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1.
Epidemiol Psychiatr Sci ; 29: e191, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33283690

RESUMO

AIM: Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. METHODS: We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. RESULTS: The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59-0.71) and 0.66 (95% UI: 0.60-0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20-982.30; ASR of DALYs = 170.74, 95% UI: 113.43-244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14-2.32; EAPC for DALYs = 2.22, 95% UI: 2.13-2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). CONCLUSION: The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.


Assuntos
Pessoas com Deficiência , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Carga Global da Doença/tendências , Adulto , Ásia/epidemiologia , Australásia/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Carga Global da Doença/estatística & dados numéricos , Saúde Global , Humanos , Masculino , América do Norte/epidemiologia , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Adulto Jovem
2.
Psychiatr Danub ; 32(3-4): 334-345, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33370730

RESUMO

BACKGROUND: The prevalence of the three main eating disorders (EDs) anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) is increasing, and a growing number of patients with EDs is seeking professional help. Thus, there is a need for additional treatment strategies in EDs. The aim of this review was to summarize the literature on the benefits and risks of music as well as the evidence for its therapeutic application in people with EDs. METHODS: Following the PRISMA guidelines, we performed a systematic literature review on scientific studies on the effect of music in people with or at risk for EDs using PubMed and the Web of Science database. The search terms used were: "music", "music therapy", "eating disorders", "anorexia nervosa", "bulimia nervosa" and "binge eating disorder". RESULTS: 16 out of 119 identified and screened articles qualified as scientific studies involving a total of 3,792 participants. They reported on the use of music or music therapy in individuals with or at risk of AN and BN, but not BED. In inpatients with AN, listening to classical music was beneficial to food consumption. Singing in a group reduced post-prandial anxiety in AN inpatients and outpatients. Vodcasts which also included positive visual or autobiographical stimuli helped BN patients with anxiety and body image perception. Songwriting and sessions with a Body Monochord helped with the processing of therapeutically relevant topics in AN. Watching music videos, however, reinforced body dissatisfaction, drive for thinness, bodyweight concerns, preoccupation with physical appearance in pre-teenage and teenage girls, and drive for muscularity in adolescent boys. CONCLUSIONS: These findings suggest that the therapeutic application of music may be beneficial in patients with AN and BN. However, the availability of studies with a rigorous randomized controlled trial (RCT) design is scarce.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Musicoterapia , Música/psicologia , Anorexia Nervosa/psicologia , Anorexia Nervosa/terapia , Transtorno da Compulsão Alimentar/psicologia , Transtorno da Compulsão Alimentar/terapia , Bulimia Nervosa/psicologia , Bulimia Nervosa/terapia , Ingestão de Alimentos/psicologia , Comportamento Alimentar , Humanos
3.
Gen Hosp Psychiatry ; 67: 136-140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33129138

RESUMO

OBJECTIVE: To describe the impact of the COVID-19 pandemic on help-seeking behaviors among individuals with eating disorders and caregivers. METHODS: We analyzed service utilization data from the National Eating Disorder Information Centre (NEDIC). We compared the number of contacts and symptom frequency between the pandemic period and previous years. RESULTS: NEDIC was contacted 609 times during March 1-April 30, 2020 (72.1% individuals affected by disordered eating, 20.4% caregivers). The number of total contacts significantly increased from 2018 to 2019 and 2018 to 2020 (X2(3) = 50.34, p < .001). Among affected individuals (80.4% women), the number of contacts during the pandemic period was significantly higher (n = 439; X2(2) = 92.74, p < .001) compared to 2018 (n = 197) and 2019 (n = 312). There were higher rates of eating disorder symptoms, anxiety, and depression in 2020 compared to previous years. Thematic analysis of instant chats from the pandemic year revealed four emerging themes: 1) lack of access to treatment, 2) worsening of symptoms, 3) feeling out of control, and 4) need for support. CONCLUSION: These findings point toward the impact of COVID-19 in individuals affected by disordered eating and hold implications for service delivery during times of crises.


Assuntos
Cuidadores/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Transtornos da Alimentação e da Ingestão de Alimentos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Controle Interno-Externo , Intervenção Baseada em Internet/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Psicoterapia/estatística & dados numéricos , Apoio Social , Exacerbação dos Sintomas , Adulto Jovem
4.
PLoS One ; 15(10): e0239904, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031400

RESUMO

In this paper, we describe the systematic development and validation of the Multidimensional Internally Regulated Eating Scale (MIRES), a new self-report instrument that quantifies the individual-difference characteristics that together shape the inclination towards eating in response to internal bodily sensations of hunger and satiation (i.e., internally regulated eating style). MIRES is a 21-item scale consisting of seven subscales, which have high internal consistency and adequate to high two-week temporal stability. The MIRES model, as tested in community samples from the UK and US, had a very good fit to the data both at the level of individual subscales, but also as a higher-order formative model. High and significant correlations with measures of intuitive eating and eating competence lent support to the convergent validity of MIRES, while its incremental validity in relation to these measures was also upheld. MIRES as a formative construct, as well as all individual subscales, correlated negatively with eating disorder symptomatology and weight-related measures (e.g., BMI, weight cycling) and positively with adaptive behavioral and psychological outcomes (e.g., proactive coping, body appreciation, life satisfaction), supporting the criterion validity of the scale. This endeavor has resulted in a reliable and valid instrument to be used for the thorough assessment of the features that synthesize the profile of those who tend to regulate their eating internally.


Assuntos
Regulação do Apetite , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Psicometria/métodos , Resposta de Saciedade , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Adulto Jovem
5.
Int J Eat Disord ; 53(12): 2049-2054, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33098579

RESUMO

OBJECTIVE: COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise. METHOD: Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020. RESULTS: COVID-19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID-19 intolerance of uncertainty moderated associations between COVID-19 anxiety and compulsive exercise and ED pathology. COVID-19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty. DISCUSSION: COVID-19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID-19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.


Assuntos
Ansiedade/psicologia , /psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Incerteza , Adulto , Ansiedade/epidemiologia , /virologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Pandemias , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Universidades/estatística & dados numéricos , Adulto Jovem
6.
J Behav Addict ; 9(3): 826-835, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-32976112

RESUMO

Background and aims: Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement. Methods: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days. Results: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder. Discussion and conclusion: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Estudantes/psicologia , Adulto , Feminino , França/epidemiologia , Humanos , Masculino , Pandemias , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
7.
Nutrients ; 12(10)2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32987773

RESUMO

Emotional eating (EE) is prevalent among women and is associated with obesity. The coronavirus 2019 (COVID-19) pandemic and mandatory quarantine increased the risk of mental symptoms and, inferentially, emotional eating (EE). We investigated the EE prevalence and predictors during this pandemic. Overall, 638 women, ages 18-39, completed an online survey incorporating the Emotional Eating Scale, Perceived Stress Scale, Generalized Anxiety Disorder-7 Scale, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, and Global Physical Activity Questionnaire. We asked about nutrition and collected data on weight, height, and pandemic responses. Most respondents (47.2%) reported low EE; 40.4% were "moderate" and 12.4% "high" emotional eaters; 42.8% reported depression, 27% anxiety, 71% moderate stress, and 12.5% severe stress. The main EE indicators/predictors were fat intake (ß = 0.192, p = 0.004), number of meals (ß = 0.187, p < 0.001), sugar consumption (ß = 0.150, p < 0.001), body mass index (ß = 0.149, p < 0.001), stress (ß = 0.143, p = 0.004), energy intake (ß = 0.134, p = 0.04), and fast food intake frequency (ß = 0.111, p < 0.01). EE score correlated negatively with increased family income (ß = -0.081, p = 0.049). Higher stress correlated with worse sleep, less sleep, and less physical activity. Emotional eating is common among young Saudi women during the pandemic. We recommend healthy food choices and increased physical activity to improve sleep and mitigate stress.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dieta Saudável/psicologia , Emoções , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Betacoronavirus , Inquéritos sobre Dietas , Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-32948005

RESUMO

Eating disorders are associated with short and long-term consequences that can affect sports performance. The purposes of this study were to investigate whether female athletes, particularly gymnasts and footballers, exhibit more eating problems compared to female non-athletes, and to identify individual personality characteristics including anxiety, self-esteem, and perfectionism as possible contributors to eating disorder risk. In a sample of 120 participants, 80 adolescent female athletes were compared to a control condition of 40 non-athletes (mean age 17.2 ± 2.82). Participants responded to a questionnaire package to investigate the presence of disordered eating (SCOFF) and psychological variables in relation to disordered eating symptoms or eating disorder status. Subsequently, anthropometric measures were obtained individually by trained staff. There were statistically significant differences between conditions. One of the most important results was the score in SCOFF (Mann-Whitney = 604, p < 0.05; Cohen's d = 0.52, r = 0.25), being higher in control than in the gymnast condition. These results suggest that non-athlete female adolescents show more disturbed eating behaviours and thoughts than female adolescents from aesthetic sport modalities and, therefore, may have an enhanced risk of developing clinical eating disorders.


Assuntos
Ansiedade/psicologia , Atletas/psicologia , Imagem Corporal/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Perfeccionismo , Adolescente , Adulto , Ansiedade/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Prevalência , Autoimagem , Inquéritos e Questionários , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-32933145

RESUMO

Eating disorders (EDs) represent a disparate group of mental health problems that significantly impair physical health or psychosocial functioning. The aim of this study was to present some evidence about the prevalence of eating-disordered behavior (EDB) in adolescents, and explore its associations with body image (BI), body composition (BC) and physical activity (PA) in this age group. Data from 780 adolescents participating in a health behavior in school-aged children (HBSC) study conducted in Slovakia in 2018 were used (mean age 13.5 ± 1.3; 56% boys). Differences in mean values of numerical indicators were evaluated using the independent samples t-test. Differences between nominal variables were assessed by the chi-square test. Pearson correlation was used to describe the associations between all the selected variables. EDB was positively screened in 26.7% (208/780) of adolescents, with a higher prevalence in girls (128/344, 37.2%) than in boys (80/436, 18.3%). Significantly higher means of BI, body weight (BW), body mass index (BMI), body fat mass (BFM), body fat percentage (BFP), body fat mass index (BFMI), fat free mass index (FFMI), and SCOFF questionnaire score (SCOFF QS) were found in those positively screened for EDB. Pearson correlation analysis revealed positive associations between EDB and BI, BW, BMI, BFM, BFP and BFMI. The prevalence of EDB is high in Slovak adolescents. Positive associations between EDB, BI, BMI and fat-related body composition parameters support the idea of a more integrated approach in EDs and obesity prevention and treatment. At the same time, gender differences suggest the need for considering gender-specific strategies aimed at girls and boys separately.


Assuntos
Composição Corporal/fisiologia , Imagem Corporal/psicologia , Exercício Físico , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Adolescente , Índice de Massa Corporal , Criança , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Eslováquia/epidemiologia
10.
Ann Behav Med ; 54(10): 738-746, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32909031

RESUMO

BACKGROUND: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE: We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS: Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS: Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (ß = 0.15, p < .001), stress (ß = 0.15, p = .001), eating as a coping strategy (ß = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS: Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.


Assuntos
Peso Corporal , Infecções por Coronavirus/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Pneumonia Viral/psicologia , Angústia Psicológica , Estigma Social , Betacoronavirus , Exercício Físico/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/psicologia , Pandemias , Adulto Jovem
11.
Psychopathology ; 53(5-6): 291-297, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32882702

RESUMO

Building on the optical-coenaesthetic disproportion model of so-called eating disorders, this paper provides a framework for the psychotherapy of people affected by these conditions. This model characterizes "eating disorders" as disorders of embodiment and identity, where a sense of unfamiliarity with one's own flesh, experienced as shifting and incomprehensible, leads to an impairment in the constitution of the Self and thus of one's own identity. Since there is a deficit of the coenaesthetic experience of the embodied Self, greater importance is assumed by body perception conveyed from without. To these persons, their corporeality is principally given as a body-object "to be seen" from a third-person perspective, rather than as a body-subject "to be felt" from a first-person perspective. The Other's look serves as an optical prosthesis to cope with dis-coenaesthesia and as a device through which these persons can define themselves. They are unable to accept the hiatus between "being a body" and "having a body," constitutively present in every human being, forcibly trying to recouple it, and finally ending up objectifying themselves to succeed. The external foundation of the Self thus takes the form of a constriction one can never be completely free of. Psychotherapy should thus accompany persons affected by eating disorders in their encounter with the miscarried dialectic between feeling oneself from within and seeing oneself from without through the gaze of the Other, so keenly feared by people desperately in search of self-control. Tactfully, the clinician accompanies the patient in taking a stance towards her symptom as the outcome of this miscarried dialectics, which is one premise for overcoming it. The clinician's gaze becomes the herald of recognition, allowing the patient to feel accepted in terms of her individuality. Feeling themselves touched by a gaze that waives its alienating potential in order to signify acceptance reactivates the identity-forming dialectics. Their body is thus revealed as the receiver of gazes, but also rediscovers its own possibility for self-determination starting out from these gazes. This intersubjective resonance between the clinician's gaze and the patient reactivates the identity-making dialectics between body-subject and body-object, creating the relational premises for overcoming the symptom.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Psicoterapia/métodos , Feminino , Humanos , Masculino
12.
Eur. j. anat ; 24(supl.1): 69-74, ago. 2020. ilus
Artigo em Inglês | IBECS | ID: ibc-195290

RESUMO

The cognitive and emotional factors linked to the body image perceived by people with eating disorders and obesity can be so negative. Even, they lead to inappropriate behaviors and surgical treatments and interventions that involve health risks. As an inducing emotion, Disgust appears frequently linked to both the body and other factors related to eating disorders


No disponible


Assuntos
Humanos , Asco , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Emoções , Imagem Corporal/psicologia , Obesidade/psicologia , Comportamento Alimentar/psicologia
13.
PLoS One ; 15(8): e0237651, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817684

RESUMO

Body dysmorphic disorder (BDD) is associated with severe comorbidity and impairment. Muscle dysmorphia (MD) is a subtype of BDD which has rarely been assessed outside of undergraduate student samples. Further, there are limited data comparing MD to other psychiatric disorders, including BDD. Thus, the aim of the current study is to explore differences in symptom severity and conformity to masculine norms in men diagnosed with BDD or MD. Men from the greater Boston, Massachusetts area completed a one-time assessment, which included clinician-based structured interviews and self-report questionnaires assessing MD symptom severity, BDD symptom severity, and conformity to traditional masculine norms. The sample was N = 30 men (MD: n = 15; BDD: n = 15). Statistically significant medium to large effects emerged with the MD group experiencing greater MD and BDD symptom severity, and positive attitudes towards the use of violence to solve problems. Although not reaching statistical significance, additional medium-to-large effects also emerged with the MD group reporting greater emotional restriction/suppression, heterosexual self-presentation, and desired sexual promiscuity compared to the BDD group. Findings suggest that men diagnosed with MD may experience greater MD/BDD symptom severity and endorsement of some components of 'traditional' masculine norms, compared to men diagnosed with BDD. Results may suggest that addressing some forms of rigid masculine norms (e.g., use of violence) in therapy could be useful in treating MD; however, additional research comparing clinical samples of men with MD and BDD are needed to guide the nosology, assessment, and treatment of MD.


Assuntos
Transtornos Dismórficos Corporais/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Músculo Esquelético/fisiopatologia , Adulto , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/fisiopatologia , Boston , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Humanos , Masculino , Massachusetts , Autorrelato , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
14.
Int J Eat Disord ; 53(11): 1855-1862, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32856333

RESUMO

OBJECTIVE: the aim of this longitudinal study was to evaluate the impact of COVID-19 epidemic on Eating Disorders (EDs) patients, considering the role of pre-existing vulnerabilities. METHOD: 74 patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) and 97 healthy controls (HCs) were evaluated before lockdown (T1) and during lockdown (T2). Patients were also evaluated at the beginning of treatment (T0). Questionnaires were collected to assess psychopathology, childhood trauma, attachment style, and COVID-19-related post-traumatic symptoms. RESULTS: A different trend between patients and HCs was observed only for pathological eating behaviors. Patients experienced increased compensatory exercise during lockdown; BN patients also exacerbated binge eating. Lockdown interfered with treatment outcomes: the descending trend of ED-specific psychopathology was interrupted during the epidemic in BN patients. Previously remitted patients showed re-exacerbation of binge eating after lockdown. Household arguments and fear for the safety of loved ones predicted increased symptoms during the lockdown. BN patients reported more severe COVID-19-related post-traumatic symptomatology than AN and HCs, and these symptoms were predicted by childhood trauma and insecure attachment. DISCUSSION: COVID-19 epidemic significantly impacted on EDs, both in terms of post-traumatic symptomatology and interference with the recovery process. Individuals with early trauma or insecure attachment were particularly vulnerable.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Adolescente , Adulto , Estudos de Casos e Controles , Exercício Físico/psicologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Itália , Estudos Longitudinais , Pessoa de Meia-Idade , Apego ao Objeto , Trauma Psicológico/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Adulto Jovem
15.
Arch Womens Ment Health ; 23(5): 625-633, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32613296

RESUMO

The postpartum period may be a particular window of vulnerability for eating disorder symptoms given changes to body shape and weight that women experience. However, no quantitative studies have identified risk factors for postpartum eating disorder symptoms, and current psychosocial frameworks of risk may be missing key elements unique to this period. This manuscript reviews existing quantitative and qualitative literature regarding the developmental trajectory of eating disorder symptoms during the perinatal period and proposes an application of three psychosocial models of eating disorder risk (objectification theory, the tripartite influence model of body image and eating disturbances, and social comparison theory) to the postpartum period. Drawing on quantitative and qualitative literature, this paper identifies novel postpartum-specific factors that should be included for consideration in psychosocial models (e.g., self-oriented body comparison and pressure to achieve a prepregnancy weight and shape). This review is the first to theorize potential postpartum-specific risk factors for postpartum eating disorder symptoms. Prior models of eating disorder risk omit key psychosocial factors that are unique to the postpartum period. Other limitations of prior research relate to measurement and methodology. This critical window of vulnerability has been largely ignored in the quantitative literature and necessitates further research.


Assuntos
Imagem Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Período Pós-Parto/psicologia , Peso Corporal , Feminino , Humanos , Período Periparto/psicologia , Gravidez , Fatores de Risco
16.
Int J Eat Disord ; 53(11): 1780-1790, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32720399

RESUMO

OBJECTIVE: We evaluated the early impact of COVID-19 on people with self-reported eating disorders. METHOD: Participants in the United States (US, N = 511) and the Netherlands (NL, N = 510), recruited through ongoing studies and social media, completed an online survey that included both quantitative measures and free-text responses assessing the impact of COVID-19 on situational circumstances, eating disorder symptoms, eating disorder treatment, and general well-being. RESULTS: Results revealed strong and wide-ranging effects on eating disorder concerns and illness behaviors that were consistent with eating disorder type. Participants with anorexia nervosa (US 62% of sample; NL 69%) reported increased restriction and fears about being able to find foods consistent with their meal plan. Individuals with bulimia nervosa and binge-eating disorder (US 30% of sample; NL 15%) reported increases in their binge-eating episodes and urges to binge. Respondents noted marked increases in anxiety since 2019 and reported greater concerns about the impact of COVID-19 on their mental health than physical health. Although many participants acknowledged and appreciated the transition to telehealth, limitations of this treatment modality for this population were raised. Individuals with past histories of eating disorders noted concerns about relapse related to COVID-19 circumstances. Encouragingly, respondents also noted positive effects including greater connection with family, more time for self-care, and motivation to recover. DISCUSSIONS: COVID-19 is associated with increased anxiety and poses specific disorder-related challenges for individuals with eating disorders that require attention by healthcare professionals and carers.


Assuntos
Infecções por Coronavirus , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Indicadores Básicos de Saúde , Pandemias , Pneumonia Viral , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Comportamentos Relacionados com a Saúde , Acesso aos Serviços de Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Países Baixos , Autorrelato , Telemedicina , Estados Unidos , Adulto Jovem
17.
Eur Eat Disord Rev ; 28(5): 594-602, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32627915

RESUMO

OBJECTIVE: Eating disorders (EDs) are characterized by dysregulated responses to palatable food. Using a multi-method approach, this study examined responses to palatable food exposure and subsequent ad libitum eating in women with binge-eating disorder (BED: n = 64), anorexia nervosa (AN: n = 16), and bulimia nervosa (BN: n = 35) and 26 healthy controls (HCs). METHOD: Participants were exposed to palatable food followed by an ad libitum eating opportunity. Affective and psychophysiological responses were measured before and during the task. RESULTS: Participants with EDs reported greater negative affect, particularly fear, following the food cue exposure, whereas HCs reported no change. BN and BED groups reported greater urge to binge after the food cue exposure, whereas AN and HC groups reported no change. Respiratory sinus arrhythmia levels, skin conductance and tonic skin conductance levels increased during food exposure for all groups. Across baseline and during the food exposure, the BED group had lower respiratory sinus arrhythmia levels relative to the BN and HC groups. The BED group consumed significantly more palatable food than the AN group. CONCLUSIONS: 'Palatable' food stimuli elicited more negative affect, particularly fear, in individuals with EDs; and this, rather than psychophysiological responses, distinguishes individuals with EDs from those without.


Assuntos
Sinais (Psicologia) , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Alimentos , Adulto , Afeto , Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/psicologia , Estudos de Casos e Controles , Medo , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
18.
BMC Public Health ; 20(1): 1114, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32677919

RESUMO

BACKGROUND: Body dissatisfaction influences women's mental and physical health. To date, most research has focused on body dissatisfaction in relation to the 'thin-ideal'. Thus, the association between body dissatisfaction, eating disorder symptomatology and muscularity-ideal in women is less clear. Lack of understanding is underpinned by the lack of reliable and valid muscularity-related assessments for women. To address this need, we developed, tested and re-tested two new body dissatisfaction scales: The Female Body Scale (FBS; adiposity dimension) and Female Fit Body Scale (FFITBS; muscularity dimension). METHODS: One hundred and fifty-two women in the United Kingdom rated which body figure best represented their current and ideal body, completed the Eating Disorder Examination Questionnaire (EDE-Q 6.0), and their body composition was measured. During re-test, the EDE-Q 6.0 and Drive for Muscularity Scale (DMS) were completed. RESULTS: Both the FBS and the FFITBS were found to be valid and reliable, and distinct types of body dissatisfaction were identified. Higher EDE-Q scores corresponded with greater body dissatisfaction scores on both the FBS and FFITBS. Thin-ideal (FBS) and larger/muscularity-ideal (FFITBS) body dissatisfaction predicted higher scores on the DMS. The muscularity scale (FFITBS) uniquely revealed that 28% of participants indicated body dissatisfaction toward the larger-muscularity-ideal. CONCLUSIONS: Results reveal distinct dimensions of body dissatisfaction. These new, validated scales may be utilized to quickly identify eating disorder risk in women as a preventative assessment for clinicians and inform female-focused body-image and eating disorder research.


Assuntos
Insatisfação Corporal/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Aptidão Física/psicologia , Escalas de Graduação Psiquiátrica/normas , Magreza/psicologia , Adulto , Composição Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Idioma , Reprodutibilidade dos Testes , Reino Unido
19.
J Sports Sci ; 38(21): 2396-2406, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32619140

RESUMO

Functional hypothalamic amenorrhoea (FHA) can occur due to the independent or combined effects of psychogenic and energetic stressors. In exercising women, research has primarily focused on energy deficiency as the cause of FHA while psychological stressors have been ignored. To assess both psychological and metabolic factors associated with FHA in exercising women, we performed across-sectional comparison of 61 exercising women (≥2 hours/week, age 18-35 years, BMI 16-25kg/m2), who were eumenorrheic or amenorrhoeic confirmed by daily urine samples assayed for reproductive hormone metabolites. Psychological factors and eating behaviours were assessed by self-report questionnaires. Exercising women with FHA had lower resting metabolic rate (p=0.023), T3 (p<0.001), T4 (p=0.013), leptin (p=0.002), higher peptide YY (p<0.001), greater drive for thinness (p=0.017), greater dietary cognitive restraint (p<0.001), and displayed dysfunctional attitudes, i.e., need for social approval (p=0.047) compared to eumenorrheic women. Amenorrhoeic women displayed asignificant positive correlation between the need for social approval and drive for thinness with indicators of stress, depression, and mood, which was not apparent in eumenorrheic women. In exercising women with FHA, eating behaviours are positively related to indicators of psychological stress and depression.


Assuntos
Amenorreia/metabolismo , Amenorreia/psicologia , Exercício Físico/psicologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/metabolismo , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Estresse Psicológico , Adolescente , Adulto , Amenorreia/fisiopatologia , Metabolismo Basal , Índice de Massa Corporal , Estudos Transversais , Depressão/psicologia , Dieta , Exercício Físico/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Feminino , Humanos , Hipotálamo/fisiologia , Ciclo Menstrual , Magreza/psicologia , Adulto Jovem
20.
Psychiatry Res ; 292: 113308, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32707219

RESUMO

This study examined the reliability, validity and internal structure of the newly developed, interview-based Schedule for the Assessment of Insight in Eating Disorders (SAI-ED) and the relationships of insight with demographic and clinical characteristics in EDs. Ninety-four female patients - 44 with anorexia nervosa (AN) and 50 with bulimia nervosa (BN) - were assessed with SAI-ED. The Brown Assessment of Beliefs Scale was used to evaluate convergent validity of SAI-ED. Hierarchical cluster analysis and multidimensional scaling were used to identify insight components and assess their inter-relationships. The final 8-item SAI-ED demonstrated good psychometric properties. Inter-rater and test-retest reliabilities were high. Three subscales of SAI-ED were identified which measure major insight components: awareness of illness, awareness of symptoms, and treatment engagement. Patients with AN had significant lower score on SAI-ED than patients with BN. Impaired insight was associated with: (a) lower current and lowest lifetime BMI and more severe dietary restrain in AN, (b) illness duration, severity of overall ED symptoms, body-related concerns and obsessionality in BN. Insight is a multidimensional construct in EDs associated with different clinical aspects in AN and BN. The SAI-ED is a valid and reliable tool for the assessment of insight in EDs patients.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Entrevista Psicológica/normas , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/psicologia , Feminino , Humanos , Entrevista Psicológica/métodos , Psicometria/métodos , Psicometria/normas , Reprodutibilidade dos Testes , Adulto Jovem
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