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de Jong M, Wynchank DSMR, Michielsen M, Beekman ATF, Kooij JJS. A Female-Specific Treatment Group for ADHD-Description of the Programme and Qualitative Analysis of First Experiences. J Clin Med 2024; 13:2106. [PMID: 38610871 PMCID: PMC11012758 DOI: 10.3390/jcm13072106] [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: 03/12/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The diagnostics and treatment of attention-deficit/hyperactivity disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period, and (peri)menopause are neglected, even though they impact ADHD symptoms and associated mood disorders. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. Methods: We describe the group programme and underlying rationale, offering a qualitative analysis of the participants' evaluation. Results: The seven bi-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25-47 years) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable, and the structure suited them well. Completing the premenstrual calendar augmented the awareness and recognition of individual cyclical symptoms. A lifespan approach increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care. Conclusions: Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD.
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Affiliation(s)
- M de Jong
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
- Department of Psychiatry, AmsterdamUMC/VUmc, 1081 HJ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VU Medical Centre, 1081 HV Amsterdam, The Netherlands
| | - D S M R Wynchank
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
| | - M Michielsen
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
- Antes Older Adults Outpatient Treatment, 3079 DZ Rotterdam, The Netherlands
| | - A T F Beekman
- Department of Psychiatry, AmsterdamUMC/VUmc, 1081 HJ Amsterdam, The Netherlands
- GGZ inGeest, 1062 NP Amsterdam, The Netherlands
| | - J J S Kooij
- Expertise Centre Adult ADHD, PsyQ, 2593 HR The Hague, The Netherlands
- Department of Psychiatry, AmsterdamUMC/VUmc, 1081 HJ Amsterdam, The Netherlands
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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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Thorsteinsdottir S, Bjarnason R, Eliasdottir HG, Olafsdottir AS. Body Composition in Fussy-Eating Children, with and without Neurodevelopmental Disorders, and Their Parents, Following a Taste Education Intervention. Nutrients 2023; 15:2788. [PMID: 37375692 DOI: 10.3390/nu15122788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Fussy eaters may have an increased risk of becoming overweight or obese as adolescents, with fussy eating and weight status also correlating with neurodevelopmental disorders (NDs) such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Further, maternal and children's weight status relationships are well-established. In this study, we analyzed the body composition of parent-child dyads using bioelectrical impedance analysis (BIA). Fifty-one children aged 8-12 years, with an ND (n = 18) and without (n = 33), and their parents, participated in a 7-week food-based Taste Education intervention with 6-month follow-up. The paired t-test was used to compare differences in body composition based on children's ND status. In logistic regression analysis, odds of children being in the overweight/obese or overfat/obese categories increased by a factor of 9.1 and 10.6, respectively, when having NDs, adjusting for parents' BMI (body mass index) or fat percentage (FAT%). Children with NDs and their parents had significantly higher mean BMI-SDS (BMI standard deviation score) and FAT% at pre-intervention than children without NDs and their parents. Mean BMI-SDS and FAT% lowered significantly between time points for children with NDs and their parents but not for children without NDs or their parents. The findings underline the need for additional exploration into the relationships between children's and parents' body composition based on children's ND status.
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Affiliation(s)
- Sigrun Thorsteinsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
| | - Ragnar Bjarnason
- Faculty of Medicine, School of Health Sciences, University of Iceland, Laeknagardur 4th Floor, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland
- Department of Pediatrics, National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | - Helga G Eliasdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
| | - Anna S Olafsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
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Li R, Kajanoja J, Tuulari JJ, Karlsson L, Karlsson H, Karukivi M. Relationships between alexithymia and food addiction: The Finnish version of Yale Food Addiction Scale and preliminary test of its psychometric properties. Front Psychol 2023; 14:1067872. [PMID: 36743252 PMCID: PMC9893275 DOI: 10.3389/fpsyg.2023.1067872] [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: 10/12/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
Background It has long been suggested that addictive behaviors are associated with alexithymia, a personality trait characterized by difficulties in emotional awareness and expression. However, little is known about the role of alexithymia in food addiction. Objectives The aim of this study was to investigate the relationship between alexithymia and food addiction. As part of the study, the validity of the Finnish version of Yale Food Addiction Scale (YFAS-F) was also investigated. Methods The sample consisted of 360 parents from the FinnBrain Birth Cohort Study. The structural validity of the YFAS-F was evaluated by confirmatory factor analysis (CFA). Exploratory factor analysis (EFA) was used to explore the structure when proposed models were not supported by CFA. The associations of alexithymia as measured by the 20-item Toronto Alexithymia Scale and food addiction were examined using regression analyses followed by structural equation modeling. Results Higher alexithymia was associated with more food addiction by conducting linear regression analysis (B = 0.013, p = 0.011) and structural equation modeling (β = 0.24, p < 0.001). Furthermore, a single-factor model for the 8 criteria of the YFAS-F was supported by CFA and showed acceptable internal reliability (KR-20 = 0.72), and a three-factor solution for the 20 items of the scale was suggested by EFA with good internal reliability (McDonald's ω = 0.91 for the YFAS-F, 0.91 for component 1, 0.87 for component 2, and Spearman-Brown coefficient = 0.89 for component 3). Conclusion The current study determined a significant relationship between alexithymia and food addiction, which suggests alexithymia as a relevant factor for food addiction and may provide clinical implications for interventions. Moreover, the YFAS-F appeared to be a valid and reliable tool to evaluate food addiction in our Finnish general population sample. Further studies on the psychometric properties of the YFAS-F in more diverse populations are recommended.
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Affiliation(s)
- Ru Li
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,*Correspondence: Ru Li, ✉
| | - Jani Kajanoja
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Department of Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Jetro J. Tuulari
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Turku Collegium for Science, Medicine and Technology, TCSMT, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Center for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland,Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland,Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Center for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Max Karukivi
- Department of Clinical Medicine, FinnBrain Birth Cohort Study, Turku Brain and Mind Center, University of Turku, Turku, Finland,Department of Adolescent Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
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Porfirio MC, Campanile R, Masi G, Purper-Ouakil D, Giovinazzo S, Ascenzi A, Troisi A, Mazzone L. Exploring the Link between ADHD and Obesity: A Focus on Temperament. Brain Sci 2022; 12:brainsci12121631. [PMID: 36552091 PMCID: PMC9775563 DOI: 10.3390/brainsci12121631] [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: 09/29/2022] [Revised: 11/11/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
Abstract
Multiple studies support the relationship between ADHD and overweight/obesity in youth. Different mechanisms may be involved, such as temperamental and psychopathological factors. The aim of this study was to test the hypothesis that specific temperamental and psychopathological dimensions could mediate the relationship between ADHD and obesity. The sample included 100 children and adolescents (78 males and 22 females; age range 6 to 18 years; mean age 9.90 ± 2.5 years). The assessment procedure included Conners' Parent Rating Scale-Long (CPRS-R:L) as the inclusion criterion for ADHD diagnosis, the Child Behavior Checklist (CBCL), a dimensional measure for psychopathology, and the Junior Temperament and Character Inventory, which describes four temperamental dimensions: novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P). While in the whole ADHD sample, the highest scores were found in NS and the lowest in P, ADHD with overweight/obesity, compared to ADHD with normal weight, showed higher HA and RD, lower NS, and higher CBCL Internalizing scores. These findings suggest that ADHD youth with overweight/obesity present specific temperamental and psychopathological features compared to those without overweight/obesity. If confirmed in larger samples, using a control group without ADHD, these temperamental and psychological features may be helpful for an earlier recognition of ADHD patients at higher risk for obesity, and may represent possible targets for temperament-based preventive interventions and tailored treatment programs. These features should be included in the routine assessment of children and adolescents with ADHD and/or are overweight/obese.
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Affiliation(s)
- Maria Cristina Porfirio
- Child Neurology and Psychiatry Unit, Tor Vergata Hospital, Fondazione PTV, Oxford Street 81, 00133 Rome, Italy
- Correspondence: ; Tel.: +39-062-090-0249
| | - Roberta Campanile
- Child Neurology and Psychiatry Unit, Tor Vergata Hospital, Fondazione PTV, Oxford Street 81, 00133 Rome, Italy
- Systems Medicine Department, University of Rome Tor Vergata, Montpellier Street 1, 00133 Rome, Italy
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy
| | - Diane Purper-Ouakil
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, School of Medicine, 34090 Montpellier, France
| | - Silvia Giovinazzo
- Child Neurology and Psychiatry Unit, Tor Vergata Hospital, Fondazione PTV, Oxford Street 81, 00133 Rome, Italy
| | - Alessandra Ascenzi
- Child Neurology and Psychiatry Unit, Tor Vergata Hospital, Fondazione PTV, Oxford Street 81, 00133 Rome, Italy
| | - Alfonso Troisi
- International Medical School, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Luigi Mazzone
- Child Neurology and Psychiatry Unit, Tor Vergata Hospital, Fondazione PTV, Oxford Street 81, 00133 Rome, Italy
- Systems Medicine Department, University of Rome Tor Vergata, Montpellier Street 1, 00133 Rome, Italy
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Berking M, Eichler E, Naumann E, Svaldi J. The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge-eating disorder-Results from a randomized controlled trial. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:998-1018. [PMID: 35567309 DOI: 10.1111/bjc.12371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. METHODS We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment-vs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview. RESULTS Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. CONCLUSIONS The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions.
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Affiliation(s)
| | - Eva Eichler
- University of Erlangen-Nuremberg, Erlangen, Germany
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