restriction. The Psychiatry Liasion Unit was asked to follow the case during the obstetric hospitalization.Discussion:Pregnant women with eating disorders have higher risk of pregnancy and neonatal complications. Pregnancy is a privileged opportunity to maximize intervention in eating disorders, since women show higher levels of motivation for therapy. Some cases of anorexia nervosa may warrant special obstetric care to ensure adequate prenatal nutrition and fetal development. Since there are few studies on this topic and they report conflicting results, it is a relevant area for future research.

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