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Palmieri S, Mansueto G, Marchant AP, Sassaroli S, Caselli G, Ruggiero GM, Spada MM. The Metacognitions about Binge Eating Questionnaire: Investigation of the association between specific metacognitions and Binge Eating Disorder. Clin Psychol Psychother 2023; 30:780-794. [PMID: 36754777 DOI: 10.1002/cpp.2839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023]
Abstract
Literature suggested that metacognitions are involved in eating problems and may be relevant to the understanding of Binge Eating Disorder (BED). The goal of the current studies was to develop the first self-report instrument on metacognitions about binge eating. In Study 1, a community sample completed the Metacognitions about Binge Eating Questionnaire (MBEQ); an Exploratory Factor Analysis (EFA) was performed. In study 2, a community sample completed the MBEQ and measures assessing severity of binge eating, irrational food beliefs, anxiety, depression, impulsiveness. A Confirmatory Factor Analysis (CFA) was performed. Concurrent and incremental validity were assessed. In study 3, a clinical sample of participants with a diagnosis of BED completed the MBEQ and other measures. Bivariate correlational analysis and hierarchical linear regression were performed. Participants from the general population and participants with a diagnosis of BED were compared. EFA and CFA supported a two-factor solution consisting of positive and negative metacognitions about binge eating. Concurrent and incremental validity were acceptable. The metacognitions factors correlated positively with anxiety, depression, irrational food beliefs, impulsiveness in the community sample, and anxiety, irrational food beliefs, impulsiveness in clinical sample. The metacognitions factors contributed to the prediction of BEDs symptoms, in community and clinical samples, over and above age, gender, impulsiveness, anxiety, depression, irrational food beliefs. The MBEQ possesses good psychometric properties and appears a reliable and valid measure of positive and negative metacognitions about binge eating. Metacognitions about binge eating could be a therapeutic target to reduce the severity of binge eating episodes.
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Affiliation(s)
- S Palmieri
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G Mansueto
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - A P Marchant
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - S Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G M Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - M M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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2
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Vergallito A, Gallucci A, Pisoni A, Punzi M, Caselli G, Ruggiero GM, Sassaroli S, Romero Lauro LJ. Effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders: a meta-analysis of sham or behaviour-controlled studies. J Psychiatry Neurosci 2021; 46:E592-E614. [PMID: 34753789 PMCID: PMC8580831 DOI: 10.1503/jpn.210050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/23/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The possibility of using noninvasive brain stimulation to treat mental disorders has received considerable attention recently. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are considered to be effective treatments for depressive symptoms. However, no treatment recommendation is currently available for anxiety disorders, suggesting that evidence is still limited. We conducted a systematic review of the literature and a quantitative analysis of the effectiveness of rTMS and tDCS in the treatment of anxiety disorders. METHODS Following PRISMA guidelines, we screened 3 electronic databases up to the end of February 2020 for English-language, peer-reviewed articles that included the following: a clinical sample of patients with an anxiety disorder, the use of a noninvasive brain stimulation technique, the inclusion of a control condition, and pre/post scores on a validated questionnaire that measured symptoms of anxiety. RESULTS Eleven papers met the inclusion criteria, comprising 154 participants assigned to a stimulation condition and 164 to a sham or control group. We calculated Hedge's g for scores on disorder-specific and general anxiety questionnaires before and after treatment to determine effect size, and we conducted 2 independent random-effects meta-analyses. Considering the well-known comorbidity between anxiety and depression, we ran a third meta-analysis analyzing outcomes for depression scores. Results showed a significant effect of noninvasive brain stimulation in reducing scores on disorder-specific and general anxiety questionnaires, as well as depressive symptoms, in the real stimulation compared to the control condition. LIMITATIONS Few studies met the inclusion criteria; more evidence is needed to strengthen conclusions about the effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders. CONCLUSION Our findings showed that noninvasive brain stimulation reduced anxiety and depression scores compared to control conditions, suggesting that it can alleviate clinical symptoms in patients with anxiety disorders.
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Affiliation(s)
| | | | - Alberto Pisoni
- From the Department of Psychology, University of Milano Bicocca, Milan, Italy (Vergallito, Pisoni, Punzi, Romero Lauro); the Neuromi, Milan, Italy (Vergallito, Gallucci, Pisoni, Romero Lauro); the Department of Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy (Gallucci); the Studi Cognitivi, Milan, Italy (Caselli, Ruggiero, Sassaroli); and the Faculty of Psychology, Sigmund Freud University, Milan, Italy (Caseli, Ruggiero, Sassaroli)
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Caselli G, Gemelli A, Ferrari C, Beltrami D, Offredi A, Ruggiero GM, Sassaroli S, Spada MM. The effect of desire thinking on facilitating beliefs in alcohol use disorder: An experimental investigation. Clin Psychol Psychother 2020; 28:355-363. [PMID: 32881148 DOI: 10.1002/cpp.2511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 11/06/2022]
Abstract
Permissive beliefs relate to the acceptability of engaging in alcohol use in spite of obvious potential negative consequences. They are considered the most proximal and precipitating cognitive factor in the decision to use alcohol and/or the activation of strategies to obtain it. Recent research suggested that 'desire thinking' may be involved in the escalation of craving and addictive behaviours and can play a role in strengthening permissive beliefs. The current study tested whether the induction of desire thinking would have a stronger effect on rate of conviction in permissive beliefs compared to a control cognitive response in the form of neutral thinking and whether this effect would be specific for patients with alcohol use disorder (AUD). Thirty AUD patients and 30 social drinkers (SD) were randomly allocated to two thinking manipulation tasks (desire thinking and neutral thinking). Current permissive beliefs were measured before and after manipulation and after a resting phase. Findings showed that desire thinking increased the level of current permissive beliefs after manipulation relative to the neutral thinking condition for the AUD group but not for the SD group. This effect was not purely dependent on the concurrent level of perceived craving. This study supports a causal relationship between the induction of desire thinking and rate of conviction in permissive beliefs and highlights the relevance of targeting desire thinking in the treatment for AUD patients.
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Affiliation(s)
- Gabriele Caselli
- Studi Cognitivi, Milan, Italy.,Faculty of Psychology, Sigmund Freud University, Milan, Italy
| | | | | | | | - Alessia Offredi
- Studi Cognitivi, Milan, Italy.,Faculty of Psychology, Sigmund Freud University, Milan, Italy
| | - Giovanni M Ruggiero
- Studi Cognitivi, Milan, Italy.,Faculty of Psychology, Sigmund Freud University, Milan, Italy
| | - Sandra Sassaroli
- Studi Cognitivi, Milan, Italy.,Faculty of Psychology, Sigmund Freud University, Milan, Italy
| | - Marcantonio M Spada
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
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Palmieri S, Mansueto G, Scaini S, Fiore F, Sassaroli S, Ruggiero GM, Borlimi R, Carducci BJ. Role of rumination in the relationship between metacognition and shyness. World J Psychiatry 2018; 8:108-113. [PMID: 30370229 PMCID: PMC6201322 DOI: 10.5498/wjp.v8.i4.108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 08/06/2018] [Accepted: 08/21/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To explore the association between metacognitive beliefs, rumination and shyness in a non-clinical sample of adults.
METHODS One hundred and three healthy subjects from the general population were enrolled in the study. Shyness was evaluated using the Revised Cheek and Buss Shyness Scale, rumination was assessed using the Ruminative Response Scale, metacognition was evaluated using the Meta-Cognitions Questionnaire 30, and anxiety levels were measured using the State Trait Anxiety Inventory form Y. Correlation analyses, mediation models and 95% bias-corrected and accelerated (BCaCI) bootstrapped analyses were performed. Mediation analyses were adjusted for sex and anxiety.
RESULTS Shyness, rumination and metacognition were significantly correlated (P < 0.05). The relationship between metacognition and shyness was fully mediated by rumination (Indirect effect: 0.20; 95% BCaCI: 0.08-0.33).
CONCLUSION These findings suggest an association between metacognition and shyness. Rumination mediated the relationship between metacognition and shyness, suggesting that rumination could be a cognitive strategy for shy people. Future research should explore the relationship between these constructs in more depth.
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Affiliation(s)
- Sara Palmieri
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan 20121, Italy
- Department of Psychology, Sigmund Freud University, Milan 20143, Italy
| | - Giovanni Mansueto
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan 20121, Italy
- Department of Psychology, Sigmund Freud University, Milan 20143, Italy
| | - Simona Scaini
- Department of Psychology, Sigmund Freud University, Milan 20143, Italy
| | - Francesca Fiore
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan 20121, Italy
| | - Sandra Sassaroli
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan 20121, Italy
- Department of Psychology, Sigmund Freud University, Milan 20143, Italy
| | - Giovanni M Ruggiero
- Department of Psychology, Sigmund Freud University, Milan 20143, Italy
- Psicoterapia Cognitiva e Ricerca, Cognitive Psychotherapy School, Milan 20121, Italy
| | - Rosita Borlimi
- Department of Psychology, Sigmund Freud University, Milan 20143, Italy
| | - Bernardo J Carducci
- Shyness Research Institute, Indiana University Southeast, New Albany, OH 47150, United States
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Ruggiero GM, Spada MM, Caselli G, Sassaroli S. A Historical and Theoretical Review of Cognitive Behavioral Therapies: From Structural Self-Knowledge to Functional Processes. J Ration Emot Cogn Behav Ther 2018; 36:378-403. [PMID: 30416258 PMCID: PMC6208646 DOI: 10.1007/s10942-018-0292-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This paper critically examines the historical conceptualization of cognitive behavioral psychotherapy approaches (CBT) as a direct clinical counterpart of the cognitive revolution. The main "second wave" cognitive psychotherapies, either standard cognitive therapy (CT) or constructivist, in spite of their differences, share a common conceptualization of psychopathological factors as superordinate structural cognitive content belonging to the self: self-beliefs, self-schemata, personality organizations and so on. On the other hand, rational emotive behavior therapy (REBT) is an exception given that in REBT self-knowledge is not the core psychopathological tenet, being rather a derivate mechanism. Moreover, in non clinical cognitive science cognition is conceived as a regulatory function that operates retroactively and not in a hierarchically super- ordered fashion centered on the self. A historical review suggests that in both CT and constructivist model the structuralistic model of self-centered cognition may have emerged for both cultural and scientific reasons: self-centered cognitive models may be more readily understandable to clinicians as they allow for a straightforward identification of operationalizable self-beliefs. The emergence of new "third wave" process-centered CBT approaches may represent a comeback to functionalism, where cognition is considered again a regulatory function and not a structure. In addition, REBT's interest in dysfunctional evaluations not focused on the self presaged this clinical and scientific turning point toward functionalism.
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Affiliation(s)
- Giovanni M. Ruggiero
- “Psicoterapia Cognitiva e Ricerca” Cognitive Psychotherapy School and Research Center, Milano, Foro Buonaparte 57, 20121 Milan, Italy
- “Studi Cognitivi” Cognitive Psychotherapy School and Research Center, Foro Buonaparte 57, 20121 Milan, Italy
| | - Marcantonio M. Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA UK
| | - Gabriele Caselli
- “Studi Cognitivi” Cognitive Psychotherapy School and Research Center, Foro Buonaparte 57, 20121 Milan, Italy
- Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy
- Sigmund Freud University, Freudplatz 1, Messestraße 1, 1020 Vienna, Austria
| | - Sandra Sassaroli
- “Studi Cognitivi” Cognitive Psychotherapy School and Research Center, Foro Buonaparte 57, 20121 Milan, Italy
- Sigmund Freud University, Ripa di Porta Ticinese 77, 20143 Milan, Italy
- Sigmund Freud University, Freudplatz 1, Messestraße 1, 1020 Vienna, Austria
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Sapuppo W, Ruggiero GM, Caselli G, Sassaroli S. The Body of Cognitive and Metacognitive Variables in Eating Disorders: Need of Control, Negative Beliefs about Worry Uncontrollability and Danger, Perfectionism, Self-esteem and Worry. Isr J Psychiatry 2018; 55:55-63. [PMID: 29916407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Many studies have described perfectionism and low self-esteem as traits associated with eating disorders (ED). More recently, research has shown the role played by worry, rumination, control and metacognitive beliefs. This paper investigates the role played by cognitive and metacognitive variables in the psychopathological mechanism of eating disorders, assuming that not only perfectionism and low selfesteem but also metacognitive beliefs and processes can discriminate between controls and EDs. METHOD The Structured Clinical Interview for DSM, the Multidimensional Perfectionism Scale, the Rosenberg Self-Esteem Scale, the Anxiety Control Questionnaire, the Penn State Worry and the Metacognition Questionnaire were administered to the samples. RESULTS Results suggested that metacognitive factors like negative beliefs about worry, uncontrollability and danger, need for control, and worry should be added to the body of cognitive factors underlying ED composed by the classical couple of cognitive factors including perfectionism and low self-esteem. CONCLUSIONS It is possible that an individual with ED assumes that metacognitive processes like worry and rumination are a further proof of his or her lack of value, capacity to control, and self-control. Such appraisals may reinforce the painful sense of low self-esteem so typical in ED and, in turn, the perfectionistic striving for excellence.
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Affiliation(s)
- Walter Sapuppo
- Sigmund Freud University, Milan, Italy and Vienna, Austria Psicoterapia Cognitiva e Ricerca Cognitive Psychotherapy School and Research Center, Milan, Italy, and a branch in Bolzano School of Applied Sciences, London South Bank University, London, U.K
| | - Giovanni M Ruggiero
- Sigmund Freud University, Milan, Italy and Vienna, Austria Psicoterapia Cognitiva e Ricerca Cognitive Psychotherapy School and Research Center, Milan, Italy, and a branch in Bolzano
| | - Gabriele Caselli
- Sigmund Freud University, Milan, Italy and Vienna, Austria Studi Cognitivi Cognitive Psychotherapy School and Research Center, Milan, Italy and branches in Modena and San Benedetto del Tronto School of Applied Sciences, London South Bank University, London, U.K
| | - Sandra Sassaroli
- Sigmund Freud University, Milan, Italy and Vienna, Austria Studi Cognitivi Cognitive Psychotherapy School and Research Center, Milan, Italy and branches in Modena and San Benedetto del Tronto
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Caselli G, Offredi A, Martino F, Varalli D, Ruggiero GM, Sassaroli S, Spada MM, Wells A. Metacognitive beliefs and rumination as predictors of anger: A prospective study. Aggress Behav 2017; 43:421-429. [PMID: 28229465 DOI: 10.1002/ab.21699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 12/07/2016] [Accepted: 12/17/2016] [Indexed: 12/25/2022]
Abstract
The metacognitive approach conceptualizes the relationship between anger and rumination as driven by metacognitive beliefs, which are information individuals hold about their own cognition and about coping strategies that impact on it. The present study aimed to test the prospective predictive impact of metacognitive beliefs and rumination on anger in a community sample. Seventy-six participants were recruited and engaged in a 2-week anger, rumination, and metacognitive beliefs monitoring protocol. A multi-wave panel design was employed to test whether metacognitive beliefs and rumination have a prospective impact on anger. Metacognitive beliefs and rumination were found to have a significant prospective impact on anger that was independent from the number of triggering events. Metacognitive beliefs about the need to control thoughts were shown to have a direct impact on subsequent anger, independently from rumination. These findings provide support for the potential value for applying metacognitive theory and therapy to anger-related problems. Aggr. Behav. 43:421-429, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Gabriele Caselli
- Sigmund Freud University; Milan Italy
- Studi Cognitivi; Milan Italy
- London South Bank University; London UK
| | | | - Francesca Martino
- Studi Cognitivi; Milan Italy
- DIMEC University of Bologna; Bologna Italy
| | | | | | | | | | - Adrian Wells
- University of Manchester; Manchester UK
- Manchester Mental Health and Social Care NHS Trust; Manchester UK
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Sassaroli S, Centorame F, Caselli G, Favaretto E, Fiore F, Gallucci M, Sarracino D, Ruggiero GM, Spada MM, Rapee RM. Anxiety control and metacognitive beliefs mediate the relationship between inflated responsibility and obsessive compulsive symptoms. Psychiatry Res 2015; 228:560-4. [PMID: 26141603 DOI: 10.1016/j.psychres.2015.05.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/27/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
Abstract
Research has indicated that beliefs about inflated responsibility, beliefs about perceived control over anxiety-related events and reactions (anxiety control) and metacognitive beliefs about the need to control thoughts are associated with obsessive compulsive symptoms. In the current study we tested a mediation model of the interactions between these variables in predicting obsessive compulsive symptoms. Thirty-seven individuals with obsessive compulsive disorder and 31 controls completed the following self-report instruments: the Responsibility Attitude Scale, the Anxiety Control Scale, the Beliefs about Need to Control Thoughts sub-scale of the Metacognitions Questionnaire 30, and the Padua Inventory. Mann-Whitney U tests revealed that participants in the clinical group scored significantly higher than those in the non-clinical group on all variables. In the mediation model we found that the relationship between beliefs about inflated responsibility and obsessive compulsive symptoms was fully mediated by anxiety control and beliefs about the need to control thoughts. These findings provide support for the significant role played by beliefs about control in predicting the severity of obsessive compulsive symptoms.
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Affiliation(s)
| | | | - Gabriele Caselli
- Studi Cognitivi, Foro Buonaparte 57, 20121 Milano, Italy; School of Applied Sciences, London South Bank University, 103 Borough Road, London SE1 0AA, UK; Sigmund Freud University, Campus Prater Freudplatz 1 1020 Wien, Austria, and Ripa di Porta Ticinese 77, 20143 Milano, Italy.
| | | | | | - Marcello Gallucci
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy.
| | - Diego Sarracino
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy.
| | | | - Marcantonio M Spada
- School of Applied Sciences, London South Bank University, 103 Borough Road, London SE1 0AA, UK.
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, NSW 2109 Sydney, Australia.
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Spada MM, Caselli G, Fernie BA, Manfredi C, Boccaletti F, Dallari G, Gandini F, Pinna E, Ruggiero GM, Sassaroli S. Desire thinking: A risk factor for binge eating? Eat Behav 2015; 18:48-53. [PMID: 25880044 DOI: 10.1016/j.eatbeh.2015.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/14/2015] [Accepted: 03/30/2015] [Indexed: 11/30/2022]
Abstract
In the current study we explored the role of desire thinking in predicting binge eating independently of Body Mass Index, negative affect and irrational food beliefs. A sample of binge eaters (n=77) and a sample of non-binge eaters (n=185) completed the following self-report instruments: Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, Desire Thinking Questionnaire, and Binge Eating Scale. Mann-Whitney U tests revealed that all variable scores were significantly higher for binge eaters than non-binge eaters. A logistic regression analysis indicated that verbal perseveration was a predictor of classification as a binge eater over and above Body Mass Index, negative affect and irrational food beliefs. A hierarchical regression analysis, on the combined sample, indicated that verbal perseveration predicted levels of binge eating independently of Body Mass Index, negative affect and irrational food beliefs. These results highlight the possible role of desire thinking as a risk factor for binge eating.
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Affiliation(s)
| | - Gabriele Caselli
- School of Applied Sciences, London South Bank University, London, UK; Studi Cognitivi, Milan, Italy
| | - Bruce A Fernie
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, London, UK; CASCAID, South London & Maudsley NHS Foundation Trust, London, UK
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Caselli G, Canfora F, Ruggiero GM, Sassaroli S, Albery IP, Spada MM. Desire Thinking Mediates the Relationship between Emotional Intolerance and Problem Drinking. Int J Ment Health Addict 2014. [DOI: 10.1007/s11469-014-9520-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ottaviani C, Borlimi R, Brighetti G, Caselli G, Favaretto E, Giardini I, Marzocchi C, Nucifora V, Rebecchi D, Ruggiero GM, Sassaroli S. Worry as an adaptive avoidance strategy in healthy controls but not in pathological worriers. Int J Psychophysiol 2014; 93:349-55. [PMID: 24873888 DOI: 10.1016/j.ijpsycho.2014.05.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 05/16/2014] [Accepted: 05/20/2014] [Indexed: 11/27/2022]
Abstract
The cognitive avoidance model of worry assumes that worry has the adaptive function to keep under control the physiological arousal associated with anxiety. This study aimed to test this model by the use of a fear induction paradigm in both pathological and healthy individuals. Thirty-one pathological worriers and 36 healthy controls accepted to be exposed to a fear induction paradigm (white noise) during three experimental conditions: worry, distraction, and reappraisal. Skin conductance (SCR) and heart rate variability (HRV) were measured as indices of sympathetic and parasympathetic nervous system functioning. Worriers showed increased sympathetic and decreased parasympathetic activation during the worry condition compared to non-worriers. There were no differences between groups for the distraction and reappraisal conditions. SCRs to the white noises during worry were higher in worriers versus controls throughout the entire worry period. Intolerance of uncertainty - but not metacognitive beliefs about worry - was a significant moderator of the relationship between worry and LF/HF-HRV in pathological worriers. Results support the cognitive avoidance model in healthy controls, suggesting that worry is no longer a functional attitude when it becomes the default/automatic and pathological response.
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Affiliation(s)
| | - Rosita Borlimi
- Department of Psychology, University of Bologna, Bologna, Italy
| | | | - Gabriele Caselli
- Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy
| | - Ettore Favaretto
- Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy; Azienda Sanitaria di Bolzano, Italy
| | - Irene Giardini
- Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy
| | - Camilla Marzocchi
- Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy
| | | | - Daniela Rebecchi
- Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy
| | - Giovanni M Ruggiero
- Psicoterapia Cognitiva e Ricerca, Post Graduate Cognitive Psychotherapy School, Milano and Bolzano, Italy.
| | - Sandra Sassaroli
- Studi Cognitivi, Post Graduate Cognitive Psychotherapy School, Milano, Modena and San Benedetto del Tronto, Italy
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Fiore F, Ruggiero GM, Sassaroli S. Emotional dysregulation and anxiety control in the psychopathological mechanism underlying drive for thinness. Front Psychiatry 2014; 5:43. [PMID: 24795659 PMCID: PMC4006023 DOI: 10.3389/fpsyt.2014.00043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/11/2014] [Indexed: 11/16/2022] Open
Abstract
Emotional dysregulation is a process which consists in mitigating, intensifying, or maintaining a given emotion and is the trigger for some psychological disorders. Research has shown that an anxiety control plays an important role in emotional expression and regulation and, in addition, for anorexia nervosa (AN) and, more in general, in drive for thinness. Scientific literature suggests that in AN there is a core of emotional dysregulation and anxiety control. The aim of this study is to explore the roles of emotional dysregulation and anxiety control as independent or third variables in a mediational regression model related to drive for thinness. One hundred fifty-four clinical individuals with anorexia participated in the study and all completed a set of self-report questionnaires: eating disorders inventory version 3 (EDI-3), DERS, and the anxiety control questionnaire. The data confirmed a mediational model in which the relation between emotional dysregulation and drive for thinness is mediated by anxiety control. The current study partially supports a clinical model in which emotional dysregulation is a distal factor in eating disorders while the mediator variable anxiety control is a proximal factor in the psychopathological process underlying it.
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Affiliation(s)
- Francesca Fiore
- Studi Cognitivi, Post-Graduate Cognitive Psychotherapy School, Milan, Italy
| | - Giovanni M. Ruggiero
- Psicoterapia Cognitiva e Ricerca, Post-Graduate Cognitive Psychotherapy School, Milan, Italy
| | - Sandra Sassaroli
- Studi Cognitivi, Post-Graduate Cognitive Psychotherapy School, Milan, Italy
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Ruggiero GM, Ammendola E, Caselli G, Sassaroli S. REBT in Italy: Dissemination and Integration with Constructivism and Metacognition. J Rat-Emo Cognitive-Behav Ther 2014. [DOI: 10.1007/s10942-013-0177-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Caselli G, Gemelli A, Querci S, Lugli AM, Canfora F, Annovi C, Rebecchi D, Ruggiero GM, Sassaroli S, Spada MM, Watkins ER. The effect of rumination on craving across the continuum of drinking behaviour. Addict Behav 2013; 38:2879-83. [PMID: 24045029 DOI: 10.1016/j.addbeh.2013.08.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/21/2013] [Accepted: 08/21/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Rumination is an abstract, persistent, and repetitive thinking style that can be adopted to control negative affect. Recent studies have suggested the role of rumination as direct or indirect cognitive predictor of craving experience in alcohol-related problems. AIMS The goal of this study was to explore the effect of rumination induction on craving across the continuum of drinking behaviour. METHODS Participants of three groups of alcohol-dependent drinkers (N=26), problem drinkers (N=26) and social drinkers (N=29) were randomly allocated to two thinking manipulation tasks: distraction versus rumination. Craving was measured before and after manipulation and after a resting phase. RESULTS Findings showed that rumination had a significant effect on increasing craving in alcohol-dependent drinkers, relative to distraction, but not in problem and social drinkers. This effect was independent of baseline depression and rumination and was maintained across the resting phase. CONCLUSIONS Rumination showed a direct causal impact on craving that is specific for a population of alcohol-dependent drinkers.
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Ruggiero GM, Stapinski L, Caselli G, Fiore F, Gallucci M, Sassaroli S, Rapee RM. Beliefs over control and meta-worry interact with the effect of intolerance of uncertainty on worry. Personality and Individual Differences 2012. [DOI: 10.1016/j.paid.2012.03.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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Marsero S, Ruggiero GM, Scarone S, Bertelli S, Sassaroli S. The relationship between alexithymia and maladaptive perfectionism in eating disorders: a mediation moderation analysis methodology. Eat Weight Disord 2011; 16:e182-7. [PMID: 22290034 DOI: 10.1007/bf03325130] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This work aimed to explore the relationship between alexithymia and maladaptive perfectionism in the psychological process leading to eating disorders (ED). METHOD Forty-nine individuals with ED and 49 controls completed the Concern over Mistakes subscale of the Frost Multidimensional Perfectionism Scale, the Perfectionism subscale of the Eating Disorders Inventory, the total score of the Toronto Alexithymia Scale, and the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorders Inventory. We tested a model in which alexythimia is the independent variable and perfectionism is the possible mediator or moderator. RESULTS Analyses confirmed the assumed model. In addition, it emerged that perfectionism played a mediating or moderating role when measured by different instruments. This result suggested that different instruments measured subtly different aspects of the same construct. DISCUSSION Results could suggest that alexithymia is a predisposing factor for perfectionism, which in turn may lead to the development of eating disorders.
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Affiliation(s)
- S Marsero
- "Studi Cognitivi", Post-graduate Cognitive Psychotherapy School, Milano, Italy.
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Manfredi C, Caselli G, Rovetto F, Rebecchi D, Ruggiero GM, Sassaroli S, Spada MM. Temperament and parental styles as predictors of ruminative brooding and worry. Personality and Individual Differences 2011. [DOI: 10.1016/j.paid.2010.09.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Paulesu E, Sambugaro E, Torti T, Danelli L, Ferri F, Scialfa G, Sberna M, Ruggiero GM, Bottini G, Sassaroli S. Neural correlates of worry in generalized anxiety disorder and in normal controls: a functional MRI study. Psychol Med 2010; 40:117-124. [PMID: 19419593 DOI: 10.1017/s0033291709005649] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Worry is considered a key feature of generalized anxiety disorder (GAD), whose neural correlates are poorly understood. It is not known whether the brain regions involved in pathological worry are similar to those involved in worry-like mental activity in normal subjects or whether brain areas associated with worry are the same for different triggers such as verbal stimuli or faces. This study was designed to clarify these issues. METHOD Eight subjects with GAD and 12 normal controls underwent functional magnetic resonance imaging (fMRI) mood induction paradigms based on spoken sentences or faces. Sentences were either neutral or designed to induce worry. Faces conveyed a sad or a neutral mood and subjects were instructed to empathize with those moods. RESULTS We found that the anterior cingulate and dorsal medial prefrontal cortex [Brodmann area (BA) 32/23 and BA 10/11] were associated with worry triggered by sentences in both subjects with GAD and normal controls. However, GAD subjects showed a persistent activation of these areas even during resting state scans that followed the worrying phase, activation that correlated with scores on the Penn State Worry Questionnaire (PSWQ). This region was activated during the empathy experiment for sad faces. CONCLUSIONS The results show that worry in normal subjects and in subjects with GAD is based on activation of the medial prefrontal and anterior cingulate regions, known to be involved in mentalization and introspective thinking. A dysregulation of the activity of this region and its circuitry may underpin the inability of GAD patients to stop worrying.
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Affiliation(s)
- E Paulesu
- Psychology Department, University of Milano Bicocca, Milano, Italy.
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20
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Ruggiero GM, Bertelli S, Boccalari L, Centorame F, Ditucci A, La Mela C, Scarinci A, Vinai P, Scarone S, Sassaroli S. The influence of stress on the relationship between cognitive variables and measures of eating disorders (in healthy female university students): a quasi-experimental study. Eat Weight Disord 2008; 13:142-8. [PMID: 19011372 DOI: 10.1007/bf03327615] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Perfectionism, poor self-esteem and stress have all been described as important risk factors for eating disorders. The purpose of this study was to assess whether a stressful situation is significantly correlated to and associated with significantly higher levels of perfectionism, stress, quantifiable measures of eating disorders, and with significantly lower levels of self-esteem in a non-clinical sample. METHOD Thirty-five female university students completed the Multidimensional Perfectionism Scale, the Rosenberg Self-Esteem Scale, the Perceived Stress Scale, and the Eating Disorder Inventory two times; once on an average university day and once on the day of an exam. Descriptive statistics and t-tests were calculated to verify whether a stressful situation was associated with a significant difference in levels of perfectionism, self-esteem, stress, and measures of eating disorders. Bivariate correlations were calculated for both the stress and non-stress situation, to observe how the dimensions of perfectionism, self-esteem, and stress were associated with measures of eating disorders. RESULTS During the stress situation, the study participants had, on average, significantly higher levels of concern over mistakes, body dissatisfaction, drive for thinness, and perceived stress. Bivariate correlations revealed that during the stress situation perceived stress, cognitive variables and measures of eating disorders showed significant correlations with each other that were absent in the non stress situation. DISCUSSION The results of the present study suggest that the dimensions of pathological perfectionism, low self-esteem, and perceived stress are related to an increase in dieting thoughts and dissatisfaction with body aspect in non-clinical women during a performance that could potentially challenge the perception of their self-esteem. The stressful situation can be interpreted as an experience of invalidation, which could explain the connection between cognitive constructs and behaviours related to eating disorders.
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Affiliation(s)
- G M Ruggiero
- Studi Cognitivi, Post-Graduate Cognitive Psychotherapy School, Milan, Italy
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Sassaroli S, Bertelli S, Decoppi M, Crosina M, Milos G, Ruggiero GM. Worry and eating disorders: a psychopathological association. Eat Behav 2005; 6:301-7. [PMID: 16257803 DOI: 10.1016/j.eatbeh.2005.05.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Accepted: 05/26/2005] [Indexed: 11/30/2022]
Abstract
UNLABELLED Worry is a mental process associated with anxiety disorders. The key feature of worry is the predominance of a negative-type and preoccupied thought about possible threatening future events. OBJECTIVE Some studies have shown that worry may be a feature of eating disorders. This study aims to measure whether worry is significantly higher in eating disordered individuals than in a normal control group and whether worry is associated with the Eating Disorders Inventory. METHODS Sixty-three individuals affected by an eating disorder (34 anorexics and 29 bulimics) completed the Penn State Worry Questionnaire, the Structured Clinical Interview for DSM, and the Eating Disorder Inventory. Thirty normal controls completed the Penn State Worry Questionnaire. RESULTS Penn State Worry Questionnaire scores were significantly higher in eating disordered individuals than in controls. It was associated with all the symptoms of eating disorders and was correlated with all the EDI subscales, except for the subscale 'bulimia'. These findings suggest that worry is important for understanding the psychopathology of eating disorders.
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Affiliation(s)
- S Sassaroli
- Studi Cognitivi Cognitive Psychotherapy School Milano, Via delle Tuberose 14, 20146 Milano, Italy
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Sassaroli S, Mezzaluna C, Amurri A, Bossoletti R, Ciccioli T, Perrotta A, Romualdi A, Stronati A, Urbani S, Valenti V, Milos G, Ruggiero GM. Stress plays a role in the association between cognitive constructs and measures of eating disorders in male subjects. Eat Weight Disord 2005; 10:117-24. [PMID: 16114225 DOI: 10.1007/bf03327533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Several theorists have hypothesized that stressful situations may trigger abnormal eating and even eating disorders in predisposed people. The purpose of this study was to assess whether a stressful situation would reveal an association between perfectionism and low self-esteem, and measures of eating disorder symptoms in male high school students. METHOD A sample of 61 male high school students completed the Eating Disorder Inventory, the Multidimensional Perfectionism Scale, and the Self Liking and Competence Scale three times: on an average school day, on the day of an exam and on the day the subjects received the results of that exam. Linear regression analysis was carried out to verify whether the dimensions of perfectionism were associated with the measures of eating disorders. RESULTS Interoceptive awareness was associated with 'Bulimia' only during the stressful situation and with 'Drive for thinness' both in stress and non stress situations. Other results were contradictory and difficult to interpret. DISCUSSION The results suggest that in nonclinical male individuals stress might bring out a previously absent association between some psychological predisposing factors for eating disorders and an actual desire or plan for ED related thoughts and behaviours. Such a finding suggests that stress may stimulate behaviours related to eating disorders in a predisposed personality. A central role may be played by interoceptive awareness in male subjects.
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Affiliation(s)
- S Sassaroli
- Studi Cognitivi, Post-graduate Cognitive Psychotherapy School, San Benedetto del Tronto and Milano, Italy
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Ruggiero GM, Mauri MC, Omboni AC, Volonteri LS, Dipasquale S, Malvini L, Redaelli G, Pasqualinotto L, Cavagnini F. Nutritional management of anorexic patients with and without fluoxetine: 1-year follow-up. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27:425-30. [PMID: 12691777 DOI: 10.1016/s0278-5846(03)00029-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study evaluated the efficacy of nutritional management with and without fluoxetine (FLX) in anorexia nervosa diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Twenty-one patients, with a mean body mass index (BMI) of 15.21+/-2.33 kg/m(2), were treated with nutritional management and FLX at a mean dosage of 30.00+/-9.35 mg (pharmacological group); seventy-four patients, with a mean BMI of 14.24+/-2.16 kg/m(2), were treated only with nutritional management (nutritional group). Clinical evaluation was carried out under single-blind conditions at basal time and after 3, 6, and 12 months by a structured clinical interview, the Eating Disorder Interview based on Longitudinal Interval Follow-Up Evaluation (EDI-LIFE) and using a self-reported questionnaire, the Eating Disorder Inventory (EDI). BMI significantly increased in both the two treatment groups. In addition, the increase shown by the pharmacological group appeared near the beginning of treatment (i.e., at T1) and it was significantly higher than the increase shown by the nutritional group. Physical exercise showed a significant decrease in the pharmacological treatment group. On the other hand, fear of fatness and the scores of the subscales of the EDI significantly decreased in the nutritional treatment group. In terms of weight, the pharmacological group presented the higher amount of therapeutic success.
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Jaeger B, Ruggiero GM, Edlund B, Gomez-Perretta C, Lang F, Mohammadkhani P, Sahleen-Veasey C, Schomer H, Lamprecht F. Body dissatisfaction and its interrelations with other risk factors for bulimia nervosa in 12 countries. Psychother Psychosom 2002; 71:54-61. [PMID: 11740169 DOI: 10.1159/000049344] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND It is widely accepted that risk factors for bulimia nervosa, mainly body dissatisfaction, are dependent on cultural factors. However, to date few studies have compared data from different cultures with an appropriate methodology. Therefore we aimed to gather reliable information on body dissatisfaction and other risk factors for bulimia from different nations and to reveal their functional interrelations. METHODS A series of 10 silhouettes, designed to be as far as possible free from cultural and other detailed aspects, was shown to 1,751 medical and nursing students in 12 nations. A functional model was applied to each sample and tested by structural equation methodology. RESULTS The most extreme body dissatisfaction was found in northern Mediterranean countries, followed by northern European countries. Countries currently undergoing a process of westernization show an intermediate amount of body dissatisfaction, and non-western countries demonstrate rather low values. Body dissatisfaction is the most important influence on dieting behaviour in most countries. CONCLUSIONS Despite ongoing adoption of western values worldwide, we observe remarkable differences in body dissatisfaction between different cultures. That body dissatisfaction seems disturbingly partly detached from the actual BMI, i.e. possible overweight, as well as from feelings of low self-esteem in some western countries, raises new questions about the possible origin of the pressure to be thin.
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Affiliation(s)
- B Jaeger
- Department of Psychosomatics and Psychotherapy, Hannover Medical School, Hannover, Germany.
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Ruggiero GM, Laini V, Mauri MC, Ferrari VM, Clemente A, Lugo F, Mantero M, Redaelli G, Zappulli D, Cavagnini F. A single blind comparison of amisulpride, fluoxetine and clomipramine in the treatment of restricting anorectics. Prog Neuropsychopharmacol Biol Psychiatry 2001; 25:1049-59. [PMID: 11444677 DOI: 10.1016/s0278-5846(01)00174-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
1. The study evaluated the efficacy of amisulpride, fluoxetine and clomipramine at the beginning of the re-feeding phase of the treatment of restricting anorexia nervosa according to DSM-IV criteria. 2. 13 patients, mean weight 37.61 kg +/- 9.80 SD, were treated with clomipramine at a mean dosage of 57.69 mg +/- 25.79 SD; 10 patients, mean weight 40.90 kg +/- 6.98 SD, were treated with fluoxetine at a mean dosage of 28.00 mg +/- 10.32 SD; 12 patients, mean weight 38.41 kg +/- 8.33 SD, were treated with amisulpride at a mean dosage of 50.00 mg +/- 0.00 SD. 3. Clinical evaluation was carried out under single-blind condition at basal time and after three months by a structured clinical interview, the Eating Disorder Interview based on Long Interval Follow-up Evaluation (LIFE II BEI). 4. Patients treated with amisulpride showed a more significant increase (p=0.016) of mean weight. Concerning weight phobia, body image disturbance and amenorrhoea, no significant difference resulted.
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Affiliation(s)
- G M Ruggiero
- Department of Clinical Psychiatry, University of Milan, Italy
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Ruggiero GM, Mantero M, Asti M, Agostinelli ML, Casaccio F, Garghentini PG, Gozzini C, Zita G, Penati G. Eating Attitudes Test and culture: a study in northern and southern Italy. Eat Weight Disord 1999; 4:89-94. [PMID: 11234247 DOI: 10.1007/bf03339723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The EAT (Eating Attitudes Test) has been widely used to compare eating morbidity in cultural groups and variations in it have been taken as indicative of cultural differences. This study assumed the existence of cultural differences between the north and the south of Italy. The EAT scores of female students from a northern and a southern Italian high school were compared. They were both higher than in other European studies, though there were no significant differences between the two groups. The result could be due to sampling limitations, but could also indicate that the EAT is not a reliable yardstick of cultural differences.
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Affiliation(s)
- G M Ruggiero
- Clinica Psichiatrica II, Ospedale Maggiore I.R.C.C.S., Università di Milano.
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