- A model-driven approach to studying dissociations between body size mental representations in anorexia nervosa. [Journal Article]
- BIBody Image 2016 Nov 29; 20:40-48
- This study compared dissociations between mental representations of current, ideal and normal body sizes (i.e., Current BS, Ideal BS and Normal BS) for women with anorexia nervosa (AN group, n=56) an...
This study compared dissociations between mental representations of current, ideal and normal body sizes (i.e., Current BS, Ideal BS and Normal BS) for women with anorexia nervosa (AN group, n=56) and healthy women (control group, n=56). Along the lines of the single channel model of Cornelissen et al. (2013), the discrepancy between Current BS and BMI for both groups was adequately described along a common linear continuum of Current BS (mis)perception. Body size mental representations were ranked similarly (Ideal BS<Current BS<Normal BS) in each group. Whilst the over-estimation of Current BS was much greater among the AN group than the control group, body dissatisfaction was better explained by Current BS for the AN group and by BMI for the control group. Dissociation between Current BS and participants' BMI appears to be a key element when seeking to understand AN.
- Persistent amenorrhea and decreased DHEAS to cortisol ratio after recovery from anorexia nervosa. [Journal Article]
- GEGynecol Endocrinol 2016 Dec 02; :1-4
- Persistent amenorrhea is a frequent condition affecting anorexic patients after stable weight recovery. It has been proposed that it could be due to alterations of the hypothalamic-pituitary-gonadal ...
Persistent amenorrhea is a frequent condition affecting anorexic patients after stable weight recovery. It has been proposed that it could be due to alterations of the hypothalamic-pituitary-gonadal axis linked with persistent hormonal impairments, such as relative hypercortisolemia and hypoleptinemia, and psychological symptoms related to anorexia nervosa (AN). The aim of our study was to evaluate the metabolic and hormonal pattern involved in the persistence of amenorrhea after recovery from AN. Eight weight-recovered anorexic patients with amenorrhea were investigated and matched with 10 healthy eumenorrhoic women, comparable for age and BMI. Data showed basal FSH and LH values similar in both groups and a normal pituitaric response to LHRH administration. Morning serum cortisol was normal but significantly higher in patients, while dehydroepiandrosterone sulfate (DHEAS) to cortisol ratio, leptin and vitamin D were significantly lower in patients than controls. Women with previous AN presented insulin resistance and two patients showed an overall picture consistent with polycystic ovary syndrome (PCOS). In conclusion, long-lasting amenorrhea after recovery from AN is linked with a persistent hypothalamic dysfunction, although other concomitant causes like PCOS and insulin resistance should be considered. Decreased DHEAS to cortisol ratio is a new finding which could be correlated to the persistent hypogonadism.
- The ability of low-magnitude mechanical signals to normalize bone turnover in adolescents hospitalized for anorexia nervosa. [Journal Article]
- OIOsteoporos Int 2016 Dec 01
- CONCLUSIONS: Bed rest during hospitalization for patients with AN is associated with a suppression of bone turnover, which may contribute to diminished bone quality. Brief, daily LMMS prevents a decline in bone turnover during bed rest in AN. Protocols prescribing strict bed rest may not be appropriate for protecting bone health for these patients. LMMS may have application for these patients in the inpatient setting.
- Brain glutamate in anorexia nervosa: a magnetic resonance spectroscopy case control study at 7 Tesla. [Journal Article]
- PPsychopharmacology (Berl) 2016 Dec 01
- CONCLUSIONS: Women with AN apparently have widespread reductions in brain glutamate. Further work will be needed to assess if this change has pathophysiological relevance or whether it is a consequence of the many physical changes produced in AN by food restriction.
- Moderators of change in an Internet-based intervention for eating disorders with different levels of therapist support: What works for whom? [Journal Article]
- BRBehav Res Ther 2016 Nov 22; 89:66-74
- This study investigated moderators of intervention response in a fully automated Internet-based monitoring and feedback intervention ('Featback') with different levels of therapist support for indivi...
This study investigated moderators of intervention response in a fully automated Internet-based monitoring and feedback intervention ('Featback') with different levels of therapist support for individuals with eating disorder (ED) symptoms. This study was part of a randomized controlled trial comparing four conditions: 1) Featback, 2) Featback with low-intensity (weekly) therapist support, 3) Featback with high-intensity (three times a week) therapist support, and 4) a waiting list. A total of 273 participants completed baseline and post-intervention assessments. The outcome measure was ED psychopathology. Model-based recursive partitioning was applied. Baseline levels of ED psychopathology were found to moderate intervention response. Specifically, in terms of improvement in symptoms of anorexia nervosa, participants with higher baseline levels of anorectic psychopathology showed better outcomes in the waiting list condition and the Featback conditions with low- and high-intensity therapist support in comparison with Featback without therapist support. In terms of improvement in symptoms of bulimia nervosa, participants with mild to moderate bulimic symptoms had better outcomes in the Featback conditions compared with the waiting list. Thus, the fully automated Internet-based intervention with and without therapist support may be particularly suitable in improving mild to moderate bulimic psychopathology, whereas the intervention without therapist support may be less effective in improving severe anorectic psychopathology. Further investigating differential intervention responses is important, as this could help to optimize the delivery and dissemination of E-health interventions and therapist support, which in turn could help moving toward personalized (E-)care.
- Service Providers' Attitudes Toward Athletes With Eating Disorders. [Journal Article]
- CJClin J Sport Med 2016 Nov 29
- CONCLUSIONS: Athlete support personnel report stigmatizing attitudes toward athletes with eating disorders such as AN. Male service providers hold greater negative attitudes toward athletes with mental health conditions.
- Listening in the dark: why we need stories of people living with severe and enduring anorexia nervosa. [Editorial]
- JEJ Eat Disord 2016; 4:33
- A bold step forward in our approach to Severe and Enduring Anorexia Nervosa invites new paradigms for research and practice. It provides an opportunity for us to explore fault lines, both in our comm...
A bold step forward in our approach to Severe and Enduring Anorexia Nervosa invites new paradigms for research and practice. It provides an opportunity for us to explore fault lines, both in our communities of practice and the social structures that inform them. This paper serves to question the medical metaphors on which treatment has been based, in favour of alternative perspectives that resonate more clearly with the lived experience of those for whom it has failed. We invite the consideration of alternative metaphors, which can disrupt the notion of heroic patients (and therapists), mediate against acts of self-silencing and sensitising us to more radical acts of listening. Beyond the randomised trials and manuals it is time for us to listen to the realities of suffering, the minutiae of resistance and the life that can still be lived.
- Trajectories of Higher- and Lower-Order Dimensions of Negative and Positive Affect Relative to Restrictive Eating in Anorexia Nervosa. [Journal Article]
- JAJ Abnorm Psychol 2016 Nov 28
- Despite robust support for the role of affect in the maintenance of binge eating and purging, the relationship between affect and restrictive eating remains poorly understood. To investigate the rela...
Despite robust support for the role of affect in the maintenance of binge eating and purging, the relationship between affect and restrictive eating remains poorly understood. To investigate the relationship between restrictive eating and affect, ecological momentary assessment data from 118 women with anorexia nervosa (AN) were used to examine trajectories of higher-order dimensions of negative affect (NA) and positive affect (PA), as well as lower-order dimensions of NA (Fear, Guilt) and PA (Joviality, Self-Assurance) relative to restrictive eating. Affect trajectories were modeled before and after restrictive eating episodes and AN subtype was examined as a moderator of these trajectories. Across the sample, Guilt significantly increased before and decreased after restrictive eating episodes. Global NA, Global PA, Fear, Joviality, and Self-Assurance did not vary relative to restrictive eating episodes across the sample. However, significant subtype by trajectory interactions were detected for PA indices. Among individuals with AN restricting subtype, Global PA, Joviality, and Self-Assurance decreased prior to and Self-Assurance increased following restrictive eating episodes. In contrast, Global PA and Self-Assurance increased prior to, but did not change following, restrictive eating episodes among individuals with AN binge eating/purging subtype. Results suggest that dietary restriction may function to mitigate guilt across AN subtypes and to enhance self-assurance among individuals with AN restricting subtype. (PsycINFO Database Record
- Altered serum level of matrix metalloproteinase-9 and its association with decision-making in eating disorders. [Journal Article]
- PCPsychiatry Clin Neurosci 2016 Nov 28
- CONCLUSIONS: Based on these results, it was suggested that the serum level of MMP-9 play a role in the pathophysiology of AN, and both the serum levels of mBDNF and MMP-9 may be associated with decision-making abilities in patients with BN.
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- A series of patients with purging type anorexia nervosa who do "tube vomiting". [Journal Article]
- BMBiopsychosoc Med 2016; 10:32
- CONCLUSIONS: Our experience suggests that a sudden decrease in the weight and blood potassium level could indicate "tube vomiting". In addition, because many information resources are available on the internet, medical practitioners should be aware of these sites.