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Zheng Q, Feng Y, Du J, Xu S, Ma Z, Wang Y. Specific effects of cumulative childhood trauma on suicidality among youths. J Affect Disord 2024; 358:260-269. [PMID: 38705526 DOI: 10.1016/j.jad.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Suicidality was very high among individuals who suffered from childhood trauma. The distribution of cumulative childhood trauma among youths remains unclear, as well as the specific effects of cumulative childhood trauma on suicidality. This study attempted to explore the distribution of cumulative childhood trauma and examine the specific effects of cumulative childhood trauma on suicidality. METHODS A cross-sectional design was employed in this study, with 117,769 college students recruited from 63 universities in Jilin Province, China. All variables were measured by corresponding self-report questionnaires. The Venn diagram was used to represent the distribution of single and cumulative childhood trauma. ANOVA and chi-square tests were conducted to identify the high-risk suicide groups. Multiple linear regression analysis was performed to examine risk factors for suicidality for overlapping subtypes. RESULTS 27,671 (23.5%) participants reported suffering from childhood trauma, of which 49.5% were male (Mage = 19.59, SD = 1.76). The "physical neglect" group accounted for the largest proportion (31.5%). Suicidality was the highest in the "overlap of childhood neglect, emotional abuse, and physical abuse" group (2.0%). Depression, obsessive-compulsive disorder, and post-traumatic stress disorder were common risk factors for suicidality. LIMITATIONS This study was limited by cross-sectional studies and self-report bias. CONCLUSIONS The childhood trauma subtype group with the largest proportion was not necessarily the highest suicidality. Both the largest group and the highest-risk suicide group require special attention to their respective risk factors.
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Affiliation(s)
- Qiaoqing Zheng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
| | - Jinmei Du
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China; and School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Linsenmeyer W, Stiles D, Garwood S, Giedinghagen A, Lewis C, Strand G. The Sick, Control, One Stone, Fat, Food (SCOFF) is a Valid Eating Disorder Questionnaire to Use With Transgender Youth. Clin Pediatr (Phila) 2024; 63:971-976. [PMID: 37712557 DOI: 10.1177/00099228231200754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Transgender youth experience elevated rates of eating disorders, yet few screening measures have been validated with transgender patients. The purpose of this study was to provide initial evidence for the internal consistency and convergent validity of the Sick, Control, One Stone, Fat, Food (SCOFF) in a sample of transgender youth. Two hundred eight participants completed the SCOFF as part of a routine screening protocol. Exploratory factor analysis and confirmatory factor analysis were used to establish the factor structure of the SCOFF in this sample. Relationships between the SCOFF, Adolescent Binge Eating Disorder (ADO-BED), Nine-Item Avoidant/Restrictive Intake Disorder (NIAS), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), and demographic characteristics were explored. The SCOFF was significantly related to all convergent validity variables, with moderate correlations with other eating disorder scales (ADO-BED and NIAS). The SCOFF is a valid measure to screen for eating disorders among transgender youth and young adults.
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Affiliation(s)
| | | | - Sarah Garwood
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - Christopher Lewis
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Gretta Strand
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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3
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An Z, Kwag KH, Kim M, Yang JW, Moon JJ, Treasure J, Kim YR. The effect of training to target cognitive biases towards social rejection in eating disorders. EUROPEAN EATING DISORDERS REVIEW 2024; 32:718-730. [PMID: 38459737 DOI: 10.1002/erv.3083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 02/06/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE This study examined the effect of cognitive bias modification for interpretation (CBM-I) training in Korean women with eating disorders (EDs). METHOD Sixty-three women with EDs participated in the study. Participants were randomly assigned to the intervention group where they received six sessions of CBM-I training (n = 31) in addition to treatment-as-usual or were put on a waiting list (n = 32). Participants' interpretation and attention biases, emotion regulation, affect, and ED psychopathology were assessed at baseline, end-of-intervention (4 weeks), and follow-up (8 weeks). RESULTS Participants who completed the CBM-I training displayed greater reductions in negative interpretation bias (Δη2 = 0.107) and emotion dysregulation (Δη2 = 0.085) with medium to large effect sizes compared to the control group, which were maintained from baseline to follow-up. Disengagement from negative faces and a focus on positive faces was found in the intervention group with a moderate effect size at the end-of-intervention (Δη2 = 0.090). Both intervention and control groups showed improvements in ED psychopathology. Baseline neuroticism was positively correlated with CBM-I effect. DISCUSSION The results suggest that modifying interpretation bias towards ambiguous social stimuli might be an effective adjuvant treatment to reduce negative expectations of social situations and improve emotion regulation in women with bulimia nervosa and anorexia nervosa.
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Affiliation(s)
- Zhen An
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Kyung Hwa Kwag
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
| | - Mirihae Kim
- Department of Psychology, Duksung Women's University, Seoul, Republic of Korea
| | - Jae-Won Yang
- Department of Psychology, The Catholic University of Korea, Bucheon, Republic of Korea
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Janet Treasure
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Youl-Ri Kim
- Institute of Eating Disorders and Mental Health, Inje University, Seoul, Republic of Korea
- Department of Psychiatry, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea
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Hart M, Hirneth S, Mendelson J, Jenkins L, Pursey K, Waller G. Brief cognitive behavioural therapy for eating disorders symptomatology among a mixed sample of adolescents and young adults in primary care: A non-randomised feasibility and pilot study. EUROPEAN EATING DISORDERS REVIEW 2024; 32:676-686. [PMID: 38413477 DOI: 10.1002/erv.3075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/21/2024] [Accepted: 02/02/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Brief and accessible therapies for people with an eating disorder is an important health target. Ten-session cognitive behavioural therapy (CBT-T) is a brief treatment evaluated in people with a non-underweight eating disorder. This study aimed to evaluate the feasibility and preliminary effectiveness of CBT-T for young people in primary care. METHOD This cohort pilot study used group (adolescents vs. young adults) by time (over four time points) Generalised Linear Mixed Model analysis. Participants included 13-25-year-olds attending an early intervention mental health service, receiving 10 sessions of CBT-T. Feasibility was assessed using recruitment, retention and satisfaction. Eating and other pathology measures were administered at baseline, weeks four and 10, and 12-week follow-up. RESULTS Of the 63 commencing treatment, 38 completed 10 CBT-T sessions (60%). Most (94%) reported high treatment satisfaction. Significant reductions in eating pathology, depression and stress were found. Age group did not yield differences in CBT-T outcome, with large to very large effect sizes across outcome variables. Anxiety was associated with attrition. CONCLUSION This study provides preliminary support for the use of CBT-T in primary care, across adolescence and early adulthood. Findings require replication in other clinical settings and comparison to other clinical approaches and control populations.
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Affiliation(s)
- Melissa Hart
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter New England Mental Health Service, Newcastle, New South Wales, Australia
| | - Stephen Hirneth
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jane Mendelson
- Hunter New England Central Coast Primary Health Network, Tamworth, New South Wales, Australia
| | - Laura Jenkins
- Hunter New England Mental Health Service, Newcastle, New South Wales, Australia
| | - Kirrilly Pursey
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton, New South Wales, Australia
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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Kiviruusu O, Ranta K, Lindgren M, Haravuori H, Silén Y, Therman S, Lehtonen J, Sares-Jäske L, Aalto-Setälä T, Marttunen M, Suvisaari J. Mental health after the COVID-19 pandemic among Finnish youth: a repeated, cross-sectional, population-based study. Lancet Psychiatry 2024; 11:451-460. [PMID: 38760112 DOI: 10.1016/s2215-0366(24)00108-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND High levels of mental health problems among young people were reported during the COVID-19 pandemic, but studies of the post-pandemic period are scarce. We assessed mental health problems among Finnish youth before, during, and after the COVID-19 pandemic using nationwide population-based samples. Our aim was to examine in which direction the heightened levels of adolescent mental health problems have developed after the pandemic. METHODS In this national, repeated cross-sectional, population-based study in Finland, we recruited students at lower and upper secondary level (aged 13-20 years) who were taking part in the Finnish School Health Promotion (SHP) survey in 2015-23 (119 681-158 897 participants per round). The SHP is based on total sampling and conducted biennially between March and May. Self-reports covered the seven-item Generalized Anxiety Disorder Scale; the two-item Patient Health Questionnaire for depression; the Mini Social Phobia Inventory for social anxiety; the Short Warwick-Edinburgh Mental Wellbeing Scale for mental wellbeing; loneliness; the Sick, Control, One Stone, Fat, Food measure for disordered eating; and suicidality (suicidal ideation, deliberate self-harm, and suicide attempts). Scales were dichotomised using validated cutoffs. Presence of any and comorbid mental health problems was assessed. Logistic (for dichotomised outcomes) and linear (for Short Warwick-Edinburgh Mental Wellbeing Scale) mixed effects models were used to analyse the effect of survey year on mental health, controlling for sociodemographic background factors and stratified by gender and school level. Cisgender and transgender youth were compared. FINDINGS Between 2015 and 2023, the SHP study recruited 722 488 students (371 634 [51·6%] girls and 348 857 [48·4%] boys) with a mean age of 15·8 years (SD 1·3) who were either in the eighth and ninth grades of comprehensive school or the first and second years of general and vocational upper secondary schools in Finland. The proportion of participants with generalised anxiety, depression, and social anxiety symptoms above the cutoff increased from pre-COVID-19 levels to 2021 and remained at these higher levels in 2023 among all study groups. Among girls in lower secondary education, prevalence of generalised anxiety, depression, and social anxiety symptoms increased from 2021 to 2023, as did social anxiety among girls in upper secondary education. Among boys, the proportion with social anxiety symptoms decreased between 2021 and 2023. Mental wellbeing scores decreased in all groups between 2021 and 2023, and disordered eating increased in girls, and in boys in lower secondary education. Suicidality increased in girls but not in boys. Loneliness was the only measure to show improvement in all groups from 2021 to 2023. In 2023, 55 895 (72·6%) of 76 994 girls and 22 718 (32·8%) of 69 205 boys reported at least one mental health problem, and 37 250 (48·4%) girls and 9442 (13·6%) boys reported comorbid mental health problems. Among both transfeminine and transmasculine youth, the prevalence of generalised anxiety and depression symptoms decreased from 2021 to 2023, but compared with cisgender youth, the proportions were significantly higher throughout. INTERPRETATION The effects of the COVID-19 pandemic on youth mental health could be long lasting. In this study, the substantial change for the better among transgender youth was a positive exception. Providing adequate support and treatment for young people with poor mental health is essential, but solutions to the mental health crisis need to address a wider societal perspective and should be developed in partnership with young people. FUNDING NordForsk, Research Council of Finland. TRANSLATIONS For the Finnish and Swedish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Olli Kiviruusu
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Klaus Ranta
- Faculty of Social Sciences, Tampere University, Tampere, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maija Lindgren
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Henna Haravuori
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Wellbeing Services County of Lapland, Rovaniemi, Finland
| | - Yasmina Silén
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Sebastian Therman
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jukka Lehtonen
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Gender Studies, University of Helsinki, Helsinki, Finland
| | - Laura Sares-Jäske
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Terhi Aalto-Setälä
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mauri Marttunen
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Mauldin K, Pignotti GAP, Gieng J. Measures of nutrition status and health for weight-inclusive patient care: A narrative review. Nutr Clin Pract 2024. [PMID: 38796769 DOI: 10.1002/ncp.11158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/07/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024] Open
Abstract
In healthcare, weight is often equated to and used as a marker for health. In examining nutrition and health status, there are many more effective markers independent of weight. In this article, we review practical and emerging clinical applications of technologies and tools used to collect non-weight-related data in nutrition assessment, monitoring, and evaluation in the outpatient setting. The aim is to provide clinicians with new ideas about various types of data to evaluate and track in nutrition care.
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Affiliation(s)
- Kasuen Mauldin
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
- Clinical Nutrition, Stanford Health Care, Stanford, California, USA
| | - Giselle A P Pignotti
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
| | - John Gieng
- Department of Nutrition, Food Science, and Packaging, San Jose State University, San Jose, California, USA
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Dinhof C, Humer E, Haider K, Rabenstein R, Jesser A, Pieh C, Probst T, Gächter A. Comprehensive examination of support needs and mental well-being: a mixed-method study of the Austrian general population in times of crisis. Front Public Health 2024; 12:1345796. [PMID: 38813409 PMCID: PMC11133677 DOI: 10.3389/fpubh.2024.1345796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction In the recent years, the Austrian general population has faced a confluence of multiple crises. This study investigates the support wishes and mental health parameters of the Austrian general population aiming to comprehending the unmet needs and providing guidance for future psychosocial interventions and research endeavors. Methods 1,031 participants attended the online survey and one third (n = 332) wished for further support to improve mental well-being in April 2022. A total of 280 participants accompanied their support wish with written accounts. Participants' mental health status was evaluated using the PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), PSS-10 (perceived stress), CAGE (alcohol abuse), WHO-5 (well-being), and the SCOFF (eating disorder) questionnaires. Data analysis employed a mixed-methods approach. Results The preeminent support wish identified was the need for professional mental support (29.3%), followed by communication (21.6%), other professional support except mental and medical support (13.9%). In line with these findings, participants expressing a support wish experienced increased mental health distress across all assessed parameters. Conclusion The findings indicate the presence of a vulnerable population within the Austrian general population, which may benefit from targeted support interventions. Consequently, this study contributes to the identification of unmet support needs among the Austrian populace during times of crisis, facilitating the development and enhancement of precisely tailored intervention strategies.
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Affiliation(s)
- Carina Dinhof
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
- Division of Psychotherapy, Department of Psychology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria
| | - Katja Haider
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
| | - Rafael Rabenstein
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
| | - Andrea Jesser
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Vienna, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
| | - Thomas Probst
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
- Division of Psychotherapy, Department of Psychology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Afsaneh Gächter
- Department for Psychosomatic Medicine and Psychotherapy, University of Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
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Eguren-García I, Sumalla-Cano S, Conde-González S, Vila-Martí A, Briones-Urbano M, Martínez-Díaz R, Elío I. Risk Factors for Eating Disorders in University Students: The RUNEAT Study. Healthcare (Basel) 2024; 12:942. [PMID: 38727499 PMCID: PMC11083517 DOI: 10.3390/healthcare12090942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
The purpose of the study is to assess the risk of developing general eating disorders (ED), anorexia nervosa (AN), and bulimia nervosa (BN), as well as to examine the effects of gender, academic year, place of residence, faculty, and diet quality on that risk. Over two academic years, 129 first- and fourth-year Uneatlántico students were included in an observational descriptive study. The self-administered tests SCOFF, EAT-26, and BITE were used to determine the participants' risk of developing ED. The degree of adherence to the Mediterranean diet (MD) was used to evaluate the quality of the diet. Data were collected at the beginning (T1) and at the end (T2) of the academic year. The main results were that at T1, 34.9% of participants were at risk of developing general ED, AN 3.9%, and BN 16.3%. At T2, these percentages were 37.2%, 14.7%, and 8.5%, respectively. At T2, the frequency of general ED in the female group was 2.5 times higher (OR: 2.55, 95% CI: 1.22-5.32, p = 0.012). The low-moderate adherence to the MD students' group was 0.92 times less frequent than general ED at T2 (OR: 0.921, 95%CI: 0.385-2.20, p < 0.001). The most significant risk factor for developing ED is being a female in the first year of university. Moreover, it appears that the likelihood of developing ED generally increases during the academic year.
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Affiliation(s)
- Imanol Eguren-García
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
| | - Sandra Sumalla-Cano
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Department of Health, Nutrition and Sport, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
| | - Sandra Conde-González
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
| | - Anna Vila-Martí
- Research Group M3O, Methodology, Methods, Models and Outcomes of Health and Social Sciences, Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, 08500 Vic, Spain;
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), 08500 Vic, Spain
| | - Mercedes Briones-Urbano
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Department of Health, Nutrition and Sport, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
- Department of Health, Universidad Internacional Iberoamericana, Arecibo, PR 00613, USA
| | - Raquel Martínez-Díaz
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Faculty of Health Sciences, Universidade do Cuanza, Cuito EN250, Bié, Angola
- Faculty of Health Sciences, Universidad de La Romana, La Romana 22000, Dominican Republic
| | - Iñaki Elío
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain; (I.E.-G.); (S.S.-C.); (S.C.-G.); (M.B.-U.); (R.M.-D.)
- Department of Health, Nutrition and Sport, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
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9
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Goto R, Pinchuk I, Kolodezhny O, Pimenova N, Kano Y, Skokauskas N. Mental Health of Adolescents Exposed to the War in Ukraine. JAMA Pediatr 2024; 178:480-488. [PMID: 38526470 PMCID: PMC10964160 DOI: 10.1001/jamapediatrics.2024.0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/17/2024] [Indexed: 03/26/2024]
Abstract
Importance With exposure to traumatic events and reduced access to mental health care, adolescents of Ukraine during the Russian invasion since February 2022 are at high risk of psychiatric conditions. However, the actual mental health burden of the war has scarcely been documented. Objective To investigate the prevalence of a positive screen for psychiatric conditions among adolescents amidst the ongoing war in Ukraine as well as their associations with war exposure. Design, Setting, and Participants This cross-sectional study reports the results from the first wave of the Adolescents of Ukraine During the Russian Invasion cohort, the largest cohort study on Ukrainian adolescents' mental health during the Russian invasion since 2022. Using self-reported questionnaires, the national-level prevalence of a positive screen for various psychiatric conditions was estimated among adolescents aged 15 years or older attending secondary school in Ukraine in person or online (including those residing abroad but attending Ukrainian secondary school online) and the prevalence among Ukrainian adolescents living abroad due to the war. Exposure Self-reported exposure to war. Main Outcomes and Measures A positive screen for psychiatric conditions. The association between self-reported war exposure and a positive screen for each of the psychiatric conditions was also evaluated. Results A total of 8096 Ukrainian adolescents (4988 [61.6%] female) living in Ukraine or abroad were included in the analyses. Based on national-level estimates, 49.6% of the adolescents were directly exposed to war, 32.0% screened positive for moderate or severe depression, 17.9% for moderate or severe anxiety, 35.0% for clinically relevant psychological trauma, 29.5% for eating disorders, and 20.5% for medium risk or higher of substance use disorder. The burden of psychiatric symptoms was similarly large among Ukrainian adolescents living abroad. Adolescents exposed to war were more likely to screen positive for depression (prevalence ratio [PR], 1.39; 95% CI, 1.29-1.50), anxiety (PR, 1.62; 95% CI, 1.45-1.81), clinically relevant psychological trauma (PR, 1.41; 95% CI, 1.32-1.50), eating disorders (PR, 1.21; 95% CI, 1.12-1.32), and substance use disorder (PR, 1.11; 95% CI, 0.98-1.25). Conclusions and Relevance The findings of this study suggest that the mental health burden of Ukrainian adolescents amidst the Russian invasion of Ukraine is substantial. Mental health care efforts to alleviate the mental health burden of Ukrainian adolescents are needed.
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Affiliation(s)
- Ryunosuke Goto
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
- Nagano Children’s Hospital, Azumino, Japan
| | - Irina Pinchuk
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Oleksiy Kolodezhny
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Nataliia Pimenova
- Institute of Psychiatry, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Yukiko Kano
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
- World Psychiatric Association, Geneva, Switzerland
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10
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Sourouni M, Estermann J, Bitterlich N, Weidlinger S, Bachmann A, Stute P. Unmet clinical needs in women with polycystic ovary syndrome in regard to mental health: a cross-sectional study. Arch Gynecol Obstet 2024; 309:2115-2126. [PMID: 38466411 PMCID: PMC11018694 DOI: 10.1007/s00404-024-07452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) management has hardly been standardized until recent years. Despite the existence of a detailed, evidence-based guideline published by the European Society of Human Reproduction and Embryology (ESHRE), it remains unclear to what extent healthcare providers adhere to this guideline. Our aim is to evaluate the gynaecological medical care provided in women with PCOS, particularly in terms of mental health, from the patients' perspective. METHODS For this cross-sectional online cohort study in women with PCOS, we designed a standardized, non-validated questionnaire covering aesthetic aspects, metabolism, menstrual cycle, reproduction, mental health, and prevention of chronic non-communicable diseases. RESULTS Among 1879 participants, various mental health aspects were reported: body image (n = 1879), eating patterns/habits (n = 1878), and emotional well-being (n = 1874). Although nearly all women (99.7%) reported complaints on at least one session of mental health, consultation rates were low (body image 9.7%, eating patterns/habits 16.6%, emotional well-being 4.4%). Mean satisfaction with counselling on the different domains varied from moderate to fairly satisfying, with scores of 56.0 points (SD 31.7), 53.5 points (SD 32.0), and 63.7 points (SD 30.2), respectively. More complaints were associated with lower satisfaction. The overall satisfaction with the management provided by the healthcare practitioner (HCP) was low, averaging 36.5 points (SD 29.7). Consequently, most women wished for more counselling (58.9%). CONCLUSION Women affected by PCOS are not properly managed according to ESHRE guideline in regard to mental health issues. Overall consultation rates and corresponding satisfaction with management were poor, highlighting the need for significant improvements in healthcare provision.
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Affiliation(s)
- Marina Sourouni
- Department for Gynaecological Endocrinology and Fertility Disorders, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Susanna Weidlinger
- Department of Obstetrics and Gynaecology, University Hospital Inselspital, Friedbuehlstrasse 19, 3010, Bern, Switzerland
| | - Annette Bachmann
- Division of Gynaecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital Frankfurt, Frankfurt, Germany
| | - Petra Stute
- Department of Obstetrics and Gynaecology, University Hospital Inselspital, Friedbuehlstrasse 19, 3010, Bern, Switzerland.
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Frontini R, Costa C, Baptista S, Garcia CDC, Vian-Lains A. Measurement-Based Care in Youth: An Opportunity for Better Clinical Outcomes? Healthcare (Basel) 2024; 12:910. [PMID: 38727467 PMCID: PMC11083159 DOI: 10.3390/healthcare12090910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Measurement-based care (MBC) is a procedure in which systematic and routine assessments are performed. Through this practice, clinicians can verify the progress of the symptomatology of the patient and adapt the appointments and the intervention to the current symptoms. Studies have reflected on the importance and the benefits of this type of procedure in the adult population, and have shown positive results. However, there is a lack of evidence concerning the remaining populations. Regarding youth, for instance, few articles have evaluated the benefits of using this procedure in clinical practice. However, research focused on this topic has revealed positive results, especially when clinicians were loyal to the MBC procedures. Still, further research is needed. This letter aims to share the methodology used by our multidisciplinary team, composed of psychologists and psychiatrists, in a clinical context at the Hospital Cruz Vermelha, Lisboa, applied to the adult population; the objective is to share and discuss some alterations that could be made to our evaluation protocol to enable the same to be used with the youth population. We believe that implementing MBC for youth is crucial for several reasons, including enhanced treatment efficacy, more personalized treatment, a reduced reliance on subjectivity, and empowerment not only of patients but also families.
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Affiliation(s)
- Roberta Frontini
- Clínica de Neurociências e Saúde Mental, Hospital Cruz Vermelha, 1500-048 Lisboa, Portugal; (C.C.); (S.B.); (A.V.-L.)
- Faculdade de Ciências Humanas, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal;
| | - Catarina Costa
- Clínica de Neurociências e Saúde Mental, Hospital Cruz Vermelha, 1500-048 Lisboa, Portugal; (C.C.); (S.B.); (A.V.-L.)
| | - Sílvia Baptista
- Clínica de Neurociências e Saúde Mental, Hospital Cruz Vermelha, 1500-048 Lisboa, Portugal; (C.C.); (S.B.); (A.V.-L.)
| | | | - António Vian-Lains
- Clínica de Neurociências e Saúde Mental, Hospital Cruz Vermelha, 1500-048 Lisboa, Portugal; (C.C.); (S.B.); (A.V.-L.)
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12
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Zhang J, Cui S, Xu Y, Cui T, Barnhart WR, Ji F, Nagata JM, He J. Introducing Diagnostic Classification Modeling as an Unsupervised Method for Screening Probable Eating Disorders. Assessment 2024:10731911241247483. [PMID: 38676565 DOI: 10.1177/10731911241247483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Screening for eating disorders (EDs) is an essential part of the prevention and intervention of EDs. Traditional screening methods mostly rely on predefined cutoff scores which have limitations of generalizability and may produce biased results when the cutoff scores are used in populations where the instruments or cutoff scores have not been validated. Compared to the traditional cutoff score approach, the diagnostic classification modeling (DCM) approach can provide psychometric and classification information simultaneously and has been used for diagnosing mental disorders. In the present study, we introduce DCM as an innovative and alternative approach to screening individuals at risk of EDs. To illustrate the practical utility of DCM, we provide two examples: one involving the application of DCM to examine probable ED status from the 12-item Short form of the Eating Disorder Examination-Questionnaire (EDE-QS) to screen probable thinness-oriented EDs and the Muscularity-Oriented Eating Test (MOET) to screen probable muscularity-oriented EDs.
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Affiliation(s)
| | - Shuqi Cui
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yinuo Xu
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | | | | | - Feng Ji
- University of Toronto, Ontario, Canada
| | - Jason M Nagata
- University of California, San Francisco, California, USA
| | - Jinbo He
- The Chinese University of Hong Kong, Shenzhen, Guangdong, China
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13
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Coop A, Clark A, Morgan J, Reid F, Lacey JH. The use and misuse of the SCOFF screening measure over two decades: a systematic literature review. Eat Weight Disord 2024; 29:29. [PMID: 38652332 PMCID: PMC11039549 DOI: 10.1007/s40519-024-01656-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested. METHODS The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors. RESULTS 180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use. CONCLUSION This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Amy Coop
- Schoen Clinic Newbridge, Birmingham, UK
| | | | - John Morgan
- St George's, University of London, London, UK
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14
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Prosser A, Leslie F. Eating disorders: is there a correlation between severity of physical compromise and admission outcomes? BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S10-S16. [PMID: 38639753 DOI: 10.12968/bjon.2024.33.8.s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND The Medical Emergencies in Eating Disorders (MEED) report was first released by the Royal College of Psychiatrists in 2022 (updated 2023) to aid clinicians in recognising medical compromise due to an eating disorder and to provide guidance for management. AIMS This study looked at admissions over 5 years to explore whether there is a correlation between MEED medical compromise parameters and three outcomes: length of stay, detainment under the Mental Health Act 1983, and discharge destination. METHODS A retrospective study of 26 patients admitted to a large teaching hospital for an eating disorder between 2018 and 2023. The risk assessment from the MEED report was used to create a score for physical compromise and analysed to determine whether there was a correlation between the score and discharge destination, detainment under the Mental Health Act and length of stay. FINDINGS Demographic data were comparable with larger studies, with increasing numbers and 19.2% having autism spectrum disorder. There was no correlation between the scoring tool and detainment under the Act, discharge destination or length of stay. CONCLUSION Increasing numbers of patients are presenting with eating disorders. Physical compromise was not a predictor for admission outcomes, but this could be further explored in larger studies.
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Affiliation(s)
| | - Fiona Leslie
- Consultant in Gastroenterology, Manchester Royal Infirmary, Honorary Senior Lecturer, University of Manchester
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15
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Topan R, Pandya S, Williams S, Ruffle JK, Zarate-Lopez N, Aziz Q, Fikree A. Comprehensive Assessment of Nutrition and Dietary Influences in Hypermobile Ehlers-Danlos Syndrome-A Cross-Sectional Study. Am J Gastroenterol 2024; 119:727-738. [PMID: 37970870 DOI: 10.14309/ajg.0000000000002586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Disorders of gut-brain interaction (DGBI) are common in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorder (hEDS/HSD). Food is a known trigger for DGBI symptoms, which often leads to dietary alterations and, increasingly, nutrition support. We aimed to explore dietary behaviors and influencing factors in patients with hEDS/HSD. METHODS In a cross-sectional study, patients with hEDS/HSD were recruited from Ehlers-Danlos Support UK (nontertiary) and tertiary neurogastroenterology clinics to complete questionnaires characterizing the following: dietary behaviors, nutrition support, DGBI (Rome IV), gastrointestinal symptoms, anxiety, depression, avoidant restrictive food intake disorder (ARFID), mast cell activation syndrome, postural tachycardia syndrome (PoTS), and quality of life. We used stepwise logistic regression to ascertain which factors were associated with dietary behaviors and nutrition support. RESULTS Of 680 participants (95% female, median age 39 years), 62.1% altered their diet in the last year and 62.3% regularly skipped meals. Altered diet was associated with the following: reflux symptoms ( P < 0.001), functional dyspepsia ( P = 0.008), reported mast cell activation syndrome ( P < 0.001), and a positive screen for ARFID, specifically fear of eating and low interest ( P < 0.001). Approximately 31.7% of those who altered their diet required nutrition support. The strongest predictor of requiring nutrition support was a positive screen for ARFID, specifically fear of eating (OR: 4.97, 95% CI: 2.09-11.8, P < 0.001). DISCUSSION Altered diet is very common in the patients with hEDS/HSD we studied and influenced by functional dyspepsia, reflux symptoms, and ARFID. Those with ARFID have a 4-fold increased risk of requiring nutrition support, and therefore, it is paramount that psychological support is offered in parallel with dietary support in the management of DGBI in hEDS/HSD.
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Affiliation(s)
- Rabia Topan
- Blizard Institute, Wingate Institute of Neurogastroenterology, Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
| | - Shraya Pandya
- Blizard Institute, Wingate Institute of Neurogastroenterology, Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
| | - Sarah Williams
- Department of Dietetics, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - James K Ruffle
- Blizard Institute, Wingate Institute of Neurogastroenterology, Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
| | - Natalia Zarate-Lopez
- Gastrointestinal Physiology Unit, University College Hospitals NHS Foundation Trust, Division of Surgery and Interventional Sciences, University College London, United Kingdom
| | - Qasim Aziz
- Blizard Institute, Wingate Institute of Neurogastroenterology, Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
| | - Asma Fikree
- Blizard Institute, Wingate Institute of Neurogastroenterology, Centre for Neuroscience, Surgery and Trauma, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, United Kingdom
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16
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Montoro-Pérez N, Montejano-Lozoya R, Martín-Baena D, Talavera-Ortega M, Rosario Gómez-Romero M. Psychometric properties of the Eating Attitudes Test-26 in Spanish schoolchildren. An Pediatr (Barc) 2024; 100:241-250. [PMID: 38604935 DOI: 10.1016/j.anpede.2024.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/18/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Disordered Eating Attitudes and Behaviours (DEABs) can impact both the mental and physical health of children. Early detection is crucial to prevent complications and improve outcomes. The Eating Attitudes Test-26 (EAT-26) is a widely used, cost-effective tool for assessing DEABs. OBJECTIVE To evaluate the psychometric properties of the EAT-26 by analysing its factor structure, internal consistency, convergent validity, and measurement invariance across sexes in Spanish schoolchildren. METHOD Validation study in a sample of 718 schoolchildren. The sample was randomly divided into 2 groups, each with 359 participants, and we carried out an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) of the instrument. Subsequently, we assessed the internal consistency by means of the ordinal alpha, the convergent validity with the SCOFF questionnaire and the measurement invariance across the sexes. RESULTS The results of the EFA and CFA supported a multidimensional structure of the EAT comprising 6 factors and 21 items. These factors underlie a second-order model of DEABs. The internal consistency was adequate for most factors. The SCOFF questionnaire showed a moderate convergent validity for most of the EAT-21 factors. We found measurement invariance across the sexes. CONCLUSIONS The abbreviated EAT-21 scale exhibited modest and promising psychometric properties, making it a suitable instrument for assessing DEABs in both sexes in educational settings.
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Affiliation(s)
- Néstor Montoro-Pérez
- Department of Nursing, Faculty of Health Sciences, University of Alicante, San Vicente del Raspeig, Alicante, Spain
| | - Raimunda Montejano-Lozoya
- La Fe School of Nursing, Center attached to the University of Valencia, GREIACC Research Group, La Fe Health Research Institute (IISLAFE), Valencia, Spain..
| | - David Martín-Baena
- La Fe School of Nursing, Center attached to the University of Valencia, GREIACC Research Group, La Fe Health Research Institute (IISLAFE), Valencia, Spain
| | - Marta Talavera-Ortega
- Department of Didactics of Experimental and Social Sciences, Faculty of Education, University of Valencia, Valencia, Spain
| | - M Rosario Gómez-Romero
- La Fe School of Nursing, Center attached to the University of Valencia, GREIACC Research Group, La Fe Health Research Institute (IISLAFE), Valencia, Spain
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Nolan LJ, Higgs S. The role of irrational beliefs in the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and disordered eating in two general student samples. Appetite 2024; 195:107229. [PMID: 38246426 DOI: 10.1016/j.appet.2024.107229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/21/2023] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
Attention deficit hyperactivity disorder (ADHD) symptoms are associated with disordered eating and negative mood. The purpose of this study was to examine whether irrational beliefs mediate this relationship along with previously reported mediators such as depression and impulsivity. Irrational beliefs trigger negative automatic thoughts which are believed, in cognitive behavior therapies, to be a source of psychopathology. Challenges brought about by symptoms of ADHD may lead to habitual emotion-eliciting thought patterns which, in turn, could lead to negative mood and disordered eating. Undergraduate students (N = 127) completed online questionnaires assessing ADHD symptoms and disordered eating and several potential mediators including irrational beliefs, depression, impulsivity, interoceptive accuracy, and reward responsiveness. The results, which were replicated in a second study (N = 254), indicated that irrational beliefs and depression mediated the relationship between ADHD symptoms and disordered eating. In the second study, impulsivity due to negative urgency was also a mediator. These findings support the theory that the symptoms of ADHD lead to enhancement of irrational beliefs, depression, and negative urgency which are linked to disordered eating.
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Affiliation(s)
- Laurence J Nolan
- Department of Psychology, Wagner College, Staten Island, NY, 10301, USA.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
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18
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Gold E, Perez de Bronner S, Goday PS. Nutrition considerations in the transgender and gender-diverse patient. Nutr Clin Pract 2024; 39:366-372. [PMID: 37528505 DOI: 10.1002/ncp.11049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/12/2023] [Accepted: 07/09/2023] [Indexed: 08/03/2023] Open
Abstract
The nutrition professional is increasingly providing care to individuals who identify as transgender. However, there are few definitive guidelines on providing medical nutrition care to this population. It is becoming better understood that this population is at elevated nutrition risk secondary to significant health disparities. More recently, the increasing prevalence of gender-affirming medical intervention has resulted in uncertainty when providing medical nutrition assessments and therapies, as many standardized guidelines and assessment tools are sex-specific. This review aims to provide clarity in exploring various gender-affirming methods to providing nutrition care to the transgender and gender-diverse population.
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Affiliation(s)
- Evelyn Gold
- Complex Healthcare Division, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Susana Perez de Bronner
- Clinical Nutrition & Lactation, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Praveen S Goday
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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19
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Gómez-Romero MR, Montoro-Pérez N, Martín-Baena D, Talavera-Ortega M, Montejano-Lozoya R. A descriptive cross-sectional study on eating disorders, suicidal thoughts, and behaviors among adolescents in the Valencian community (Spain). The pivotal role of school nurses. J Pediatr Nurs 2024; 75:1-7. [PMID: 38091926 DOI: 10.1016/j.pedn.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE The aims of this study were: 1) to describe the rates of risk of having an Eating Disorder (ED) and the rates of suicidal thoughts and behaviors, and 2) to examine the relationship between the risk of having an ED with suicidal thoughts and behaviors in adolescents enrolled in educational centers in the Community of Valencia (Spain). DESIGN AND METHODS A cross-sectional study was conducted with 718 adolescents between September 2019 and July 2020 in five schools in the Community of Valencia (Spain). RESULTS The adolescents studied, mostly females, are at risk of having an ED (18.6% to 30.8%) and experiencing suicidal thoughts (23% to 30.7%) and behaviors (2.2% to 6.2%). A strong association was found between EDs and suicidal thoughts and behaviors in both sexes. This association was higher in females with positive EAT-26 scores (OR: 2.09; 95% CI: 1.35-3.24) and in males with positive SCOFF scores (OR: 4.66; 95% CI: 2.40-9.02). Suicidal behaviors were positively associated with both EAT-26 (OR: 2.58; 95% CI: 1.17-5.67) and SCOFF (OR: 1.89; 95% CI: 1.21-2.26) scores in females. CONCLUSIONS A considerable number of adolescents, females in particular, are at risk of having an ED and of experiencing suicidal thoughts and behaviors, establishing a strong link between EDs and suicidal tendencies. PRACTICAL IMPLICATIONS The study highlights the importance of establishing national and regional regulations to ensure the availability of school nurses in the Community of Valencia (Spain). Collaboration between school nurses, educators, and policy makers is critical to the early detection of problems and the provision of support to both adolescents and families.
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Affiliation(s)
| | - Néstor Montoro-Pérez
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, Spain.
| | - David Martín-Baena
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Marta Talavera-Ortega
- Department of Didactics of Experimental and Social Sciences, Faculty of Teaching, University of Valencia, Valencia, Spain
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Friedlich CE, Park H, Duval CJ, Keshishian T, Murray SB. The prevalence of disordered eating in outpatient general psychiatry settings in publicly insured populations: a case series. Eat Disord 2024; 32:169-177. [PMID: 37933621 DOI: 10.1080/10640266.2023.2277055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
There is a dearth of research assessing the prevalence of eating disorders in publicly insured populations. While evidence shows that eating disorders affect people of all racial, ethnic, and socioeconomic backgrounds, research has neglected to focus on the rate at which they occur among those who have public health insurance. The present study indexes the prevalence of clinically significant disordered eating in a case series of 165 adults in a publicly insured sample at an outpatient general psychiatry clinic in Los Angeles, California. Results illustrate that 46 (27.8%) participants screened positive for clinically significant disordered eating with no significant differences relating to age or gender in those who screened positive versus those who did not (p > .05). This markedly elevated frequency of disordered eating presentations underscores the need for improved clinician training and education around disordered eating and eating disorder assessment as a whole. In addition, there is a critical need to study publicly insured populations so as to mitigate stereotypes about who has eating disorders and improve the likelihood of diagnosis and care.
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Affiliation(s)
- Cassandra E Friedlich
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Hyoungjin Park
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Christina J Duval
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Talene Keshishian
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
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21
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Levinson JA, Kinkel-Ram S, Myers B, Hunger JM. A systematic review of weight stigma and disordered eating cognitions and behaviors. Body Image 2024; 48:101678. [PMID: 38278088 DOI: 10.1016/j.bodyim.2023.101678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/28/2024]
Abstract
Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.
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Affiliation(s)
- Jordan A Levinson
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, United States
| | - Shruti Kinkel-Ram
- Department of Psychology, Miami University, 90 N Patterson Avenue, Oxford, OH 45056, United States
| | - Bethany Myers
- University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Jeffrey M Hunger
- Department of Psychology, Miami University, 90 N Patterson Avenue, Oxford, OH 45056, United States.
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22
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Tabiś K, Maćków M, Nowacki D, Poprawa R. Adapting the Dietary Fat and Free Sugar Short Questionnaire: A Comprehensive Polish Modification for Enhanced Precision in Nutritional Assessments. Nutrients 2024; 16:503. [PMID: 38398827 PMCID: PMC10892036 DOI: 10.3390/nu16040503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This study aimed to investigate whether The Dietary Fat and Free Sugar-Short Questionnaire (DFS) is a reliable and valid measure that can be used in Polish conditions. It involved 291 participants, aged 14 to 70 (M = 25.9, SD = 10.1), the majority of whom were women (75%). METHODS The questionnaire consisted of, among others, Polish DFS version, FFQ-6, TFEQ, and SCOFF. Test-retest reliability was established on the group of 26 students with a 2-week interval. Participants' percentage of energy intake from both free sugars and saturated fats based on FFQ was correlated with DFS total and subscales scores. To investigate convergent and divergent validity, DFS scores with TFEQ correlations were performed. Diagnostic validity was established based on difference analysis between groups with the risk of eating disorders and those without the risk of those based on SCOFF. RESULTS Test-retest reliability (rtr = 0.856) and internal consistency (α = 0.797) indicated excellent reliability. DFS correlated significantly with FFQ for both total scores (r = 0.82) and each subscale: sugar (0.79), fat (0.75), and fat-sugar (0.59). The correlations of DFS and TFEQ were statistically significant for cognitive restraint (r = 0.32) and uncontrolled eating (r = 0.19). There also have been found significant differences based on SCOFF regarding DFS. CONCLUSIONS The results suggest good reliability and validity of the Polish version of DFS.
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Affiliation(s)
- Katarzyna Tabiś
- Institute of Psychology, University of Wroclaw, 50-137 Wroclaw, Poland;
| | - Monika Maćków
- Department of Human Nutrition, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland; (M.M.); (D.N.)
| | - Dorian Nowacki
- Department of Human Nutrition, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland; (M.M.); (D.N.)
| | - Ryszard Poprawa
- Institute of Psychology, University of Wroclaw, 50-137 Wroclaw, Poland;
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McLean CP, Chen Z, Song R, Le J, Fielding J, Sharp G. Development and preliminary validation of a novel eating disorder screening tool for vegetarians and vegans: the V-EDS. J Eat Disord 2024; 12:4. [PMID: 38195575 PMCID: PMC10775595 DOI: 10.1186/s40337-024-00964-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Eating disorders have one of the highest mortality of all mental illnesses but are associated with low rates of screening and early intervention. In addition, there remains considerable uncertainty regarding the use of current standardised screening tools in measuring eating pathology in vegetarians and vegans. With these groups presenting as potential at-risk groups for disordered eating development, the present study aimed to develop and preliminary validate a novel eating disorder screening tool, the Vegetarian Vegan Eating Disorder Screener (V-EDS). METHODS We utilised a mixed-methods approach, comprising four phases. RESULTS A conceptual framework was developed from 25 community, clinician, and lived experience interviews and used to derive a preliminary set of 163 items (Phase 1). Phase 2 piloted the items to establish face and content validity through cognitive debriefing interviews of 18 additional community, clinician, and lived experience participants, resulting in a reduced, revised questionnaire of 53 items. Phase 3 involved scale purification using Item Response Theory in analysis of 230 vegetarians and 230 vegans resulting in a further reduced 18-item questionnaire. Phase 4 validated the screening tool in a large community sample of 245 vegetarians and 405 vegans using traditional psychometric analysis, finding the V-EDS supports a unidimensional factor structure with excellent internal consistency (α = 0.95-0.96) and convergent validity (0.87-0.88), and moderate discriminate validity (0.45-0.55). CONCLUSIONS This study provided strong initial support for the psychometric validity and theoretical assumptions of the novel V-EDS screening tool. The V-EDS has the potential to increase early intervention rates for vegetarians and vegans experiencing eating disorder symptoms, further supporting advocacy and treatment approaches for these expanding dietary groups.
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Affiliation(s)
- Courtney P McLean
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia.
| | - Zhibin Chen
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
| | - Richard Song
- University of Melbourne, Grattan Street, Parkville, VIC, Australia
- Alfred Hospital, 55 Commercial Rd, Melbourne, VIC, Australia
| | - Jessica Le
- Alfred Hospital, 55 Commercial Rd, Melbourne, VIC, Australia
| | - Joanne Fielding
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
| | - Gemma Sharp
- Department of Neuroscience, Monash University, 99 Commercial Rd, Melbourne, VIC, Australia
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Muley A, Deshmane A, Mahajan A, Shah J. Eating Disorders: Assessing Its Prevalence and Pattern Among Adults With Type 2 Diabetes. Cureus 2024; 16:e52425. [PMID: 38371141 PMCID: PMC10870338 DOI: 10.7759/cureus.52425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Eating disorders (EDs) are severe and multifaceted mental health issues that affect a person's perception of their body weight in relationship with food. Existing evidence shows that EDs significantly affect the physical and emotional health of individuals with Type-2 Diabetes (T2D) and are associated with impaired metabolic control and a high risk of medical complications, including higher mortality rates. However, there is a paucity of research looking into the prevalence of EDs. OBJECTIVE A cross-sectional study was conducted to map the prevalence of EDs and to assess its pattern among adults with T2D from Ahmedabad City, Gujarat, India. METHODOLOGY Two hundred fifty-four T2D individuals aged 30-60 were enrolled in the study. A questionnaire was developed using the Sick, Control, One, Fat, Food (SCOFF) questionnaire and a five-question screening tool intended to identify the possibility of EDs as well as the Eating Disorder Examination-Questionnaire (EDEQ), which is used to identify the pattern of EDs with subscales like Restraint, Eating Concern, Shape Concern, and Weight Concern. Written informed consent was obtained from all participants. Descriptive statistics, Pearson's Correlation, and Logistic Regression analysis were used. A p-value of < 0.05 was considered significant. RESULTS The results revealed that 90 (35%) of the total participants were at a high risk of EDs. Among these, 54 (21% of the total population) were males, and 36 (14% of total participants) were females. There was a mild statistically significant negative correlation between age and exercise with the presence of ED (r = -0.151, p = 0.016 and r = -0.186, p = 0.003, respectively), while education showed a significant positive correlation (r = 0.150, p = 0.017). Males had significantly higher scores for eating concerns than females (19.75±4.88 vs 17.88±5.92; p = 0.008). The logistic regression model revealed that education was a significant predictor of EDs (OD = 1.47, 95% CI 1.00-2.16 and p = 0.04). CONCLUSION The study identified that people with T2D are at risk of EDs, and eating concerns worry them the most. Thus, counseling sessions should focus on identifying the determinants of EDs and educating the patients regarding quality eating. This will have implications in addressing the other morbidities as well as health risks related to BMI; especially obesity as it is more prevalent in the T2D population.
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Affiliation(s)
- Arti Muley
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Aditi Deshmane
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Anu Mahajan
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
| | - Jeel Shah
- Nutrition and Dietetics, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, IND
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25
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Hilling JJ, Robertson C. A review of the nutritional guidance for athletes to prevent eating disorders. EUROPEAN EATING DISORDERS REVIEW 2024; 32:116-129. [PMID: 37670429 DOI: 10.1002/erv.3029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023]
Abstract
Since the 1980s eating disorders (ED) have gained increasing prevalence, with athletes proving to be at a higher risk compared to non-athletes. Eating disorders can significantly impact the health and performance of an athlete, however, certain guidelines are in place for prevention, treatment and management. NICE and UK Sport were two guidelines that were identified as being referenced within the UK. This paper aimed to evaluate their utility and establish whether modifications are required to prevent ED within athletic populations. A checklist was created based on peer-reviewed recommendations and used in conjunction with conceptualised case studies based on information sourced from proposed key informant interviews. Whilst both guidelines are extensive in the identification of symptoms associated with ED, they lack recognised recommended screening methods. Furthermore, although both contain some form of validated treatment, NICE recommends cognitive behavioural therapy despite acknowledging the lack of evidence supporting its beneficial application. In contrast to recommendations regarding physical therapy, NICE also states to avoid certain treatments, such as yoga, despite beneficial evidence of its treatment/rehabilitation for ED. When applied to case studies, both guidelines demonstrated the need for refinement and improvement in recommendations relating to weight loss and screening methods. To form an accurate critique of the guidelines, an assessment of their applicability and suitability in the prevention, treatment and management of ED in a practical sporting environment involving consenting participants is required.
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26
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Alcaraz-Ibáñez M, Paterna A, Griffiths MD. Exploring the differentiated relationship between body-, eating-, and exercise-related social comparisons and depressive symptoms among adolescents. J Affect Disord 2024; 344:389-396. [PMID: 37839470 DOI: 10.1016/j.jad.2023.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The present study examined (i) the potential differentiated relationship between three forms of social comparison previously identified as particularly relevant within the context of eating disorders (EDs) (i.e., those related to body, eating, and exercise) and depressive symptomatology among adolescents, and (ii) whether this relationship may differ according to gender and ED risk status. METHODS A sample comprising 689 adolescents (46.15 % females) aged 12-19 years (M = 15.06, SD = 2.04) were recruited using non-probabilistic techniques from nine schools in southern Spain. Cross-sectional data derived from a self-report survey which included the variables of interest were analysed using the PROCESS macro for SPSS. RESULTS Bootstrapped regression/moderation analysis with 5000 resamples demonstrated two key sets of findings. Firstly, that having low self-esteem, being a girl, being at risk for ED, having social-physique anxiety, and social comparisons referring to body and exercise accounted for unique variance in depressive symptomatology. Secondly, the relationship between both eating-related and exercise-related comparisons and depressive symptomatology tended to be stronger in the group of females at risk for EDs. LIMITATIONS The study was mainly limited by the use of self-reported cross-sectional data. CONCLUSIONS Prevention and treatment efforts aimed at reducing depressive symptomatology among adolescents could benefit from incorporating content alluding to body comparison and, particularly in the case of females at risk for EDs, content alluding to eating and exercise comparisons.
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Affiliation(s)
| | - Adrian Paterna
- Health Research Centre and Department of Education, University of Almería, Spain.
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27
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Caspi A, Houts RM, Fisher HL, Danese A, Moffitt TE. The general factor of psychopathology (p): Choosing among competing models and interpreting p. Clin Psychol Sci 2024; 12:53-82. [PMID: 38236494 PMCID: PMC10794018 DOI: 10.1177/21677026221147872] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Over the past 10 years, the general factor of psychopathology, p, has attracted interest and scrutiny. We review the history of the idea that all mental disorders share something in common, p; how we arrived at this idea; and how it became conflated with a statistical representation, the Bi-Factor Model. We then leverage the Environmental Risk (E-Risk) longitudinal twin study to examine the properties and nomological network of different statistical representations of p. We find that p performed similarly regardless of how it was modelled, suggesting that if the sample and content are the same the resulting p factor will be similar. We suggest that the meaning of p is not to be found by dueling over statistical models but by conducting well-specified criterion-validation studies and developing new measurement approaches. We outline new directions to refresh research efforts to uncover what all mental disorders have in common.
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Affiliation(s)
- Avshalom Caspi
- Department of Psychology & Neuroscience, Duke University
- PROMENTA, Department of Psychology, University of Oslo
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
| | | | - Helen L. Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
- ESRC Centre for Society and Mental Health, Kings’ College London, London, UK
| | - Andrea Danese
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Terrie E. Moffitt
- Department of Psychology & Neuroscience, Duke University
- PROMENTA, Department of Psychology, University of Oslo
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, & Neuroscience, King’s College London, London, UK
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Hübel C, Abdulkadir M, Herle M, Palmos AB, Loos RJF, Breen G, Micali N, Bulik CM. Persistent thinness and anorexia nervosa differ on a genomic level. Eur J Hum Genet 2024; 32:117-124. [PMID: 37474786 PMCID: PMC10772076 DOI: 10.1038/s41431-023-01431-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023] Open
Abstract
Thinness and anorexia nervosa are both characterised by persistent low weight. Individuals with anorexia nervosa concurrently report distorted perceptions of their body and engage in weight-loss behaviours, whereas individuals with thinness often wish to gain weight. Both conditions are heritable and share genomics with BMI, but are not genetically correlated with each other. Based on their pattern of genetic associations with other traits, we explored differences between thinness and anorexia nervosa on a genomic level. In Part 1, using publicly available data, we compared genetic correlations of persistent thinness/anorexia nervosa with eleven psychiatric disorders. In Part 2, we identified individuals with adolescent persistent thinness in the Avon Longitudinal Study of Parents and Children (ALSPAC) by latent class growth analysis of measured BMI from 10 to 24 years (n = 6594) and evaluated associations with psychiatric and anthropometric polygenic scores. In Part 1, in contrast to the positive genetic correlations of anorexia nervosa with various psychiatric disorders, persistent thinness showed negative genetic correlations with attention deficit hyperactivity disorder (rgAN = 0.08 vs. rgPT = -0.30), alcohol dependence (rgAN = 0.07 vs. rgPT = -0.44), major depressive disorder (rgAN = 0.27 vs. rgPT = -0.18) and post-traumatic stress disorder (rgAN = 0.26 vs. rgPT = -0.20). In Part 2, individuals with adolescent persistent thinness in the ALSPAC had lower borderline personality disorder polygenic scores (OR = 0.77; Q = 0.01). Overall, results suggest that genetic variants associated with thinness are negatively associated with psychiatric disorders and therefore thinness may be differentiable from anorexia nervosa on a genomic level.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
- National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Pediatric Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Mohamed Abdulkadir
- National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alish B Palmos
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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29
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Gordon AR, Beccia AL, Egan N, Lipson SK. Intersecting gender identity and racial/ethnic inequities in eating disorder risk factors, symptoms, and diagnosis among U.S. college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy. Int J Eat Disord 2024; 57:146-161. [PMID: 37933620 PMCID: PMC10842502 DOI: 10.1002/eat.24089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION There are documented inequities in eating disorders (EDs) by gender and race/ethnicity, yet, little is known about population-level prevalence of ED risk factors, symptoms, and diagnosis at the intersection of diverse gender and racial/ethnic identities. METHODS Data from the Healthy Minds Study 2015-2019 (N = 251,310 U.S. university students) were used in a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). Participants were nested in 35 intersectional strata given by all combinations of 5 gender and 7 racial/ethnic categories. Multilevel logistic models with participants at level 1 and intersectional strata at level 2 were used to estimate stratum-specific predicted prevalence estimates for self-reported thin-ideal internalization, ED symptoms, and ED diagnosis. The variance partition coefficient (VPC) was calculated to quantify the contextual effect of the strata. RESULTS There was considerable heterogeneity in the predicted prevalence of our ED outcomes across the strata (e.g., .3%-18.3% for ED diagnoses). There were large disparities in all three outcomes, with transgender participants of color having a higher predicted prevalence than expected based on the additive effects of gender and race/ethnicity. Moderation by race/ethnicity was also apparent, such that racial/ethnic disparities were wider within the cisgender groups relative to the transgender groups. VPCs indicated that ~10% of the total variance in ED outcomes was due to intersectionality between gender and race/ethnicity, over and above variance due to individual-level differences. CONCLUSION Findings suggest that gender and racial/ethnic disparities in EDs are interrelated, underscoring the need to develop preventive interventions centering health equity. PUBLIC SIGNIFICANCE Despite evidence that sexism, racism, and cissexism (i.e., anti-transgender prejudice) can impact EDs risk, little research examines the social patterning of EDs at the intersection of diverse gender and racial/ethnic identities. Using data from a sample of 250,000 U.S. university students, this study found that gender and racial/ethnic disparities in eating disorder risk are interrelated, highlighting the need to develop health equity centered preventive interventions.
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Affiliation(s)
- Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Natalie Egan
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah K. Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA USA
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Levinson CA, Osborn K, Hooper M, Vanzhula I, Ralph-Nearman C. Evidence-Based Assessments for Transdiagnostic Eating Disorder Symptoms: Guidelines for Current Use and Future Directions. Assessment 2024; 31:145-167. [PMID: 37997290 DOI: 10.1177/10731911231201150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Eating disorders are severe and often chronic mental illnesses that are associated with high impairment and mortality rates. Recent estimates suggest that eating disorder prevalence rates are on the rise, indicating an increased need for accurate assessment and detection. The current review provides an overview of transdiagnostic eating disorder assessments, including interview, self-report, health and primary care screeners, and technology-based and objective assessments. We focused on assessments that are transdiagnostic in nature and exhibit high impact in the field. We provide recommendations for how these assessments should be used in research and clinical settings. We also discuss considerations that are crucial for assessment, including the use of a categorical versus dimensional diagnostic framework, assessment of eating disorders in related fields (i.e., anxiety and depression), and measurement-based care for eating disorders. Finally, we provide suggestions for future research, including the need for more research on short transdiagnostic screeners for use in health care settings, standardized assessments for ecological momentary assessment, development of state-based assessment of eating disorder symptoms, and consideration of assessment across multiple timescales.
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Affiliation(s)
| | - Kimberly Osborn
- University of Louisville, KY, USA
- Oklahoma State University, Stillwater, USA
| | - Madison Hooper
- University of Louisville, KY, USA
- Vanderbilt University, Nashville, TN, USA
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31
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Wiedemann A, Bhatti J, Hook RW, Neufeld SAS. Cohort Profile Update: The Neuroscience in Psychiatry Network (NSPN) 2400 cohort during the COVID-19 pandemic. Int J Epidemiol 2023; 52:e315-e323. [PMID: 37418602 PMCID: PMC10749753 DOI: 10.1093/ije/dyad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Affiliation(s)
- Anna Wiedemann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- National Institute for Health Research, Applied Research Collaboration, East of England, UK
| | - Junaid Bhatti
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Foyster M, Sultan N, Tonkovic M, Govus A, Burton-Murray H, Tuck CJ, Biesiekierski JR. Assessing the presence and motivations of orthorexia nervosa among athletes and adults with eating disorders: a cross-sectional study. Eat Weight Disord 2023; 28:101. [PMID: 38070009 PMCID: PMC10710386 DOI: 10.1007/s40519-023-01631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Orthorexia nervosa involves restricting diet based on quality rather than quantity. Although orthorexia is well reported in many at-risk populations, limited data addresses its presence in individuals with eating disorder history (EDs) or athletes. We aimed to identify the presence and potential drivers of orthorexia in adults with EDs and endurance athletes, compared to control subjects. METHODS Participants ≥ 18y included: people with a diagnosed eating disorder (ED as per DSM-5); endurance athletes (training/competing ≥ 5 h/week); or control subjects. Participants (n = 197) completed an online survey assessing orthorexia (eating habits questionnaire, EHQ), eating motivations (TEMS-B) and compulsive exercise (CET). RESULTS ED had the highest orthorexia symptom severity (92.0 ± 3.02, n = 32), followed by athletes (76.2 ± 2.74, n = 54) and controls (71.0 ± 1.80, n = 111) (F (2) = 18.2, p < 0.001). A strong positive correlation existed between weight control motives and higher orthorexia symptom severity (r = 0.54, 95% CI [1.35, 2.36], p < 0.001), while a weak negative association existed between Hunger and Pleasure motives and higher orthorexia symptom severity (r = 0.23, 95% CI [- 2.24, - 0.34], p = 0.008; r = 0.26, 95% CI [- 2.11, - 0.47], p = 0.002, respectively). A moderate positive relationship was found between CET and orthorexia symptom severity (95% CI [1.52, 3.12], p < 0.001). CONCLUSION Adults with ED history and endurance athletes have greater orthorexia symptom severity compared to control. Clinicians working with at-risk populations should screen patients and be aware of red-flags of orthorexic traits, desire to control weight, and compulsive exercise behavior. LEVEL OF EVIDENCE III: Evidence obtained from cohort studies.
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Affiliation(s)
- Mandy Foyster
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Nessmah Sultan
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Matilda Tonkovic
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Andrew Govus
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
| | - Helen Burton-Murray
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Caroline J Tuck
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia
- Department of Nursing and Allied Health, Swinburne University, Hawthorn, VIC, Australia
| | - Jessica R Biesiekierski
- Department of Dietetics, Nutrition and Sport, La Trobe University, Bundoora, VIC, Australia.
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia.
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Ramos-Vera C, Basauri-Delgado M, Obregón SH, Saintila J. Structure and factorial invariance of a brief version of the Eating Attitudes Test in Peruvian university students. Front Psychol 2023; 14:1238211. [PMID: 38144998 PMCID: PMC10746388 DOI: 10.3389/fpsyg.2023.1238211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Background University students often experience significant changes in their eating habits, which can increase the risk of developing eating disorders (ED). This situation calls for the creation of brief assessment tools to identify college students who may be most at risk. The aim of the study was to determine the psychometric properties of the Eating Attitudes Test-8 (EAT-8) in a Peruvian university population; additionally, the possible differences in the scores of the instrument according to sociodemographic variables, such as gender and age, were examined. Methods A psychometric study was conducted on 610 participants (M = 24.3, SD = 2.16, and 61.5% female), aged 19 to 31 years, belonging to four universities of different professional careers. Results The unidimensional eight-item model was found to have fit indices that confirm acceptable factorial validity (X2/df = 3.23, CFI = 0.984, TLI = 0.977, RMSEA = 0.061, SRMR = 0.049) and an internal consistency of 0.833 for the Cronbach's alpha coefficient and 0.838 for the McDonald's omega coefficient. In addition, the EAT-8 was reported to be invariant according to gender and age; likewise, there were no significant differences in the age and gender categories. Conclusion The EAT-8 has solid psychometric properties, including validity, reliability, and invariance, in the Peruvian university population, which supports its ability to assess the risk of developing ED in this specific group.
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Namimi-Halevi C, Dor C, Stark AH, Dichtiar R, Bromberg M, Sinai T. Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents. Pediatr Res 2023:10.1038/s41390-023-02925-3. [PMID: 38049648 DOI: 10.1038/s41390-023-02925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023]
Abstract
AIM Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents. METHODS Participants in the Israeli Youth Health and Nutrition Survey (2015-2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index. RESULTS Of 4616 participants (12-18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170-1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD. CONCLUSION Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship's causality. IMPACT Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being. This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE. This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.
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Affiliation(s)
- Chen Namimi-Halevi
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Chen Dor
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Aliza H Stark
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Rita Dichtiar
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Michal Bromberg
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel.
- School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
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Abstract
ABSTRACT Binge-eating disorder (BED) has the highest prevalence of any eating disorder in the US today. However, the condition is frequently not recognized as an eating disorder by healthcare providers or patients. Patients with this diagnosis often have significant psychiatric and medical comorbidities that might respond to evidence-based treatments. NPs in primary care with awareness of the diagnostic criteria for BED and knowledge of its assessment and treatment options can coordinate care for patients experiencing this health challenge.
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Tokatly Latzer I, Richmond TK, Zhang B, Pearl PL. Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality. Epilepsia 2023; 64:2982-2992. [PMID: 37611929 DOI: 10.1111/epi.17759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To assess the occurrence rate, characteristics, and impact of eating disorders (EDs) in adolescents with epilepsy. METHODS In this observational study, adolescents with epilepsy seen in a single center between 2013 and 2022 who had comorbid EDs were compared to two control groups of adolescents with only epilepsy and only EDs. Patients with intellectual disability or autism spectrum disorder were excluded. Data retrieved included demographic and anthropometric details and clinical variables relating to seizure types, EDs, and psychiatric disorders and behaviors. RESULTS A total of 376 subjects were included in the study: 84 adolescents with both epilepsy and eating disorders, 135 with only epilepsy, and 157 with only EDs. The rate of EDs in adolescents with epilepsy was 7.0% (95% confidence interval [CI] 5.6%-8.5%) overall, 11.3% (95% CI 8.8%-14.3%) in females, and 3.1% (95% CI 1.9%-4.8%) in males. The median (interquartile range [IQR]) time difference between the onset of epilepsy to an ED was 1.6 (.5-3.6) years. Among adolescents with epilepsy, those with an ED were more likely to be female (p = .001) and have a lower body mass index z-score (zBMI) percentile (p < .001). Epilepsy type, seizure frequency, or seizure duration were not specific for having or not having EDs. Among adolescents with EDs, those with epilepsy had a younger onset of their EDs (p < .001), included relatively more males (p = .007), and consisted of more cases of anorexia-nervosa-restrictive type (p < .001), and fewer cases of bulimia nervosa (p = .04) and binge eating disorder (p = .003). Adolescents with epilepsy and a comorbid ED were more likely to have psychiatric comorbidities such as depression, anxiety, and suicidality than adolescents with only epilepsy or EDs. SIGNIFICANCE EDs should be suspected and screened for in intellectually intact female and male adolescents with epilepsy, irrespective of their epilepsy type. If disturbed eating behaviors or EDs are identified, further evaluation should be directed at detecting other psychopathologies, including suicidality.
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Bo Zhang
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Phillip L Pearl
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Kádár BK, Péter L, Paksi B, Horváth Z, Felvinczi K, Eisinger A, Griffiths MD, Czakó A, Demetrovics Z, Andó B. Religious status and addictive behaviors: Exploring patterns of use and psychological proneness. Compr Psychiatry 2023; 127:152418. [PMID: 37699271 DOI: 10.1016/j.comppsych.2023.152418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Previous studies have emphasized the role of religiosity as both a protective factor and a factor contributing to the success of recovery in the case of addictive beahaviors. However, the associations between religious status and the involvement in distinct addictive behaviors as well as the associations between religious status and psychological factors have not been comprehensively examined. Therefore, the aims of the present study were to extend the literature by examining the (i) relationship between religiosity and distinct addictive behaviors including substance use and behavioral addictions, and (ii) interactive effects of religious status and psychological factors on addictive behaviors. MATERIAL AND METHODS Data from two representative samples were analyzed (National Survey on Addiction Problems in Hungary [NSAPH]: N = 1385; 46.8% male; mean age = 41.77 years [SD = 13.08]; and Budapest Longitudinal Study [BLS]: N = 3890; 48.4% male; mean age = 27.06 years [SD = 4.76]). Distinct addictive behaviors and psychological factors related to the psychological proneness to addictive behaviors (impulsivity, sensation seeking, rumination, well-being, mentalization, and worry) were comprehensively examined in relation to religious status (religious, agnostic, and non-religious). Chi-square, Kruskal-Wallis and Mann-Whitney (MW) tests and multinomial logistic regressions were performed. RESULTS Religious individuals showed significantly lower involvement in addictive behaviors whereas agnostic individuals showed significantly higher involvement in addictive behaviors. With regards to psychological factors related to the proneness to addictive behaviors, agnostic individuals showed the highest level of psychological proneness. The results of multinomial regression models showed that religiosity was protective in the NSAPH sample. However, worry could overwrite the protective effect. In the BLS study, the protective role of religiosity was uncertain. It was not protective in itself, but through interaction with sensation seeking, rumination and uncertian mentalization, religiosity can also be protective. DISCUSSION The findings highlight the general protective role of religiosity in addictions. However, interaction with some psychological contructs can modify the protective role of religious status. The study also highlights the need to take into account agnostic religious status of individuals in future research. Consequently, further studies are needed to explore the causality and mediating roles between these variables.
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Affiliation(s)
- Bettina Kata Kádár
- Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged H-6720, Hungary
| | - Lea Péter
- Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged H-6720, Hungary
| | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, 23-27 Kazinczy Street, Budapest H-1075, Hungary
| | - Zsolt Horváth
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar
| | - Katalin Felvinczi
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
| | - Andrea Eisinger
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary; Doctoral School of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, NG1 4FQ Nottingham, United Kingdom
| | - Andrea Czakó
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest H-1064, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar.
| | - Bálint Andó
- Department of Psychiatry, University of Szeged, 8-10 Korányi fasor, Szeged H-6720, Hungary.
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Bachir Y, El-Hachem C, Richa S, Bou Khalil R. The risk of eating disorders following the August 4th, 2020 explosion in Beirut and its relationship with trauma exposure and PTSD symptoms. Asian J Psychiatr 2023; 89:103749. [PMID: 37639769 DOI: 10.1016/j.ajp.2023.103749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION To date, no study has demonstrated the link between the diagnosis of provisional PTSD and ED in people exposed to the explosion of August 4th, 2020. METHODS Online participants were classified into 4 categories according to the degree of exposure to the explosion (unexposed, slightly exposed, moderately exposed, and severely exposed). The screening for ED was done using the standardized SCOFF questionnaire and the screening for provisional PTSD using the standardized IES-R questionnaire. RESULTS Our sample included 703 participants. In the bivariate analysis, there was a trend for an association between degree of exposure to the explosion and the risk of development of an ED (p = 0.055). The independent variables included in the multivariate analysis that were statistically associated with a risk of developing eating disorders are secondary school as the highest level of education (p = 0.029; OR = 2.15) and the risk of PTSD (p = 0.041; OR = 2.05) according to IES-R, specifically hyperarousal (p = 0.028; OR = 1.07) as a symptom cluster. Provisional PTSD played a mediating role, creating a partial and indirect relationship between the degree of exposure to the explosion and the risk of developing ED with a β coefficient of 0.075 (p < 0.001) CONCLUSION: The risk of PTSD according to IES-R was found to be a determinant of a higher risk of developing ED among participants exposed to the explosion in addition to mediating between the effect of exposure severity and the risk of ED. It is essential to fully assess and manage PTSD symptoms and ED patients exposed to such a psychological trauma.
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Affiliation(s)
- Yara Bachir
- Department of Psychiatry at Saint Joseph University, Beirut, Lebanon
| | - Charline El-Hachem
- Department of Psychiatry at Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Psychiatry at Saint Joseph University, Beirut, Lebanon
| | - Sami Richa
- Department of Psychiatry at Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Psychiatry at Saint Joseph University, Beirut, Lebanon
| | - Rami Bou Khalil
- Department of Psychiatry at Hotel Dieu de France Hospital, Beirut, Lebanon; Department of Psychiatry at Saint Joseph University, Beirut, Lebanon.
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Perrin EC, Ravi HL, Borra GS, South AM. Prevalence and risk factors of disordered eating behavior in youth with hypertension disorders. Pediatr Nephrol 2023; 38:3779-3789. [PMID: 37195544 PMCID: PMC10189692 DOI: 10.1007/s00467-023-05921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Adolescents with certain health conditions requiring lifestyle management, such as diabetes mellitus, have higher disordered eating behavior (DEB) risk than the general adolescent population, but DEB is underdiagnosed and can lead to adverse health consequences. In youth with other conditions requiring lifestyle counseling such as hypertension (HTN), DEB prevalence and associated risk factors are unknown. We hypothesized that youth with HTN disorders would have higher DEB prevalence than the general adolescent population, and that obesity, chronic kidney disease (CKD), and less specialized lifestyle counseling would be associated with higher DEB risk. METHODS Prospective cross-sectional study of youth aged 11-18 years with HTN disorders. We excluded patients with diabetes mellitus, kidney failure or transplantation, or gastrostomy tube dependence. We collected data via surveys and electronic health record abstraction. We administered the validated SCOFF DEB screening questionnaire. We compared DEB prevalence using a one-sample z-test of proportions (p0 = 0.1) and estimated DEB risk by obesity, CKD, and lifestyle counseling source using multivariable generalized linear models. RESULTS Of 74 participants, 59% identified as male, 22% as Black or African American, and 36% as Hispanic or Latino; 58% had obesity and 26% had CKD. DEB prevalence was 28% (95% CI 18-39%, p < 0.001). CKD was associated with higher DEB prevalence (adjusted RR 2.17, 95% CL 1.09 to 4.32), but obesity and lifestyle counseling source were not. CONCLUSIONS DEB prevalence is higher in youth with HTN disorders and comparable to other conditions requiring lifestyle counseling. Youth with HTN disorders may benefit from DEB screening. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Ella C Perrin
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Hanna L Ravi
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gagana S Borra
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Andrew M South
- Department of Pediatrics, Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, One Medical Center Boulevard, Winston Salem, NC, 27157, USA.
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC, USA.
- Cardiovascular Sciences Center, Wake Forest University School of Medicine, Winston Salem, NC, USA.
- Center for Biomedical Informatics, Wake Forest University School of Medicine, Winston Salem, NC, USA.
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Pacanowski CR, Dominick G, Crosby RD, Engel SG, Cao L, Linde JA. Daily self-weighing compared with an active control causes greater negative affective lability in emerging adult women: A randomized trial. Appl Psychol Health Well Being 2023; 15:1695-1713. [PMID: 37339756 DOI: 10.1111/aphw.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/26/2023] [Indexed: 06/22/2023]
Abstract
Age-related weight gain prevention may reduce population overweight/obesity. Emerging adulthood is a crucial time to act, as rate of gain accelerates and health habits develop. Evidence supports self-weighing (SW) for preventing weight gain; however, how SW impacts psychological states and behaviors in vulnerable groups is unclear. This study assessed daily SW effects on affective lability, stress, weight-related stress, body satisfaction, and weight-control behaviors. Sixty-nine university females (aged 18-22) were randomized to daily SW or temperature-taking (TT) control. Over 2 weeks, participants completed five daily ecological momentary assessments with their intervention behavior. A graph of their data with a trendline was emailed daily, with no other intervention components. Multilevel mixed models with random effect for day assessed variability in positive/negative affect. Generalized linear mixed models assessed outcomes pre- and post-SW or TT and generalized estimating equations assessed weight-control behaviors. Negative affective lability was significantly greater for SW versus TT. While general stress did not differ between groups, weight-related stress was significantly higher and body satisfaction was significantly lower post-behavior for SW but not TT. Groups did not significantly differ in the number or probability of weight-control behaviors. Caution is advised when recommending self-weighing to prevent weight gain for emerging adults.
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Affiliation(s)
- C R Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - G Dominick
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - R D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - S G Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - L Cao
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - J A Linde
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
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Alsheweir A, Goyder E, Alnooh G, Caton SJ. Prevalence of Eating Disorders and Disordered Eating Behaviours amongst Adolescents and Young Adults in Saudi Arabia: A Systematic Review. Nutrients 2023; 15:4643. [PMID: 37960296 PMCID: PMC10649920 DOI: 10.3390/nu15214643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/08/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders (EDs) and disordered eating behaviours (DEBs) are significant health problems related to body image and weight dissatisfaction among adolescents and young adults worldwide. During this stage of sensitive development, these behaviours may hinder the optimal growth process and can consequently lead to wasting, stunting, and micronutrient deficiencies. However, there is a limited amount of literature on DEB among Arab populations, particularly in Saudi Arabia. This review aims to assess the prevalence of EDs/DEB and to develop a clear understanding of the epidemiology of such conditions among adolescents and youth in Saudi Arabia. Five databases were systematically searched and 14 papers met the inclusion criteria. The Eating Attitudes Test (EAT-26) was the predominant tool used for evaluating aberrant eating behaviours, indicating a high prevalence of EDs/DEB ranging from 10.2% to 48.1%. The highest prevalence of EDs/DEB was reported in the eastern region ranging from 29.4% to 65.5%. In terms of age and sex, the prevalence was higher among older students compared to younger school students and males reported more Eds/DEB compared to female students. These disorders are found to be prevalent in Saudi Arabia, and the risk of developing such conditions is high across the whole age range.
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Affiliation(s)
- Azzah Alsheweir
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); (S.J.C.)
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 145111, Saudi Arabia
| | - Elizabeth Goyder
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); (S.J.C.)
| | - Ghadah Alnooh
- Centre for Assistive Technology and Connected Healthcare, Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK;
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Samantha J. Caton
- Sheffield Centre for Health & Related Research (SCHARR), School of Medicine & Population Health, University of Sheffield, Sheffield S1 4DA, UK; (E.G.); (S.J.C.)
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Barnard-Brak L, Yang Z. A 4pL item response theory examination of perceived stigma in the screening of eating disorders with the SCOFF among college students. Eat Weight Disord 2023; 28:79. [PMID: 37792143 PMCID: PMC10550868 DOI: 10.1007/s40519-023-01604-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 08/27/2023] [Indexed: 10/05/2023] Open
Abstract
We examined the psychometric properties of the SCOFF, a screening instrument for eating disorders, with consideration of the perceived stigma of items that can produce socially desirable responding among a sample of college students. The results of the current study suggest evidence of the sufficient psychometric properties of the SCOFF in terms of confirmatory factor and item response theory analyses. However, two items of the SCOFF revealed that individuals who otherwise endorsed other items of the SCOFF were less likely to endorse the items of Fat and Food. It is hypothesized that this is the result of perceived stigma regarding those two items that prompts individuals to respond in a socially desirable way. A weighted scoring procedure was developed to counteract the performance of these two items, but the psychometric performance was only slightly better and there would be a clear tradeoff of specificity over sensitivity if utilized. Future research should consider other ways to counteract such perceived stigma.Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
| | - Zhanxia Yang
- Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
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de Oliveira Galvão PP, Valente JY, Cogo-Moreira H, Mari JJ, Sanchez ZM. Bullying as a Risk Factor for Eating Disorder Behaviors Among Students: Secondary Analysis for a Cluster Randomized Controlled Trial. Child Psychiatry Hum Dev 2023; 54:1404-1414. [PMID: 35325334 DOI: 10.1007/s10578-022-01343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to examine whether being a victim of bullying predicted body dissatisfaction and eating disorder behavior (EDB). In this study, we performed secondary analysis from a cluster randomized controlled trial among 5208 eight grade students from 73 public schools in three Brazilian cities. Data were collected in 2019 through an anonymous self-report questionnaire on bullying, body dissatisfaction, and EDB. We used factor analysis, multivariate linear regression, and multinomial logistic regression to verify whether being a victim of bullying during the baseline results in body dissatisfaction and EDB at the nine months follow-up for the control and intervention groups. Our results showed that being female (OR 1.41, 95% CI 1.22-1.63) is a risk factor for dissatisfaction by overweight. Bullying was not a predictor of body dissatisfaction; however, being a victim of bullying (β 0.40, 95% CI 0.35-0.46) is a predictor of having more EDB, independent of the exposure to the program. Therefore, bullying deserves attention in the school environment.
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Affiliation(s)
- Patricia Paiva de Oliveira Galvão
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, sala 404, São Paulo, SP, CEP 04.023-062, Brazil.
| | | | - Hugo Cogo-Moreira
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Jair J Mari
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, sala 404, São Paulo, SP, CEP 04.023-062, Brazil
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Beckmann EA, Aarnio-Peterson CM, Jastrowski Mano KE. Advancing the Assessment and Treatment of Comorbid Pediatric Chronic Functional Abdominal Pain (CFAP) and Restrictive Eating Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1539. [PMID: 37761500 PMCID: PMC10527586 DOI: 10.3390/children10091539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/03/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
The aim of this review is to heighten awareness of the association between chronic functional abdominal pain (CFAP) and restrictive eating disorders (ED) in adolescents. We describe current diagnostic practices and propose future research efforts to improve the assessment and treatment of comorbid CFAP and restrictive EDs. A narrative review of the literature on CFAP and EDs was performed using PubMed, JSTOR, ScienceDirect, and PsycINFO and the following search terms: 'restrictive eating disorders', 'chronic functional abdominal pain', 'chronic pain' 'treatment' 'diagnosis' and 'adolescents'. Published studies on restrictive EDs and CFAP from May 2008 to March 2023 were included. Ascribable to the overlap in etiology and symptom presentation, adolescents with chronic pain are significantly less likely to have their ED pathology promptly identified by providers compared to adolescents without comorbid chronic pain. This highlights the importance of the time sensitive and accurate identification of EDs in adolescents with CFAP. Overall, assessment methods are limited and EDs take longer to be identified in adolescents with comorbid CFAP. Future efforts should address diagnostic practices in pediatric settings and improve the communication among medical and mental health providers in order to promote the rapid and effective diagnosis and treatment of comorbid CFAP and EDs.
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Affiliation(s)
- Emily A. Beckmann
- Department of Psychology, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Claire M. Aarnio-Peterson
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
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45
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Smith L, López Sánchez GF, Fernandez-Egea E, Ford T, Parris C, Underwood BR, Butler L, Barnett Y, Trott M, Koyanagi A. Eating disorders and physical multimorbidity in the English general population. Eat Weight Disord 2023; 28:72. [PMID: 37676625 PMCID: PMC10485116 DOI: 10.1007/s40519-023-01600-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE People with eating disorders may be at increased risk for physical health problems, but there are no data on the relationship between eating disorders and physical multimorbidity (i.e., ≥ 2 physical conditions) and its potential mediators. Thus, we investigated this association in a representative sample of adults from the UK, and quantified the extent to which this can be explained by various psychological and physical conditions, and lifestyle factors. METHODS Cross-sectional data of the 2007 Adult Psychiatric Morbidity Survey were analyzed. Questions from the five-item SCOFF screening instrument were used to identify possible eating disorder. Respondents were asked about 20 physical health conditions. Multivariable logistic regression and mediation analysis were conducted. RESULTS Data on 7403 individuals aged ≥ 16 years were analyzed [mean (SD) age 46.3 (18.6) years; 48.6% males]. After adjustment, possible eating disorder was associated with 2.11 (95%CI = 1.67-2.67) times higher odds for physical multimorbidity. Anxiety disorder explained the largest proportion this association (mediated percentage 26.3%), followed by insomnia (21.8%), perceived stress (13.4%), depression (13.1%), obesity (13.0%), and alcohol dependence (4.3%). CONCLUSION Future longitudinal studies are warranted to understand potential causality and the underlying mechanisms in the association between eating disorder and multimorbidity, and whether addressing the identified potential mediators in people with eating disorders can reduce multimorbidity.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Emilio Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, Cambridge, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Christopher Parris
- Medical Technology Research Centre, School of Life Sciences, Anglia Ruskin University, Cambridge, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn Hospital, Fulbourn, Cambridge, UK
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Mike Trott
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
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46
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Ahuja L, Diedrichs PC, Garbett KM, Chaudhry A, Hasan F, Uglik-Marucha N, Vitoratou S, Dhillon M, Shroff H, Lewis-Smith H. Adaptation and Validation of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) for Use in English among Adolescents in Urban India. Nutrients 2023; 15:3836. [PMID: 37686868 PMCID: PMC10490473 DOI: 10.3390/nu15173836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Eating pathology is increasingly common among Indian adolescents. However, brief validated measures of disordered eating in Indian contexts are scarce. This study adapted and validated a culturally appropriate English language version of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) among 385 adolescents (mean age = 13.42 years; 47.3% girls) in urban India. Confirmatory factor analysis indicated that a two-factor eight-item solution had an acceptable fit to the data across gender: an 'Eating Concerns and Restraint' subscale and a 'Weight and Shape Concerns' subscale. Further, the questionnaire can be utilised as both a unidimensional and multidimensional tool. This allows for the computation of a total score on the primary factor of 'Child Eating Pathology', as well as the two subscales. Internal consistency of the 'Weight and Shape Concerns' subscale (α = 0.825) and 'Eating Concerns and Restraint' subscale (α = 0.649) was satisfactory. Concurrent validity was established through medium significant correlations with measures of body image and broader mental health. The results support the use of the ChEDE-Q for assessing disordered eating among urban Indian adolescents, thus providing the research community and practitioners with a measure to investigate the nature and scale of disordered eating among adolescents in India.
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Affiliation(s)
- Latika Ahuja
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, UK; (P.C.D.); (K.M.G.); (F.H.)
| | - Phillippa C. Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, UK; (P.C.D.); (K.M.G.); (F.H.)
| | - Kirsty M. Garbett
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, UK; (P.C.D.); (K.M.G.); (F.H.)
| | | | - Farheen Hasan
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, UK; (P.C.D.); (K.M.G.); (F.H.)
| | - Nora Uglik-Marucha
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (N.U.-M.); (S.V.)
| | - Silia Vitoratou
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE5 8AF, UK; (N.U.-M.); (S.V.)
| | - Megha Dhillon
- Lady Shri Ram College, University of Delhi, New Delhi 110024, India;
| | - Hemal Shroff
- Toronto District School Board, Toronto, ON M2N 5N8, Canada;
| | - Helena Lewis-Smith
- Centre for Appearance Research, University of the West of England, Bristol BS16 1QY, UK; (P.C.D.); (K.M.G.); (F.H.)
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47
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Martin E, Dourish CT, Higgs S. Interoceptive accuracy mediates the longitudinal relationship between attention deficit hyperactivity disorder (ADHD) inattentive symptoms and disordered eating in a community sample. Physiol Behav 2023; 268:114220. [PMID: 37142150 DOI: 10.1016/j.physbeh.2023.114220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 05/06/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) symptoms are associated with disordered eating and interoceptive deficits (as assessed by reliance on hunger/satiety cues) have been suggested as a potential mediating influence. The aim of this longitudinal study was to examine whether the association between ADHD symptoms and disordered eating is explained by deficits in specific facets of interoception. We also aimed to provide further evidence on the previously reported association between ADHD symptoms, negative mood and disordered eating. A community-based sample of 345 adult men and women (M age = 33.9, 72.5% women) completed questionnaires assessing disordered eating (restrictive and binge-type), ADHD symptoms, reliance on hunger/ satiety cues, specific facets of interoception (interoceptive accuracy and interoceptive sensibility) and negative mood at two timepoints over a 6-month period. We tested the mediating influence of reliance on hunger/satiety cues, facets of interoception and negative mood on the relationship between ADHD symptoms and disordered eating. Reliance on hunger/satiety cues mediated the relationship between inattentive symptoms of ADHD and both restrictive and binge-type eating. Interoceptive accuracy, but not sensibility mediated the relationship between inattentive ADHD symptoms and binge-type eating. Negative mood mediated the relationship between both ADHD symptom types and restrictive and binge-type eating. The results from this longitudinal study confirm that deficits in interoception and negative mood contribute to the relationship between ADHD symptoms and disordered eating and extend knowledge by highlighting interoceptive accuracy specifically as the most important facet of interoception in the relationship between inattentive symptoms and binge-type eating.
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Affiliation(s)
- Elizabeth Martin
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, Birmingham, United Kingdom
| | - Colin T Dourish
- P1vital, Wallingford, Oxfordshire, OX10 8BA, United Kingdom; P1vital Products, Wallingford, Oxfordshire, OX10 8BA, United Kingdom.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, Birmingham, United Kingdom
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48
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Fried EI, Proppert RKK, Rieble CL. Building an Early Warning System for Depression: Rationale, Objectives, and Methods of the WARN-D Study. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e10075. [PMID: 38356901 PMCID: PMC10863640 DOI: 10.32872/cpe.10075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 07/02/2023] [Indexed: 02/16/2024] Open
Abstract
Background Depression is common, debilitating, often chronic, and affects young people disproportionately. Given that only 50% of patients improve under initial treatment, experts agree that prevention is the most effective way to change depression's global disease burden. The biggest barrier to successful prevention is to identify individuals at risk for depression in the near future. To close this gap, this protocol paper introduces the WARN-D study, our effort to build a personalized early warning system for depression. Method To develop the system, we follow around 2,000 students over 2 years. Stage 1 comprises an extensive baseline assessment in which we collect a broad set of predictors for depression. Stage 2 lasts 3 months and zooms into participants' daily experiences that may predict depression; we use smartwatches to collect digital phenotype data such as sleep and activity, and we use a smartphone app to query participants about their experiences 4 times a day and once every Sunday. In Stage 3, we follow participants for 21 months, assessing transdiagnostic outcomes (including stress, functional impairment, anxiety, and depression) as well as additional predictors for future depression every 3 months. Collected data will be utilized to build a personalized prediction model for depression onset. Discussion Overall, WARN-D will function similarly to a weather forecast, with the core difference that one can only seek shelter from a thunderstorm and clean up afterwards, while depression may be successfully prevented before it occurs.
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Affiliation(s)
- Eiko I. Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | | | - Carlotta L. Rieble
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
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Zagaria A, Barbaranelli C, Mocini E, Lombardo C. Cross-cultural adaptation and psychometric properties of the Italian version of the Orthorexia Nervosa Inventory (ONI). J Eat Disord 2023; 11:144. [PMID: 37620907 PMCID: PMC10463941 DOI: 10.1186/s40337-023-00858-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Orthorexia Nervosa (ON) is an emerging clinical condition characterized by a pathological fixation with healthy eating. Recently, the Orthorexia Nervosa Inventory (ONI) has emerged as a promising tool for assessing orthorexic tendencies and behaviours, aiming to overcome the well-established limitations of existing measures for ON. The present study aimed to examine the psychometric properties of the Italian version of the ONI. METHODS A total of 879 participants (Mage = 33.22 years, SD = 9.19; 56.9% females) completed the ONI along with the Düsseldorf Orthorexia Scale (DOS), measures of disordered eating, obsessive-compulsive symptoms (OCD), and psychosocial impairment. To establish the factorial validity of the ONI, a competing measurement modeling approach was employed by comparing standard confirmatory factor analytic (CFA) with exploratory structural equation modeling (ESEM) solutions. Model-based omega coefficients were computed to examine the internal consistency of the scale. Factorial invariance tests across gender were conducted within a multi-group framework. RESULTS A three-factor first-order ESEM solution provided the best and most parsimonious representation of the data: χ2(207) = 558.641, p < .001, RMSEA = 0.044 (90% CI 0.040-0.048), CFI = 0.976, TLI = 0.968, SRMR = 0.036. The three latent dimensions, labelled behaviors, emotions, and impairments, showed excellent internal consistency (ω > 0.88). Furthermore, ONI scores were found to be positively correlated with DOS scores, disordered eating, OCD symptoms, and psychosocial impairment, supporting its convergent and criterion validity. Eventually, the ONI was factorially invariant across gender. CONCLUSIONS Overall, the present study provides evidence for the satisfactory psychometric properties of the ONI in the Italian context, endorsing its use in both clinical and research settings.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy.
| | | | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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50
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Humer E, Neubauer V, Brühl D, Dale R, Pieh C, Probst T. Prevalence of mental health symptoms and potential risk factors among Austrian veterinary medicine students. Sci Rep 2023; 13:13764. [PMID: 37612368 PMCID: PMC10447431 DOI: 10.1038/s41598-023-40885-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023] Open
Abstract
Although the poor mental health of veterinarians has been reported in different countries, no data exist on mental health in Austrian veterinary students. This study aimed to provide first data on a broad range of mental health indicators in Austrian veterinary students, compare these data with the Austrian general population, and explore factors associated with poor mental health. A total of 29.1% (n = 430; 85.8% female; mean age: 23.14 ± 3.69 years) of the total Austrian veterinary student population (N = 1477 students; 82.1% females) took part in an online survey conducted from November 2022 to January 2023. Indicators of mental health were symptoms of depression (PHQ-9), anxiety (GAD-7), insomnia (ISI-7), stress (PSS-4), alcohol abuse (CAGE) and disordered eating (SCOFF). Compared to the general Austrian population a higher proportion of veterinary students exceeded the cut-offs for clinically relevant mental health symptoms (P < 0.05). A total of 55.3% of participating veterinary students exceeded the cut-off for moderate depressive symptoms, 52.6% for moderate anxiety symptoms, 20.9% for clinically relevant insomnia symptoms, 79.3% for high-stress symptoms, 22.8% for symptoms of alcohol abuse and 38.6% for symptoms of disordered eating. Multivariable logistic regression including several sociodemographic, health behavior, and study-related variables as predictors revealed that mental health symptoms in veterinary students were associated with female gender, older age, low physical activity, high smartphone usage, and desired specification in small animal or wildlife medicine. In conclusion, Austrian veterinary students experience a high mental health burden. The teaching of coping skills and strategies to improve mental hygiene should be implemented in the curricula of veterinary education to improve mental health in the veterinary profession.
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Affiliation(s)
- Elke Humer
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500, Krems, Austria.
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020, Vienna, Austria.
| | - Viktoria Neubauer
- Unit for Food Microbiology, Institute of Food Safety, Food Technology, and Veterinary Public Health, Department for Farm Animals and Public Health, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
- FFoQSI GmbH-Austrian Competence Centre for Feed and Food Quality, Safety and Innovation, 3430, Tulln, Austria
| | - Deianira Brühl
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500, Krems, Austria
- Unit for Food Microbiology, Institute of Food Safety, Food Technology, and Veterinary Public Health, Department for Farm Animals and Public Health, University of Veterinary Medicine Vienna, 1210, Vienna, Austria
| | - Rachel Dale
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500, Krems, Austria
| | - Christoph Pieh
- Department for Psychosomatic Medicine and Psychotherapy, University for Continuing Education Krems, 3500, Krems, Austria
| | - Thomas Probst
- Division of Psychotherapy, Department of Psychology, University of Salzburg, 5020, Salzburg, Austria
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