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Linsenmeyer W, Stiles D, Garwood S, Giedinghagen A, Lewis C, Strand G. The Sick, Control, One Stone, Fat, Food (SCOFF) is a Valid Eating Disorder Questionnaire to Use With Transgender Youth. Clin Pediatr (Phila) 2024; 63:971-976. [PMID: 37712557 DOI: 10.1177/00099228231200754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Transgender youth experience elevated rates of eating disorders, yet few screening measures have been validated with transgender patients. The purpose of this study was to provide initial evidence for the internal consistency and convergent validity of the Sick, Control, One Stone, Fat, Food (SCOFF) in a sample of transgender youth. Two hundred eight participants completed the SCOFF as part of a routine screening protocol. Exploratory factor analysis and confirmatory factor analysis were used to establish the factor structure of the SCOFF in this sample. Relationships between the SCOFF, Adolescent Binge Eating Disorder (ADO-BED), Nine-Item Avoidant/Restrictive Intake Disorder (NIAS), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), and demographic characteristics were explored. The SCOFF was significantly related to all convergent validity variables, with moderate correlations with other eating disorder scales (ADO-BED and NIAS). The SCOFF is a valid measure to screen for eating disorders among transgender youth and young adults.
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Affiliation(s)
| | | | - Sarah Garwood
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - Christopher Lewis
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Gretta Strand
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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2
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Adamic EM, Teed AR, Avery JA, de la Cruz F, Khalsa SS. Hemispheric divergence of interoceptive processing across psychiatric disorders. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.08.570759. [PMID: 38105986 PMCID: PMC10723463 DOI: 10.1101/2023.12.08.570759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Interactions between top-down attention and bottom-up visceral inputs are assumed to produce conscious perceptions of interoceptive states, and while each process has been independently associated with aberrant interoceptive symptomatology in psychiatric disorders, the neural substrates of this interface are unknown. We conducted a preregistered functional neuroimaging study of 46 individuals with anxiety, depression, and/or eating disorders (ADE) and 46 propensity-matched healthy comparisons (HC), comparing their neural activity across two interoceptive tasks differentially recruiting top-down or bottom-up processing within the same scan session. During an interoceptive attention task, top-down attention was voluntarily directed towards cardiorespiratory or visual signals, whereas during an interoceptive perturbation task, intravenous infusions of isoproterenol (a peripherally-acting beta-adrenergic receptor agonist) were administered in a double-blinded and placebo-controlled fashion to drive bottom-up cardiorespiratory sensations. Across both tasks, neural activation converged upon the insular cortex, localizing within the granular and ventral dysgranular subregions bilaterally. However, contrasting hemispheric differences emerged, with the ADE group exhibiting (relative to HCs) an asymmetric pattern of overlap in the left insula, with increased or decreased proportions of co-activated voxels within the left or right dysgranular insula, respectively. The ADE group also showed less agranular anterior insula activation during periods of bodily uncertainty (i.e., when anticipating possible isoproterenol-induced changes that never arrived). Finally, post-task changes in insula functional connectivity were associated with anxiety and depression severity. These findings confirm the dysgranular mid-insula as a key cortical interface where attention and prediction meet real-time bodily inputs, especially during heightened awareness of interoceptive states. Further, the dysgranular mid-insula may indeed be a "locus of disruption" for psychiatric disorders.
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Affiliation(s)
- Emily M Adamic
- Laureate Institute for Brain Research, Tulsa, OK, USA, 74136
- Department of Biological Sciences, University of Tulsa, Tulsa, OK, USA, 74104
| | - Adam R Teed
- Laureate Institute for Brain Research, Tulsa, OK, USA, 74136
| | - Jason A Avery
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA, 20814
| | - Feliberto de la Cruz
- Laboratory for Autonomic Neuroscience, Imaging, and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Thuringia, Germany, 07743
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA, 74136
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA, 74119
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Zhang J, Cui S, Xu Y, Cui T, Barnhart WR, Ji F, Nagata JM, He J. Introducing Diagnostic Classification Modeling as an Unsupervised Method for Screening Probable Eating Disorders. Assessment 2024:10731911241247483. [PMID: 38676565 DOI: 10.1177/10731911241247483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Screening for eating disorders (EDs) is an essential part of the prevention and intervention of EDs. Traditional screening methods mostly rely on predefined cutoff scores which have limitations of generalizability and may produce biased results when the cutoff scores are used in populations where the instruments or cutoff scores have not been validated. Compared to the traditional cutoff score approach, the diagnostic classification modeling (DCM) approach can provide psychometric and classification information simultaneously and has been used for diagnosing mental disorders. In the present study, we introduce DCM as an innovative and alternative approach to screening individuals at risk of EDs. To illustrate the practical utility of DCM, we provide two examples: one involving the application of DCM to examine probable ED status from the 12-item Short form of the Eating Disorder Examination-Questionnaire (EDE-QS) to screen probable thinness-oriented EDs and the Muscularity-Oriented Eating Test (MOET) to screen probable muscularity-oriented EDs.
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Affiliation(s)
| | - Shuqi Cui
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yinuo Xu
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | | | | | - Feng Ji
- University of Toronto, Ontario, Canada
| | - Jason M Nagata
- University of California, San Francisco, California, USA
| | - Jinbo He
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
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Nolan LJ, Higgs S. The role of irrational beliefs in the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and disordered eating in two general student samples. Appetite 2024; 195:107229. [PMID: 38246426 DOI: 10.1016/j.appet.2024.107229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/21/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
Attention deficit hyperactivity disorder (ADHD) symptoms are associated with disordered eating and negative mood. The purpose of this study was to examine whether irrational beliefs mediate this relationship along with previously reported mediators such as depression and impulsivity. Irrational beliefs trigger negative automatic thoughts which are believed, in cognitive behavior therapies, to be a source of psychopathology. Challenges brought about by symptoms of ADHD may lead to habitual emotion-eliciting thought patterns which, in turn, could lead to negative mood and disordered eating. Undergraduate students (N = 127) completed online questionnaires assessing ADHD symptoms and disordered eating and several potential mediators including irrational beliefs, depression, impulsivity, interoceptive accuracy, and reward responsiveness. The results, which were replicated in a second study (N = 254), indicated that irrational beliefs and depression mediated the relationship between ADHD symptoms and disordered eating. In the second study, impulsivity due to negative urgency was also a mediator. These findings support the theory that the symptoms of ADHD lead to enhancement of irrational beliefs, depression, and negative urgency which are linked to disordered eating.
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, NY, 10301, USA.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
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Alexander T, Burnette CB, Cory H, McHale S, Simone M. The need for more inclusive measurement to advance equity in eating disorders prevention. Eat Disord 2024:1-19. [PMID: 38488765 DOI: 10.1080/10640266.2024.2328460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Eating disorder (ED) research and practice have been shaped by prevailing stereotypes about who EDs are most likely to affect. Subsequently, the field has prioritized the needs and concerns of affluent, cisgender, heterosexual, white girls and women to the exclusion of others, especially people marginalized based on their race, ethnicity, sexual orientation, and/or gender identity. However, EDs exist across diverse groups and actually occur with elevated prevalence in several marginalized groups. Growing research points to differences in the drivers of EDs in such groups (e.g. desire to attain the curvy rather than thin ideal; dietary restraint due to food insecurity rather than weight/shape concerns), yet tools typically used for screening and intervention evaluation do not capture eating pathology driven by such factors. In this commentary, we describe gaps in existing ED assessment tools and argue these gaps likely underestimate EDs among marginalized groups, bias who is invited, participates in, and benefits from ED prevention programs, and obscure potential group differences in the efficacy of such programs. We also discuss the potential of these ramifications to exacerbate inequities in EDs. Finally, we outline recommendations to overcome existing gaps in measurement and, consequently, advance equity in the realm of ED prevention.
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Affiliation(s)
- Tricia Alexander
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - C Blair Burnette
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Hannah Cory
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
- Department of Health Promotion and Community Health, School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA
| | - Safiya McHale
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado Denver, Denver, CO, USA
| | - Melissa Simone
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado Denver, Denver, CO, USA
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Ghazzawi HA, Nimer LS, Haddad AJ, Alhaj OA, Amawi AT, Pandi-Perumal SR, Trabelsi K, Seeman MV, Jahrami H. A systematic review, meta-analysis, and meta-regression of the prevalence of self-reported disordered eating and associated factors among athletes worldwide. J Eat Disord 2024; 12:24. [PMID: 38326925 PMCID: PMC10851573 DOI: 10.1186/s40337-024-00982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/31/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The purpose of this meta-analysis was to provide a pooled prevalence estimate of self-reported disordered eating (SRDE) in athletes based on the available literature, and to identify risk factors for their occurrence. METHODS Across ten academic databases, an electronic search was conducted from inception to 7th January 2024. The proportion of athletes scoring at or above predetermined cutoffs on validated self-reporting screening measures was used to identify disordered eating (DE). Subgroup analysis per country, per culture, and per research measure were also conducted. Age, body mass index (BMI), and sex were considered as associated/correlated factors. RESULTS The mean prevalence of SRDE among 70,957 athletes in 177 studies (132 publications) was 19.23% (17.04%; 21.62%), I2 = 97.4%, τ2 = 0.8990, Cochran's Q p value = 0. Australia had the highest percentage of SRDE athletes with a mean of 57.1% (36.0%-75.8%), while Iceland had the lowest, with a mean of 4.9% (1.2%-17.7%). The SRDE prevalence in Eastern countries was higher than in Western countries with 29.1% versus 18.5%. Anaerobic sports had almost double the prevalence of SRDE 37.9% (27.0%-50.2%) compared to aerobic sports 19.6% (15.2%-25%). Gymnastics sports had the highest SRDE prevalence rate, with 41.5% (30.4%-53.6%) while outdoor sports showed the lowest at 15.4% (11.6%-20.2%). Among various tools used to assess SRDE, the three-factor eating questionnaire yielded the highest SRDE rate 73.0% (60.1%-82.8%). Meta-regression analyses showed that female sex, older age, and higher BMI (all p < 0.01) are associated with higher prevalence rates of SRDE. CONCLUSION The outcome of this review suggests that factors specific to the sport affect eating behaviors throughout an athlete's life. As a result, one in five athletes run the risk of developing an eating disorder. Culture-specific and sport-specific diagnostic tools need to be developed and increased attention paid to nutritional deficiencies in athletes.
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Affiliation(s)
- Hadeel A Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Lana S Nimer
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Areen Jamal Haddad
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Adam T Amawi
- Department of Exercise Science and Kinesiology, School of Sport Science, The University of Jordan, Amman, Jordan
| | - Seithikurippu R Pandi-Perumal
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Division of Research and Development, Lovely Professional University, Phagwara, Punjab, 144411, India
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, University of Sfax, EM2S, LR19JS013000, Sfax, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain.
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
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Gorgas DL. Eating Disorders. Emerg Med Clin North Am 2024; 42:163-179. [PMID: 37977748 DOI: 10.1016/j.emc.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Anorexia nervosa (AN) and bulimia nervosa (BN) are easily missed in the emergency department, because patients may present with either low, normal, or increased BMI. Careful examination for signs of purging and excessive use of laxatives and promotility agents is important. Careful examination for and documentation of dental erosions, posterior oropharyngeal bruising, Russel's sign, and salivary and parotid gland inflammation are clues to the purging behavior. Treatment for AN should include cognitive behavioral therapy with concomitant efforts to treat any psychiatric comorbidities, whereas BN and BED have been successfully treated with fluoxetine and lisdexamfetamine, respectively.
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Affiliation(s)
- Diane L Gorgas
- Department of Emergency Medicine, Health Sciences Center for Global Health, The Ohio State University, Prior Hall, Floor 7376 West Tenth Avenue, Colubus, OH 43210, USA.
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Gordon AR, Beccia AL, Egan N, Lipson SK. Intersecting gender identity and racial/ethnic inequities in eating disorder risk factors, symptoms, and diagnosis among U.S. college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy. Int J Eat Disord 2024; 57:146-161. [PMID: 37933620 PMCID: PMC10842502 DOI: 10.1002/eat.24089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION There are documented inequities in eating disorders (EDs) by gender and race/ethnicity, yet, little is known about population-level prevalence of ED risk factors, symptoms, and diagnosis at the intersection of diverse gender and racial/ethnic identities. METHODS Data from the Healthy Minds Study 2015-2019 (N = 251,310 U.S. university students) were used in a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). Participants were nested in 35 intersectional strata given by all combinations of 5 gender and 7 racial/ethnic categories. Multilevel logistic models with participants at level 1 and intersectional strata at level 2 were used to estimate stratum-specific predicted prevalence estimates for self-reported thin-ideal internalization, ED symptoms, and ED diagnosis. The variance partition coefficient (VPC) was calculated to quantify the contextual effect of the strata. RESULTS There was considerable heterogeneity in the predicted prevalence of our ED outcomes across the strata (e.g., .3%-18.3% for ED diagnoses). There were large disparities in all three outcomes, with transgender participants of color having a higher predicted prevalence than expected based on the additive effects of gender and race/ethnicity. Moderation by race/ethnicity was also apparent, such that racial/ethnic disparities were wider within the cisgender groups relative to the transgender groups. VPCs indicated that ~10% of the total variance in ED outcomes was due to intersectionality between gender and race/ethnicity, over and above variance due to individual-level differences. CONCLUSION Findings suggest that gender and racial/ethnic disparities in EDs are interrelated, underscoring the need to develop preventive interventions centering health equity. PUBLIC SIGNIFICANCE Despite evidence that sexism, racism, and cissexism (i.e., anti-transgender prejudice) can impact EDs risk, little research examines the social patterning of EDs at the intersection of diverse gender and racial/ethnic identities. Using data from a sample of 250,000 U.S. university students, this study found that gender and racial/ethnic disparities in eating disorder risk are interrelated, highlighting the need to develop health equity centered preventive interventions.
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Affiliation(s)
- Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Natalie Egan
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah K. Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA USA
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Levinson CA, Osborn K, Hooper M, Vanzhula I, Ralph-Nearman C. Evidence-Based Assessments for Transdiagnostic Eating Disorder Symptoms: Guidelines for Current Use and Future Directions. Assessment 2024; 31:145-167. [PMID: 37997290 DOI: 10.1177/10731911231201150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Eating disorders are severe and often chronic mental illnesses that are associated with high impairment and mortality rates. Recent estimates suggest that eating disorder prevalence rates are on the rise, indicating an increased need for accurate assessment and detection. The current review provides an overview of transdiagnostic eating disorder assessments, including interview, self-report, health and primary care screeners, and technology-based and objective assessments. We focused on assessments that are transdiagnostic in nature and exhibit high impact in the field. We provide recommendations for how these assessments should be used in research and clinical settings. We also discuss considerations that are crucial for assessment, including the use of a categorical versus dimensional diagnostic framework, assessment of eating disorders in related fields (i.e., anxiety and depression), and measurement-based care for eating disorders. Finally, we provide suggestions for future research, including the need for more research on short transdiagnostic screeners for use in health care settings, standardized assessments for ecological momentary assessment, development of state-based assessment of eating disorder symptoms, and consideration of assessment across multiple timescales.
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Affiliation(s)
| | - Kimberly Osborn
- University of Louisville, KY, USA
- Oklahoma State University, Stillwater, USA
| | - Madison Hooper
- University of Louisville, KY, USA
- Vanderbilt University, Nashville, TN, USA
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Namimi-Halevi C, Dor C, Stark AH, Dichtiar R, Bromberg M, Sinai T. Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents. Pediatr Res 2023:10.1038/s41390-023-02925-3. [PMID: 38049648 DOI: 10.1038/s41390-023-02925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023]
Abstract
AIM Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents. METHODS Participants in the Israeli Youth Health and Nutrition Survey (2015-2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index. RESULTS Of 4616 participants (12-18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170-1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD. CONCLUSION Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship's causality. IMPACT Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being. This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE. This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.
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Affiliation(s)
- Chen Namimi-Halevi
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Chen Dor
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Aliza H Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Michal Bromberg
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel.
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
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Abstract
ABSTRACT Binge-eating disorder (BED) has the highest prevalence of any eating disorder in the US today. However, the condition is frequently not recognized as an eating disorder by healthcare providers or patients. Patients with this diagnosis often have significant psychiatric and medical comorbidities that might respond to evidence-based treatments. NPs in primary care with awareness of the diagnostic criteria for BED and knowledge of its assessment and treatment options can coordinate care for patients experiencing this health challenge.
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12
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Perrin EC, Ravi HL, Borra GS, South AM. Prevalence and risk factors of disordered eating behavior in youth with hypertension disorders. Pediatr Nephrol 2023; 38:3779-3789. [PMID: 37195544 PMCID: PMC10189692 DOI: 10.1007/s00467-023-05921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Adolescents with certain health conditions requiring lifestyle management, such as diabetes mellitus, have higher disordered eating behavior (DEB) risk than the general adolescent population, but DEB is underdiagnosed and can lead to adverse health consequences. In youth with other conditions requiring lifestyle counseling such as hypertension (HTN), DEB prevalence and associated risk factors are unknown. We hypothesized that youth with HTN disorders would have higher DEB prevalence than the general adolescent population, and that obesity, chronic kidney disease (CKD), and less specialized lifestyle counseling would be associated with higher DEB risk. METHODS Prospective cross-sectional study of youth aged 11-18 years with HTN disorders. We excluded patients with diabetes mellitus, kidney failure or transplantation, or gastrostomy tube dependence. We collected data via surveys and electronic health record abstraction. We administered the validated SCOFF DEB screening questionnaire. We compared DEB prevalence using a one-sample z-test of proportions (p0 = 0.1) and estimated DEB risk by obesity, CKD, and lifestyle counseling source using multivariable generalized linear models. RESULTS Of 74 participants, 59% identified as male, 22% as Black or African American, and 36% as Hispanic or Latino; 58% had obesity and 26% had CKD. DEB prevalence was 28% (95% CI 18-39%, p < 0.001). CKD was associated with higher DEB prevalence (adjusted RR 2.17, 95% CL 1.09 to 4.32), but obesity and lifestyle counseling source were not. CONCLUSIONS DEB prevalence is higher in youth with HTN disorders and comparable to other conditions requiring lifestyle counseling. Youth with HTN disorders may benefit from DEB screening. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Ella C Perrin
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Hanna L Ravi
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gagana S Borra
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Andrew M South
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA.
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC, USA.
- Cardiovascular Sciences Center, Wake Forest University School of Medicine, Winston Salem, NC, USA.
- Center for Biomedical Informatics, Wake Forest University School of Medicine, Winston Salem, NC, USA.
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Barnard-Brak L, Yang Z. A 4pL item response theory examination of perceived stigma in the screening of eating disorders with the SCOFF among college students. Eat Weight Disord 2023; 28:79. [PMID: 37792143 PMCID: PMC10550868 DOI: 10.1007/s40519-023-01604-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 08/27/2023] [Indexed: 10/05/2023] Open
Abstract
We examined the psychometric properties of the SCOFF, a screening instrument for eating disorders, with consideration of the perceived stigma of items that can produce socially desirable responding among a sample of college students. The results of the current study suggest evidence of the sufficient psychometric properties of the SCOFF in terms of confirmatory factor and item response theory analyses. However, two items of the SCOFF revealed that individuals who otherwise endorsed other items of the SCOFF were less likely to endorse the items of Fat and Food. It is hypothesized that this is the result of perceived stigma regarding those two items that prompts individuals to respond in a socially desirable way. A weighted scoring procedure was developed to counteract the performance of these two items, but the psychometric performance was only slightly better and there would be a clear tradeoff of specificity over sensitivity if utilized. Future research should consider other ways to counteract such perceived stigma.Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
| | - Zhanxia Yang
- Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
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Martin E, Dourish CT, Higgs S. Interoceptive accuracy mediates the longitudinal relationship between attention deficit hyperactivity disorder (ADHD) inattentive symptoms and disordered eating in a community sample. Physiol Behav 2023; 268:114220. [PMID: 37142150 DOI: 10.1016/j.physbeh.2023.114220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 05/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) symptoms are associated with disordered eating and interoceptive deficits (as assessed by reliance on hunger/satiety cues) have been suggested as a potential mediating influence. The aim of this longitudinal study was to examine whether the association between ADHD symptoms and disordered eating is explained by deficits in specific facets of interoception. We also aimed to provide further evidence on the previously reported association between ADHD symptoms, negative mood and disordered eating. A community-based sample of 345 adult men and women (M age = 33.9, 72.5% women) completed questionnaires assessing disordered eating (restrictive and binge-type), ADHD symptoms, reliance on hunger/ satiety cues, specific facets of interoception (interoceptive accuracy and interoceptive sensibility) and negative mood at two timepoints over a 6-month period. We tested the mediating influence of reliance on hunger/satiety cues, facets of interoception and negative mood on the relationship between ADHD symptoms and disordered eating. Reliance on hunger/satiety cues mediated the relationship between inattentive symptoms of ADHD and both restrictive and binge-type eating. Interoceptive accuracy, but not sensibility mediated the relationship between inattentive ADHD symptoms and binge-type eating. Negative mood mediated the relationship between both ADHD symptom types and restrictive and binge-type eating. The results from this longitudinal study confirm that deficits in interoception and negative mood contribute to the relationship between ADHD symptoms and disordered eating and extend knowledge by highlighting interoceptive accuracy specifically as the most important facet of interoception in the relationship between inattentive symptoms and binge-type eating.
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Affiliation(s)
- Elizabeth Martin
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, Birmingham, United Kingdom
| | - Colin T Dourish
- P1vital, Wallingford, Oxfordshire, OX10 8BA, United Kingdom; P1vital Products, Wallingford, Oxfordshire, OX10 8BA, United Kingdom.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, Birmingham, United Kingdom
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15
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Kumar MM. Eating Disorders in Youth with Chronic Health Conditions: Clinical Strategies for Early Recognition and Prevention. Nutrients 2023; 15:3672. [PMID: 37686703 PMCID: PMC10490114 DOI: 10.3390/nu15173672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023] Open
Abstract
Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions. In this review, clinical strategies are provided to support youth with chronic health conditions through early recognition of eating disorder behaviors and prompt referral to treatment, which is important for a better prognosis. Suggestions are also given to mitigate their risk of developing eating disorders by proactively addressing risk factors and offering thoughtful anticipatory guidance that promotes a positive relationship with food and eating.
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Affiliation(s)
- Maya Michelle Kumar
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Diego, San Diego, CA 92123, USA
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16
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Paul A, Ghanta A, Chao AM. Features of Addiction in Binge-Eating Disorder: Considerations for Screening and Treatment. Subst Abuse Rehabil 2023; 14:77-87. [PMID: 37560533 PMCID: PMC10408689 DOI: 10.2147/sar.s391636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
Similarities have been reported between the diagnostic and associated characteristics of binge-eating disorder (BED) and substance-related and non-substance-related disorders. This has resulted in interest in using addiction models to inform clinical care for people with BED. The purpose of this paper was to review features of addiction in BED with a focus on clinical implications. First, we briefly summarize similarities and differences in diagnostic and mechanistic features and symptoms for BED and food addiction, substance-related disorders, and non-substance-related disorders. Then we review aspects of addiction in BED that have clinical implications for screening and treatment of this condition. Similarities in diagnostic criteria between BED and substance-related and non-substance-related disorders include loss of control, greater use than intended, continued use despite adverse consequences, and marked distress. Addiction models may help inform aspects of clinical care of BED, particularly for shared antecedents and mechanisms underlying both disorders and to enhance engagement in treatment. Yet, there are large gaps in evidence regarding the effects of many aspects of addiction models to BED. More research is needed to examine the safety and efficacy of using addiction theories and frameworks for clinical strategies for BED.
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Affiliation(s)
- Alexandra Paul
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Aleena Ghanta
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ariana M Chao
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
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17
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Ghazzawi HA, Nimer LS, Sweidan DH, Alhaj OA, Abulawi D, Amawi AT, Levine MP, Jahrami H. The global prevalence of screen-based disordered eating and associated risk factors among high school students: systematic review, meta-analysis, and meta-regression. J Eat Disord 2023; 11:128. [PMID: 37537604 PMCID: PMC10398929 DOI: 10.1186/s40337-023-00849-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 07/24/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE Estimate the prevalence, and associated risk factors, of high school students who are considered at risk for an eating disorder based on screening measures. METHODS An electronic search of nine databases was completed from their inception until 1st September 2022. A random-effects meta-analysis was conducted, and confounder (moderator) analyses and meta-regressions examined whether the overall prevalence estimate for of screen-based disordered eating (SBDE) was moderated by student age, BMI, or gender, as well as culture and type of SBDE assessment. RESULTS The mean estimate of the prevalence of SBDE among high school students (K = 42 (66 datapoints), N = 56282] in the sample of 25 countries was 13% ([95% CI] = 10.0-16.8%, I2 = 99.0%, Cochran's Q p = 0.001). This effect was not moderated by features of the samples such as gender, BMI, or age. Among cultures, non-Western countries had a higher prevalence of SBDE prevalence than Western countries, but the difference was not significant. There was considerable variability in the prevalence estimates as a function of the assessment measure, but no meaningful pattern emerged. CONCLUSION The estimated figure of 1 in 8 high school students with SBDE-unmoderated by gender and BMI-stands out as a problem in need of attention from public health officials, psychologists, psychiatrists, pediatricians, parents, and educators. There is a great need for innovative, integrated policy and program development all along the spectrum of health promotion and universal, selective, and indicated prevention. Further research is also needed to validate and refine this estimate by (a) conducting basic research on the accuracy of eating disorder screening measurements in samples ages 14 through 17; (b) examining representative samples in more countries in general and Latin American countries in particular; (c) clarifying the relationships between SBDE and age throughout the different phases of late childhood, adolescence, and emerging adulthood; and (d) investigating whether there are meaningful forms of disordered eating and whether these are associated with variables such as gender, ethnicity, and BMI.
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Affiliation(s)
- Hadeel A. Ghazzawi
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Lana S. Nimer
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Dima H. Sweidan
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Duha Abulawi
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, P.O. Box 11942, Amman, Jordan
| | - Adam T. Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, As-Salt, 19328 Jordan
| | | | - Haitham Jahrami
- Goverment Hospitals, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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18
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Ganson KT, Cuccolo K, Nagata JM. Loneliness is associated with eating disorders among a national sample of U.S. college students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 37486743 DOI: 10.1080/07448481.2023.2232872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 05/25/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To identify the association between loneliness and eating disorder symptomatology among a national sample of U.S. college students during COVID-19. PARTICIPANTS Cross-sectional data from the 2020-2021 Healthy Minds Study (N = 96,645) were analyzed. METHODS Loneliness was measured using the UCLA 3-item Loneliness Scale and eating disorder symptomology was measured using the SCOFF questionnaire. Multiple modified Poisson regression analyses were conducted, adjusting for confounding variables. RESULTS Greater loneliness was associated with both a positive eating disorder screen (risk ratio [RR] 1.09, 95% confidence interval [CI] 1.09-1.10) and greater number of eating disorder symptoms (RR 1.07, 95% CI 1.06-1.08). Gender modified this relationship, and men who endorsed greater loneliness had higher risk of eating disorder symptomatology compared to women. CONCLUSIONS Loneliness during the COVID-19 pandemic was associated with a greater risk of eating disorder symptomatology among college students. Findings underscore the need for social support and eating disorders programming on college campuses.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kelly Cuccolo
- Department of Psychology, Alma College, Alma, MI, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, CA, USA
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19
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Meshkova TA, Mitina OV, Aleksandrova RV. Risk factors of disordered eating in adolescent girls from a community sample: a multidimensional approach. CONSORTIUM PSYCHIATRICUM 2023; 4:21-39. [PMID: 38250642 PMCID: PMC10795956 DOI: 10.17816/cp6132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/26/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Eating disorders (ED) are severe, chronic, and complex in nature mental illnesses that are difficult to treat. One of the ways to stave off EDs is by screening among adolescents to preempt the development of clinical forms of ED in risk groups. AIM 1) to investigate the prevalence of ED risk among adolescent girls and compare subgroups at high and low risk of ED; 2) to investigate using a multidimensional approach those variables that can interact with temperament and character traits to predict ED symptomatology. METHODS The cross-sectional observational self-report study of a community sample of adolescent girls 1217 years old (n=298; M=14.771.13) was carried out in the city of Ryazan, Russia. The Russian versions of Eating Attitudes Test and Cloningers Temperament and Character Inventory-Revised were used. In addition, an original questionnaire (Risk Factors of Eating Disorders) was developed. Regression models (to test for significant moderation) and path analysis (to test for significant mediations) were used. RESULTS Girls at risk of developing EDs are characterized by a heightened level of concern about weight and dissatisfaction with their body, tend to suffer from low self-directedness, higher novelty seeking and tendency to higher harm avoidance, display high alexithymia, experience self-distrust, negative emotionality and are dissatisfied with family relationships. They also suffer from low self-esteem and tend to be perfectionism and engage in risk behavior. Significant moderating effects were uncovered between the following ED risk factors: (1) self-distrust/risk behavior and BMI; (2) alexithymia/negative emotionality/self-esteem and cooperativeness; and (3) negative emotionality/risk behavior and self-transcendence. Family relationship dissatisfaction mediates the association between self-directedness/cooperativeness/self-transcendence and disordered eating. CONCLUSION There are various mutual influences between the numerous ED risk and prevention factors, which all together determine the paths between the predictors and final outcome.
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Affiliation(s)
| | | | - Roza V. Aleksandrova
- Research Educational Center of Applied Psychology and Psychological Services of S. Yesenin Ryazan State University
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20
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Al Mestaka N, Alneyadi A, AlAhbabi A, AlMatrushi A, AlSaadi R, Alketbi LB. Prevalence of probable eating disorders and associated risk factors in children and adolescents aged 5-16 years in Al Ain City, United Arab Emirates: observational case-control study. J Eat Disord 2023; 11:114. [PMID: 37420301 DOI: 10.1186/s40337-023-00840-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Eating disorders, including anorexia, bulimia, and binge eating, have become a significant health concern among young children and adolescents worldwide. The objective of this study is to examine the probable eating disorder prevalence and associated risk factors among obese and normal-weight children and adolescents aged (5-16 years) in Al Ain, United Arab Emirates (UAE). METHODS This observational case-control study utilized data obtained from electronic medical records (age, gender, body measurements). SCOFF questionnaire and Patient Health Questionnaire-2 (PHQ-2) were used to estimate the probable prevalence of eating disorders and depression, respectively, in children and adolescents. The study was conducted in Al Ain Ambulatory health services clinics from 2018 to 2019. Descriptive statistics and linear regression analysis were employed for data analysis. RESULTS A total of 551 subjects participated in the study, with 288 (52%) categorized as normal-weight and 263 (48%) as obese. Among the obese participants, there was an equal distribution of males and females. Screening for eating disorders using the SCOFF questionnaire revealed that approximately 42% of the obese participants had a positive SCOFF result, indicating abnormal eating behaviors. In contrast, only 7% of the normal-weight participants had a positive SCOFF result. A significant positive correlation was observed between a positive SCOFF screening result, PHQ-2 score, and the participants' weight at the age of 6 years. CONCLUSION This study represents the first attempt to assess the probable prevalence of the risk of eating disorders in children and adolescents in the UAE. This young population have high risk of eating disorders and it was significantly higher in obese children than normal weight children. These results highlight the importance of addressing eating disorders in this population and the need for early detection and intervention strategies.
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Affiliation(s)
- Naji Al Mestaka
- Department of Family Medicine, Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Al Ain, United Arab Emirates
| | - Amna Alneyadi
- Department of Family Medicine, Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Al Ain, United Arab Emirates.
| | - Ali AlAhbabi
- Department of Family Medicine, Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Al Ain, United Arab Emirates
| | - Abdulla AlMatrushi
- Department of Family Medicine, Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Al Ain, United Arab Emirates
| | - Rehab AlSaadi
- Department of Family Medicine, Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Al Ain, United Arab Emirates
| | - Latifa Baynouna Alketbi
- Department of Family Medicine, Ambulatory Healthcare Services, Abu Dhabi Health Services Company, Al Ain, United Arab Emirates
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21
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Ciciulla D, Soriano VX, McWilliam V, Koplin JJ, Peters RL. Systematic Review of the Incidence and/or Prevalence of Eating Disorders in Individuals With Food Allergies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2196-2207.e13. [PMID: 37088367 DOI: 10.1016/j.jaip.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/14/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Chronic diseases involving strict dietary adherence have been associated with an increased risk of eating disorders (EDs). This is the first systematic review investigating the rate of EDs among individuals with food allergies (FAs). OBJECTIVE To report the incidence, prevalence, and types of EDs in individuals with FAs. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched 4 databases for studies published to January 2022 that reported the prevalence or incidence of EDs in samples with immunoglobulin E (IgE) or non-IgE-mediated allergy. Risk of bias was assessed and evidence qualitatively synthesized. RESULTS From 1,180 papers identified, 9 met inclusion criteria. There were 4,161 adult and pediatric participants with IgE-mediated FAs or eosinophilic esophagitis. Avoidant/Restrictive Food Intake Disorder (ARFID) or anorexia nervosa/bulimia nervosa were the main EDs identified. The prevalence of EDs in samples with FA ranged from 0.8% to 62.9%. Among studies investigating IgE-mediated FA (n = 6), the prevalence of anorexia nervosa and/or bulimia nervosa ranged from 17.6 to 61%, ARFID was 62.9%, and unspecified EDs was 0.8% to 6%. Among samples with eosinophilic esophagitis (n = 3), ARFID prevalence ranged from 4.5% to 51%. Most studies were limited by small sample size, possible selection bias, and lack of diagnostic EDs tools validated for food allergic populations. CONCLUSIONS Eating disorders appear prevalent in individuals with FA; however, prevalence estimates varied widely. Large studies with healthy control groups and validated measures to identify EDs in individuals with FA are needed to accurately determine the prevalence of EDs.
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Affiliation(s)
- Daniela Ciciulla
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.
| | - Victoria X Soriano
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Vicki McWilliam
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia; Child Health Research Centre, University of Queensland, Brisbane, St. Lucia, Queensland, Australia
| | - Rachel L Peters
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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22
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Linsenmeyer W, Stiles D, Garwood S, Giedinghagen A, Lewis C, Strand G. Validation of the adolescent binge eating disorder measure (ADO-BED) among transgender youth and young adults. J Eat Disord 2023; 11:91. [PMID: 37287086 DOI: 10.1186/s40337-023-00816-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Transgender youth and young adults are at increased risk for eating disorders, including binge eating disorder, yet few measures have been validated for screening purposes with the transgender population. METHODS The purpose of this study was to provide initial evidence for the internal consistency and convergent validity of the Adolescent Binge Eating Disorder questionnaire (ADO-BED) in a sample of transgender youth and young adults. 208 participants completed the ADO-BED as part of a routine nutrition screening protocol at a gender center. Exploratory factor analysis and confirmatory factor analysis was used to establish the factor structure of the ADO-BED. Relationships between the ADO-BED, Sick, Control, One Stone, Fat, Food (SCOFF), Nine Item Avoidant/restrictive Intake Disorder (NIAS), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), and demographic characteristics were explored. RESULTS Analyses revealed a one-factor structure of the ADO-BED with good fit to the data in the present sample. The ADO-BED was shown to be significantly related to all convergent validity variables, except the NIAS. CONCLUSIONS The ADO-BED is a valid measure to screen for BED among transgender youth and young adults. Healthcare professionals can screen all transgender patients for BED, regardless of body size, in order to effectively identify and manage binge eating concerns.
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Affiliation(s)
| | - Dana Stiles
- Saint Louis University, 3437 Caroline Street, St. Louis, MO, 63104, USA
| | - Sarah Garwood
- Washington University School of Medicine in St. Louis, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Andrea Giedinghagen
- Washington University School of Medicine in St. Louis, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Christopher Lewis
- Washington University School of Medicine in St. Louis, 660 South Euclid Ave, St. Louis, MO, 63110, USA
| | - Gretta Strand
- Washington University School of Medicine in St. Louis, 660 South Euclid Ave, St. Louis, MO, 63110, USA
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Parpia R, Spettigue W, Norris ML. Approche de l’anorexie mentale et de l’anorexie mentale atypique chez l’adolescent. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2023; 69:393-398. [PMID: 37315980 PMCID: PMC10266404 DOI: 10.46747/cfp.6906393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objectif Aborder le dépistage, le diagnostic et le traitement de l’anorexie mentale et de l’anorexie mentale atypique chez les adolescents en soins primaires. Sources de l’information Une recherche documentaire a été effectuée dans PubMed à l’aide des rubriques thématiques en anglais anorexia nervosa, adolescents, COVID-19, review, guidelines et primary care . Les articles pertinents ont été passés en revue et les principales recommandations ont été résumées. La plupart des données probantes sont de niveau I. Message principal De récentes études font valoir que la pandémie mondiale de la COVID-19 a contribué à une augmentation de l’incidence des troubles du comportement alimentaire, en particulier chez les adolescents. Il s’ensuit de plus grandes responsabilités pour les professionnels des soins primaires concernant l’évaluation, le diagnostic et la prise en charge de ces troubles. En outre, les professionnels des soins primaires sont bien placés pour identifier les adolescents à risque de troubles du comportement alimentaire. Une intervention précoce revêt une importance capitale pour éviter les conséquences à long terme pour la santé. Des taux élevés d’anorexie mentale atypique indiquent la nécessité que les professionnels soient sensibilisés aux préjudices et à la stigmatisation entourant le poids. Le traitement comporte principalement une combinaison de renutrition et de psychothérapie, généralement au moyen d’une thérapie familiale, et la pharmacothérapie joue un rôle secondaire. Conclusion L’anorexie mentale et l’anorexie mentale atypique sont des maladies graves et potentiellement mortelles, et leur prise en charge optimale comprend la détection et le traitement précoces. Les médecins de famille sont très bien placés pour dépister, diagnostiquer et traiter ces maladies.
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Affiliation(s)
| | - Wendy Spettigue
- Professeure agrégée au Département de psychiatrie de l'Université d'Ottawa (Ontario) et psychiatre pour les enfants et les adolescents au Centre hospitalier pour enfants de l'est de l'Ontario
| | - Mark L Norris
- Professeur de pédiatrie à l'Université d'Ottawa et médecin spécialisé en santé des adolescents au Centre hospitalier pour enfants de l'est de l'Ontario
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24
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O' Riordan A, Young DA, Ginty AT. Disordered eating is associated with blunted blood pressure reactivity and poorer habituation to acute psychological stress. Biol Psychol 2023; 179:108553. [PMID: 37028794 DOI: 10.1016/j.biopsycho.2023.108553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023]
Abstract
Psychological stress has been shown to influence the development and progression of disordered eating. Psychophysiological studies have reported that individuals with disordered eating behavior exhibit atypical cardiovascular reactions to acute psychological stress. However, prior studies have been limited by small sample sizes and have examined cardiovascular responses to a singular stress exposure. The current study examined the association between disordered eating and cardiovascular reactivity, as well as cardiovascular habituation to acute psychological stress. A mixed-sex sample (N = 450) of undergraduate students were categorized into a disordered eating or non-disordered eating group using a validated disordered eating screening questionnaire and attended a laboratory stress testing session. The testing session included two identical stress-testing protocols, each consisting of a 10-minute baseline and 4-minute stress task. Cardiovascular parameters including heart rate, systolic/diastolic blood pressure and mean arterial pressure (MAP) were recorded throughout the testing session. Post task measures of self-reported stress, as well as positive affect and negative affect (NA) reactivity were used to assess psychological reactions to stress. The disordered eating group exhibited greater increases in NA reactivity in response to both stress exposures. Additionally, in comparison to the control group, those in the disordered eating group exhibited blunted MAP reactivity to the initial stress exposure and less MAP habituation across both stress exposures. These findings indicate that disordered eating is characterized by dysregulated hemodynamic stress responsivity, which may constitute a physiological mechanism leading to poor physical health outcomes.
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Affiliation(s)
- Adam O' Riordan
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States.
| | - Danielle A Young
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
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25
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Richson BN, Hazzard VM, Christensen KA, Hagan KE. Do the SCOFF items function differently by food-security status in U.S. college students?: Statistically, but not practically, significant differences. Eat Behav 2023; 49:101743. [PMID: 37209568 PMCID: PMC10681748 DOI: 10.1016/j.eatbeh.2023.101743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/05/2023] [Accepted: 04/24/2023] [Indexed: 05/22/2023]
Abstract
Despite food insecurity (FI) being associated with eating disorders (EDs), little research has examined if ED screening measures perform differently in individuals with FI. This study tested whether items on the SCOFF performed differently as a function of FI. As many people with FI hold multiple marginalized identities, this study also tested if the SCOFF performs differently as a function of food-security status in individuals with different gender identities and different perceived weight statuses. Data were from the 2020/2021 Healthy Minds Study (N = 122,269). Past-year FI was established using the two-item Hunger Vital Sign. Differential item functioning (DIF) assessed whether SCOFF items performed differently (i.e., had different probabilities of endorsement) in groups of individuals with FI versus those without. Both uniform DIF (constant between-group difference in item-endorsement probability across ED pathology) and non-uniform DIF (variable between-group difference in item-endorsement probability across ED pathology) were examined. Several SCOFF items demonstrated both statistically significant uniform and non-uniform DIF (ps < .001), but no instances of DIF reached practical significance (as indicated by effect sizes pseudo ΔR2 ≥ 0.035; all pseudo ΔR2's ≤ 0.006). When stratifying by gender identity and weight status, although most items demonstrated statistically significant DIF, only the SCOFF item measuring body-size perception showed practically significant non-uniform DIF for perceived weight status. Findings suggest the SCOFF is an appropriate screening measure for ED pathology among college students with FI and provide preliminary support for using the SCOFF in individuals with FI and certain marginalized identities.
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Affiliation(s)
- Brianne N Richson
- Department of Psychology, University of Kansas, Lawrence, KS, USA; Department of Psychiatry, University of California San Diego Eating Disorders Center for Treatment and Research, San Diego, CA, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Kara A Christensen
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Kelsey E Hagan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
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López-Gil JF, García-Hermoso A, Smith L, Firth J, Trott M, Mesas AE, Jiménez-López E, Gutiérrez-Espinoza H, Tárraga-López PJ, Victoria-Montesinos D. Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:363-372. [PMID: 36806880 PMCID: PMC9941974 DOI: 10.1001/jamapediatrics.2022.5848] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/30/2022] [Indexed: 02/22/2023]
Abstract
Importance The 5-item Sick, Control, One, Fat, Food (SCOFF) questionnaire is the most widely used screening measure for eating disorders. However, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents. Objective To establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool. Data Sources Four databases were systematically searched (PubMed, Scopus, Web of Science, and the Cochrane Library) with date limits from January 1999 to November 2022. Study Selection Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies. Data Extraction and Synthesis A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures Proportion of disordered eating among children and adolescents assessed with the SCOFF tool. Results Thirty-two studies, including 63 181 participants, from 16 countries were included in this systematic review and meta-analysis. The overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P < .001; n = 63 181) (I2 = 98.58%). Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) (P < .001). Disordered eating became more elevated with increasing age (B, 0.03; 95% CI, 0-0.06; P = .049) and body mass index (B, 0.03; 95% CI, 0.01-0.05; P < .001). Conclusions and Relevance In this systematic review and meta-analysis, the available evidence from 32 studies comprising large samples from 16 countries showed that 22% of children and adolescents showed disordered eating according to the SCOFF tool. Proportion of disordered eating was further elevated among girls, as well as with increasing age and body mass index. These high figures are concerning from a public health perspective and highlight the need to implement strategies for preventing eating disorders.
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Affiliation(s)
- José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mike Trott
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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López-Gil JF, Jiménez-López E, Fernández-Rodríguez R, Garrido-Miguel M, Victoria-Montesinos D, Gutiérrez-Espinoza H, Tárraga-López PJ, Mesas AE. Prevalence of Disordered Eating and Its Associated Factors From a Socioecological Approach Among a Sample of Spanish Adolescents: The EHDLA Study. Int J Public Health 2023; 68:1605820. [PMID: 37051310 PMCID: PMC10084851 DOI: 10.3389/ijph.2023.1605820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives: The aim of this study was twofold: a) to establish the prevalence of adolescents with disordered eating and b) to determine the factors associated with this prevalence in a sample of Spanish adolescents from the Valle de Ricote (Region of Murcia, Spain).Methods: This cross-sectional study analyzed data from 730 adolescents (56.2% girls) from the EHDLA study. To determine the prevalence of disordered eating, the Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used. A socioecological approach was used to identify individual-, interpersonal-, or organizational-level factors associated with disordered eating.Results: The prevalence of disordered eating was 30.1%. This condition was associated with female sex (odds ratio [OR] = 2.60; 95% confidence interval [CI], 1.81–3.73), immigrant status (OR = 2.22; 95% CI, 1.51–3.25), or excess weight (OR = 2.74; 95% CI, 1.93–3.89). Furthermore, for each additional hour slept, lower odds of having disordered eating were found (OR = 0.81; 95% CI, 0.67–0.98).Discussion: Almost one-third of the sample of Spanish adolescents analyzed reported disordered eating. Female sex, immigrant status and excess weight are individual aspects that seem to be related to disordered eating among Spanish adolescents.
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Affiliation(s)
- José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, United States
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Miram Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain
| | - Desirée Victoria-Montesinos
- Faculty of Pharmacy and Nutrition, UCAM Universidad Católica San Antonio de Murcia, Murcia, Spain
- *Correspondence: Héctor Gutiérrez-Espinoza, ; Desirée Victoria-Montesinos,
| | - Héctor Gutiérrez-Espinoza
- Escuela de Fisioterapia, Universidad de las Américas, Quito, Ecuador
- *Correspondence: Héctor Gutiérrez-Espinoza, ; Desirée Victoria-Montesinos,
| | - Pedro J. Tárraga-López
- Department of Medical Sciences, Faculty of Medicine, University of Castilla-La Mancha, Albacete, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
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Romano KA, Lipson SK, Beccia AL, Quatromoni PA, Murgueitio J. Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students. Int J Eat Disord 2023; 56:203-215. [PMID: 36479981 PMCID: PMC9851957 DOI: 10.1002/eat.23869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Early COVID-19 eating disorders (EDs) research used regionally restricted samples with little sociodemographic diversity. The present study aimed to address these research gaps by examining whether pandemic-related changes in ED symptoms and mental healthcare prevalence differed for historically marginalized groups within a national sample of US college students. METHOD Participants included 242,906 US college students (Mage = 23.45, SD = 7.04; MBMI = 25.28, SD = 5.91) who completed the repeated cross-sectional multi-institute Healthy Minds Study between January 2019 and May 2021. Moderated logistic regressions examined whether pandemic-related changes in individuals' likelihoods of exhibiting current probable ED, reporting lifetime ED diagnoses, and-among individuals with current probable ED-mental healthcare engagement differed for diverse gender, sexual, and racial/ethnic identity groups, and by body mass index (BMI) and financial stress. RESULTS There were increases of 5% and 12% in individuals' likelihoods of exhibiting current probable ED and symptomatic individuals' mental healthcare engagement, respectively, pre- to post-COVID-19 onset, but no pandemic-related changes in lifetime ED diagnosis prevalence. There were also important variations in these time-trends for different marginalized groups. For example, individuals identifying as genderqueer/gender nonconforming and lesbian exhibited increasing ED symptoms pre- to post-COVID-19 onset, and individuals with current probable ED and higher BMIs were increasingly likely to receive mental healthcare. Associations between financial stress, and the ED and mental healthcare outcomes did not change over time. DISCUSSION These findings provide insight into groups of US college students that experienced disproportionate ED burden during the pandemic at the population level, and directions for research and interventions that warrant consideration.
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Affiliation(s)
- Kelly A Romano
- Department of Psychology, Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah K Lipson
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, Massachusetts, USA
| | - Ariel L Beccia
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Paula A Quatromoni
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Jose Murgueitio
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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29
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Alhaj OA, Fekih-Romdhane F, Sweidan DH, Saif Z, Khudhair MF, Ghazzawi H, Nadar MS, Alhajeri SS, Levine MP, Jahrami H. The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression. Eat Weight Disord 2022; 27:3215-3243. [PMID: 35925546 PMCID: PMC9362208 DOI: 10.1007/s40519-022-01452-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/12/2022] [Indexed: 01/05/2023] Open
Abstract
PURPOSE The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world. METHODS An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex. RESULTS Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p value = 0.001. Bayesian meta-analysis produced an estimate of 0.24, 95% credible intervals [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased. CONCLUSIONS These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment. LEVEL OF EVIDENCE I, systematic review and meta-analysis.
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Affiliation(s)
- Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- The Tunisian Center of Early Intervention Is Psychiatry, Department of Psychiatry “Ibn Omrane”, Razi Hospital, rue des orangers, Manouba, Tunisia
| | - Dima H. Sweidan
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | | | - Mina F. Khudhair
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Hadeel Ghazzawi
- Nutrition and Food Science Department, Agriculture School, The University of Jordan, P.O.Box 11942, Amman, Jordan
| | - Mohammed Sh. Nadar
- Occasional Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | | | - Michael P. Levine
- Emeritus Professor, Department of Psychology, Kenyon College, Gambier, OH 43022 USA
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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30
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Forney KJ, Horvath SA, Pucci G, Harris ER. Elevated fullness and bloating as correlates of eating pathology: Implications for screening. Eat Disord 2022; 31:375-387. [PMID: 36409019 DOI: 10.1080/10640266.2022.2141705] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A minority of individuals with eating disorders report being asked about their eating by health care professionals; delayed detection of eating disorders may contribute to poorer outcomes. The current study investigated common meal-related gastrointestinal symptoms (i.e., elevated fullness and bloating) as correlates of eating pathology that may be more readily disclosed to health professionals and indicate the need to assess for eating pathology. The current study also tested the hypothesis that elevated fullness and bloating are more strongly linked to eating pathology among those with higher body dissatisfaction. 281 university students (70.1% female, 84.3% white) completed gastrointestinal symptom and eating pathology assessments. Elevated fullness and bloating were each associated with increased purging, restrictive eating behaviors, and likelihood of having an eating disorder. Elevated fullness and bloating were more strongly linked to purging and probable eating disorder diagnosis with higher, relative to lower, body dissatisfaction. However, body dissatisfaction did not moderate the relationship between gastrointestinal symptoms and restrictive eating behaviors. Results indicate that elevated fullness and bloating are correlates of eating pathology. Healthcare professionals should consider and/or assess for eating pathology when elevated fullness and bloating are reported; further assessment of body dissatisfaction may be helpful in identifying purging behaviors.
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Affiliation(s)
- K Jean Forney
- Department of Psychology, Ohio University, Athens, Ohio 45701 United States
| | - Sarah A Horvath
- Department of Psychology, Ohio University, Athens, Ohio 45701 United States
| | - Gabriella Pucci
- Department of Psychology, Ohio University, Athens, Ohio 45701 United States
| | - Emma R Harris
- Department of Psychology, Ohio University, Athens, Ohio 45701 United States
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31
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Daly M, Costigan E. Trends in eating disorder risk among U.S. college students, 2013-2021. Psychiatry Res 2022; 317:114882. [PMID: 36228436 DOI: 10.1016/j.psychres.2022.114882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 01/05/2023]
Abstract
Despite concerns about rising rates of mental health problems among college students in recent years, little is known about trends in eating disorder (ED). This study examined data from the 2013-2020/2021 Healthy Minds Study (HMS), a large study of US college students (N = 267,599). Students completed the SCOFF scale, a validated measure of ED symptoms. From 2013 to 2020/2021 the prevalence of ED risk increased significantly from 15% to 28% (13% increase, 95% CI, 12.2-13.9) with young, female, and Hispanic students experiencing the largest increases. ED risk increased significantly by 3 percentage points (95% CI, 1.7-4.2) during the COVID-19 pandemic.
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Affiliation(s)
- Michael Daly
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
| | - Erin Costigan
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
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32
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Forbush KT, Richson BN, Swanson TJ, Thomeczek ML, Negi S, Johnson SN, Chapa DAN, Morgan RW, O'Brien CJ, Gould SR, Christensen KA, Chen Y. Screening for eating disorders across genders in college students: Initial validation of the brief assessment of stress and eating. Int J Eat Disord 2022; 55:1553-1564. [PMID: 36135594 PMCID: PMC10044497 DOI: 10.1002/eat.23815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/02/2022] [Accepted: 09/03/2022] [Indexed: 11/08/2022]
Abstract
Given that eating disorders (EDs) are relatively common in college populations, it is important to have reliable and valid tools to identify students so that they can be referred to evidence-based care. Although research supports the psychometric properties of existing ED screens for identifying cases of EDs, most studies have been conducted in samples of young white-majority women or have not reported the psychometric properties of the screening tool in men. OBJECTIVE The purpose of the current study was to validate a brief, 10-item screening tool for the identification of EDs-the brief assessment of stress and eating (BASE). METHOD Participants were college students (N = 596; 68.2% cisgender women) from a large Midwestern university who completed the BASE and SCOFF. The Eating Disorders Diagnostic Survey was used to generate DSM-5 ED diagnoses. We evaluated area under the curve (AUC) for both receiver operating curves (ROC) and precision-recall curves (PRC). RESULTS Both the BASE and SCOFF performed significantly better than chance at identifying probable EDs in cisgender women (BASE AUC: ROC = .787, PRC = .633, sensitivity = .733, specificity = .697; SCOFF AUC: ROC = .810, PRC = .684, sensitivity = .793, specificity = .701). However, the BASE (AUC: ROC = .821, PRC = .605, sensitivity = .966, specificity = .495) significantly outperformed the SCOFF (AUC: ROC = .710, PRC = .354, sensitivity = .828, specificity = .514) for identifying probable EDs in cisgender college men. DISCUSSION The BASE is appropriate for student healthcare and college research settings. Because the BASE outperforms the SCOFF in college men, results from the current study are expected to contribute to improved identification of EDs on college campuses. PUBLIC SIGNIFICANCE The BASE is a new screening tool to identify eating disorders. The BASE performed as well as, if not better than, the SCOFF (particularly in men). Given the need for brief, psychometrically strong, and unbiased ED screening tools in college students, the current study helps address an unmet student healthcare need that we expect will contribute to improved identification of EDs on college campuses.
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Affiliation(s)
- Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Brianne N Richson
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Trevor J Swanson
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | | | - Sonakshi Negi
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Sarah N Johnson
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | | | - R William Morgan
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Colin J O'Brien
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
| | - Sara R Gould
- Department of Pediatrics, Children's Mercy-Kansas City, Kansas City, Missouri, USA
| | - Kara Alise Christensen
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Department of Psychology, University of Las Vegas Nevada, Las Vegas, Nevada, USA
| | - Yiyang Chen
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
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33
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House ET, Lister NB, Seidler AL, Li H, Ong WY, McMaster CM, Paxton SJ, Jebeile H. Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires. Int J Eat Disord 2022; 55:1171-1193. [PMID: 35809028 PMCID: PMC9545314 DOI: 10.1002/eat.23769] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/15/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This review aimed to examine the validity of self-report screening questionnaires for identifying eating disorder (ED) risk in adults and adolescents with overweight/obesity. METHOD Five databases were searched from inception to September 2020 for studies assessing validation of self-report ED screening questionnaires against diagnostic interviews in adolescents and adults with overweight/obesity. The review was registered with PROSPERO (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=220013). RESULTS Twenty-seven papers examining 15 questionnaires were included. Most studies validated questionnaires for adults (22 of 27 studies), and most questionnaires (12 of 15) screened for binge eating or binge-eating disorder (BED). The Eating Disorder Examination Questionnaire (sensitivity = .16-.88, specificity = .62-1.0) and Questionnaire on Eating and Weight Patterns (sensitivity = .07-1.0, specificity = .0-1.0) were most frequently validated (six studies each). Five studies of three questionnaires were in adolescents, with the Adolescent Binge-Eating Disorder Questionnaire having highest sensitivity (1.0) but lower specificity (.27). Questionnaires designed to screen for BED generally had higher diagnostic accuracy than those screening for EDs in general. DISCUSSION Questionnaires have been well validated to identify BED in adults with overweight/obesity. Validated screening tools to identify other EDs in adults and any ED in adolescents with overweight/obesity are lacking. Thus, clinical assessment should inform the identification of patients with co-morbid EDs and overweight/obesity. PUBLIC SIGNIFICANCE Individuals with overweight/obesity are at increased risk of EDs. This review highlights literature gaps regarding screening for ED risk in this vulnerable group. This work presents possibilities for improving care of individuals with overweight/obesity by reinventing ED screening tools to be better suited to diverse populations.
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Affiliation(s)
- Eve T. House
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia,Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia
| | - Natalie B. Lister
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia,Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia
| | - Anna L. Seidler
- National Health and Medical Research Council Clinical Trials CentreUniversity of SydneySydneyNew South WalesAustralia
| | - Haozhen Li
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Faculty of ScienceThe University of SydneyCamperdownNew South WalesAustralia
| | - Wee Yee Ong
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Faculty of ScienceThe University of SydneyCamperdownNew South WalesAustralia
| | - Caitlin M. McMaster
- Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia,Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Susan J. Paxton
- School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Hiba Jebeile
- Institute of Endocrinology and DiabetesThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia,Children's Hospital Westmead Clinical SchoolThe University of SydneyWestmeadNew South WalesAustralia
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34
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López-Gil JF, García-Hermoso A, Smith L, Trott M, López-Bueno R, Gutiérrez-Espinoza H, Mesas AE, Tárraga-López PJ. Physical fitness and disordered eating among adolescents: Results from the EHDLA study. Appetite 2022; 178:106272. [PMID: 35964793 DOI: 10.1016/j.appet.2022.106272] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 12/21/2022]
Abstract
The aim of this study was to examine the association between a comprehensive spectrum of physical fitness components and disordered eating symptoms in a sample of Spanish adolescents. This cross-sectional study analysed a representative sample of 741 adolescents (55.1% girls) from the Eating Healthy and Daily Life Activities (EHDLA) study (Valle de Ricote, Region of Murcia, Spain). Objective physical fitness (i.e., cardiorespiratory fitness, upper body strength, lower body strength, speed-agility, and flexibility) was assesed by the ALPHA-FIT Test Battery for a young population. Disordered eating symptoms were assessed with the Sick, Control, One, Fat, Food (SCOFF) questionnaire. An incremental inverse association was found in participants with low cardiorespiratory fitness (OR = 2.33; 95% CI: 1.56-3.50), low handgrip strength (OR = 1.99; 95% CI: 1.33-2.97), low lower body strength (OR = 1.91; 95% CI: 1.28-2.86), low speed-agility (OR = 1.75; 95% CI: 1.17-2.62), and low global physical fitness (OR = 2.03; 95% CI: 1.37-3.01) and disordered eating symptoms, compared to participants with a high level of each of these physical fitness components. Our study provides evidence that, in Spanish adolescents, disordered eating symptoms are inversely associated with a comprehensive set of physical fitness components. Hence, it could be relevant to promote physical fitness, e.g., by a multifactorial approach, since it seems to be related to lower disordered eating symptoms in adolescents.
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Affiliation(s)
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain.
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Mike Trott
- Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | | | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain; Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Pedro Juan Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad Castilla-La Mancha (UCLM), Albacete, Spain
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Abstract
Eating disorders are common behavioral disorders associated with substantial psychological and physical morbidity and mortality. Persons with eating disorders frequently present to primary care providers, who may also be responsible for their general medical management. This article reviews the diagnosis, medical assessment, and treatment of the most common eating disorders.
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Affiliation(s)
- Blair Uniacke
- Columbia Center for Eating Disorders, New York, New York
| | - B Timothy Walsh
- Columbia University Irving Medical Center, New York, New York
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36
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Coakley KE, Lardier DT. Self-reported Alcohol Misuse Is Associated with Disordered Eating and Binge Eating Disorder in Adults. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2101409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Kathryn E Coakley
- Department of Individual, Family and Community Education, University of New Mexico, Albuquerque, New Mexico, USA
| | - David T Lardier
- Department of Psychiatry & Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Bunting L, McCartan C, Davidson G, Grant A, Mulholland C, Schubotz D, McBride O, Murphy J, Shevlin M. Rationale and methods of the 'Northern Ireland Youth Wellbeing Survey' and initial findings from the Strengths and Difficulties Questionnaire. Clin Child Psychol Psychiatry 2022; 27:670-685. [PMID: 35232265 PMCID: PMC9234773 DOI: 10.1177/13591045221075525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Backgrounds and Aims: The Northern Ireland Youth Wellbeing Survey (NIYWS) was commissioned by the Health and Social Care Board (NI) with the aim of providing reliable prevalence estimates of the mental health problems of children and young people aged 2-19 years. Method: The NIYWS used a random probability design, stratified by deprivation decile and county, to ensure even geographical distribution and representation. The survey used a broad range of validated measures to identify children and young people who met established clinical criteria for common mood, anxiety and behaviour disorders, trauma related disorders, as well as those at risk of autism spectrum disorder, eating disorders, future psychotic illness, self-injury or suicide. Results: Data were collected on 3074 children and young people aged 2-19 years, as well as over 2800 parents. The survey achieved a high response rate (67%) and initial findings indicated that 11% of the sample were at risk of emotional or behavioural problems. Conclusions: The NIYWS was the first large scale nationally representative survey of the mental health of children and young people in NI. Despite the legacy of political violence the initial findings show comparable levels of emotional and behavioural problems to England.
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Affiliation(s)
- Lisa Bunting
- 1596Queen's University Belfast, Northern Ireland
| | | | | | - Anne Grant
- 1596Queen's University Belfast, Northern Ireland
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Freizinger M, Recto M, Jhe G, Lin J. Atypical Anorexia in Youth: Cautiously Bridging the Treatment Gap. CHILDREN 2022; 9:children9060837. [PMID: 35740774 PMCID: PMC9221982 DOI: 10.3390/children9060837] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
Abstract
Atypical anorexia nervosa (AAN) is a restrictive eating disorder (ED) that describes individuals who may be normal weighted or overweight; many have a premorbid history of obesity. Pediatric care providers are trained to identify and provide best practices for youth with pediatric obesity; however, most pediatric care providers are not trained to assess and treat restrictive EDs which typically present in youth aged 10 and 14 years. Although individuals with AAN may appear to be within a ‘healthy weight’, many experience malnutrition, psychological symptoms, and severe physiological complications after weight loss. These individuals are presenting to pediatric services at an increasing rate and exhibit acute medical instability along with severe ED psychopathology. One complicating factor is youth with AAN may take longer to be identified by pediatric providers and may be reluctant to engage in treatment. Delayed treatment for AAN, along with all EDs often results in poorer treatment outcomes. A greater understanding of this complex illness is essential to inform medical decisions, such as labs, vitals, hospital admissions, and psychological therapy. Currently, there are no standardized guidelines for treating AAN in youths. This review is designed to present evidence-based treatment to inform and guide best treatment practices.
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Affiliation(s)
- Melissa Freizinger
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA 02115, USA; (G.J.); (J.L.)
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
- Correspondence:
| | - Michelle Recto
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45229, USA
| | - Grace Jhe
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA 02115, USA; (G.J.); (J.L.)
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Jessica Lin
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA 02115, USA; (G.J.); (J.L.)
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45229, USA
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Romano KA, Lipson SK, Beccia AL, Quatromoni PA, Gordon AR, Murgueitio J. Changes in the prevalence and sociodemographic correlates of eating disorder symptoms from 2013 to 2020 among a large national sample of U.S. young adults: A repeated cross-sectional study. Int J Eat Disord 2022; 55:776-789. [PMID: 35338504 PMCID: PMC9204707 DOI: 10.1002/eat.23709] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The present study aimed to: (1) identify recent temporal changes in the prevalence of different cognitive and behavioral eating disorder (ED) symptoms, current probable EDs, lifetime ED diagnoses, and mental healthcare use among college students across the United States; (2) determine whether established disparities in ED prevalence and receiving mental healthcare have widened or narrowed over time for marginalized groups within this population. METHOD Participants included a large national sample of U.S. college students (N = 286,720) who completed the repeated cross-sectional Healthy Minds Study from 2013 to 2020. Descriptive statistics and polynomial regressions quantified time-trends in participants' ED symptoms and past 12-month mental healthcare. Moderated regressions examined temporal changes in ED symptoms and mental healthcare based on sociodemographic characteristics. RESULTS Individuals' engagement in different cognitive and behavioral ED symptoms, and likelihoods of exhibiting current probable EDs, reporting lifetime ED diagnoses, and (for individuals with current probable EDs) receiving therapy or counseling in the past 12-months exhibited nonlinear increases from 2013 to 2020. Further, the prevalence of current and lifetime ED symptoms and (for symptomatic individuals) past 12-month mental healthcare differed over time for individuals with different BMIs and gender, sexual, and racial/ethnic identities (but not ages). In particular, individuals with higher BMIs and those who identified as male, bisexual, and gay, lesbian, or queer exhibited increasing ED pathology over time. DISCUSSION These findings provide important information on groups of U.S. college students that have experienced increasing burden of ED symptoms and may help guide ED prevention, treatment, and research priorities. PUBLIC SIGNIFICANCE Recent temporal changes in the prevalence of eating disorder (ED) symptoms and mental healthcare were examined in a national sample of U.S. young adults. Non-linear increases in ED symptoms and mental healthcare were identified among U.S. young adults overall from 2013 to 2020. U.S. young adults with higher BMIs, males, bisexual, and gay, lesbian, or queer individuals exhibited increasing ED burden over time.
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Affiliation(s)
- Kelly A. Romano
- The Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah K. Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ariel L. Beccia
- Clinical and Population Health Research Program, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA,Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Paula A. Quatromoni
- Department of Health Sciences, Boston University, Boston, Massachusetts, USA
| | - Allegra R. Gordon
- Department of Community Health Science, Boston University School of Public Health, Boston, Massachusetts, USA,Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Jose Murgueitio
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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40
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Voss MM. Eating Disorders & the Primary Care Physician. MISSOURI MEDICINE 2022; 119:243-249. [PMID: 36035575 PMCID: PMC9324705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Eating disorder is a term to describe a wide variety of maladaptive eating patterns and becoming more prominent in today's culture. The primary care provider (PCP) plays a key role in detection of eating disorders. Medical management by an informed provider is an essential part of the treatment team and focuses on preventing acute and chronic physical sequela of the disease. There are various levels of care offered, with family-based approaches showing the best outcomes.
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Affiliation(s)
- Michaela M Voss
- Assistant Professor of Pediatrics, University of Missouri - Kansas City School of Medicine, Kansas City, Missouri
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41
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Ganson KT, Rodgers RF, Lipson SK, Cadet TJ, Putnam M. Sexual Assault Victimization and Eating Disorders Among College-enrolled Men. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP5143-NP5166. [PMID: 32951507 DOI: 10.1177/0886260520958634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual assault victimization and eating disorder rates are high among college populations and have significant psychological, physiological, and social outcomes. Previous research has found a positive relationship between experiences of sexual assault and eating disorder symptoms; however, these analyses have primarily focused on female students. Using data from the 2017-2018 Healthy Minds Study, the aim of this study was to investigate the relationship between experiencing a sexual assault within the previous 12 months and screening positive for an eating disorder among cisgender college-enrolled men. It was hypothesized that college-enrolled men who report experiencing a sexual assault within the previous 12 months would be more likely to screen positive for an eating disorder. Analyses were conducted using a sample of 14,964 cisgender college-enrolled men. Among the sample, nearly 4% reported a sexual assault within the previous 12 months and nearly 16% screened positive for an eating disorder. Results from logistic regression analyses indicated that college-enrolled men who reported experiencing a sexual assault in the previous 12 months, compared to those who did not, had significantly greater odds of screening positive for an eating disorder (OR = 1.40, p < .01). Analyses also indicated that college-enrolled men who identified as gay, queer, questioning, or other sexual orientation and reported experiencing a sexual assault in the previous 12 months had greater odds of screening positive for an eating disorder (OR = 2.50, p < .001) compared to their heterosexual peers who did not experience a sexual assault in the previous 12 months. These results indicate that eating disorders may be a negative outcome among college-enrolled men who have experienced a sexual assault, particularly among sexual minority men. Thus, mental health professionals need to be adequately prepared to treat the underserved population of men who experience an eating disorder and who have experienced sexual assault.
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42
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Ganson KT, Cuccolo K, Nagata JM. Associations between psychosis symptoms and eating disorders among a national sample of U.S. college students. Eat Behav 2022; 45:101622. [PMID: 35255356 DOI: 10.1016/j.eatbeh.2022.101622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/03/2022]
Abstract
This study aimed to determine the associations between psychosis symptoms and eating disorders among a national sample of college and university students ages 18 to 26 years. Data from the 2020-2021 Healthy Minds Study (United States) were analyzed (N = 96,791). Multiple modified Poisson regression analyses were conducted to estimate the association between four self-reported lifetime psychosis symptoms and a positive eating disorder screen (measured using the SCOFF) and any self-reported lifetime eating disorder diagnosis, while adjusting for demographic and confounding variables. Participants who reported all four lifetime psychosis symptoms were more likely to screen positive for an eating disorder, while participants who reported three lifetime psychosis symptoms were more likely to report any lifetime eating disorder diagnosis. Those who reported a higher cumulative number of lifetime psychosis symptoms and reported any psychosis symptoms in the past 12 months were more likely to screen positive for an eating disorder and report any lifetime eating disorder diagnosis. Psychosis symptoms were associated with eating disorders among a national sample of college students. Health care professionals should be aware of the relationship between psychosis symptoms and eating disorders to ensure effective screening and early-intervention.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Kelly Cuccolo
- Department of Psychology, Alma College, Alma, MI, United States
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
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43
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Affiliation(s)
- Evelyn Attia
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Angela S Guarda
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
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44
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Zickgraf HF, Hazzard VM, O'Connor SM. Food insecurity is associated with eating disorders independent of depression and anxiety: Findings from the 2020-2021 Healthy Minds Study. Int J Eat Disord 2022; 55:354-361. [PMID: 35006611 DOI: 10.1002/eat.23668] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the association between food insecurity and eating disorder (ED) risk independent of co-occurring anxiety/depression. METHOD Data were provided by 121,627 undergraduate/graduate students who participated in the 2020-2021 Healthy Minds Study (HMS). Participants responded to questionnaire measures of food insecurity and risk for EDs, depression, and anxiety. Established cut-offs were used to identify students with food insecurity and probable psychopathology. Separate modified Poisson regressions adjusted for age, gender, race/ethnicity, and socioeconomic background examined the association between food insecurity and each form of psychopathology. The association between food insecurity and probable ED was then examined in a regression further adjusted for probable depression and anxiety. RESULTS Food insecurity was significantly associated with all three forms of psychopathology when examined separately (prevalence ratios ranged from 1.41 to 1.54, all p's < .001). When accounting for probable depression/anxiety, food insecurity was significantly associated with 1.19 times greater prevalence of a probable ED (p < .001). DISCUSSION The association between food insecurity and EDs was replicated in a large, national sample of university students. To our knowledge, this is the first study to examine the independence of this relationship after adjusting for depression/anxiety. This finding supports the hypothesis that specific mechanisms, rather than general psychological distress, likely underlie the food insecurity-ED relationship.
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Affiliation(s)
- Hana F Zickgraf
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Vivienne M Hazzard
- Department of Psychiatry & Behavioral Sciences, Medical School, Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shannon M O'Connor
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
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45
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Le Floch M, Crohin A, Duverger P, Picard A, Legendre G, Riquin E. Prevalence and phenotype of eating disorders in assisted reproduction: a systematic review. Reprod Health 2022; 19:38. [PMID: 35130918 PMCID: PMC8822730 DOI: 10.1186/s12978-022-01341-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/12/2022] [Indexed: 12/02/2022] Open
Abstract
Background Eating disorders (EDs) are common conditions that mainly affect women of reproductive age and have a major impact on fertility. Our systematic review focuses on the prevalence of EDs in patients in the process of assisted reproductive technique (ART) and describes the phenotypes of EDs identified. Methods Our systematic review is based on the PRISMA criteria. Articles were collected using the Medline/Pubmed, Web Of Science and Cochrane databases. The articles chosen had to mention the prevalence of ED in infertile patients undergoing ART and be cohort or case–control studies assessing the prevalence of ED during fertility treatment. Main findings Fifteen articles were included in this review. The prevalence of active ED varied between 0.13 and 44% depending on the types considered in each study. The main phenotypes described were EDNOS (eating disorder not otherwise specified) and binge eating disorders (BED) occurring in women with a normal body mass index (BMI) and a history of ED. Mainly subthreshold forms with cognitive distortions were described. Conclusion This review highlights a 6 times higher prevalence of EDs in infertile patients undergoing fertility treatment compared to regular pregnant women. However, diagnosing these conditions is complex. As a result, it is essential that professionals in contact with this population are alert to symptoms consistent with these conditions in order to refer them to specialized psychiatric care. Eating disorders are frequent pathologies that primarily affect women of childbearing age. Numerous articles reveal an increased risk for the mother and the child in case of an active disorder during pregnancy. We conducted a systematic review to determine the prevalence and phenotypes of eating disorders in infertile subjects undergoing fertility treatment. The results of the fifteen articles included show a prevalence six times higher than in pregnant women in the general population. Subjects with eating disorders have normal body mass indexes. The active forms are mainly characterized by episodes of binge eating disorders or other unspecified forms. Studies also describe incomplete forms characterized by the presence of dysfunctional thoughts around shape and weight without associated compensatory behavior. Professionals working in the field of reproductive medicine and providing fertility treatment have a major role to play in identifying and referring these subjects at risk to specialized care.
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Affiliation(s)
- Marine Le Floch
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Universitaire d'Angers, Angers, France. .,Pediatric Psychiatry Department, University Hospital of Angers, 4, Rue Larrey, 49933, Angers Cedex 9, France.
| | - Anaïs Crohin
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Philippe Duverger
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Aline Picard
- Department of Perinatal Psychiatry, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Guillaume Legendre
- Department of Obstetrics and Gynecology and Medically Assisted Reproduction, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Elise Riquin
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Universitaire d'Angers, Angers, France.,University of Angers, University of Nantes, LPPL, SFR Confluences, 49000, Angers, France.,University Service of the Fondation Santé des Étudiants de France, Sablé sur Sarthe Clinic, Paris, France
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46
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Claydon EA, Davidov DM, DeFazio C, Zullig KJ, Ward RM, Smith KZ. The Relationship Between Sexual Assault, Intimate Partner Violence, and Eating Disorder Symptomatology Among College Students. VIOLENCE AND VICTIMS 2022; 37:63-76. [PMID: 35165160 DOI: 10.1891/vv-d-21-00019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study examined the interrelationship of intimate partner violence (IPV), sexual assault (SA), and eating disorder (ED) symptomatology among a sample of college students (n = 1,580). Students reporting a history of SA were 2.5 times more likely to screen positively for further ED assessment. A history of IPV also increased odds of having a positive ED screener. The model showed that 6% of the variance in ED symptomatology was explained by IPV and SA. Results did not differ based on gender. This study furthers our understanding of the relationship between IPV, SA, and ED to guide future prevention and treatment efforts. Specifically, the use of trauma-informed ED treatment could assist with full ED recovery and other comorbid mental health conditions.
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Affiliation(s)
- Elizabeth A Claydon
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV
| | - Danielle M Davidov
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV
| | - Caterina DeFazio
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV
| | - Keith J Zullig
- Department of Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, WV
| | - Rose Marie Ward
- Department of Kinesiology & Health, Miami University College of Education, Health, & Society, Oxford, OH
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Gómez Del Barrio A, Ruiz Guerrero F, Benito Gonzalez P, Perez Fernandez M, Sanchez Blanco L, Losa Mugica E, Calcedo Giraldo G, González Gómez J. A retrospective investigation of the prodromal stages of eating disorders and use of health services in young patients the year prior to the diagnosis. Early Interv Psychiatry 2022; 16:162-167. [PMID: 33725745 DOI: 10.1111/eip.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/01/2021] [Accepted: 03/06/2021] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to analyse the characteristics and the frequency of medical consultations in the year prior to the diagnosis and the intervention onset of the Eating Disorder, as well as the different prodromal symptoms. The final aim was to understand the origin of all referrals and their possible influence on the duration of untreated illness. METHODS We selected 99 young patients (15-25 years) and 61 healthy controls. Their primary and specialized care medical records were both studied retrospectively. RESULTS 87.6% of patients attended different consultations (primary care, specialized care and emergency department) the year prior compared to 67.2% of the controls (p = .002). The average number of consultations was 3.59 in the case group and 1.57 in the control group (p < .001). These consultations were related to prodromal symptoms in 57.4% compared to 16.4% for the controls (p < .001). They ranged from 29.8% of unspecific digestive symptoms, 22.8% of psychological symptoms, 19.3% of gynaecologic symptoms, 11.9% of weight variation, 8.8% of analytical changes, to 5.3% of malnutrition symptoms. Patients were mainly referred by Primary Care (42.7%). Overall, the mean of the Duration of Untreated Illness was of 7.45 months. CONCLUSIONS The majority of reasons for consultation were related to symptoms that could be prodromal symptoms, but the patients were not diagnosed with an eating disorder. These findings highlight the importance of professionals understanding how to identify the warning signs of an eating disorder, so they can refer patients to a specialized unit to establish an early treatment.
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Affiliation(s)
- Andrés Gómez Del Barrio
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain.,Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Madrid, Spain.,Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Francisco Ruiz Guerrero
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Pilar Benito Gonzalez
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Marta Perez Fernandez
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
| | | | | | - Gabriel Calcedo Giraldo
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Jana González Gómez
- Eating Disorders Unit, Department of Psychiatry, Marqués de Valdecilla University Hospital, Santander, Spain.,Instituto de Investigación Marqués de Valdecilla, IDIVAL, Santander, Spain
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48
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Jafar AJN, Jafar WJJ, Everitt EK, Gill I, Sait HM, Tan J. Recognising and managing eating disorders in the emergency department. Postgrad Med J 2021; 99:postgradmedj-2021-140253. [DOI: 10.1136/postgradmedj-2021-140253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 11/23/2021] [Indexed: 11/03/2022]
Abstract
Compared with other mental health conditions or psychiatric presentations, such as self-harm, which may be seen in emergency departments, eating disorders can seem relatively rare. However, they have the highest mortality across the spectrum of mental health, with high rates of medical complications and risk, ranging from hypoglycaemia and electrolyte disturbances to cardiac abnormalities. People with eating disorders may not disclose their diagnosis when they see healthcare professionals. This can be due to denial of the condition itself, a wish to avoid treatment for a condition which may be valued, or because of the stigma attached to mental health. As a result their diagnosis can be easily missed by healthcare professionals and thus the prevalence is underappreciated. This article presents eating disorders to emergency and acute medicine practitioners from a new perspective using the combined emergency, psychiatric, nutrition and psychology lens. It focuses on the most serious acute pathology which can develop from the more common presentations; highlights indicators of hidden disease; discusses screening; suggests key acute management considerations and explores the challenge of mental capacity in a group of high-risk patients who, with the right treatment, can make a good recovery.
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Mitchell KS, Masheb R, Smith BN, Kehle-Forbes S, Hardin S, Vogt D. Eating disorder measures in a sample of military veterans: A focus on gender, age, and race/ethnicity. Psychol Assess 2021; 33:1226-1238. [PMID: 34292003 PMCID: PMC8720058 DOI: 10.1037/pas0001050] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Early detection of eating disorders (EDs) is crucial for both prevention and treatment; however, few ED measures have been validated among older adults, men, and racially/ethnically diverse individuals, who may have varying symptom presentations. We examined the psychometric quality of three self-report ED measures within a diverse sample of U.S. military veterans, a population that may have elevated rates of EDs. Participants (N = 1,187) completed the Eating Disorder Diagnostic Scale-5 (EDDS-5), the Eating Disorder Examination-Questionnaire (EDE-Q), the SCOFF (Sick, Control, One, Fat, and Food) questionnaire, and measures of associated mental health symptoms. We examined proportions of probable EDs and reliability estimates, associations among ED measures, and their relationship with mental health measures for the sample as a whole and based on age, gender, and race/ethnicity. Proportions of probable EDs ranged from 9.9% to 27.7% and were comparable for White, Black, and Latinx participants. Participants aged 40-49 had significantly higher proportions of EDs compared to other age groups, whereas participants aged ≥60 had significantly lower proportions of EDs. Participants with obesity had significantly higher proportions of probable EDs compared to participants with healthy weight or overweight. There was fair to moderate agreement between the ED measures, with varying evidence for psychometric quality across demographic subsamples. Overall, the EDDS-5 performed best in this sample and yielded estimates of probable EDs consistent with expectations. These data add to the growing body of literature on the assessment of EDs and provide insight into measures that may be most useful in research and intervention efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Brian N Smith
- National Center for PTSD, VA Boston Healthcare System
| | | | | | - Dawne Vogt
- National Center for PTSD, VA Boston Healthcare System
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Identifying and Managing Eating Disorders in Persons Presenting for Addiction Treatment. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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