Disorders - Eating Disorders
Turk, F., Kellett, S., Waller, G.
This study assessed the feasibility
and effectiveness of two brief online interventions for body shame for women with moderate to severe negative body image, to inform the design of a
future randomized controlled trial. The primary feasibility outcomes were recruitment, measure completion rates, retention rates and internet
connection failure rates. The secondary pilot outcomes were change on clinical measures and state shame ratings during the interventions.
Participants were randomized to either online (40-min single session) body exposure or self-compassion interventions. Five validated nomothetic
outcome measures (body dissatisfaction, appreciation, eating disorder, external shame and anxiety) were taken at three time points (preintervention,
postintervention and 2-week follow-up). Subjective units of body shame (SUBS 0-100 scale) were rated every 5 min during the interventions. The target
of recruiting 30 participants in 60 days was successfully achieved. The measure completion rate was high (100%), and retention rates (80% to 100%)
showed moderate-to-high acceptability of the interventions. Online delivery was moderately viable with a 12.5% session disconnection rate. The self-
compassion intervention significantly reduced SUBS ratings during the course of the intervention, but there was no significant improvement or
difference between the interventions on nomothetic outcome measures. Findings suggest that a fully powered trial is viable, and sample size
calculation and methodological requirements are provided.
Clinical
Psychology & Psychotherapy, 29(4) : 1475-1480
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Other Psychological Interventions
Tobin, L. N., Sears, C. R., von-Ranson, K. M.
OBJECTIVE: This cluster randomized controlled trial evaluated the efficacy of participation in the Body Project-a
cognitive-dissonance-based preventive intervention that reduces self-reported body dissatisfaction-for reducing body-dissatisfaction-related
attentional biases. We hypothesized that women in a Body Project condition would show a greater reduction in attentional biases to weight-related
images and words at postintervention than women in a wait-list control condition.\rMETHOD: Body-dissatisfied university women (N = 168;
Mage = 20.50 +/- 3.37 years; 42.0% White; MBMI = 23.08 +/- 4.45 kg/m2) were randomly assigned to a Body Project, media
psychoeducation (i.e., active control), or wait-list control condition. We assessed attentional biases via eye-gaze tracking and body satisfaction
using the Body Shape Questionnaire, at baseline and postintervention.\rRESULTS: Self-reported outcomes from previous literature were replicated.
Compared to wait-list, Body Project participation reduced attention to images of thin models (ps < .05; ds = .19, .24), but not to weight-related
words. Compared to wait-list, the media psychoeducation condition reduced attention to fat-related images and words (ds = .17, .18).\rCONCLUSIONS:
This study, which replicates previous self-report findings, is the first to find that two preventive interventions reduced an objective outcome
(attentional bias to weight-related images) in body-dissatisfied women. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Journal of Consulting &
Clinical Psychology, 90(12) : 911-924
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation, Other Psychological Interventions
Stentz, L. A., Wilver, N. L., McDermott, K. A., Cougle, J. R.
Background: Conceptualizations of body image-related disorders suggest that targeting safety behaviors (SB)
may help reduce eating disorder (ED) symptoms. No consensus exists regarding the mechanism underlying the relationship between SBs and ED symptoms,
though one hypothesized construct is overvaluation of appearance.
Cognitive Therapy and Research, 46(5) : 1006-
1015
- Year: 2022
- Problem: Eating Disorders
(any), Bulimia Nervosa
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Sonntag, M., Russell, J.
OBJECTIVE: Mentalisation-based treatment (MBT) aims to improve reflective
functioning. There is a growing evidence base outlining positive clinical outcomes for the use of MBT in eating disorder patients with co-morbid
borderline personality disorder (BPD). The use of MBT has not been studied for eating disorder patients without BPD. This pilot study is an
exploratory randomised controlled trial in which outcomes from MBT are compared with standard clinical management in a cohort of patients diagnosed
with an eating disorder but not BPD. The main objectives were two-fold-to explore the use of MBT as a therapeutic modality and to test the
acceptability and feasibility of the protocol design. METHOD(S): Thirty-two participants were randomised to receive either MBT or standard treatment
during an inpatient eating disorders program. All patients enrolled in the study were diagnosed with an eating disorder but did not meet DSM-5
criteria for BPD. On admission patients were categorised as very underweight (BMI 15.0-16.4 kg/m2 ), underweight (BMI 16.5-18.4 kg/m2 ) or healthy
weight range (BMI >= 18.5-24.9 kg/m2 ). Upon discharge participants were further categorised as weight restored (BMI >= 18.5 kg/m2 ) or non-weight
restored (BMI < 18.5 kg/m2 ). The primary outcome was the subscale score on the Reflective Functioning Questionnaire (RFQ-8). Secondary outcomes were
subscale scores on the Eating Disorder Examination Questionnaire and the Depression, Anxiety and Stress Scale (DASS)-21. Participants were assessed
at baseline and on discharge. Statistical significance was determined using repeated measurements analysis of variance (ANOVA). RESULT(S): Both
groups experienced improvements in eating disorder symptoms and measures of psychological well-being. Participants within the MBT group exhibited
greater improvements in reflective capacity as defined by the RFQ-8 however these benefits appeared to be limited to patients who achieved weight
restoration at discharge. The eligibility criteria-which excluded comorbid BPD-led to challenges in recruitment which limited the power of the study
analysis. As participants with a range of different eating disorder diagnoses were included this led to complexities in estimating the treatment
effect within a defined cohort. CONCLUSION(S): Although the small sample size must be noted as a limitation-the finding that weight restoration
appears to be associated with improvements in reflective capacity in MBT would be worth exploring in a subsequent larger study. Modification of
eligibility criteria and recruitment from a defined cohort may increase the efficiency of a future study. Copyright © 2022 Eating Disorders
Association and John Wiley & Sons Ltd.
European eating disorders review : the journal of the Eating Disorders
Association., 07 :
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Mentalization-based
therapy
Schneider, E., Martin, E., Rotshtein, P., Qureshi, K. L., Chamberlain, S. R., Spetter, M. S., Dourish, C. T., Higgs, S.
Lisdexamfetamine dimesylate (LDX) is the only drug currently approved by the FDA for the treatment of Binge-
Eating Disorder (BED), but little is known about the behavioural mechanisms that underpin the efficacy of LDX in treating BED. We examined the
behavioural and neural effects of an acute dose of LDX (50 mg) in 22 women with binge-eating symptomatology using a randomised, crossover, double-
blind, placebo-controlled experimental medicine design. LDX reduced self-reported appetite ratings and intake of both a pasta meal and a palatable
cookie snack. LDX also decreased the eating rate of pasta but not of cookies and reduced self-reported liking ratings for pasta at the end of the
meal. When viewing food pictures during an fMRI scan, LDX reduced activity bilaterally in the thalamus. LDX enhanced sustained attention and reduced
impulsive responding in a continuous performance task but had no effect on emotional bias or working memory. These results suggest the observed
effects of LDX on food intake (and by implication the efficacy of LDX in treating BED) may be related to the actions of the drug to enhance satiety,
reduce food-related reward responding when full and/or increase cognitive control. Novel pharmacotherapies for BED might be most effective if they
have a broad spectrum of effects on appetite, reward and cognition. Copyright © 2021, The Author(s).
Translational Psychiatry, 12(1) (no pagination) :
- Year: 2022
- Problem: Eating Disorders
(any), Binge Eating Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Biological Interventions
(any), Appetite
moderators, Other biological interventions
Savaglio, M., O'Donnell, R., Hatzikiriakidis,
K., Vicary, D., Skouteris, H.
Australia has undergone significant youth mental health reform
over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth.
However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based
mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people's
mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if
they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial
outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10-25 years. Thirty-seven studies were included. Four
types of community-based youth mental health care programs were identified: therapy (n=16), case management (n=9), integrated 'one-stop-shop' (n=6)
and lifestyle (n=6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and
integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective
in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary
and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health
concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs
to ultimately enhance young people's life trajectory. Copyright © 2022. The Author(s).
, 16 :
- Year: 2022
- Problem: Anxiety Disorders (any), Depressive Disorders, Eating Disorders
(any), Psychosis Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder), First episode (psychosis only)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any)
Rowlands, K., Beaty, T., Simic, M., Grafton, B., Hirsch, C., Treasure, J., Cardi, V.
Objective: This study aimed to investigate whether a
computerized cognitive bias modification training delivered remotely would reduce expectations of rejection in adolescents with eating disorders.
Method(s): Sixty-seven adolescents aged 12-18 (99.5% female) with an eating disorder diagnosis (94% anorexia nervosa) and receiving specialist
treatment were recruited. Participants were randomized to an intervention condition (n = 37) which included treatment as usual (TAU) supplemented by
nine sessions of online cognitive bias modification training for social stimuli (CBMT + TAU), or a control condition (n = 30), which included TAU
only. Participants were invited to complete assessments at baseline and post-intervention. Result(s): In the intervention condition, 22/37
participants completed six or more training sessions and post-intervention measures, the pre-defined criteria to be considered \"completers.\" In the
control condition, 28/30 participants completed the post-intervention measures. Participants who completed the intervention displayed a significantly
greater reduction in negative interpretations of ambiguous social scenarios, with a medium effect size (p =.048, etap2 =.090), and eating disorder
psychopathology, with a medium effect size (p =.027, etap2 =.105), compared to participants in the control condition. No significant between-group
differences were found on emotional response to criticism, and anxiety and depression symptoms post-intervention (ps >.05; small effect sizes).
Discussion(s): Enhancing treatment as usual with CBMT targeting expectations of social rejection might be feasible and effective to reduce
expectations of social rejection and eating disorder psychopathology in adolescents with eating disorders. Training adaptations might be necessary to
impact on emotional processing and comorbid psychological distress. Public Significance: Adolescents with eating disorders who completed a brief (4-
week) online cognitive training intervention, alongside their usual treatment, reported greater reductions in expectations of social rejection and
eating disorder psychopathology after the intervention, compared to a separate group of patients who received their usual treatment only. This brief
and accessible intervention may be a helpful treatment adjunct for adolescents with eating disorders. Copyright © 2022 The Authors. International
Journal of Eating Disorders published by Wiley Periodicals LLC.
International Journal of Eating Disorders, 55
(11) : 1506-1520
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Redden, S. A., Patel, T. A., Cougle, J. R.
BACKGROUND AND OBJECTIVES: Perfectionism has important implications for self-worth,
personal standards, and psychopathology. The aim of this study was to test the efficacy of a novel two-week, computerized, exposure-based treatment
for perfectionism (ETP).\rMETHODS: Seventy-one university students with elevated perfectionism were randomized to either the ETP group (n = 36) or
the waitlist (WL) control group (n = 35). The ETP group was asked to complete the intervention at home, every three days for two weeks for a total of
five treatment sessions. The tasks in the ETP condition were engineered to have participants repeatedly make mistakes. All participants returned two
weeks after the baseline visit for a post-treatment assessment.\rRESULTS: Compared to WL, ETP led to lower overall perfectionism, concern over
mistakes, personal standards, depressive symptoms, social anxiety symptoms, and error sensitivity at post-treatment. No effects of treatment were
found on trait anxiety, obsessive-compulsive symptoms, or eating disorder symptoms.\rLIMITATIONS: Participants were university students of similar
age and education level, which restricts generalizability. Additionally, the study relied on a waitlist control condition.\rCONCLUSIONS: This study
provided preliminary evidence for a novel online intervention for perfectionism.
Journal of Behavior Therapy & Experimental
Psychiatry, 77 : 101771
- Year: 2022
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Social phobia (social anxiety disorder), Depressive Disorders, Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Technology, interventions delivered using technology (e.g. online, SMS)
Perelman, H., Schwartz, N., Yeoward-Dodson, J., Quinones, I.
C., Murray, M. F., Dougherty, E. N., Townsel, R., Arthur-
Cameselle, J., Haedt-Matt, A. A.
Objective: No study to date has investigated an intervention program for male athletes that
targets eating disorder risk factors. The purpose of this study was to measure the effects of the Male Athlete Body Project (MABP), an adaptation of
the Female Athlete Body Project on body dissatisfaction, drive for muscularity, body-ideal internalization, and muscle dysmorphia. Method(s):
Participants were 79 male collegiate athletes who were randomized to the MABP (n = 39) or an assessment-only control condition (n = 40). All
participants completed psychometrically validated measures at three time points: baseline, post-treatment (3 weeks after baseline for the control
condition), and 1-month follow-up. Result(s): Hierarchical Linear Modeling assessed differences between conditions across time. Interaction effects
revealed that participation in the MABP improved satisfaction with specific body parts and reduced drive for muscularity and body-ideal
internalization at post-treatment compared to a control group. Athletes in the MABP also reported increased body areas satisfaction and reductions in
drive for muscularity at 1-month follow-up. Reductions in supplement use were observed at 1-month follow-up only. Discussion(s): This study provides
preliminary evidence of the efficacy of the MABP in reducing some eating disorder risk factors up to 1 month after the intervention; follow-up study
considerations are discussed. Clinical Trial Registration Number: NCT04077177. Public Significance: This study highlights the importance of eating
disorder and body image intervention efforts for male athletes. Findings suggest that male college athletes who attended a 3-session group
intervention based on a well-established program for college women experienced an increase in satisfaction with specific body areas and a reduction
in some eating disorder risk factors (e.g., drive for muscularity, supplement use, and body-ideal internalization) compared to a control group.
Copyright © 2022 Wiley Periodicals LLC.
International Journal of Eating Disorders, 55(2) : 193-206
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Pauli, D., Flutsch, N., Hilti, N., Schraer, C., Soumana, M., Haberling, I., Berger, G.
Objective: This pilot study examines the feasibility and the effectiveness of add-on
home treatment (HT) to family-based treatment (FBT) in adolescents with anorexia nervosa (AN). The HT intervention is delivered by specialised nurses
and aims at supporting patients and parents to re-establish family meals in the home environment. Method(s): We performed a 3-month study in AN
patients with a waiting-list control design comparing 45 (43 females, 2 males) adolescents receiving FBT augmented with HT compared to 22 (21
females, 1 male) participants receiving FBT alone on the waiting list for additional HT. Eating disorder diagnosis, psychopathology and severity of
clinical symptoms were assessed using the Eating Disorder Examination (EDE) interview, the Eating Disorders Inventory (EDI-2) and clinical parameters
(BMI, menstrual status, level of over-exercising) at baseline and after 3 months. Result(s): After 3 months of treatment, both treatment groups
showed a significant early weight gain, a reduction in the rate of AN diagnoses assessed with the EDE interview and a reduction in EDI-2 total
scores. The combined HT/FBT group showed a significantly greater increase in BMI than the FBT-only group. In the combined HT/FBT group, none of the
patients had to be admitted to hospital, while three (13.6%) of the FBT-only group had to be referred to inpatient treatment. Discussion(s): Our
results suggest that HT augmented FBT might be useful compared to FBT alone in terms of early weight gain and might reduce the risk of hospital
admission in adolescent AN. Copyright © 2022 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley &
Sons Ltd.
European Eating Disorders Review, 30(2) : 168-
177
- Year: 2022
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy, Other Psychological Interventions
Ohene, R., Logan, C., Loresto, F., Watters, A., Eron, K., Markovchick, T., Mehler, P. S.
IMPORTANCE:
Interventions to reduce anxiety are needed for patients with anorexia nervosa (AN) and avoidant- restrictive food intake disorder (ARFID). Weighted
blankets are one such intervention. OBJECTIVE(S): To evaluate the impact of weighted blankets on anxiety for patients with AN and ARFID. DESIGN:
Randomized controlled trial conducted between November 2018 and March 2019. Patients were randomized into the control group or the intervention
group. SETTING: Inpatient setting; medical stabilization unit. PARTICIPANTS: Patients (N = 23) diagnosed with AN or ARFID and experiencing moderate
anxiety. The majority were female (91%), with a mean age of 26 yr (SD = 9.3), and the mean length of hospitalization was 22 days (SD = 17.3).
INTERVENTIONS: Control group participants received usual care, which included occupational therapy services. Intervention group participants received
a weighted blanket along with usual care. OUTCOMES AND MEASURES: Mixed-effects regression models were conducted. Primary outcomes included
improvement in Beck Anxiety Inventory (BAI) scores by discharge. RESULT(S): Intervention group patients had a greater, non-statistically significant
decrease in BAI score over time (B = 1.16, p = .83) than control group patients. CONCLUSIONS AND RELEVANCE: Weighted blankets may be an effective
tool for reducing anxiety among patients with AN or ARFID. What This Article Adds: The use of a weighted blanket, in conjunction with occupational
therapy interventions, is potentially a beneficial non-pharmacological option for patients with anorexia nervosa (AN) and avoidant-restrictive food
intake disorder (ARFID). The current study adds an additional modality to the multidisciplinary treatment approach for eating disorders. Copyright ©
2023 by the American Occupational Therapy Association, Inc.
The American journal of occupational therapy : official publication of the American Occupational Therapy
Association, 76(6) :
- Year: 2022
- Problem: Anxiety Disorders (any), Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Monteleone, A.
M., Pellegrino, F., Croatto, G., Carfagno, M., Hilbert, A., Treasure,
J., Wade, T., Bulik, C. M., Zipfel, S., Hay, P., Schmidt, U., Castellini, G., Favaro, A., Fernandez-Aranda, F., Il Shin, J., Voderholzer, U., Ricca, V., Moretti, D., Busatta, D., Abbate-Daga, G., Ciullini, F., Cascino,
G., Monaco, F., Correll, C. U., Solmi, M.
Treatment efficacy for eating disorders (EDs) is modest and guidelines
differ. We summarized findings/quality of (network) meta-analyses (N)MA of randomized controlled trials (RCTs) in EDs. Systematic meta-review ((N)MA
of RCTs, ED, active/inactive control), using (anorexia or bulimia or eating disorder) AND (meta-analy*) in PubMed/PsycINFO/Cochrane database up to
December 15th, 2020. Standardized mean difference, odds/risk ratio vs control were summarized at end of treatment and follow-up. Interventions
involving family (family-based therapy, FBT) outperformed active control in adults/adolescents with anorexia nervosa (AN), and in adolescents with
bulimia nervosa (BN). In adults with BN, individual cognitive behavioural therapy (CBT)-ED had the broadest efficacy versus active control; also,
antidepressants outperformed active. In mixed age groups with binge-eating disorder (BED), psychotherapy, and lisdexamfetamine outperformed active
control. Antidepressants, stimulants outperformed placebo, despite lower acceptability, as did CBT-ED versus waitlist/no treatment. Family-based
therapy is effective in AN and BN (adolescents). CBT-ED has the largest efficacy in BN (adults), followed by antidepressants, as well as
psychotherapy in BED (mixed). Medications have short-term efficacy in BED (adults). Copyright © 2022 Elsevier Ltd
Neuroscience and Biobehavioral Reviews, 142 (no pagination) :
- Year: 2022
- Problem: Eating Disorders
(any), Anorexia Nervosa, Bulimia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Family therapy