Objective
Eating disorder symptoms, including eating disorder diagnosis, binge eating, and unhealthy weight loss, are associated with health risks, and adolescence may be an optimal time to provide ...education on healthy alternatives. This research explored whether in‐school health information during adolescence is associated with eating disorder symptoms in young adulthood.
Method
Data were used from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of American youth, including information from Wave I, when participants were in Grades 7–12, and from Wave III, when participants were aged 18–26. Logistic regression analyses predicted eating disorder symptoms from in‐school health information, adjusting for demographic and educational covariates. In‐school health information and eating disorder symptoms were based on participant self‐report.
Results
In‐school health information about both diet (the foods you should and should not eat) and the importance of exercise compared to no health information reduced the odds of youth‐reported eating disorder history odds ratio ((OR) = 0.23, 95% CI = 0.11–0.48). Individuals who received information on exercise alone compared to no health information were also less likely to use weight pills to control weight (OR = 0.26, 95% CI = 0.11–0.61). There was no difference in binge‐eating symptoms based on school health class.
Discussion
Findings from this exploratory research study indicate that in‐school receipt of information on diet and exercise has modest associations with eating disorder symptoms, including lower odds of a self‐reported eating disorder and lower odds of using weight loss pills. Further research is needed to definitely test the role of school health class on eating disorder symptoms.
Exercise may improve neuropsychiatric and cognitive symptoms in people with mental disorders, but the totality of the evidence is unclear. We conducted a meta-review of exercise in (1) serious mental ...illness (schizophrenia spectrum, bipolar disorder and major depression (MDD)); (2) anxiety and stress disorders; (3) alcohol and substance use disorders; (4) eating disorders (anorexia nervosa bulimia nervosa, binge eating disorders, and (5) other mental disorders (including ADHD, pre/post-natal depression).
Systematic searches of major databases from inception until 1/10/2018 were undertaken to identify meta-analyses of randomised controlled trials (RCTs) of exercise in people with clinically diagnosed mental disorders. In the absence of available meta-analyses for a mental disorder, we identified systematic reviews of exercise interventions in people with elevated mental health symptoms that included non-RCTs. Meta-analysis quality was assessed with the AMSTAR/+.
Overall, we identified 27 systematic reviews (including 16 meta-analyses representing 152 RCTs). Among those with MDD, we found consistent evidence (meta-analyses = 8) that exercise reduced depression in children, adults and older adults. Evidence also indicates that exercise was more effective than control conditions in reducing anxiety symptoms (meta-analyses = 3), and as an adjunctive treatment for reducing positive and negative symptoms of schizophrenia (meta-analyses = 2). Regarding neurocognitive effects, exercise improved global cognition in schizophrenia (meta-analyses = 1), children with ADHD (meta-analyses = 1), but not in MDD (meta-analyses = 1). Among those with elevated symptoms, positive mental health benefits were observed for exercise in people with pre/post-natal depression, anorexia nervosa/bulimia nervosa, binge eating disorder, post-traumatic stress disorder and alcohol use disorders/substance use disorders. Adverse events were sparsely reported.
Our panoramic meta-overview suggests that exercise can be an effective adjunctive treatment for improving symptoms across a broad range of mental disorders.
Objective
Evaluate the association of military sexual trauma (MST) screen status with eating disorder diagnoses among veterans within 1‐ and 5‐years after initiating Veterans Health Administration ...(VHA) care, and whether the association varied by sex.
Method
Retrospective cohort study of US Afghanistan/Iraq veterans who used VHA services between FY 2004 and 2014 (N = 595,525). This study used VHA administrative data to assess the presence of eating disorder diagnoses in medical records within 1‐ and 5‐years of initiating VHA care, and whether a positive screen for MST was associated with eating disorders.
Results
Three percent (n = 18,488) screened positive for MST. At 1‐ and 5‐year follow up, 0.1% (n= 513, 74% female), and 0.2% (n = 504, 71% female) were diagnosed with an eating disorder, respectively. In regression models adjusted for demographic variables, military service, and psychiatric comorbidities, the presence of an eating disorder diagnosis was nearly two times higher among those with a positive screen for MST in the 1‐year (adjusted odds ratio AOR = 1.94, 95% confidence interval CI = 1.57–2.40) and 5‐year (AOR = 1.86, 95%CI = 1.49–2.32) cohorts. The increased likelihood conferred by MST for an eating disorder diagnosis was differentially stronger among male veterans than female veterans in the 1‐year cohort only (AOR = 2.13, 95%CI = 1.01–4.50).
Discussion
Veterans with a positive screen for MST, especially male veterans, had a nearly two‐fold increased likelihood of having an eating disorder diagnosis. Screening for eating disorders may be important in both male and female veterans who report MST.
Labelling specific psychiatric concerns as 'niche' topics relegated to specialty journals obstructs high-quality research and clinical care for these issues. Despite their severity, eating disorders ...are under-represented in high-impact journals, underfunded, and under-addressed in psychiatric training. We provide recommendations to stimulate broad knowledge dissemination for under-acknowledged, yet severe, psychiatric disorders.
Behavioral and personality characteristics associated with excessive inhibition and disinhibition are observed in patients with eating disorders, but neural correlates of inhibitory control have not ...been examined in adolescents with these disorders.
Thirteen female adolescents with binge eating and purging behaviors (i.e., bulimia nervosa or anorexia nervosa, binge eating/purging type);14 with anorexia nervosa, restricting type; and 13 healthy comparison subjects performed a rapid, jittered event-related go/no-go task. Functional magnetic resonance images were collected using a 3 Tesla GE scanner and a spiral pulse sequence. A whole-brain three-group analysis of variance in SPM5 was used to identify significant activation associated with the main effect of group for the comparison of correct no-go versus go trials. The mean activation in these clusters was extracted for further comparisons in SPSS.
The binge eating/purging group showed significantly greater activation than the healthy comparison group in the bilateral precentral gyri, anterior cingulate cortex, and middle and superior temporal gyri as well as greater activation relative to both comparison and restricting type anorexia subjects in the hypothalamus and right dorsolateral prefrontal cortex. Within-group analysis found that only the restricting type anorexia group showed a positive correlation between the percent correct on no-go trials and activation in posterior visual and inferior parietal cortex regions.
The present study provides preliminary evidence that during adolescence, eating disorder subtypes may be distinguishable in terms of neural correlates of inhibitory control. This distinction is consistent with differences in behavioral impulsivity in these patient groups.
Eating disorders are deadly psychiatric illnesses, with treatments working for less than half of individuals who seek treatment. The transdiagnostic theory of eating disorders proposes that eating ...disorders share similar maintaining symptoms, such as what this theory calls clinical perfectionism (i.e., high levels of concern over mistakes and personal standards). However, it has been difficult to examine the interrelationship of specific aspects of perfectionism, beyond assessing moderation effects, which have generally not found support for the theory of clinical perfectionism in eating disorders. Thus, we used network analysis to test the theory of perfectionism by testing the interrelationships between maladaptive perfectionism facets (concern over mistakes, personal standards, parental criticism, parental expectations, and personal standards) and eating disorder symptoms in 397 individuals diagnosed with an eating disorder. Concern over mistakes was a central symptom and demonstrated the strongest interrelationships with eating disorder symptoms compared to the other aspects of perfectionism, connecting to eating concerns and cognitive restraint. Objective binge eating had a strong negative connection to personal standards. We identified specific central symptoms and illness pathways of perfectionism, which partially supports the theory of clinical perfectionism. Results, if replicated, may suggest that concern over mistakes might be best reconceptualized as part of eating disorder pathology and be targeted to improve treatment outcomes for eating disorders.
Investigating eating disorders and orthorexia nervosa, especially in the young population, is an important step in taking protective precautions and identifying disease. This study was carried out to ...determine the relationship of eating disorders and orthorexia nervosa to gender, BMI, and field of study in a population of university students in Turkey. In all, 900 university students aged 17-23 years participated in this study. EAT-40 and ORTO-15, which are validated instruments for the screening of participants with anormal eating behaviors and orthorexia nervosa, respectively, were used. There was not a significant difference in EAT-40 scores according to gender and BMI classification. However, EAT-40 scores were high among the students in social science. The number of orthorectic participants among women is higher than that among men, and ORTO-15 scores were not associated with BMI classification and field of study. A significant negative correlation was found between EAT-40 and ORTO-15 scores.
Traditional approaches for the classification of eating disorders (EDs) attribute symptoms to an underlying, latent disease entity. The network approach is an alternative model in which mental ...disorders are represented as networks of interacting, self-reinforcing symptoms. This project was the first to use network analysis to identify interconnected systems of ED symptoms.
Adult participants (n = 143; 77.6% women) with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) ED were recruited from the community to take part in a larger ongoing longitudinal study. The Structured Clinical Interview for DSM Disorders (SCID-I) was used to establish diagnoses. An undirected network of ED symptoms was created using items from the Eating Pathology Symptoms Inventory (EPSI) and the R package qgraph.
Body checking emerged as the strongest and most important single symptom in the entire network by having the shortest average distance to other symptoms in the network, and by being the most frequent symptom on the path between any two other symptoms. Feeling the need to exercise every day and two symptoms assessing dietary restraint/restricting emerged as 'key players', such that their removal from the network resulted in maximal fracturing of the network into smaller components.
Although cognitive-behavioral therapy for EDs focuses on reducing body checking to promote recovery, our data indicate that amplified efforts to address body checking may produce stronger (and more enduring) effects. Finally, results of the 'key players analysis' suggested that targeting interventions at these key nodes might prevent or slow the cascade of symptoms through the 'network' of ED psychopathology.
Several studies support the efficacy of interpersonal psychotherapy (IPT) in the treatment of eating disorders. Treatment outcomes are likely to be augmented through a greater understanding, and ...hence treatment targeting, of the mechanisms whereby IPT induces therapeutic gains. To this end, the present paper seeks to develop a theoretical model of IPT in the context of eating disorders (IPT-ED). After providing a brief description of IPT, the IPT-ED model is presented and research supporting its theorized mechanisms is summarized. This model proposes that negative social evaluation plays a pivotal role as both a cause (via its detrimental impact on self evaluation and associated affect) and consequence of eating disorder symptoms. In the final section, key eating disorder constructs (namely, the developmental period of adolescence, clinical perfectionism, cognitive dysfunction, and affect regulation) are re-interpreted from the standpoint of negative social evaluation thereby further explicating IPT's efficacy as an intervention for individuals with an eating disorder.
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