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1.
Int J Eat Disord ; 57(4): 879-891, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38192012

RESUMO

OBJECTIVE: Certain symptom and risk/maintenance factor similarities between individuals with atypical anorexia nervosa (AN) and 'typical' AN have been documented, but few studies have investigated how atypical AN compares to bulimia nervosa (BN). Further, the role of affective mechanisms in maintaining restrictive eating in atypical AN has not been examined. The current study investigated whether atypical AN resembles AN and/or BN on affect-related processes using questionnaires and ecological momentary assessment (EMA). METHOD: Women with atypical AN (n = 24), AN-restrictive subtype, (n = 27), AN-binge eating/purging subtype (n = 34), and BN (n = 58) completed questionnaires measuring depressive symptoms and emotion regulation difficulties. They also completed a 14-day EMA protocol during which they reported negative and positive affect and skipped meals five times/day (signal-contingent surveys) and restrictive eating after meals/snacks (event-contingent surveys). RESULTS: Diagnostic groups generally did not differ on questionnaire measures nor affective patterns surrounding restrictive eating behaviors. Momentary changes in affect did not predict or follow restriction at meals/snacks, though higher momentary negative affect ratings predicted skipped meals, and higher positive affect was reported after skipped meals. Greater average negative affect and lower average positive affect predicted both restrictive eating behaviors. DISCUSSION: Across diagnoses, reductions in food intake do not appear to be influenced by momentary changes in affect, though skipping meals may serve an emotion regulation function. Atypical AN seems to resemble AN and BN on affective processes underlying restrictive eating, raising further questions regarding the unique diagnosis of atypical AN. PUBLIC SIGNIFICANCE: Though atypical anorexia appears to strongly resemble anorexia nervosa, it is less clear how this disorder relates to bulimia nervosa. It is further unknown whether affective-related processes underlie restrictive eating in atypical anorexia nervosa, and how these processes compare to those in anorexia nervosa and bulimia nervosa. Results suggest that atypical anorexia does not differ from anorexia nervosa or bulimia nervosa on emotion-related measures, nor in affective patterns surrounding restrictive eating behaviors.


Assuntos
Anorexia Nervosa , Bulimia Nervosa , Humanos , Feminino , Anorexia Nervosa/complicações , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Bulimia Nervosa/complicações , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/psicologia , Anorexia , Avaliação Momentânea Ecológica , Comportamento Alimentar/psicologia
2.
J Pers ; 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429250

RESUMO

INTRODUCTION: Negative urgency is a personality pathway toward impulsive behavior that increases risk for transdiagnostic psychopathology. Limited research supports the core tenant of urgency theory, that is, that individuals with high trait negative urgency act more impulsive when experiencing increased negative emotion. We hypothesized that it may not be negative emotion intensity, but difficulty in differentiating among negative emotions, that prompts impulsive behavior among individuals with elevated negative urgency. METHODS: We tested this hypothesis in 200 undergraduates using both ecological momentary assessment (measured momentary undifferentiated negative affect and impulsivity) and experimental methods (manipulated emotion differentiation and measured behavioral impulsivity). RESULTS: Momentary undifferentiated negative affect predicted impulsivity in the specific domains of work/school and exercise, but interactions between momentary undifferentiated negative affect and negative urgency were not supported. Manipulated emotion differentiation did not impact behavioral impulsivity regardless of negative urgency scores. CONCLUSION: Inconsistent with theory, the impulsive behavior of individuals with negative urgency may not be conditional on elevated or undifferentiated negative affect.

3.
Int J Eat Disord ; 56(8): 1603-1613, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37158655

RESUMO

OBJECTIVE: Latent class or latent profile analysis (LPA) studies in patients with eating disorders consistently identify a low-weight, restrictive eating subgroup that does not endorse weight/shape concerns. To date, similar studies in samples unselected for disordered eating symptoms have not identified a high restriction-low weight/shape concerns group, which may be due to a lack of inclusion of measures of dietary restriction. METHOD: We conducted an LPA using data from 1623 college students (54% female) recruited across three different studies. The Eating Pathology Symptoms Inventory Body Dissatisfaction, Cognitive Restraint, Restricting, and Binge Eating subscales were used as indicators, and body mass index, gender, and dataset were covaried. Purging, excessive exercise, emotion dysregulation, and harmful alcohol use were compared across resulting clusters. RESULTS: Fit indices supported a 10-class solution, including five disordered eating groups (largest to smallest): "Elevated General Disordered Eating", "Body Dissatisfied Binge Eating," "Most Severe General Disordered Eating," "Non-Body Dissatisfied Binge Eating," and "Non-Body Dissatisfied Restriction." The "Non-Body Dissatisfied Restriction" group scored as low on other measures of traditional eating pathology and harmful alcohol use as non-disordered eating groups but scored as high on a measure of emotion dysregulation as other disordered eating groups. DISCUSSION: This study is the first to identify a latent restrictive eating group that does not endorse traditional disordered eating cognitions in an unselected sample of undergraduate students. Results underscore the importance of using measures of disordered eating behaviors without implied motivation to capture overlooked problematic eating patterns in the population that are distinct from our "traditional" understanding of disordered eating. PUBLIC SIGNIFICANCE: We identified a group of individuals with high levels of restrictive eating but low body dissatisfaction and intent to diet in an unselected adult sample of men and women. Results underscore the need to investigate restrictive eating outside of the traditional lens of body shape concerns. Findings also suggest that individuals with nontraditional eating difficulties may struggle with emotion dysregulation, putting them at risk of poor psychological and relational outcomes.


Assuntos
Transtorno da Compulsão Alimentar , Bulimia , Transtornos da Alimentação e da Ingestão de Alimentos , Masculino , Adulto , Humanos , Feminino , Índice de Massa Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Emoções , Comportamento Alimentar/psicologia , Sobrepeso , Estudantes/psicologia
4.
Int J Eat Disord ; 55(8): 993-1011, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35579043

RESUMO

OBJECTIVE: Eating disorders and borderline personality disorder have high rates of comorbidity. However, the extent to which individual BPD symptoms are elevated in patients with EDs is largely unknown. Meta-analyses examined: (1) which of the nine BPD symptoms are especially elevated in individuals with versus without EDs, (2) whether particular ED subtypes have elevated levels of certain BPD symptoms, and (3) which BPD symptoms remain unstudied/understudied in relation to EDs. METHODS: We performed nine separate meta-analyses (one for each BPD symptom) to compare levels of symptoms in patients with EDs versus healthy controls. A total of 122 studies (range = 4-34 studies across symptoms) were included. RESULTS: Affective instability was the BPD symptom most elevated, while anger was the BPD symptom least elevated, in patients with EDs compared to controls. When comparing effect sizes across ED subtypes, anorexia nervosa binge-eating/purging subtype had the largest effect sizes for the greatest number of BPD symptoms, while effect sizes for AN restrictive subtype were not significantly larger than those of other EDs for any BPD symptom. The least studied BPD symptoms were identity disturbance and interpersonal difficulties. DISCUSSION: These meta-analyses suggest that certain symptoms of BPD play a more prominent role in the comorbidity between BPD and EDs than others. Targeting affective instability when treating cases of comorbid ED and BPD may be especially likely to ameliorate the negative outcomes related to this comorbidity. Future research should further investigate identity disturbance and interpersonal difficulties in the context of EDs. PUBLIC SIGNIFICANCE: Having an eating disorder and borderline personality disorder is a common comorbidity associated with a severe clinical presentation. BPD is characterized by nine distinct symptoms. This research examined levels of individual BPD symptoms in patients with versus without EDs. Findings can guide researchers and clinicians towards studying and treating symptoms that may be most relevant for BPD-ED comorbidity and in turn, improve outcomes for these patients.


OBJETIVO: Los trastornos de la conducta alimentaria (TCA) y el trastorno límite de la personalidad (TLP) tienen altas tasas de comorbilidad. Sin embargo, se desconoce en gran medida hasta qué punto los síntomas individuales del TLP están elevados en pacientes con TCA. Este metaanálisis examinó: (1) cuál de los nueve síntomas de TLP está especialmente elevado en individuos con TCA versus sin TCA, (2) si los subtipos particulares de TCA tienen niveles elevados de ciertos síntomas de TLP, y (3) qué síntomas de TLP permanecen sin estudiar/poco estudiados en relación con los TCA. MÉTODOS: Se realizaron nueve metanálisis separados (uno para cada síntoma de TLP) para comparar los niveles de síntomas en pacientes con TCA versus controles sanos. Se incluyeron un total de 122 estudios (rango = 4-34 estudios entre los síntomas). RESULTADOS: La inestabilidad afectiva fue el síntoma de TLP más elevado, mientras que el enojo fue el síntoma de TLP menos elevado, en pacientes con TCA en comparación con los controles. Al comparar los tamaños del efecto entre los subtipos de TCA, la anorexia nervosa (AN) subtipo atracón/purgación tuvo los tamaños de efecto más grandes para el mayor número de síntomas de TLP, mientras que los tamaños del efecto para la AN subtipo restrictivo no fueron significativamente mayores que los de otros TCA para cualquier síntoma de TLP. Los síntomas de TLP menos estudiados fueron alteración de la identidad y dificultades interpersonales. DISCUSIÓN: Estos metanálisis sugieren que ciertos síntomas de TLP juegan un papel más prominente que otros en la comorbilidad entre el TLP y los TCA. Enfocarse en la inestabilidad afectiva al tratar casos de TCA y TLP comórbidos puede ser especialmente probable que mejore los resultados negativos relacionados con esta comorbilidad. Los estudios de investigación futuros deben investigar más a fondo la alteración de la identidad y las dificultades interpersonales en el contexto de los TCA.


Assuntos
Transtorno da Personalidade Borderline , Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Humanos
5.
J Clin Psychol ; 78(4): 710-728, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34560819

RESUMO

OBJECTIVES: This study explored how the coronavirus disease 2019 (COVID-19) pandemic has affected individuals with mental health conditions. METHODS: Participants were 477 adults (82% female) who reported a past-year mental health condition. They completed an online survey that included an open-ended question. Mixed methods analysis was conducted. RESULTS: While all mental health conditions were moderately impacted by the COVID-19 pandemic, self-reported impact on anxiety disorder and obsessive-compulsive disorder symptoms was greater than for all other mental health symptoms. Thematic analysis revealed five themes: (1) the contribution of the pandemic to worsening mental health; (2) life interruptions due to the pandemic; (3) increased loneliness/isolation; (4) upsides of the pandemic; and (5) normalization of the anxieties previously experienced by those with mental health conditions. CONCLUSION: Individuals with pre-existing mental health conditions reported a worsening of symptoms during the COVID-19 pandemic. Governments and organizations must focus on supporting and increasing access to treatment for this population.


Assuntos
COVID-19 , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pandemias , SARS-CoV-2
6.
Appetite ; 166: 105441, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34090943

RESUMO

The interpersonal psychotherapy model of eating disorders (IPT-ED) argues that interpersonal problems result in negative affect, and that an inability to cope with this negative affect triggers ED symptoms. Relatedly, it is theorized that 'feeling fat' (i.e., the somatic experience of being overweight not entirely explained by one's body mass) results from shifting negative affect onto one's body, which can then be controlled via ED symptoms. Research has yet to identify why negative affect caused by interpersonal problems may trigger ED symptoms as opposed to other maladaptive behaviours. Integrating 'feeling fat' into the IPT-ED may help to explain this relationship. This study examined whether interpersonal problems positively related to ED symptoms via negative affect and 'feeling fat' in 190 undergraduate women (mean age [SD] = 19.05 [1.23]; mean BMI [SD] = 21.76 [3.17]; 72.8% Caucasian). Using both cross-sectional and longitudinal path analyses, we tested the indirect effects of ostracism and peer victimization on binge eating and restricting via negative affect and 'feeling fat' using serial indirect effects analyses. Cross-sectional path analysis revealed significant indirect effects of ostracism on both binge eating and restricting sequentially via negative affect and 'feeling fat', such that ostracism related to negative affect, which related to 'feeling fat', which was ultimately associated with disordered eating behaviours. Longitudinal path analysis replicated the significant indirect effects of ostracism on binge eating sequentially via negative affect and 'feeling fat'. Results suggest that individuals may displace negative feelings that result from ostracism onto their body, triggering 'feelings of fatness' and prompting ED symptoms. Future research should examine 'feeling fat' within the IPT-ED in a sample of individuals with EDs to determine its clinical utility beyond an undergraduate sample.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Psicoterapia Interpessoal , Estudos Transversais , Emoções , Feminino , Humanos , Relações Interpessoais
7.
Body Image ; 49: 101688, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38442437

RESUMO

Body dissatisfaction (BD) includes negative thoughts and feelings about one's body shape. Although typically assessed as a trait, BD has been found to fluctuate within a day. The present study examined whether daily instability in BD differs according to trait BD, eating disorder (ED) diagnosis, and engagement in maladaptive exercise. Participants with EDs (n = 166) and controls (n = 44) completed a self-report measure of trait BD and reported BD and engagement in maladaptive exercise five times daily for 14 days as part of an ecological momentary assessment protocol. BD instability was calculated as adjusted mean squared successive difference. On average across assessments, participants with EDs reported a 16% change in their BD ratings between consecutive assessments, which was significantly higher than the 12% change in controls. Trait BD was significantly inversely associated with BD instability in individuals with EDs, but not in controls. BD instability did not differ across ED diagnoses or between days with versus without maladaptive exercise. Findings suggest that BD is a dynamic state that varies within a day, especially in participants with EDs. Further research is needed to clarify whether this heightened instability in BD is a clinically relevant factor underlying ED symptoms.


Assuntos
Insatisfação Corporal , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , Feminino , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Adulto , Insatisfação Corporal/psicologia , Adulto Jovem , Masculino , Exercício Físico/psicologia , Avaliação Momentânea Ecológica , Adolescente , Imagem Corporal/psicologia , Autorrelato , Satisfação Pessoal
8.
Anxiety Stress Coping ; 35(1): 124-140, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34314272

RESUMO

BACKGROUND AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted people's lives, with significant mental health consequences emerging. In addition to sociodemographic and COVID-19 specific factors, psychological risk and protective mechanisms likely influence individual differences in mental health during the COVID-19 pandemic. We examined associations between a broad set of risk and protective factors with depression, anxiety, alcohol problems, and eating pathology, and investigated interactions between objective stress due to COVID-19 and risk/protective variables in predicting psychopathology. METHODS: Participants were 877 adults (73.7% female) recruited via internet sources from around the globe, but primarily residing in North America (87.4%). RESULTS: Structural equation modelling revealed that certain risk and protective factors (e.g., loneliness, mindfulness) were broadly related to psychopathology, whereas others showed unique relations with specific symptoms (e.g., greater repetitive thinking and anxiety; low meaning and purpose and depression). COVID-19 objective stress interacted with risk factors, but not protective factors, to predict greater anxiety symptoms, but not other forms of psychopathology. CONCLUSIONS: Findings contribute to our understanding of psychological mechanisms underlying individual differences in psychopathology in the context of a global stressor. Strategies that reduce loneliness and increase mindfulness will likely impact the greatest number of mental health symptoms.


Assuntos
COVID-19 , Adulto , Ansiedade/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Pandemias , Fatores de Proteção , SARS-CoV-2 , Estresse Psicológico
9.
Eat Behav ; 44: 101597, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35124542

RESUMO

'Feeling fat,' the somatic experience of being overweight not entirely explained by objective weight, may occur due to the projection of negative affect onto the body. Individuals may manage 'feeling fat' via eating pathology (e.g., binge eating or dietary restriction) rather than address the source of negative affect. Thus, 'feeling fat' may occur in the absence of adaptive emotion regulation strategies. The COVID-19 pandemic has increased negative affect widely and may potentially contribute to the experience of 'feeling fat' and eating pathology among individuals with emotion dysregulation. This study examined whether emotion dysregulation moderates 'feeling fat's' role as a mechanism underlying the relationship between COVID-19-related distress and eating pathology. This uniqueness of this model to eating pathology was investigated by comparing effects for binge eating and dietary restriction versus anxiety, depression, and problematic alcohol use. Structural equation modelling was used to analyze questionnaire data from 877 participants (77.3% women). 'Feeling fat' explained significant variance in the relationship between COVID-19-related distress and both binge eating and restriction. Emotion dysregulation modulated the strength of these relationships. However, 'feeling fat's role in the relationship between pandemic-related distress and negative psychological outcomes was not unique to eating pathology and did not vary based upon emotion dysregulation. Individuals with elevated emotion dysregulation are more likely to report eating pathology, but not other outcomes, in the context of 'feeling fat'. In contrast, 'feeling fat' underlies the relationship between COVID-19-distress and transdiagnostic psychological outcomes, meaning 'feeling fat' should be considered in risk for psychopathology beyond eating disorders.


Assuntos
Transtorno da Compulsão Alimentar , COVID-19 , Emoções , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2
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