Eating habits and attitudes among 10-year-old children of mothers with eating disorders

BackgroundChildren of mothers with eating disorders are at increased risk of developmental disturbance, but there has been little research in middle childhood, when disturbed eating habits tend to emerge.AimsTo examine whether maternal eating disorders identified in the postnatal year are associated with the development of disturbed eating habits and attitudes in children at 10 years of age.MethodFollow-up comparative study of 56 families (33 mothers with eating disorders and 23 controls). Psychopathology of children, mothers and fathers was assessed by interview, and mother-child interaction observed.ResultsThe index group of children scored higher than controls on three of four domains of eating disorder psychopathology and on a global score. Children's eating disturbance was associated with length of exposure to mothers' eating disorder and mother-child mealtime conflict at 5 years. There was some evidence of increased emotional problems in index children.ConclusionsThe children of mothers with eating disorders manifested disturbed eating habits and attitudes compared with controls, and may be at heightened risk of developing frank eating disorder psychopathology.

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Temperament-Based Treatment for Young Adults with Eating Disorders: Acceptability and Initial Efficacy of an Intensive, Multi-Family, Parent-Involved Treatment.

10.21203/rs.3.rs-529512/v1 ◽

2021 ◽

Author(s):

Stephanie Knatz Peck ◽

Terra Towne ◽

Christina Wierenga ◽

Laura Hill ◽

Ivan Eisler ◽

...

Keyword(s):

Eating Disorders ◽

Young Adults ◽

Eating Disorder ◽

Self Report ◽

Program Satisfaction ◽

Full Remission ◽

Eating Disorder Psychopathology ◽

Clinical Impairment ◽

Spectrum Disorders

Abstract Background: Adult eating disorder treatments are hampered by lack of access and limited efficacy. This open-trial study evaluated the acceptability and preliminary efficacy of a novel intervention for adults with eating disorders delivered to young adults and parent-supports in an intensive, multi-family format (Young Adult Temperament-Based Treatment with Supports; YA-TBT-S). Methods: 38 YA-TBT-S participants (m age = 19.58; SD 2.13) with anorexia nervosa (AN)-spectrum disorders, bulimia nervosa (BN)-spectrum disorders, and avoidant/restrictive food intake disorder (ARFID) completed self-report assessments at admission, discharge, and 12-month follow-up. Assessments measured program satisfaction, eating disorder psychopathology and impairment, body mass index (BMI), and trait anxiety. Outcomes were analyzed using linear mixed effects models to examine changes in outcome variables across diagnoses over time. Results: Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. Participants reported reductions in ED symptomatology (AN and BN), increases in BMI (AN and ARFID), and reductions in clinical impairment (AN and ARFID) at 12-month follow-up. Conclusions: YA-TBT-S is a feasible and acceptable treatment that may improve ED outcomes in young adults with a broad range of diagnoses. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches.

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A qualitative study on the multi-level process of resilience development for adults recovering from eating disorders

Journal of Eating Disorders ◽

10.1186/s40337-021-00422-8 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Katie Grogan ◽

Hannah O’Daly ◽

Jessica Bramham ◽

Mary Scriven ◽

Caroline Maher ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Qualitative Study ◽

Significant Proportion ◽

Well Being ◽

Fundamental Aspect ◽

Increased Risk ◽

Resilience Process ◽

Multi Level ◽

Level Process

Abstract Background Resilience research to date has been criticised for its consideration of resilience as a personal trait instead of a process, and for identifying individual factors related to resilience with no consideration of the ecological context. The overall aim of the current study was to explore the multi-level process through which adults recovering from EDs develop resilience, from the perspectives of clients and clinicians. The objective of this research was to outline the stages involved in the process of developing resilience, which might help to inform families and services in how best to support adults with EDs during their recovery. Method Thirty participants (15 clients; 15 clinicians) took part in semi-structured interviews, and responded to questions relating to factors associated with resilience. Using an inductive approach, data were analysed using reflexive thematic analysis. Results The overarching theme which described the process of developing resilience was ‘Bouncing back to being me’, which involved three stages: ‘Who am I without my ED?’, ‘My eating disorder does not define me’, and ‘I no longer need my eating disorder’. Twenty sub-themes were identified as being involved in this resilience process, thirteen of which required multi-level involvement. Conclusion This qualitative study provided a multi-level resilience framework for adults recovering from eating disorders, that is based on the experiences of adults with eating disorders and their treating clinicians. This framework provided empirical evidence that resilience is an ecological process involving an interaction between internal and external factors occurring between adults with eating disorder and their most immediate environments (i.e. family and social). Plain English summary Anorexia nervosa, bulimia nervosa and binge-eating disorder demonstrate high rates of symptom persistence across time and poor prognosis for a significant proportion of individuals affected by these disorders, including health complications and increased risk of mortality. Many researchers have attempted to explore how to improve recovery outcomes for this population. Eating disorder experts have emphasised the need to focus not only on the weight indicators and eating behaviours that sustain the eating disorder during recovery, but also on the psychological well-being of the person recovering. One way to achieve this is to focus on resilience, which was identified as a fundamental aspect of eating disorder recovery in previous research. This study conceptualises resilience as a dynamic process that is influenced not only at a personal level but also through the environment in which the person lives. This study gathered data from adults with eating disorders and their treating clinicians, to devise a framework for resilience development for adults recovering from eating disorders. The paper discussed ways in which these findings and the framework identified can be easily implemented in clinical practice to facilitate a better understanding of eating disorder resilience and to enhance recovery outcomes.

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Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden

10.2337/figshare.14040212 ◽

2021 ◽

Author(s):

Ashley E. Tate ◽

Shengxin Liu ◽

Ruyue Zhang ◽

Zeynep Yilmaz ◽

Janne T. Larsen ◽

...

Keyword(s):

Eating Disorders ◽

Type 1 Diabetes ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Eating Behaviors ◽

Diabetes Diagnosis ◽

Disordered Eating Behaviors ◽

Increased Risk ◽

Clinical Diagnoses

OBJECTIVE To ascertain the association and co-aggregation of eating disorders and childhood-onset type 1 diabetes in families. RESEARCH DESIGN AND METHODS Using population samples from national registers in Sweden (n= 2 517 277) and Demark (n= 1 825 920) we investigated the within-individual association between type 1 diabetes and EDs, and their familial co-aggregation among full siblings, half-siblings, full cousins, and half-cousins. Based on clinical diagnoses we classified eating disorders (EDs) into: any eating disorder (AED), anorexia nervosa and atypical anorexia nervosa (AN), and other eating disorder (OED). Associations were determined with hazard ratios (HR) with confidence intervals (CI) from Cox regressions. RESULTS <pre>Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an ED diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80 – 2.27], AN 1.63 [1.36 – 1.96], OED 2.34 [2.07 – 2.63]; Denmark: AED 2.19 [1.84 – 2.61], AN 1.78 [1.36 – 2.33], OED 2.65 [2.20 – 3.21]). We also meta-analyzed the results: AED 2.07 [1.88 – 2.28], AN 1.68 [1.44 – 1.95], OED 2.44 [2.17 – 2.72]. There was an increased risk of receiving an ED diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07 – 1.46], AN 1.28 [1.04 – 1.57], OED 1.28 [1.07 – 1.52]), these results were non-significant in the Danish cohort.</pre> CONCLUSION Patients with 1 diabetes are at a higher risk of subsequent EDs; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and ED diagnosis. Diabetes healthcare teams should be vigilant for disordered eating behaviors in children and adolescents with type 1 diabetes.

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Comorbidity between types of eating disorder and general medical conditions

The British Journal of Psychiatry ◽

10.1192/bjp.2021.104 ◽

2021 ◽

pp. 1-8

Author(s):

Natalie C. Momen ◽

Oleguer Plana-Ripoll ◽

Cynthia M. Bulik ◽

John J. McGrath ◽

Laura M. Thornton ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Proportional Hazards ◽

Medical Condition ◽

Detailed Examination ◽

Cox Proportional Hazards ◽

Medical Conditions ◽

Relative Risks ◽

Hazard Ratios ◽

Increased Risk

Background Comorbidity with general medical conditions is common in individuals with eating disorders. Many previous studies do not evaluate types of eating disorder. Aims To provide relative and absolute risks of bidirectional associations between (a) anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and (b) 12 general medical conditions. Method We included all people born in Denmark between 1977 and 2010. We collected information on eating disorders and considered the risk of subsequent medical conditions, using Cox proportional hazards regression. Absolute risks were calculated using competing risks survival analyses. We also considered risks for prior medical conditions and subsequent eating disorders. Results An increased risk was seen for almost all disorder pairs (69 of 70). Hazard ratios for those with a prior eating disorder receiving a subsequent diagnosis of a medical condition ranged from 0.94 (95% CI 0.57−1.55) to 2.05 (95% CI 1.86−2.27). For those with a prior medical condition, hazard ratios for later eating disorders ranged from 1.35 (95% CI 1.26–1.45) to 1.98 (95% CI 1.71–2.28). Absolute risks for most later disorders were increased for persons with prior disorders, compared with reference groups. Conclusions This is the largest and most detailed examination of eating disorder–medical condition comorbidity. The findings indicate that medical condition comorbidity is increased among those with eating disorders and vice versa. Although there was some variation in comorbidity observed across eating disorder types, magnitudes of relative risks did not differ greatly.

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Impulsivity and Eating Disorders

The British Journal of Psychiatry ◽

10.1192/bjp.162.2.193 ◽

1993 ◽

Vol 162 (2) ◽

pp. 193-197 ◽

Cited By ~ 108

Author(s):

Thomas Fahy ◽

Ivan Eisler

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Treatment Trial ◽

Eating Disturbance ◽

Distinct Subgroup ◽

Impulsive Behaviour ◽

Poor Treatment ◽

One Year ◽

Poor Treatment Response

Sixty-seven patients with bulimia nervosa and 29 patients with anorexia nervosa completed the Impulsiveness Questionnaire and questionnaires detailing severity of eating disorder. Bulimic patients had higher impulsivity scores than anorexic patients. Bulimics with high impulsivity scores did not have more severe eating disorders than low scorers. When 39 bulimics and 25 anorexics were interviewed about other impulsive behaviour, 51 % of bulimics and 28% of anorexics reported at least one other impulsive behaviour. Patients with so-called ‘multiimpulsive’ bulimia reported more severe eating disturbance, but this was not reflected on more reliable measures of symptoms. Thirty-nine bulimics entered an eight-week treatment trial and their progress was assessed at eight weeks, 16 weeks and one year. ‘Non-impulsive’ bulimics had a more rapid response than ‘impulsives' during treatment, but there was no difference at follow-up. There was no evidence of an association between high impulsivity trait scores and poor treatment response. It is concluded that impulsivity may shape the expression of eating disorders, but that ‘multi-impulsives' do not constitute a categorically distinct subgroup of bulimics.

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Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2014.01.002 ◽

2014 ◽

Vol 36 (3) ◽

pp. 355-357 ◽

Cited By ~ 22

Author(s):

Jaana T. Suokas ◽

Jaana M. Suvisaari ◽

Marjut Grainger ◽

Anu Raevuori ◽

Mika Gissler ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Suicide Attempts ◽

Follow Up Study

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Mixture Modeling to Characterize Anorexia Nervosa: Integrating Personality and Eating Disorder Psychopathology

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390319862029 ◽

2019 ◽

pp. 107839031986202

Author(s):

Karen M. Jennings ◽

Lindsay P. Bodell ◽

Ross D. Crosby ◽

Ann F. Haynos ◽

Jennifer E. Wildes

Keyword(s):

Anorexia Nervosa ◽

Eating Disorder ◽

Latent Class ◽

Clinical Presentation ◽

Mixture Modeling ◽

Eating Disorder Psychopathology ◽

Personality Psychopathology ◽

Latent Dimension ◽

Eating Disorder Behaviors

BACKGROUND: Efforts to examine alternative classifications (e.g., personality) of anorexia nervosa (AN) using empirical techniques are crucial to elucidate diverse symptom presentations, personality traits, and psychiatric comorbidities. AIM: The purpose of this study was to use an empirical approach (mixture modeling) to test an alternative classification of AN as categorical, dimensional, or hybrid categorical–dimensional construct based on the co-occurrence of personality psychopathology and eating disorder clinical presentation. METHOD: Patients with AN ( N = 194) completed interviews and questionnaires at treatment admission and 3-month follow-up. Mixture modeling was used to test whether indicators best classified AN as categorical, dimensional, or hybrid. RESULTS: A four-latent class, one-latent dimension mixture model that was variant across groups provided the best fit to the data. Results suggest that all classes were characterized by low self-esteem and self-harming and suicidality tendencies. Individuals assigned to Latent Class 2 (LC2; n = 21) had a greater tendency toward being impulsive and easily angered and having difficulties controlling anger compared with those in LC1 ( n = 84) and LC3 ( n = 66). Moreover, individuals assigned to LC1 and LC3 were more likely to have a poor outcome from intensive treatment compared with those in LC4 ( n = 21). Findings indicate that the dimensional aspect within each class measured frequency of specific eating disorder behaviors but did not predict treatment outcomes. CONCLUSION: These results emphasize the complexity of AN and the importance of considering how facets of clinical presentation beyond eating disorder behaviors may have different treatment and prognostic implications.

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Targeting binge eating in bulimia nervosa and binge eating disorder using inhibitory control training and implementation intentions: a feasibility trial

Psychological Medicine ◽

10.1017/s0033291720002494 ◽

2020 ◽

pp. 1-10

Author(s):

Rayane Chami ◽

Valentina Cardi ◽

Natalia Lawrence ◽

Pamela MacDonald ◽

Katie Rowlands ◽

...

Keyword(s):

Eating Disorder ◽

Bulimia Nervosa ◽

Binge Eating ◽

Binge Eating Disorder ◽

Implementation Intentions ◽

Effect Sizes ◽

Post Intervention ◽

Eating Frequency ◽

Eating Disorder Psychopathology

Abstract Background This trial examined the feasibility, acceptability, and effect sizes of clinical outcomes of an intervention that combines inhibitory control training (ICT) and implementation intentions (if-then planning) to target binge eating and eating disorder psychopathology. Methods Seventy-eight adult participants with bulimia nervosa or binge eating disorder were randomly allocated to receive food-specific, or general, ICT and if-then planning for 4 weeks. Results Recruitment and retention rates at 4 weeks (97.5% and 79.5%, respectively) met the pre-set cut-offs. The pre-set adherence to the intervention was met for the ICT sessions (84.6%), but not for if-then planning (53.4%). Binge eating frequency and eating disorder psychopathology decreased in both intervention groups at post-intervention (4 weeks) and follow-up (8 weeks), with moderate to large effect sizes. There was a tendency for greater reductions in binge eating frequency and eating disorders psychopathology (i.e. larger effect sizes) in the food-specific intervention group. Across both groups, ICT and if-then planning were associated with small-to-moderate reductions in high energy-dense food valuation (post-intervention), food approach (post-intervention and follow-up), anxiety (follow-up), and depression (follow-up). Participants indicated that both interventions were acceptable. Conclusions The study findings reveal that combined ICT and if-then planning is associated with reductions in binge eating frequency and eating disorder psychopathology and that the feasibility of ICT is promising, while improvements to if-then planning condition may be needed.

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Mortality in eating disorders: A follow-up study of adult eating disorder patients treated in tertiary care, 1995–2010

Psychiatry Research ◽

10.1016/j.psychres.2013.07.042 ◽

2013 ◽

Vol 210 (3) ◽

pp. 1101-1106 ◽

Cited By ~ 46

Author(s):

Jaana T. Suokas ◽

Jaana M. Suvisaari ◽

Mika Gissler ◽

Rasmus Löfman ◽

Milla S. Linna ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Tertiary Care ◽

Follow Up Study

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Eating Disorder Attitudes and Psychopathology in Caucasian Australian, Asian Australian and Thai University Students

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2006.01761.x ◽

2006 ◽

Vol 40 (2) ◽

pp. 143-149 ◽

Cited By ~ 17

Author(s):

Piangchai S Jennings ◽

David Forbes ◽

Brett Mcdermott ◽

Gary Hulse ◽

Sato Juniper

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

University Students ◽

Eating Attitudes ◽

Eating Attitudes Test ◽

Unhealthy Eating ◽

Eating Disorder Psychopathology ◽

Eating Disorders Inventory ◽

Eat 26 ◽

Thai University

Objective: To examine eating disorder attitudes and psychopathology among female university students in Australia and Thailand. Method: Participants were 110 Caucasian Australians, 130 Asian Australians and 101 Thais in Thailand. The instruments included the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI). Results: Eating disorder attitudes and psychopathology scores in the Thai group were found to be highest. The Asian Australian group did not have significantly higher scores on the EAT-26 than the Caucasian Australian group, but had higher scores in some subscales of the EDI-2. That the Thai group had the highest scores in susceptibility to developing an eating disorder and eating disorder psychopathology may be partially explained in sociocultural terms, with pressure to be thin more extreme in Thailand than in Australia. The evidence suggested that unhealthy eating disorder psychopathology is not limited to Western societies but is already present in Thai and other Asian societies.

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