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Nguyen N, Woodside DB, Lam E, Quehenberger O, German JB, Shih PAB. Fatty Acids and Their Lipogenic Enzymes in Anorexia Nervosa Clinical Subtypes. Int J Mol Sci 2024; 25:5516. [PMID: 38791555 DOI: 10.3390/ijms25105516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Disordered eating behavior differs between the restricting subtype (AN-R) and the binging and purging subtype (AN-BP) of anorexia nervosa (AN). Yet, little is known about how these differences impact fatty acid (FA) dysregulation in AN. To address this question, we analyzed 26 FAs and 7 FA lipogenic enzymes (4 desaturases and 3 elongases) in 96 women: 25 AN-R, 25 AN-BP, and 46 healthy control women. Our goal was to assess subtype-specific patterns. Lauric acid was significantly higher in AN-BP than in AN-R at the fasting timepoint (p = 0.038) and displayed significantly different postprandial changes 2 h after eating. AN-R displayed significantly higher levels of n-3 alpha-linolenic acid, stearidonic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid, and n-6 linoleic acid and gamma-linolenic acid compared to controls. AN-BP showed elevated EPA and saturated lauric acid compared to controls. Higher EPA was associated with elevated anxiety in AN-R (p = 0.035) but was linked to lower anxiety in AN-BP (p = 0.043). These findings suggest distinct disordered eating behaviors in AN subtypes contribute to lipid dysregulation and eating disorder comorbidities. A personalized dietary intervention may improve lipid dysregulation and enhance treatment effectiveness for AN.
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Affiliation(s)
- Nhien Nguyen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, USA
| | - D Blake Woodside
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Eileen Lam
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Oswald Quehenberger
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA
| | - J Bruce German
- Department of Food Science & Technology, University of California, Davis, Davis, CA 95616, USA
| | - Pei-An Betty Shih
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, USA
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Desrivières S, Zhang Z, Robinson L, Whelan R, Jollans L, Wang Z, Nees F, Chu C, Bobou M, Du D, Cristea I, Banaschewski T, Barker G, Bokde A, Grigis A, Garavan H, Heinz A, Bruhl R, Martinot JL, Martinot MLP, Artiges E, Orfanos DP, Poustka L, Hohmann S, Millenet S, Fröhner J, Smolka M, Vaidya N, Walter H, Winterer J, Broulidakis M, van Noort B, Stringaris A, Penttilä J, Grimmer Y, Insensee C, Becker A, Zhang Y, King S, Sinclair J, Schumann G, Schmidt U. Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder. Res Sq 2024:rs.3.rs-3777784. [PMID: 38352452 PMCID: PMC10862965 DOI: 10.21203/rs.3.rs-3777784/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This study uses machine learning models to uncover diagnostic and risk prediction markers for eating disorders (EDs), major depressive disorder (MDD), and alcohol use disorder (AUD). Utilizing case-control samples (ages 18-25 years) and a longitudinal population-based sample (n=1,851), the models, incorporating diverse data domains, achieved high accuracy in classifying EDs, MDD, and AUD from healthy controls. The area under the receiver operating characteristic curves (AUC-ROC [95% CI]) reached 0.92 [0.86-0.97] for AN and 0.91 [0.85-0.96] for BN, without relying on body mass index as a predictor. The classification accuracies for MDD (0.91 [0.88-0.94]) and AUD (0.80 [0.74-0.85]) were also high. Each data domain emerged as accurate classifiers individually, with personality distinguishing AN, BN, and their controls with AUC-ROCs ranging from 0.77 to 0.89. The models demonstrated high transdiagnostic potential, as those trained for EDs were also accurate in classifying AUD and MDD from healthy controls, and vice versa (AUC-ROCs, 0.75-0.93). Shared predictors, such as neuroticism, hopelessness, and symptoms of attention-deficit/hyperactivity disorder, were identified as reliable classifiers. For risk prediction in the longitudinal population sample, the models exhibited moderate performance (AUC-ROCs, 0.64-0.71), highlighting the potential of combining multi-domain data for precise diagnostic and risk prediction applications in psychiatry.
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Miranda-Olivos R, Agüera Z, Granero R, Vergeer RR, Dieguez C, Jiménez-Murcia S, Gearhardt AN, Fernández-Aranda F. Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders. J Behav Addict 2022; 11:102-115. [PMID: 35029544 PMCID: PMC9109624 DOI: 10.1556/2006.2021.00087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/21/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes. METHODS The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out. RESULTS Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors. DISCUSSION AND CONCLUSIONS Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Zaida Agüera
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, L’Hospitalet de Llobregat, Spain,Corresponding author. E-mail:
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rhianna R. Vergeer
- Laboratory on Human Psychopharmacology, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Carlos Dieguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Instituto de Investigaciones Sanitarias (IDIS), Department of Physiology (CIMUS), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain,Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Corresponding author. E-mail:
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4
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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] [What about the content of this article? (0)] [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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Gibson D, Benabe J, Watters A, Oakes J, Mehler PS. Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients-a pilot study. J Eat Disord 2021; 9:146. [PMID: 34736530 PMCID: PMC8567337 DOI: 10.1186/s40337-021-00502-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. METHODS Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. RESULTS Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. CONCLUSION There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.
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Affiliation(s)
- Dennis Gibson
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA.
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA.
| | - Jodie Benabe
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Ashlie Watters
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Judy Oakes
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA
- Department of Medicine, Denver Health Hospital Authority, 780 Bannock Street, Denver, CO, 80204, USA
| | - Philip S Mehler
- ACUTE Center for Eating Disorders at Denver Health, 723 Delaware Street, Denver, CO, 80204, USA
- Department of Medicine, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Eating Recovery Center, 7351 E Lowry Blvd, Denver, CO, 80230, USA
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6
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Hiluy JC, David IA, Daquer AFC, Duchesne M, Volchan E, Appolinario JC. A Systematic Review of Electrophysiological Findings in Binge-Purge Eating Disorders: A Window Into Brain Dynamics. Front Psychol 2021; 12:619780. [PMID: 33995178 PMCID: PMC8116794 DOI: 10.3389/fpsyg.2021.619780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/29/2021] [Indexed: 12/18/2022] Open
Abstract
Binge-purge eating disorders (BP-ED), such as bulimia nervosa and binge eating disorder, may share some neurobiological features. Electroencephalography (EEG) is a non-invasive measurement modality that may aid in research and diagnosis of BP-ED. We conducted a systematic review of the literature on EEG findings in BP-ED, seeking to summarize and analyze the current evidence, as well as identify shortcomings and gaps to inform new perspectives for future studies. Following PRISMA Statement recommendations, the PubMed, Embase, and Web of Science databases were searched using terms related to “electroencephalography” and “binge-purge” eating disorders. Of 555 articles retrieved, 15 met predefined inclusion criteria and were included for full-text analysis. Eleven studies investigated EEG by means of event-related potentials (ERP) in BP-ED individuals: 7 using eating disorder-related stimuli (i.e., food, body image) and 4 using non-eating disorder-related stimuli (i.e., facial expressions or auditory clicks). These studies found significant differences in the N200, P200, P300, and LPP components in BP-ED participants compared to controls, indicating that this population exhibits impairments in selective attention, attentional allocation/processing, and allocation of motivational or emotion-based attention. Five studies investigated EEG using frequency analysis; reporting significant differences in beta activity in fronto-temporal and occipito-temporo-parietal areas in BP-ED individuals compared to controls, revealing a dysfunctional brain network. However, the small number of studies, the heterogeneity of samples, study paradigms, stimulus types, and the lack of an adequate assessment of neuropsychological parameters are some limitations of the current literature. Although some EEG data are promising and consistent with neuroimaging and neuropsychological findings in individuals with BP-ED, future studies need to overcome current methodological shortcomings.
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Affiliation(s)
- Joao C Hiluy
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabel A David
- Laboratory of Behavioral Neurophysiology, Physiology and Pharmacology Department, Biomedical Institute, Federal Fluminense University, Niteroi, Brazil
| | - Adriana F C Daquer
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,State Institute of Diabetes and Endocrinology, Rio de Janeiro, Brazil
| | - Monica Duchesne
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,State Institute of Diabetes and Endocrinology, Rio de Janeiro, Brazil
| | - Eliane Volchan
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jose C Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,State Institute of Diabetes and Endocrinology, Rio de Janeiro, Brazil
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Tinghino B, Lugoboni F, Amatulli A, Biasin C, Bramani Araldi M, Cantiero D, Cremaschini M, Galimberti GL, Giusti S, Grosina C, Mulazzani GEG, Nizzoli U. The FODRAT study (FOod addiction, DRugs, Alcohol and Tobacco): first data on food addiction prevalence among patients with addiction to drugs, tobacco and alcohol. Eat Weight Disord 2021; 26:449-455. [PMID: 32072572 DOI: 10.1007/s40519-020-00865-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 02/01/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The main focus of this study was to evaluate the prevalence of food addiction (FA) in a population of 575 subjects, all affected by drugs, alcohol and/or tobacco addiction. METHODS Patients were enrolled in Addiction Service Centers and 25 items YFAS questionnaire was administered. Prevalence of FA was studied among patients who already have an addiction and then this prevalence was compared between groups of abusers (by type of substance), comparing mono abusers with polyabusers, as well as regressions by age, BMI, sex, through multiple regression analysis. RESULTS Prevalence of FA in the sample is 20.17%. Risk of FA increases with the number of substances used (polyabuse). Results show a positive correlation, in addicted people, between BMI values and FA, with significant values (OR 1.08; 95% CI 1.04-1.13; p = 0.006). Age is inversely correlated with FA (OR 0.97; 95% CI 0.95-0.99; p = 0.01). Female sex is positively associated (OR 2.60; 95% CI 1.59-4.27, p = 0.000). No significant association appears with any substance, even if the highest prevalence is recorded among cannabis users (31.03%), and heroin (21.07%), followed by cocaine (18.53%), alcohol (14.49%) and tobacco (11.61%). A comparison between the FA prevalence in our study and that from another study in the Italian general population (11%) shows a significant difference (p < 0.001). CONCLUSIONS Prevalence of FA among addicted people is greater than in the general population. Risk of FA increases with the increase in number of used substances (polyabuse). Age is inversely correlated with FA. There is a positive and significant correlation between BMI and FA among substance/tobacco abusers. LEVEL OF EVIDENCE Level V, observational cross-sectional descriptive study.
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Affiliation(s)
- B Tinghino
- UO Alcologia e Nuove Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy.
| | - F Lugoboni
- UO Medicina delle Dipendenze, Ospedale Universitario di Verona, Verona, Italy
| | - A Amatulli
- Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy
| | - C Biasin
- SER.D ULSS 9 Scaligera, Verona, UOC Bussolengo e Legnago, Legnago, Italy
| | - M Bramani Araldi
- UO Tossicodipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy
| | - D Cantiero
- SER.D ULSS 9 Scaligera, Verona, UOC Bussolengo e Legnago, Legnago, Italy
| | - M Cremaschini
- Dipartimento Cure Primarie, ATS di Bergamo, Bergamo, Italy
| | - G L Galimberti
- UOSD Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Monza, Monza, Italy
| | - S Giusti
- UO Medicina delle Dipendenze, Ospedale Universitario di Verona, Verona, Italy
| | - C Grosina
- UO Alcologia e Nuove Dipendenze, Dipartimento di Salute Mentale e Dipendenze, ASST di Vimercate, Vimercate, Italy
| | - G E G Mulazzani
- Medico specializzando in Scienza dell'Alimentazione, Università Statale di Milano, Milano, Italy
| | - U Nizzoli
- Società Italiana Studio Disturbi Comportamento Alimentare, SISDCA, Roma, Italy
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Abstract
Personality traits and diet can be used to predict if a person is predisposed to disordered eating. Results of this study demonstrate a strong significant relationship between the personality trait of selflessness, diet group, and disordered eating. Vegans were most likely to display selflessness tendencies associated with disordered eating; however when selflessness was controlled for, vegans displayed substantially less disordered eating pathology than non-vegetarians. OBJECTIVE To explore the relationship between diet group (non-vegetarian, semi-vegetarian, true-vegetarian, and vegan) and disordered eating while investigating to what extent personality trait of selflessness mediates the relationship between diet group and disordered eating. METHOD Cross-sectional data from 634 Australian nonclinical women who completed a series of online questionnaires including measures of diet group, disordered eating, and selflessness were used to examine associations between diet, personality (selflessness), and disordered eating. RESULTS Selflessness was found to be a significant positive predictor of disordered eating. Results confirm that selflessness played a suppressing role in the relationship between the vegan diet group and disordered eating, when compared to non-vegetarians. Surprisingly, vegans displayed significantly less disordered eating than non-vegetarians and semi-vegetarians. DISCUSSION Results of the current study imply that the role of selflessness on disordered eating, when broken down across diet group, may be more complex than first thought. If replicated, these results suggest that targeted treatment of selflessness in different diet groups may improve treatment outcomes for disordered eating. Further research should explore why diet groups differ in terms of selflessness and how this impacts disordered eating.
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Ciberti A, Cavalletti M, Palagini L, Mariani MG, Dell'Osso L, Mauri M, Maglio A, Mucci F, Marazziti D, Miniati M. Decision-Making, Impulsiveness and Temperamental Traits in Eating Disorders. Clin Neuropsychiatry 2020; 17:199-208. [PMID: 34908995 PMCID: PMC8629064 DOI: 10.36131/cnfioritieditore20200401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To explore decision-making, impulsiveness and temperamental traits in patients suffering from eating disorders (EDs), as compared with healthy controls (HC). METHOD Fifty-one patients affected by ED (fourteen with anorexia restricting subtype, AN-R; fourteen with bulimia, BN; thirteen with anorexia bingeing/purging subtype, AN-BP; ten with binge-eating disorder, BED) and twenty-eight HC. The patients, recruited at the Section of Psychiatry of the University of Pisa (Italy, were evaluated with a battery of neuropsychological questionnaires, including the IOWA Gambling Task (IGT), the Barratt Impulsiveness Scale (BIS-11), the Temperament and Character Inventory (TCI), the Frontal Assessment Battery (FAB) and the Hamilton Depression Rating Scale (HAM-D). RESULTS The results indicated that AN-R, AN-BP and BN patients showed poorer IGT performances than HC (p < .05), while BED performances were similar to those of HC. IGT scores suggested the existence of similarities in decision-making performances of AN-BP and BN patients, as they performed differently from HC starting from block 3 (F(16.2)=1.7). In addition, differences between AN-BP/BN and AN-R patients were detected, given that they performed differently starting from block 4. As far as BIS-11 is concerned, AN-BP and BN patients reached the highest BIS total scores, when compared with the other groups. Further, they shared similar temperamental and impulsiveness profiles, as demonstrated by their BIS-11 'motor impulsiveness' scores, and by their TCI 'novelty seeking', 'reward dependence' and 'persistence' dimensions. The post-hoc analyses revealed that both AN groups (namely, AN-R and AN-BP) scored significantly lower than HC on the FAB. No patients fulfilled the criteria for the diagnosis of a current major depression. CONCLUSIONS Decision-making deficits are common in EDs. In AN-R these seem related to cognitive styles, while in AN-BP and BN patients with temperament features and impulsiveness traits.
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Affiliation(s)
- Agnese Ciberti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Laura Palagini
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Mauro Mauri
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Alessandra Maglio
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Federico Mucci
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.,Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy.,Saint Camillus International University of Health and Medical Sciences, Rome, Italy.,Brain Research Foundation, Lucca, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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10
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Lozano-Madrid M, Clark Bryan D, Granero R, Sánchez I, Riesco N, Mallorquí-Bagué N, Jiménez-Murcia S, Treasure J, Fernández-Aranda F. Impulsivity, Emotional Dysregulation and Executive Function Deficits Could Be Associated with Alcohol and Drug Abuse in Eating Disorders. J Clin Med 2020; 9:jcm9061936. [PMID: 32575816 PMCID: PMC7355820 DOI: 10.3390/jcm9061936] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Empirical data suggests a high comorbid occurrence of eating disorders (EDs) and substance use disorders (SUDs), as well as neurological and psychological shared characteristics. However, no prior study has identified the neuropsychological features of this subgroup. This study examines the prevalence of alcohol and/or drug abuse (A/DA) symptoms in ED patients. It also compares the clinical features and neuropsychological performance of ED patients with and without A/DA symptoms. Methods: 145 participants (74.5% females) with various forms of diagnosed EDs underwent a comprehensive clinical (TCI-R, SCL-90-R and EDI-2) and neuropsychological assessment (Stroop, WCST and IGT). Results: Approximately 19% of ED patients (across ED subtypes) had A/DA symptoms. Those with A/DA symptoms showed more impulsive behaviours and higher levels of interoceptive awareness (EDI-2), somatisation (SCL-90-R) and novelty seeking (TCI-R). This group also had a lower score in the Stroop-words measure, made more perseverative errors in the WCST and showed a weaker learning trajectory in the IGT. Conclusions: ED patients with A/DA symptoms display a specific phenotype characterised by greater impulsive personality, emotional dysregulation and problems with executive control. Patients with these temperamental traits may be at high risk of developing a SUD.
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Affiliation(s)
- María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; (M.L.-M.); (I.S.); (N.R.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge—IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
| | - Danielle Clark Bryan
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (D.C.B.); (J.T.)
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
- Departament de Psicobiologia i Metodologia. Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; (M.L.-M.); (I.S.); (N.R.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge—IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
| | - Nadine Riesco
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; (M.L.-M.); (I.S.); (N.R.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge—IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
| | - Núria Mallorquí-Bagué
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
- Department of Psychiatry, Addictive Behavior Unit, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, 08001 Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; (M.L.-M.); (I.S.); (N.R.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge—IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Janet Treasure
- Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF London, UK; (D.C.B.); (J.T.)
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; (M.L.-M.); (I.S.); (N.R.); (S.J.-M.)
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge—IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain; (R.G.); (N.M.-B.)
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
- Correspondence: ; Tel.: +34-93-2607227; Fax: +34-93-2607193
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Claudat K, Brown TA, Anderson L, Bongiorno G, Berner LA, Reilly E, Luo T, Orloff N, Kaye WH. Correlates of co-occurring eating disorders and substance use disorders: a case for dialectical behavior therapy. Eat Disord 2020; 28:142-156. [PMID: 32301683 DOI: 10.1080/10640266.2020.1740913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Given the high rates of comorbidity between eating disorders (EDs) and substance use disorders (SUDs), it is important to develop effective treatment approaches for individuals with both an ED and SUD (ED-SUD). To date, there is limited information guiding the concurrent treatment of these disorders. To build on existing research, the present study compared adult patients with ED-SUD (n = 36) to patients with ED-only (n = 62) in terms of demographics, psychiatric comorbidity, and self-reported eating disorder and related psychopathology. Results indicated that ED-SUD patients had a higher number of psychiatric comorbidities, were more likely to be prescribed mood stabilizers, and were more sensitive to reward. They also reported greater difficulty with emotion regulation, including more difficulty engaging in goal-directed activity, higher impulsivity, and more limited access to emotion regulation strategies. These differences highlight the importance of targeting emotion dysregulation for ED-SUD, and provide evidence for the importance of integrated, transdiagnostic treatment to simultaneously address the SUD, ED, and other psychiatric comorbidities. Implications for tailoring treatment are discussed with a focus on Dialectical Behavior Therapy (DBT).
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Affiliation(s)
- Kimberly Claudat
- Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
| | - Tiffany A Brown
- Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
| | - Leslie Anderson
- Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
| | - Gina Bongiorno
- Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
| | - Laura A Berner
- Mount Sinai Department of Psychiatry, Icahn School of Medicine
| | - Erin Reilly
- Department of Psychology, Hofstra University, Hempstead, USA
| | - Tana Luo
- Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
| | - Natalia Orloff
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Walter H Kaye
- Eating Disorder Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA, USA
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12
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Jiménez-Murcia S, Agüera Z, Paslakis G, Munguia L, Granero R, Sánchez-González J, Sánchez I, Riesco N, Gearhardt AN, Dieguez C, Fazia G, Segura-García C, Baenas I, Menchón JM, Fernández-Aranda F. Food Addiction in Eating Disorders and Obesity: Analysis of Clusters and Implications for Treatment. Nutrients 2019; 11:E2633. [PMID: 31684127 DOI: 10.3390/nu11112633] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/30/2019] [Accepted: 10/14/2019] [Indexed: 12/30/2022] Open
Abstract
Food addiction (FA) has been associated with greater psychopathology in individuals with eating disorders (ED) and obesity (OBE). The current study aims to provide a better phenotypic characterization of the FA construct by conducting a clustering analysis of FA in both conditions (ED and OBE). The total sample was comprised of 234 participants that scored positive on the Yale Food Addiction Scale 2.0. (YFAS-2) (119 bulimia nervosa (BN), 50 binge eating disorder (BED), 49 other specified feeding or eating disorder (OSFED) and 16 OBE). All participants completed a comprehensive battery of questionnaires. Three clusters of FA participants were identified. Cluster 1 (dysfunctional) was characterized by the highest prevalence of OSFED and BN, the highest ED severity and psychopathology, and more dysfunctional personality traits. Cluster 2 (moderate) showed a high prevalence of BN and BED and moderate levels of ED psychopathology. Finally, cluster 3 (adaptive) was characterized by a high prevalence of OBE and BED, low levels of ED psychopathology, and more functional personality traits. In conclusion, this study identified three distinct clusters of ED-OBE patients with FA and provides some insight into a better phenotypic characterization of the FA construct when considering psychopathology, personality and ED pathology. Future studies should address whether these three food addiction categories are indicative of therapy outcome.
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13
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Abstract
Background:
Although bigorexia symptoms are rapidly increasing, it is mostly an underrecognized
condition in Turkish male bodybuilders. There are no validated screening tools to identify
the symptoms.
Objective:
The purpose of this study is to evaluate the validity of the Turkish version of the MDDI
and the BIG towards the diagnosis of bigorexia and to provide health care professionals with early
screening tools.
Methods:
One hundred twenty male bodybuilders, fifty-eight professional bodybuilders and sixtytwo
recreational bodybuilders, all of whom matched the research criteria, were included in this study.
MDDI and BIG forms were filled by the bodybuilders, along with an “Individual Characteristic Information
Form”, a “Nutrition-related Information Form”, and a “Bodybuilding-related Information
Form”. To evaluate the construct validity, factor analysis was conducted and resulted in a threefactor
construct.
Results:
The factor-loading values ranged from 0.542- 0.827. Calculations of Cronbach’s alpha for
the MDDI sum (α = 0.657) revealed a good internal consistency. The MDDI, BIG O, and BIG S intraclass
correlation coefficients (ICC) were found to be 0.840, 0.908, and 0.879, respectively. As a
result, MDDI had acceptable reliability and that of BIG O and BIG S was excellent.
Discussion:
Turkish MDDI, BIG-O and BIG-S forms proved to be valid and reliable scales and were
adequate for determining the symptoms of bigorexia in male bodybuilders. Using these forms, there
was a statistically significant relationship between bigorexia and eating disorders, which were significantly
positively correlated.
Conclusion:
Our results support the feasibility of using the MDDI, the BIG-O, and the BIG-S forms
to determine symptoms of bigorexia in Turkish population. Further studies are needed to confirm if
this result can be generalized to female bodybuilders.
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Affiliation(s)
- Asli Devrim
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Pelin Bilgic
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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14
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Reas DL, Wisting L, Stedal K, Dahlgren CL. Unhealthy eating and weight dissatisfaction in adolescents who never, occasionally, or regularly use smokeless tobacco (Swedish snus). Int J Eat Disord 2019; 52:846-854. [PMID: 31032987 DOI: 10.1002/eat.23085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Although cigarette smoking has been linked to weight-related concerns and unhealthy weight control practices, little is known about weight dissatisfaction and eating among adolescents who use smokeless tobacco (SLT) products. The use of Swedish moist snuff (snus) has increased dramatically over recent years, surpassing cigarette smoking among young people in several countries. This study investigated differences in unhealthy eating behaviors and weight dissatisfaction in male and female adolescents who never, occasionally, or regularly use snus. METHOD Adolescents aged 16-19 years enrolled in high school (11th, 12th, and 13th grades) completed a cross-sectional, online survey of adolescent health and well-being. Meal skipping and snus use frequency were assessed in the total sample (N = 23,622), and items assessing weight dissatisfaction (n = 4,195) and eating-related pathology (n = 3,563) were administered to subsamples. Analyses were adjusted for cigarette smoking, parental education, and socioeconomic status. RESULTS Adolescents who used snus, especially on a daily basis, reported less regular breakfast, lunch, and dinner consumption. Females who used snus on an occasional basis reported significantly more disturbed eating pathology. Snus use was associated with weight dissatisfaction in males and females, manifesting differentially according to gender and snus use frequency. DISCUSSION Unhealthy eating behaviors and weight dissatisfaction were significantly elevated among snus users aged 16-19 years. An increased awareness that occasional snus use may signal disturbed eating pathology among adolescent females is important for detection and prevention efforts. Parents, schools, and health professionals should be vigilant for possible snus use among weight-dissatisfied adolescents.
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Affiliation(s)
- Deborah L Reas
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kristin Stedal
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Camilla Lindvall Dahlgren
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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15
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Simone M, Hooper L, Eisenberg ME, Neumark-Sztainer D. Unhealthy weight control behaviors and substance use among adolescent girls: The harms of weight stigma. Soc Sci Med 2019; 233:64-70. [PMID: 31181470 DOI: 10.1016/j.socscimed.2019.05.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/14/2019] [Accepted: 05/27/2019] [Indexed: 01/09/2023]
Abstract
RATIONALE Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences. OBJECTIVE The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma. METHODS Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma. RESULTS Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p = .08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p = .005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. CONCLUSIONS Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution.
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Affiliation(s)
- Melissa Simone
- University of Minnesota, Minneapolis, MN, USA; Department of Psychiatry, 2450 Riverside Avenue, F227, Minneapolis, MN, 55454, USA.
| | - Laura Hooper
- University of Minnesota, Minneapolis, MN, USA; Division of Epidemiology and Community Health, School of Public Health, 1300 South 2nd Street, Minneapolis, MN, 55454, USA
| | - Marla E Eisenberg
- University of Minnesota, Minneapolis, MN, USA; Department of Pediatrics, 717 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Dianne Neumark-Sztainer
- University of Minnesota, Minneapolis, MN, USA; Division of Epidemiology and Community Health, School of Public Health, 1300 South 2nd Street, Minneapolis, MN, 55454, USA
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16
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Stam D, Huang YA, Van den Stock J. Non-overlapping and Inverse Associations Between the Sexes in Structural Brain-Trait Associations. Front Psychol 2019; 10:904. [PMID: 31105624 PMCID: PMC6491880 DOI: 10.3389/fpsyg.2019.00904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/04/2019] [Indexed: 01/03/2023] Open
Abstract
Personality reflects the set of psychological traits and mechanisms characteristic for an individual. The brain-trait association between personality and gray matter volume (GMv) has been well studied. However, a recent study has shown that brain structure-personality relationships are highly dependent on sex. In addition, the present study investigates the role of sex on the association between temperaments and regional GMv. Sixty-six participants (33 male) completed the Temperament and Character Inventory (TCI) and underwent structural magnetic resonance brain imaging. Mann-Whitney U tests showed a significant higher score on Novelty Seeking (NS) and Reward Dependence (RD) for females, but no significant group effects were found for Harm Avoidance (HA) and Persistence (P) score. Full factor model analyses were performed to investigate sex-temperament interaction effects on GMv. This revealed increased GMv for females in the superior temporal gyrus when linked to NS, middle temporal gyrus for HA, and the insula for RD. Males displayed increased GMv compared to females relating to P in the posterior cingulate gyrus, the medial superior frontal gyrus, and the middle cingulate gyrus, compared to females. Multiple regression analysis showed clear differences between the brain regions that correlate with female subjects and the brain correlates that correlate with male subjects. No overlap was observed between sex-specific brain-trait associations. These results increase the knowledge of the role of sex on the structural neurobiology of personality and indicate that sex differences reflect structural differences observed in the normal brain. Furthermore, sex hormones seem an important underlying factor for the found sex differences in brain-trait associations. The present study indicates an important role for sex in these brain structure-personality relationships, and implies that sex should not just be added as a covariate of no interest.
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Affiliation(s)
- Daphne Stam
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Yun-An Huang
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jan Van den Stock
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium.,Brain and Emotion Laboratory, Maastricht University, Maastricht, Netherlands
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Hernández-Vázquez F, Reyes-Guzmán C, Méndez M. Impact of a novel environment on alcohol-induced locomotor activity in Wistar rats. Alcohol 2018; 71:5-13. [PMID: 29929089 DOI: 10.1016/j.alcohol.2018.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 02/02/2018] [Accepted: 02/13/2018] [Indexed: 11/17/2022]
Abstract
Clinical studies have shown a positive correlation between novelty-seeking behavior and the susceptibility to consume drugs of abuse. Although several animal studies have demonstrated this correlation with psychostimulants or morphine, studies with alcohol have shown conflicting results. The aim of this work was to investigate alcohol-induced motor effects in Wistar rats with different responses to novelty. Animals were classified as Low- (LR) or High-Responders (HR) to novelty, depending on their horizontal activity in an automated open field. Motor activity was recorded in naïve, saline, and alcohol-administered rats at different doses (0.1, 0.25, 0.5, 1.0, or 2.5 g/kg). Horizontal movements, rearings, and stereotyped behaviors were evaluated. After the behavioral test, animals were sacrificed and blood alcohol concentrations (BACs) were measured. Low (0.1 and 0.25 g/kg) and high (2.5 g/kg) alcohol doses decreased horizontal movements in LR animals, whereas 1.0 g/kg increased this parameter in HR rats. Rearings were increased by alcohol 1.0 g/kg in LR animals. In HR rats, alcohol doses of 0.5 and 1.0 g/kg also increased this parameter. Stereotyped behaviors were decreased by an alcohol dose of 2.5 g/kg in LR animals, but were increased by an intermediate dose (1.0 g/kg) in HR rats. Differences in horizontal movements and rearings were found between LR and HR animals at certain ethanol doses. Horizontal movements (0.25 g/kg) and rearings (0.5 g/kg) were lower in LR than HR rats; however, rearings were lower in HR than LR rats at 1.0 g/kg. BACs were similar between LR and HR rats at all ethanol doses. These findings suggest that HR rats are more responsive to the stimulant effects of intermediate alcohol doses, whereas LR animals are sensitive to low/high doses of the drug. Sensitivity to alcohol motor effects may substantially depend on the initial animal's response to a novel environment. The stimulant effects of alcohol may constitute important behavioral traits significantly associated with the rewarding properties of the drug.
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Affiliation(s)
- Fabiola Hernández-Vázquez
- Departamento de Neuroquímica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, 14370 Ciudad de México, Mexico.
| | - Cosette Reyes-Guzmán
- Departamento de Neuroquímica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, 14370 Ciudad de México, Mexico.
| | - Milagros Méndez
- Departamento de Neuroquímica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente, Calzada México-Xochimilco 101, Col. San Lorenzo Huipulco, 14370 Ciudad de México, Mexico.
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18
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Brewerton TD, Cotton BD, Kilpatrick DG. Sensation seeking, binge-type eating disorders, victimization, and PTSD in the National Women's Study. Eat Behav 2018; 30:120-4. [PMID: 30012278 DOI: 10.1016/j.eatbeh.2018.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 06/28/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Higher degrees of sensation seeking (SS) are reported in community and clinical samples of individuals with eating disorders with binge-type features (BTEDs), but no reports exist in representative probability samples of adult women. Additionally, SS has been linked to victimization and PTSD, also associated with BTEDs, yet interrelationships between these variables are unexplored. METHODS A national, probability sample of 3006 adult women (≥18 y/o) completed structured telephone interviews including assessments for victimization, PTSD, bulimia nervosa (BN) and binge eating disorder (BED). The survey included the 6 items of the Disinhibition-Intentions for the Future (DIF) subscale of Zuckerman's Sensation Seeking Scale-VI, which asks how likely participants would be to engage in given activities. Total SS score (TSSS-DIFS) was the sum of the 6 items' scores. Differences among the 3 groups (BN, BED, non-BN/BED) were compared using ANOVA covaried by age and post-hoc t-tests. Multiple regression tested the effects of age, number of victimization experiences (NVE), lifetime PTSD, and BTEDs on TSSS-DIFS. RESULTS There were significant differences in TSSS-DIFS across BTED diagnoses (p ≤ .001). Participants with BN (p ≤ .002) and those with BED (p ≤ .01) had significantly higher scores than those without BTEDs. These findings persisted in both groups after correcting for NVE and lifetime PTSD. TSSS-DIFS was significantly higher in participants with BTED with PTSD versus those without (p ≤ .025). DISCUSSION SS traits related to disinhibition occur more commonly in U.S. adult women with BN and BED, even after controlling for NVE and PTSD, which were also associated with higher TSSS-DIFS.
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19
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Rotella F, Mannucci E, Gemignani S, Lazzeretti L, Fioravanti G, Ricca V. Emotional eating and temperamental traits in Eating Disorders: A dimensional approach. Psychiatry Res 2018; 264:1-8. [PMID: 29626825 DOI: 10.1016/j.psychres.2018.03.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/02/2018] [Accepted: 03/22/2018] [Indexed: 12/19/2022]
Abstract
Growing evidence shows that temperamental features and emotional dysregulation are linked to Eating Disorders (EDs). Aim of this study was to explore the possible relationship between temperament and emotional eating (EE) from a dimensional standpoint, and the association of specific temperamental dimensions with overeating triggered by specific emotions. We enrolled 253 women with Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Of those, 189 (74.7%), 73 (28.8%), and 80 (31.6%) reported binge eating, purging, or restrictive behaviors, respectively (the categories are not mutually exclusive). Participants completed the Emotional Eating Scale (EES), the Temperament and Character Inventory, the Eating Disorder Examination Questionnaire (EDE-Q) and the Symptom Checklist 90-Revised (SCL-90-R). Higher Persistence scores were found in the Restriction group, while the Binge group reported lower Persistence and higher Novelty Seeking scores. The Purge group showed lower Reward Dependence, Self Directedness and Cooperativeness scores. Patients with Purge also reported lower BMI and higher scores on EDE-Q restriction and eating concern subscales as well as higher scores for all SCL 90-R subscales. Patterns of association between temperamental traits and specific emotions were found in each group. Therefore, some temperamental features could be considered predictors of specific associations between emotions and the tendency to eat.
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Affiliation(s)
- Francesco Rotella
- Psychiatric Unit, Careggi Teaching Hospital, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy.
| | - Edoardo Mannucci
- Diabetes Agency, Careggi Teaching Hospital, Via delle Oblate 4, Florence 50141, Italy
| | - Sara Gemignani
- Department of Health Sciences, Psychiatry Unity, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy
| | - Lisa Lazzeretti
- Department of Health Sciences, Psychiatry Unity, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy
| | - Giulia Fioravanti
- Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, via di San Salvi 12, Florence 50100, Italy
| | - Valdo Ricca
- Department of Health Sciences, Psychiatry Unity, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy
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20
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Abstract
Personality reflects the set of psychological traits and mechanisms characteristic for an individual. Geno-neuro-biologically inspired personality accounts have proposed a set of temperaments and characters that jointly compose personality profiles. The present study addresses the link between neurobiology and personality and investigates the association between temperament traits and regional gray matter volume. Furthermore, the specificity of these associations as well as the underlying components that drive the association are addressed. One hundred and four participants completed the Temperament and Character Inventory (TCI) and underwent structural magnetic resonance brain imaging. The participants included premanifest carriers of Huntington's disease, as this population is associated with temperament-related neuropsychiatric symptoms. Whole brain voxel-based multiple regression analyses on gray matter volume revealed a significant specific positive correlation between a region in the left thalamic pulvinar and novelty seeking score, controlled for the other traits (Pheight < 0.05, FWE-corrected). No significant associations were observed for the other temperament traits. Region of interest analyses showed that this association is driven by the subscale NS2: impulsiveness. The results increase the knowledge of the structural neurobiology of personality and indicate that individual differences in novelty seeking reflect the structural differences observed in the brain in an area that is widely and densely connected, which is in line with the typically domain-general behavioral influence of personality traits on a wide range of affective, perceptual, mnemotic, executive, and other cognitive functions.
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Affiliation(s)
- Daphne Stam
- Laboratory for Translational Neuropsychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Yun-An Huang
- Laboratory for Translational Neuropsychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Jan Van den Stock
- Laboratory for Translational Neuropsychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium.,Old Age Psychiatry, University Psychiatric Center KU Leuven, Leuven, Belgium.,Brain and Emotion Laboratory, Maastricht University, Maastricht, Netherlands
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21
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del Pino-Gutiérrez A, Jiménez-Murcia S, Fernández-Aranda F, Agüera Z, Granero R, Hakansson A, Fagundo AB, Bolao F, Valdepérez A, Mestre-Bach G, Steward T, Penelo E, Moragas L, Aymamí N, Gómez-Peña M, Rigol-Cuadras A, Martín-Romera V, Menchón JM. The relevance of personality traits in impulsivity-related disorders: From substance use disorders and gambling disorder to bulimia nervosa. J Behav Addict 2017; 6:396-405. [PMID: 28838248 PMCID: PMC5700725 DOI: 10.1556/2006.6.2017.051] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background and aims The main aim of this study was to analyze and describe the clinical characteristics and shared personality traits in different impulsivity-compulsivity spectrum disorders: substance use disorders (SUD), gambling disorder (GD), and bulimia nervosa (BN). The specific aims were to compare personality differences among individuals with pure SUD, BN with and without SUD, and GD with and without SUD. In addition, we assessed the differential predictive capacity of clinical and personality variables in relation to diagnostic subtype. Methods The sample comprised 998 subjects diagnosed according to DSM-IV-TR criteria: 101 patients were diagnosed with SUD, 482 with GD, 359 with BN, 11 with GD + SUD, and 45 patients with BN + SUD. Various assessment instruments were administered, as well as other clinical measures, to evaluate their predictive capacity. Results Marked differences in personality traits were observed between groups. Novelty seeking, harm avoidance, self-directedness, cooperation, and self-transcendence best differentiated the groups. Notably, novelty seeking was significantly higher in the two dual pathology subgroups. Patients with dual pathology showed the most dysfunctional personality profiles. Discussion and conclusion Our results indicate the existence of shared dysfunctional personality traits among the groups studied, especially in novelty seeking and self-directedness.
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Affiliation(s)
- Amparo del Pino-Gutiérrez
- Department of Nursing in Public Health, Mental Health, and Maternal and Child Health, School of Nursing, University of Barcelona, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail:
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail:
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anders Hakansson
- Division of Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Ana B. Fagundo
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Ferran Bolao
- Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Ana Valdepérez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Eva Penelo
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Assumpta Rigol-Cuadras
- Department of Nursing in Public Health, Mental Health, and Maternal and Child Health, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Virginia Martín-Romera
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain
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22
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Marzola E, Fassino S, Amianto F, Abbate-Daga G. Affective temperaments in anorexia nervosa: The relevance of depressive and anxious traits. J Affect Disord 2017; 218:23-29. [PMID: 28456073 DOI: 10.1016/j.jad.2017.04.054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/09/2017] [Accepted: 04/24/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Affective temperaments have been so far understudied in anorexia nervosa (AN) despite the relevance of personality and both affective and anxious comorbidity with regard to vulnerability, course, and outcome of this deadly disorder. METHODS Ninety-eight female inpatients diagnosed with AN and 131 healthy controls (HCs) were enrolled in this study and completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) in addition to assessments of eating psychopathology, depression, and anxiety. RESULTS AN patients and HCs differed in all affective temperaments. The diagnostic subtypes of AN differed as well with binge-purging individuals being more cyclothymic and anxious than those with restricting-type AN. TEMPS-A scores correlated with body mass index and eating psychopathology but not with duration of illness. Concerning comorbidity, grater scores on the depressive and lower scores on the hyperthymic temperaments were found in depressed patients. Those who had either an anxious or irritable temperament were significantly more diagnosed with an anxious disorder than those who did not show this temperament. When logistic regression was performed, high depressive/low hyperthymic and high irritable/anxious traits resulted to be associated with depressive and anxious comorbidity, respectively, independently of confounding factors. LIMITATIONS Cross-sectional design, some patients on medications, few baseline clinical differences between diagnostic subtypes, no other personality assessments. CONCLUSIONS An affective continuum strongly associated with mood and anxious comorbidity emerged in AN. Such an evaluation could have several research and clinical implications given the need of improving treatment individualization and early interventions for such a complex disorder.
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Affiliation(s)
- Enrica Marzola
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy
| | - Secondo Fassino
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy
| | - Federico Amianto
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.
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23
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Steinhausen HC, Jakobsen H, Munk-Jørgensen P. Family aggregation and risk factors in substance use disorders over three generations in a nation-wide study. PLoS One 2017; 12:e0177700. [PMID: 28545101 PMCID: PMC5435303 DOI: 10.1371/journal.pone.0177700] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 05/02/2017] [Indexed: 11/23/2022] Open
Abstract
Objective This nation-wide register-based study investigated how often substance use disorders (SUD) and co-morbid disorders occurred in affected families compared to control families. Method A total of N = 2504 child and adolescent psychiatric participants who were born between 1969 and 1986 and were registered in the Danish Psychiatric Central Research Register (DPCRR) had a mental disorder before the age of 18 and developed SUD at some point during their life-time. In addition, N = 7472 controls without any psychiatric diagnosis before age 18 and matched for age, sex, and residential region were included. Psychiatric diagnoses of the first-degree relatives were also obtained. A family load component was assessed. Results SUD occurred significantly more often in case families than in control families. SUD risk factors included SUD, depression, anxiety disorders, personality disorders, or conduct disorders in the family. Furthermore, male sex, more recent year of birth, and living in the capital city of Copenhagen were also significantly associated with having SUD. The family load explained 30% of the SUD manifestation in the case-probands. The findings in the total SUD group were mostly replicated in the two major subgroups of pure alcohol or multiple substance use disorders. Discussion These findings based on a very large and representative dataset provide additional evidence for the strong family aggregation and further risk factors in SUD. The pattern of risk factors is largely the same for the total group of SUD and the major subgroups of pure alcohol and multiple substance use disorders.
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Affiliation(s)
- Hans-Christoph Steinhausen
- Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
- Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland
- Department of Child and Adolescent Psychiatry, University of Zurich, Neumünsterallee 9, Zurich, Switzerland
- * E-mail:
| | - Helle Jakobsen
- Research Unit for Child and Adolescent Psychiatry, Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark
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Wills AG, Evans LM, Hopfer C. Phenotypic and Genetic Relationship Between BMI and Drinking in a Sample of UK Adults. Behav Genet 2017; 47:290-297. [PMID: 28238197 PMCID: PMC5546738 DOI: 10.1007/s10519-017-9838-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
The health impairments derived from both alcoholism and obesity are well known. However, reports that relate increased alcohol use with increased measures of obesity have been mixed in their findings, especially with respect to genetic factors that could potentially link these two behaviors. Here, using a large sample of adults from the UK (n ≈ 113,000), we report both the observed and genetic correlations between BMI (kg/m2) and two measures of alcohol use: reported quantity (drinks per week) and frequency of use (from never to daily). Overall, both observationally and genetically, alcohol intake is negatively correlated with BMI. Phenotypic correlations ranged from -0.01 to -0.17, and genetic correlations ranged from -0.1 to -0.4. Genetic correlations tended to be stronger than the phenotypic correlations, and these correlations were stronger in females and between BMI and, specifically, frequency of use. Though the mechanisms driving these relationships are yet to be identified, we can conclude that the genetic factors related to drinking both more and more often are shared with those responsible for lower BMI.
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Affiliation(s)
- Amanda G Wills
- Department of Pharmacology, University of Colorado School of Medicine, 12800 E. 19th Ave., Aurora, CO, 80045, USA.
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO, 80301, USA.
- Department of Pharmacology, University of Colorado Denver, Research North Tower, 12800 East 19th Ave., Aurora, CO, 80010, USA.
| | - Luke M Evans
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO, 80301, USA
| | - Christian Hopfer
- Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO, 80301, USA
- Division of Substance Dependence, Department of Psychiatry, University of Colorado School of Medicine, 12469 E 17th Place, Bldg 400, Mail Stop F478, Aurora, CO, 80045, USA
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25
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Leurquin-Sterk G, Van den Stock J, Crunelle CL, de Laat B, Weerasekera A, Himmelreich U, Bormans G, Van Laere K. Positive Association Between Limbic Metabotropic Glutamate Receptor 5 Availability and Novelty-Seeking Temperament in Humans: An 18F-FPEB PET Study. J Nucl Med 2016; 57:1746-1752. [PMID: 27283933 DOI: 10.2967/jnumed.116.176032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/06/2016] [Indexed: 11/16/2022] Open
Abstract
Heritable temperament traits have been linked to several neuropsychiatric illnesses, including disorders associated with metabotropic glutamate receptor 5 (mGluR5) and dopaminergic dysfunctions. Considering its modulating effect on neurotransmission, we hypothesized that cerebral mGluR5 availability is associated with temperament traits in healthy humans. METHODS Forty-four nonsmoking healthy volunteers (mean age ± SD, 40 ± 14 y; age range, 22-66 y; 22 women) were included in this cross-sectional investigation. Brain mGluR5 availability was quantified on both a voxel-by-voxel and a volume-of-interest basis using the total distribution volume of the radioligand 18F-3-fluoro-5-[(pyridin-3-yl)ethynyl]benzonitrile (18F-FPEB) with 90-min dynamic PET and arterial input function. Moreover, glutamate-glutamine concentrations in the anterior cingulate cortex were measured using MR spectroscopy. These measures were related to the temperament traits of the 240-item Cloninger temperament and character inventory using a regression analysis with age and sex as nuisance variables. RESULTS High novelty-seeking temperament was robustly associated with increased mGluR5 availability in various regions including the thalamus (r = 0.71; the strongest association), amygdala, parahippocampus, insula, anterior and posterior cingulate cortex, and several primary sensory areas (all r > 0.58; P < 0.05, corrected for familywise error). These associations were specific because no correlations were found with other temperament scales or with spectroscopic measures of glutamatergic transmission. CONCLUSION Overall, these data posit mGluR5 in key paralimbic areas as a strong determinant of the temperament trait novelty seeking. These data add to our understanding of how brain neurochemistry accounts for the variation in human behavior and strongly support further research on mGluR5 as a potential therapeutic target in neuropsychiatric disorders associated with abnormal novelty-seeking behaviors.
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Affiliation(s)
- Gil Leurquin-Sterk
- Department of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium
| | - Jan Van den Stock
- Laboratory for Translational Neuropsychiatry, Department of Neurosciences, KU Leuven and Department of Old Age Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | | | - Bart de Laat
- Department of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium.,MoSAIC, Molecular Small Animal Imaging Center, KU Leuven, Leuven, Belgium
| | - Akila Weerasekera
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; and
| | - Uwe Himmelreich
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium; and
| | - Guy Bormans
- Laboratory for Radiopharmacy, KU Leuven, Leuven, Belgium
| | - Koen Van Laere
- Department of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium.,MoSAIC, Molecular Small Animal Imaging Center, KU Leuven, Leuven, Belgium
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Nicholls D, Statham R, Costa S, Micali N, Viner RM. Childhood risk factors for lifetime bulimic or compulsive eating by age 30 years in a British national birth cohort. Appetite 2016; 105:266-73. [PMID: 27263069 DOI: 10.1016/j.appet.2016.05.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 05/17/2016] [Accepted: 05/28/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether previously identified childhood risk factors for bulimia or compulsive eating (BCE) predict self-reported lifetime BCE by age 30 years in a prospective birth cohort. METHOD Using data from the 1970 British Cohort Study at birth, 5, and 10 years, associations between 22 putative childhood risk factors and self-reported lifetime BCE at 30 years were examined, adjusting for sex and socioeconomic status. RESULTS Only female sex (odds ratio (OR): 9.2; 95% confidence interval (CI): 1.9-43.7; p = 0.005), low self-esteem (OR:2.9; 95%CI: 1.1-7.5; p = 0.03) and high maternal education (OR:5.4; 95%CI: 2.0-14.8; p = 0.001) were significantly associated with higher risk of BCE, whereas high SES at 10 years was significantly protective (OR:0.2; 95%CI: 0.1-0.8; p = 0.022) of BCE in fully adjusted multivariable logistic regression analysis. DISCUSSION Our findings do not support a strong role for childhood weight status and eating behaviours in the development of bulimia and compulsive eating pathology, rather suggesting a focus on self esteem may have greater relative importance. Findings in relation to maternal education and SES need further exploration.
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Affiliation(s)
- D Nicholls
- Department of Child and Adolescent Mental Health, Great Ormond Street Hospital, London, WC1N 3JH, UK; UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | - R Statham
- Department of Child and Adolescent Mental Health, Great Ormond Street Hospital, London, WC1N 3JH, UK
| | - S Costa
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - N Micali
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - R M Viner
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
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Mikheeva OV, Tragesser SL. Personality features, disordered eating, and alcohol use among college students: A latent profile analysis. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
OBJECTIVE Anorexia nervosa (AN) is a serious disorder with associated morbidity and mortality, most commonly diagnosed in females. Existing literature on male anorexia is sparse, and a review of the endocrine effects of AN in males has not previously been published. Our objective is to highlight the clinical characteristics of AN in males as a routinely overlooked cause of multiple endocrinopathies and systemic illness in hospitalized patients. METHODS We present 4 cases (2 cases at The Mount Sinai Hospital; 2 cases at Long Island Jewish Hospital) of young men with hormonal dysfunction due to underlying AN. Pertinent de-identified data were collected from a chart review of cases seen on the endocrinology consult service at both hospitals. Institutional Review Board approval was not required for an observational report of the cases presented. RESULTS Four young men with AN demonstrated evidence of multiple systemic complications from severe caloric and protein malnutrition. Varying degrees of endocrinopathies were present, including hypogonadotropic hypogonadism, hypercortisolemia, and nonthyroidal illness syndrome, resulting in bradycardia, gastroparesis, hypothermia, acute systolic heart failure, and erectile dysfunction. Ages at diagnosis were 20, 24, 23, and 20 years, with mean age 21.75 years. Most of the clinical effects from these endocrinopathies resolved with improved caloric intake and nutrition, although symptoms of hypogonadism persisted. CONCLUSION This small case series highlights the importance of AN as a potential cause of multiple endocrinopathies in males. The heterogeneous presentations and varying degrees of clinical manifestations in our cohort emphasize the challenge in diagnosis. Increased awareness of AN in males is vital, as its prevalence is likely underestimated and appropriate diagnosis and treatment can ameliorate the metabolic dysfunction in a majority of cases. Further studies on males with eating disorders are needed to help guide diagnostic and therapeutic decisions.
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Affiliation(s)
- Aren Skolnick
- Division of Endocrinology and Metabolism, Hofstra Northwell School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York
| | - Rifka C Schulman
- Division of Endocrinology and Metabolism, Hofstra Northwell School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York
| | - Rodolfo J Galindo
- Division of Endocrinology, Diabetes, and Bone Diseases, Icahn School of Medicine at Mount Sinai, St. Luke's Hospital, New York, New York
| | - Jeffrey I Mechanick
- Division of Endocrinology, Diabetes, and Bone Diseases, Icahn School of Medicine at Mount Sinai, New York, New York
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Abstract
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations.
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Affiliation(s)
- Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Shyam Sundar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
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Wang Y, Liu Y, Yang L, Gu F, Li X, Zha R, Wei Z, Pei Y, Zhang P, Zhou Y, Zhang X. Novelty seeking is related to individual risk preference and brain activation associated with risk prediction during decision making. Sci Rep 2015; 5:10534. [PMID: 26065910 DOI: 10.1038/srep10534] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/23/2015] [Indexed: 01/10/2023] Open
Abstract
Novelty seeking (NS) is a personality trait reflecting excitement in response to novel stimuli. High NS is usually a predictor of risky behaviour such as drug abuse. However, the relationships between NS and risk-related cognitive processes, including individual risk preference and the brain activation associated with risk prediction, remain elusive. In this fMRI study, participants completed the Tridimensional Personality Questionnaire to measure NS and performed a probabilistic decision making task. Using a mathematical model, we estimated individual risk preference. Brain regions associated with risk prediction were determined via fMRI. The NS score showed a positive correlation with risk preference and a negative correlation with the activation elicited by risk prediction in the right posterior insula (r-PI), left anterior insula (l-AI), right striatum (r-striatum) and supplementary motor area (SMA). Within these brain regions, only the activation associated with risk prediction in the r-PI showed a correlation with NS after controlling for the effect of risk preference. Resting-state functional connectivity between the r-PI and r-striatum/l-AI was negatively correlated with NS. Our results suggest that high NS may be associated with less aversion to risk and that the r-PI plays an important role in relating risk prediction to NS.
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31
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Fraga A, Caggianesse V, Carrera O, Graell M, Morandé G, Gutiérrez E. Seasonal BMI differences between restrictive and purging anorexia nervosa subtypes. Int J Eat Disord 2015; 48:35-41. [PMID: 25327157 DOI: 10.1002/eat.22357] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/19/2014] [Accepted: 09/22/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Seasonal differences in anorexia nervosa is an area of research which has received scarce attention in the literature. The aim of this study was to explore patterns of seasonal variation in body weight in anorexia nervosa patients admitted to an eating disorders unit from January 2007 to December 2011. METHOD Anorexia nervosa restrictive (ANR) and binge eating/purging (ANBP) subtypes were compared with respect to BMI on admission during the Warm and Cold Semester, and in terms of lenght of hospital stay. RESULTS The main result was that BMI differences between ANBP and ANR patients were due to bodyweight differences during the colder months of the year (p < 0.01) whereas no difference in bodyweight on admission was observed between both subtypes during the Warm Semester months. Furthermore, ANR patients' bodyweight was lower when admitted during the Cold compared to the Warm Semester (p < 0.05). Length of stay was significantly associated with reduced BMI in ANR patients (p < 0.01), but not so for ANBP patients. DISCUSSION To our knowledge, this is the first study in the literature providing data on seasonal variations in the BMI on admission of anorexia nervosa patients, and in the length of hospitalization.
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Affiliation(s)
- Angela Fraga
- Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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Atiye M, Miettunen J, Raevuori-Helkamaa A. A meta-analysis of temperament in eating disorders. Eur Eat Disord Rev 2014; 23:89-99. [PMID: 25546554 DOI: 10.1002/erv.2342] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 11/09/2022]
Abstract
Although suggested as an important contributor to the development and maintenance of eating disorders, temperament has not previously been studied adopting a meta-analytical approach. We therefore pooled data (N = 14 studies; N = 3315 cases, N = 3395 controls) on Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders not otherwise specified. Persistence was significantly higher than in the controls in all eating disorders except for BED the highest levels being observed in AN. Correspondingly, the highest effect sizes for harm avoidance were seen in AN. Novelty seeking was significantly elevated relative to the controls only in BN. Harm avoidance was significantly lower, and reward dependence was significantly higher in individuals who had recovered from AN than in those who remained ill. Future studies with a longitudinal design are needed to explore the temporal relationships between eating disorders and temperament traits.
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Affiliation(s)
- Minna Atiye
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
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Munn-Chernoff MA, Duncan AE, Grant JD, Wade TD, Agrawal A, Bucholz KK, Madden PAF, Martin NG, Heath AC. A twin study of alcohol dependence, binge eating, and compensatory behaviors. J Stud Alcohol Drugs 2014; 74:664-73. [PMID: 23948525 DOI: 10.15288/jsad.2013.74.664] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Rates of alcohol dependence are elevated in women with eating disorders who engage in binge eating or compensatory behaviors compared with women with eating disorders who do not report binge eating or compensatory behaviors and with healthy controls. Alcohol dependence, binge eating, and compensatory behaviors are heritable; however, it is unclear whether a shared genetic liability contributes to the phenotypic association among these traits, and little information exists regarding this shared liability in men. We investigated genetic and environmental correlations among alcohol dependence, binge eating, and compensatory behaviors in male and female twins. METHOD Participants included 5,993 same- and opposite-sex twins from the Australian Twin Registry who completed a modified version of the Semi-Structured Assessment for the Genetics of Alcoholism that assessed lifetime alcohol dependence and binge eating as defined in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Compensatory behaviors were assessed via a general health questionnaire in women only. Biometrical twin models estimated genetic and environmental influences on alcohol dependence, binge eating, and compensatory behaviors. RESULTS In women, the multivariate twin model suggested that additive genetic and nonshared environmental effects influenced alcohol dependence, binge eating, and compensatory behaviors, with heritability estimates ranging from 38% to 53%. The best-fitting sex-limitation model was a common effects model that equated all genetic and nonshared environmental influences in men and women. The heritability estimates were 50% and 38% for alcohol dependence and binge eating, respectively. Overall, there were significant genetic correlations between alcohol dependence and binge eating, alcohol dependence and compensatory behaviors, and binge eating and compensatory behaviors. CONCLUSIONS These findings indicate that common genetic factors may underlie the vulnerability to alcohol dependence and the liability to binge eating and compensatory behaviors.
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Affiliation(s)
- Melissa A Munn-Chernoff
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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Gregorowski C, Seedat S, Jordaan GP. A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders. BMC Psychiatry 2013; 13:289. [PMID: 24200300 PMCID: PMC4226257 DOI: 10.1186/1471-244x-13-289] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/31/2013] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Research has shown that eating disorder (ED) patients who abuse substances demonstrate worse ED symptomatology and poorer outcomes than those with EDs alone, including increased general medical complications and psychopathology, longer recovery times, poorer functional outcomes and higher relapse rates. This article provides a broad overview of the prevalence, aetiology, assessment and management of co-morbid EDs and substance use disorders (SUDs). REVIEW The co-occurrence of EDs and SUDs is high. The functional relationship between EDs and SUDs vary within and across ED subtypes, depends on the class of substance, and needs to be carefully assessed for each patient. Substances such as caffeine, tobacco, insulin, thyroid medications, stimulants or over the counter medications (laxatives, diuretics) may be used to aid weight loss and/or provide energy, and alcohol or psychoactive substances could be used for emotional regulation or as part of a pattern of impulsive behaviour. A key message conveyed in the current literature is the importance of screening and assessment for co-morbid SUDs and EDs in patients presenting with either disorder. There is a paucity of treatment studies on the management of co-occurring EDs and SUDs. Overall, the literature indicates that the ED and SUD should be addressed simultaneously using a multi-disciplinary approach. The need for medical stabilization, hospitalization or inpatient treatment needs to be assessed based on general medical and psychiatric considerations. Common features across therapeutic interventions include psycho-education about the aetiological commonalities, risks and sequelae of concurrent ED behaviours and substance abuse, dietary education and planning, cognitive challenging of eating disordered attitudes and beliefs, building of skills and coping mechanisms, addressing obstacles to improvement and the prevention of relapse. Emphasis should be placed on building a collaborative therapeutic relationship and avoiding power struggles. Cognitive behavioural therapy has been frequently used in the treatment of co-morbid EDs and SUDs, however there are no randomized controlled trials. More recently evidence has been found for the efficacy of dialectical behavioural therapy in reducing both ED and substance use behaviours. CONCLUSION Future research would benefit from a meta-analysis of the current research in order to better understand the relationships between these two commonly co-occurring disorders.
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Affiliation(s)
- Claire Gregorowski
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Gerhard P Jordaan
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
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Abstract
A greater understanding of neuropsychological traits in eating disorders may help to construct a more biologically based taxonomy. The aim of this paper is to review the current evidence base of neuropsychological traits in people with eating disorders. Evidence of difficulties in set shifting, weak central coherence, emotional processing difficulties, and altered reward sensitivity is presented for people both in the acute and recovered phase of the illness. These traits are also seen in first degree relatives. At present there is limited research linking these neuropsychological traits with genetic and neuroanatomical measures. In addition to improving the taxonomy of eating disorders, neuropsychological traits may be of value in producing targeted treatments.
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Affiliation(s)
- Natalie Kanakam
- Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
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Abstract
AIM Anorexia Nervosa (AN) is a complex and clinically challenging syndrome. Intended for specialist audiences, this narrative review aims to summarise the available literature related to assessment in the adult patient context, synthesising both research evidence and clinical consensus guidelines. METHOD We provide a review of the available literature on specialist assessment of AN focusing on common trajectories into assessment, obstacles accessing assessment, common presenting issues and barriers to the assessment process, the necessary scope of assessment, and tools and techniques. It describes the further step of synthesising assessment information in ways that can inform resultant care plans. RESULTS In addition to assessment of core behaviours and diagnostic skills, considerations for the expert assessor include the functions of primary care, systemic and personal barriers, knowledge of current assessment tools and research pertaining to comorbid pathology in AN, assessing severity of illness, role of family at assessment, as well as medical, nutritional and compulsory elements of assessment. CONCLUSION Comprehensive assessment of AN in the current healthcare context still remains largely the remit of the specialist ED clinician. Assessment should remain an on-going process, paying particular attention to available empirical evidence, thereby reducing the gap between research and practice.
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Affiliation(s)
- Lois J Surgenor
- Department of Psychological Medicine, University of Otago at Christchurch, 4 Oxford Terrace, Christchurch 8140, New Zealand
| | - Sarah Maguire
- Centre for Eating and Dieting Disorders, University of Sydney, 92-94 Parramatta Road, Camberdown, New South Wales 2050, Australia
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Bueno B, Krug I, Bulik CM, Jiménez-Murcia S, Granero R, Thornton L, Penelo E, Menchón JM, Sánchez I, Tinahones FJ, Fernández-Aranda F. Late onset eating disorders in Spain: clinical characteristics and therapeutic implications. J Clin Psychol 2013; 70:1-17. [PMID: 23801539 DOI: 10.1002/jclp.22006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The literature on later age of onset (LAO) in women with eating disorders is scarce. We compared the severity of eating disorders, eating disorder subtype, and personality profiles in a clinical sample of consecutively assessed women with eating disorders with later age of onset (LAO, > = 25 years) to women with typical age of onset (TAO, <25 years). METHOD All eating disorder patients met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria and were admitted to the Eating Disorder Unit of the University Hospital of Bellvitge in Barcelona, Spain. Ninety-six patients were classified as LAO and 759 as TAO. ASSESSMENT Measures included the Eating Attitude Test-40 (EAT-40), Eating Disorders Inventory-2 (EDI-2), Bulimic Investigatory Test Edinburgh (BITE), Symptom Checklist Revised (SCL-90-R), and the Temperament and Character Inventory-Revised (TCI-R), as well as other clinical and psychopathological indices. RESULTS LAO individuals reported significantly fewer weekly vomiting episodes, fewer self-harming behaviours, less drug abuse, and lower scores on the BITE symptoms, the EDI-2 drive for thinness, and the TCI-R harm avoidance scales than TAO individuals. Conversely, the LAO group reported more current and premorbid obesity than the TAO group. CONCLUSION LAO eating disorder patients in this sample presented with milder symptomatology and less extreme personality traits. Premorbid obesity may be more relevant to LAO than TAO eating disorders and should be routinely assessed and considered when planning treatment.
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Affiliation(s)
- B Bueno
- Department of Psychiatry, University Hospital of Bellvitge; CIBER Salud Mental (CIBERSAM), ISCIII
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Meczekalski B, Podfigurna-Stopa A, Katulski K. Long-term consequences of anorexia nervosa. Maturitas 2013; 75:215-20. [PMID: 23706279 DOI: 10.1016/j.maturitas.2013.04.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 04/06/2013] [Accepted: 04/08/2013] [Indexed: 11/27/2022]
Abstract
Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed.
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Affiliation(s)
- Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Polna 33, Poznan, Poland.
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Papadopoulos FC, Karamanis G, Brandt L, Ekbom A, Ekselius L. Childbearing and mortality among women with anorexia nervosa. Int J Eat Disord 2013; 46:164-70. [PMID: 22887053 DOI: 10.1002/eat.22051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2012] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To assess the association between childbearing and mortality from anorexia nervosa (AN). METHOD A total of 5,251 females, from a population-based Swedish registry, admitted with an AN diagnosis during the period 1973-2003 were included. Standardized mortality ratios (SMR) were estimated and hazard ratios (HR) were calculated using Cox regression. RESULTS Nulliparous women had a sixfold higher mortality due to natural causes and ninefold higher mortality due to unnatural causes compared to the general population. Parous women had higher mortality compared to the general population only due to unnatural causes. Suicide was the most common cause of death. Childbearing was associated with a 65% lower mortality. One hundred forty four women out of 1,941 parous women were hospitalized perinatally for any psychiatric disorder (7.4%). DISCUSSION Childbearing is associated with lower mortality among women with AN.
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Affiliation(s)
- Fotios C Papadopoulos
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
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Allen KL, Mori TA, Beilin L, Byrne SM, Hickling S, Oddy WH. Dietary intake in population-based adolescents: support for a relationship between eating disorder symptoms, low fatty acid intake and depressive symptoms. J Hum Nutr Diet 2012; 26:459-69. [PMID: 23216519 DOI: 10.1111/jhn.12024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Relatively little is known about the dietary intake and nutritional status of community-based individuals with eating disorders. This research aimed to: (i) describe the dietary intake of population-based adolescents with an eating disorder and (ii) examine associations between eating disorder symptoms, fatty acid intake and depressive symptoms in adolescents with and without an eating disorder. METHODS Data were drawn from the Western Australian Pregnancy Cohort (Raine) Study, a population-based cohort study that has followed participants from birth to young adulthood. This research utilised self-report data from the 17-year Raine Study assessment. Participants comprised 429 female adolescents who completed comprehensive questionnaire measures on dietary intake, eating disorder symptoms and depressive symptoms. RESULTS Adolescents with an eating disorder (n = 66) reported a significantly lower intake of total fat, saturated fat, omega-6 fatty acid, starch, vitamin A and vitamin E compared to adolescents without an eating disorder (n = 363). Adolescents with an eating disorder and pronounced depressive symptoms (n = 23) also reported a significantly lower intake of polyunsaturated fat and omega-3 and omega-6 fatty acid than adolescents with an eating disorder but no marked depression (n = 43). In the eating disorder sample but not the control sample, omega-3 and omega-6 fatty acid correlated significantly and negatively with eating disorder symptoms and with depressive symptoms. CONCLUSIONS Support is provided for a relationship between low omega-3 and omega-6 fatty acid intake and depressive symptoms in adolescents with eating disorders. Research is needed to examine the feasibility and effectiveness of fatty acid supplementation in this high-risk group.
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Affiliation(s)
- K L Allen
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia; School of Psychology, The University of Western Australia, Perth, WA, Australia
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Abstract
AIM To review the main psychological and mental conditions that are manifested dentally in the form of tooth wear. These conditions include depression, eating disorders, and alcohol and drug use disorders. The paper will also review the comorbidity of these conditions and the relevance of other medical conditions and lifestyle factors, such as gastroesophageal reflux disorder, smoking and diet, in the expression of tooth wear. CONCLUSION A holistic, multidisciplinary, healthcare approach is required in management of tooth wear patients with underlying mental health disorders. Dentists and Dental Care Professionals can have an important role in identifying these mental disorders through the observed tooth wear. They can also play a key role in monitoring patients' response and compliance to medical treatment through the monitoring of tooth wear progression and expression.
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Affiliation(s)
- Khaled E Ahmed
- Clinical Academic Fellow, Restorative Dentistry Group, University of Glasgow Dental School, Glasgow, UK.
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Hintsanen M, Jokela M, Cloninger CR, Pulkki-Råback L, Hintsa T, Elovainio M, Josefsson K, Rosenström T, Mullola S, Raitakari OT, Keltikangas-Järvinen L. Temperament and character predict body-mass index: a population-based prospective cohort study. J Psychosom Res 2012; 73:391-7. [PMID: 23062814 DOI: 10.1016/j.jpsychores.2012.08.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 08/17/2012] [Accepted: 08/20/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Personality is a potential factor determining individual differences in body-weight change. The current study examines associations between personality traits and change in body-mass index (BMI) over six years. METHOD The participants were 762 women and 648 men aged 24-39 years at the base-line. Personality was assessed with the Temperament and Character Inventory (TCI). For calculating BMI, height and weight were assessed at a clinic. RESULTS Longitudinal analyses conducted with linear regressions showed that in men and women, higher Novelty seeking predicted higher BMI (p<.05), whereas lower Reward dependence predicted higher BMI in women (p<.05) when baseline BMI was taken into account. In addition, cross-sectional associations for several TCI traits were found in age and education adjusted analyses. In women, higher Self transcendence (p<.05) was associated with higher BMI. In men, higher Novelty seeking (p<.001) and Self transcendence (p<.01) and lower Self directedness (p<.01) and Cooperativeness (p<.05) were associated with higher BMI. In addition, analyses of variance were conducted for multidimensional trait profiles (trait combinations). Significant temperament profile related differences in BMI were found in all analyses in women. Associations with character profiles and in men were less consistent. CONCLUSION The results give support for personality playing a role in weight gain. Knowledge on personality may be used for motivating weight loss and designing weight management interventions.
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Affiliation(s)
- Mirka Hintsanen
- Helsinki Collegium for Advanced Studies, Unit of Personality Work and Organizational Psychology, Center for Research on Teaching, Department of Teacher Education, University of Helsinki, Finland.
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Dooley-Hash S, Banker JD, Walton MA, Ginsburg Y, Cunningham RM. The prevalence and correlates of eating disorders among emergency department patients aged 14-20 years. Int J Eat Disord 2012; 45:883-90. [PMID: 22570093 DOI: 10.1002/eat.22026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2012] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study describes the rates of eating disorders in patients who present to the emergency department (ED) for any reason and examines the relationship between eating disorders, depression, and substance use in these patients. METHOD ED patients aged 14-20 years (n = 942) completed a computerized questionnaire. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, and public assistance), body mass index, substance use, and depression. RESULTS Sixteen percent of patients screened positive for an eating disorder. These patients were more likely to also screen positive for depression and substance use. Males accounted for 26.6% of all eating disorders, and no difference was seen in rates across ethnic or income groups. DISCUSSION Eating disorders are common amongst all patients aged 14-20 years presenting to the ED and are associated with high rates of psychiatric comorbidity.
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Affiliation(s)
- Suzanne Dooley-Hash
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
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Lee NM, Carter A, Owen N, Hall WD. The neurobiology of overeating. Treating overweight individuals should make use of neuroscience research, but not at the expense of population approaches to diet and lifestyle. EMBO Rep 2012; 13:785-90. [PMID: 22898978 DOI: 10.1038/embor.2012.115] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Natalia M Lee
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia
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Miettunen J, Raevuori A. A meta-analysis of temperament in axis I psychiatric disorders. Compr Psychiatry 2012; 53:152-66. [PMID: 21565334 DOI: 10.1016/j.comppsych.2011.03.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 03/06/2011] [Accepted: 03/12/2011] [Indexed: 12/20/2022] Open
Abstract
This article reports on a meta-analysis of Cloninger's temperament dimensions (novelty seeking, harm avoidance, reward dependence, and persistence) in individuals with lifetime psychiatric disorders compared with controls and on interdisorder comparisons between these disorders. Nine disorders from 75 studies were included in the meta-analyses. The most consistent feature was elevated harm avoidance: compared with the controls, harm avoidance was higher in all diagnostic groups studied except for those with alcohol use disorders. The increase in effect sizes in harm avoidance scores varied from a very large (d = 2.66) in social phobia to a small effect (effect size, d = 0.29) in alcohol use disorders. In other dimensions, differences between cases and controls were relatively small. However, in pairwise comparisons, notable differences also in other dimensions emerged: in novelty seeking, the lowest scores were in social phobia (d = -0.87) and the highest in bulimia nervosa (d = 0.33); in reward dependence, the lowest scores were in schizophrenia (d = -0.36) and the highest in social phobia (d = 0.12); and in persistence, the lowest scores were in social phobia (d = -0.30) and the highest in anorexia nervosa (d = 0.49). The provided data should be taken into account in the future studies on suggestive vulnerability markers for psychiatric morbidity.
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Affiliation(s)
- Jouko Miettunen
- Department of Psychiatry, University of Oulu, PO Box 5000, 90014 Oulu, Finland.
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Denoth F, Siciliano V, Iozzo P, Fortunato L, Molinaro S. The association between overweight and illegal drug consumption in adolescents: is there an underlying influence of the sociocultural environment? PLoS One 2011; 6:e27358. [PMID: 22110632 DOI: 10.1371/journal.pone.0027358] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 10/14/2011] [Indexed: 12/28/2022] Open
Abstract
Background The aims of the study were to: a) Examine the distribution of gender-stratified body mass index (BMI), eating attitudes and use of addictive substances, under the hypothesis of a confluent prevalence of weight abnormalities, eating disorders and substance abuse. b) Demonstrate the extent to which family, peer-related and psychosocial factors are common elements in categories of compulsive behaviour. Methodology/Principal Findings In the present cross-sectional study, data were collected through self reported questionnaires administered to a large sample of 33,185 15–19 years old adolescents (ESPAD®Italia), divided into weight categories based on the BMI percentile distribution. Multinomial analyses were adopted to address the influence of social, family, leisure time factors, Eating Attitude Test (EAT26) on the association between weight categories and drug use. Recent drugs use was more frequent in overweight and underweight adolescents (p<0.05), especially in females. An EAT26 score ≥20 was more common in overweight adolescents. Multinomial analysis abolished the relationship between overweight and the use of most drugs, implicating self-esteem, parents' educational level, and friendships as mediators of the association. Within the overweight category, adolescents reporting recent drug use, showed greater frequency of having drug-abusing friends (∼80%), and severe problems with parents and school (∼30%) compared to overweight adolescents without recent drug use. Conclusion The frequent association of overweight and substance use and the presence of common underlying social factors, highlights the need for an interdisciplinary approach involving individual-focused treatment models as well as public health, social and environmental changes to reduce food- and substances-related problems.
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Rosas-Vargas H, Martínez-Ezquerro JD, Bienvenu T. Brain-derived neurotrophic factor, food intake regulation, and obesity. Arch Med Res 2011; 42:482-94. [PMID: 21945389 DOI: 10.1016/j.arcmed.2011.09.005] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 08/10/2011] [Indexed: 12/14/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) is a neurotrophin that plays a fundamental role in development and plasticity of the central nervous system (CNS). It is currently recognized as a major participant in the regulation of food intake. Multiple studies have shown that different regulators of appetite such as leptin, insulin and pancreatic polypeptide (PP) potentially exert anorexigenic effects through BDNF. Low circulating levels of BDNF are associated with a higher risk of eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN). Strict food restriction reduces BDNF and may trigger binge-eating episodes and weight gain. The existence of mutations that cause haploinsufficiency of BDNF as well as some genetic variants, notably the BDNF p.Val66Met polymorphism, are also associated with the development of obese phenotypes and hyperphagia. However, association of the Met allele with AN and BN, which have different phenotypic characteristics, shows clearly the existence of other relevant factors that regulate eating behavior. This may, in part, be explained by the epigenetic regulation of BDNF through mechanisms like DNA methylation and histone acetylation. Environmental factors, primarily during early development, are crucial to the establishment of these stable but reversible changes that alter the transcriptional expression and are transgenerationally heritable, with potential concomitant effects on the development of eating disorders and body weight control.
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Krug I, Root T, Bulik C, Granero R, Penelo E, Jiménez-Murcia S, Fernández-Aranda F. Redefining phenotypes in eating disorders based on personality: a latent profile analysis. Psychiatry Res 2011; 188:439-45. [PMID: 21664698 DOI: 10.1016/j.psychres.2011.05.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 04/14/2011] [Accepted: 05/22/2011] [Indexed: 11/19/2022]
Abstract
To conduct a latent profile analysis (LPA) in eating disorder (ED) patients using temperament and character (TCI-R) measures as indicators. 1312 ED patients including those with anorexia nervosa (AN), bulimia nervosa (BN) and EDNOS were assessed. The final LPA solution was validated using demographics, clinical variables, ED symptomatology (EDI-2) and impulsive behaviors. The best-fitting model consisted of a six-profile solution using the seven subscales of the TCI-R. These profiles were labeled: "self-focused", "inhibited", "average", "impulsive", "adaptive" and "maladaptive". Validation analyses indicated that the "inhibited" and "maladaptive" profiles generally presented with the highest values for ED symptomatology and impulsive behaviors. Whereas high levels of Harm Avoidance and low levels of Novelty Seeking and Persistence characterized the "inhibited" profile, the "maladaptive" profile presented with low levels of Reward Dependence, Self-Directedness and Cooperativeness. The most favorable results on the other hand were exhibited by the "adaptive" profile, characterized by high scores on Reward Dependence, Self-Directedness, Cooperativeness and low levels on Novelty Seeking. Finally, when our six-profile solution was compared with the DSM-IV ED diagnoses, significant differences among profiles and ED diagnoses were observed. Our study shows that ED patients can be meaningfully grouped according to temperament and character.
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Affiliation(s)
- Isabel Krug
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain and CIBER, Fisiopatología de la Obesidad y Nutricion (CIBERObn), Instituto Carlos III, Spain
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Abstract
OBJECTIVE To identify factors associated with incidence and course of broadly defined binge eating disorder (BED) in pregnancy. METHOD As a part of the Norwegian Mother and Child Cohort Study (MoBa), 45,644 women completed a questionnaire at approximately 18 weeks of gestation. RESULTS Incidence of BED was significantly associated with lifetime sexual abuse, lifetime physical abuse, lifetime major depression, symptoms of anxiety and depression, low life satisfaction, low self-esteem, low partner relationship satisfaction, smoking, alcohol use, lack of social support, and several weight-related factors. Continuation was negatively associated with thoughts of being overweight before pregnancy. Remission was positively associated with thoughts of being overweight before pregnancy and negatively associated with overvaluation of weight. DISCUSSION Onset of BED in pregnancy was associated with psychological, social and weight-related factors, as well as health behaviors and adverse life events. In women with prepregnancy BED, thoughts of being overweight before pregnancy and overvaluation of weight were associated with course of BED during pregnancy.
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Affiliation(s)
- Cecilie Knoph Berg
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
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Benton D. The plausibility of sugar addiction and its role in obesity and eating disorders. Clin Nutr 2009; 29:288-303. [PMID: 20056521 DOI: 10.1016/j.clnu.2009.12.001] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Revised: 12/02/2009] [Accepted: 12/06/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND & AIMS To consider the hypothesis that addiction to food, or more specifically sucrose, plays a role in obesity and eating disorders. METHODS By considering the relevant literature a series of predictions were examined, derived from the hypothesis that addiction to sucrose consumption can develop. Fasting should increase food cravings, predominantly for sweet items; cravings should occur after an overnight fast; the obese should find sweetness particularly attractive; a high-sugar consumption should predispose to obesity. More specifically predictions based on the hypothesis that addiction to sugar is central to bingeing disorders were developed. Dieting should predate the development of bingeing; dietary style rather than psychological, social and economic factors should be predispose to eating disorders; sweet items should be preferentially consumed while bingeing; opioid antagonists should cause withdrawal symptoms; bingeing should develop at a younger age when there is a greater preference for sweetness. RESULTS The above predications have in common that on no occasion was the behaviour predicted by an animal model of sucrose addiction supported by human studies. CONCLUSION There is no support from the human literature for the hypothesis that sucrose may be physically addictive or that addiction to sugar plays a role in eating disorders.
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Affiliation(s)
- David Benton
- Department of Psychology, University of Swansea, Swansea SA2 8PP, Wales, United Kingdom.
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