Delusionality of beliefs among 50 adult females with severe and extreme anorexia nervosa upon admission to an acute medical stabilization facility.

We aimed to evaluate whether the content of eating/body image-related beliefs in individuals with anorexia nervosa (AN) was associated with important aspects of eating disorder (ED) psychopathology. Females with AN completed assessments within 96 hours of admission to an inpatient medical stabilization program. Study staff administered the Brown Assessment of Beliefs Scale and participants completed self-report measures. We derived belief content domains using an inductive approach and examined associations between beliefs and clinical variables. The following belief categories emerged (% with a belief in that category): body image beliefs (64%), food beliefs (30%), body function beliefs (20%), rejection of illness beliefs (12%), morality beliefs (10%), and control beliefs (6%). No one belief domain was significantly associated with greater delusional intensity. However, findings indicate that greater delusionality was generally associated with worse ED psychopathology.

Delusional intensity as a prognostic indicator among individuals with severe to extreme anorexia nervosa hospitalized at an acute medical stabilization program.

OBJECTIVE: Eating disorder-related beliefs among individuals with anorexia nervosa (AN) often approach delusional intensity. Research to date on delusional beliefs in AN has been cross sectional. Thus, it is unknown how the intensity of delusional beliefs changes over time and if such change has prognostic value. METHOD: We assessed 50 individuals with severe to extreme AN (≥18 years old; M [SD] body mass index =12.7[1.3] kg/m2 ) at an inpatient medical stabilization facility within 96 hr of admission; 35 (70%) also completed the assessment at discharge (M[SD] = 25.53[13.21] days). Participants completed the Brown Assessment of Beliefs Scale and a battery of self-report measures of eating disorder-related psychopathology. RESULTS: The admission-to-discharge decrease in delusional intensity was not significant (p = .592; Hedges g = .10). Tests of predictive effects indicated that higher delusional intensity at intake predicted higher fear of fatness and restrictive eating, two hallmark features of AN, but not BMI, body checking, feared food avoidance, eating disorder-related impairment, depression, binge eating, or purging behavior at discharge. DISCUSSION: Although the delusional intensity of eating disorder beliefs did not significantly improve over this relatively brief interval, delusional intensity may be associated with the severity of central eating disorder attitudes and behaviors. Delusional intensity may therefore be a negative prognostic indicator, possibly warranting further treatment. Future research should examine changes in delusional intensity over longer intervals and test whether specifically targeting delusional beliefs improves treatment outcomes among individuals with AN.

A Comprehensive Review of Complications and New Findings Associated with Anorexia Nervosa.

Anorexia nervosa is a complex and deadly psychiatric disorder. It is characterized by a significant degree of both co-occurring psychiatric diseases and widespread physiological changes which affect nearly every organ system. It is important for clinicians to be aware of the varied consequences of this disorder. Given the high rate of mortality due to AN, there is a need for early recognition so that patients can be referred for appropriate medical and psychiatric care early in the course of the disorder. In this study, we present a comprehensive review of the recent literature describing medical findings commonly encountered in patients with AN. The varied and overlapping complications of AN affect pregnancy, psychological well-being, as well as bone, endocrine, gastrointestinal, cardiovascular, and pulmonary systems.

Medical Complications of Anorexia Nervosa.

OBJECTIVE: The purpose of this study was to describe the medical complications of anorexia nervosa (AN) to enable a consult-liaison psychiatrist to be familiar with these complications when involved with the care of a hospitalized patient with AN. METHODS: Comprehensive PubMed search of English language publications of adult patients with AN was carried out using keywords, phrases, and medical subject headings of anorexia nervosa-medical complications, cardiac, osteoporosis, gastrointestinal, hematological, and endocrine. The database search was restricted by time of publication of studies from 2005 to 2020. RESULTS: Every organ system can be adversely affected by AN. Most are fully reversible with time and informed medical care. A multidisciplinary team is needed to optimally care for patients who are hospitalized as a result of the medical complications of their AN. CONCLUSIONS: Consult-liaison psychiatrists are asked to help in the care of patients with AN who are admitted to a hospital because of a medical complication of their illness. Being familiar with these complications and their treatments will optimize their hospital stays and the care provided. In addition, involving other relevant ancillary services is an important care consideration.

Examining body dissatisfaction in young men within a biopsychosocial framework.

This study examined biopsychosocial factors related to body dissatisfaction in young men within multivariate and moderator contexts. A female sample was included as a gender comparison. Male (n=111) and female (n=236) undergraduates filled out self-report questionnaires assessing body mass index (BMI), media influence, a history of weight-related teasing, and socially prescribed perfectionism, along with various indices of body dissatisfaction. Perceived pressure from the media was consistently related to body dissatisfaction in men whereas multiple biopsychosocial variables accounted for body dissatisfaction in women. Socially prescribed perfectionism and a history of weight teasing each moderated the relationship between BMI and male body dissatisfaction, identifying men low in body dissatisfaction. Findings indicate that applying a biopsychosocial framework to the study of body dissatisfaction in men is useful and suggest the need for including other factors, such as male peers and sports involvement, in understanding contributors to male body image.

What does viewing a pro-anorexia website do? An experimental examination of website exposure and moderating effects.

OBJECTIVE: This study experimentally examined the effects of viewing a pro-anorexia website. METHOD: Following construction of a prototypic pro-anorexia website, 235 female undergraduates were randomly assigned to view either the pro-anorexia website or one of two comparison websites related to female fashion (using average-sized models) or home décor. Post-website affect, cognitions, and behavioral expectations were examined along with moderator effects. RESULTS: Study participants exposed to the pro-anorexia website had greater negative affect, lower social self-esteem, and lower appearance self-efficacy post-website than those who viewed a comparison website. Additionally, they perceived themselves as heavier, reported a greater likelihood of exercising and thinking about their weight in the near future, and engaged in more image comparison. Minimal support was found for moderator effects. CONCLUSION: Results provide an empirical basis for concern (expressed by clinicians, researchers, the media) that pro-anorexia websites are a troubling new form of thin-ideal exposure that warrants further examination.